What is Dissociative Identity Disorder (DID)?

DID is what used to be called “multiple personality disorder,” and many people with DID use the term “multiple” to refer to themselves. It is a condition in which two or more separate identity states co-exist and alternately take control of the person’s behavior, with amnesia typically occurring from one state to the other. These separate identities have distinct patterns of thought, different beliefs, likes and dislikes, preferences, and ways of speaking and behaving.

So when you meet someone with DID, she may introduce herself as Sarah but the next time you say hello to Sarah she may look confused, as if she’s never met you, and tell you you must have her confused with someone else because her name is Anna. (Or, more likely, she will have developed an adaptation to situations like these to avoid drawing attention to the amnesia and confusion, and she will laugh disarmingly about using a “nickname” while she tries to figure out who you are from the the context of your current conversation.)



Is DID the same as schizophrenia?

No. Schizophrenia is a mental illness characterized by disorganized thinking and hallucinations.

This can include “hearing voices” which is why it is sometimes confused with the internal conversations among parts that can occur with someone who has DID. The voices “heard” by someone with DID are not hallucinations, they are actually “spoken thoughts” of other parts. The person with DID “hears” these thoughts as another voice because they don’t associate themselves with that part.

What causes DID?

The medical model generally accepts that DID is a response to early, severe, and repeated traumatic events in childhood with a whole host of other contributing environmental and neurological “predisposers.” There are some people with DID who report no abuse in childhood; there are also those who initially reported no abuse and then discovered the alters who HAD been abused and had hidden it from the main personality. Generally speaking, to cope with severe trauma a child unconsciously determines that the abuse “didn’t happen” to him or her. It happened to “someone else.” And when the abuse happens again, it’s that “someone else” who takes the place of the child so he or she doesn’t have to cope with it. Once this coping strategy is established, it’s a go-to strategy for other, smaller stressors like taking a test or social interactions. Alters emerge to handle a whole range of situations, and these separate identities continue to develop alongside but independently from the original child.

What does someone with DID look or act like?

Most people with DID are successful and highly functional in virtual all areas of their life, because they have developed a unique strategy for getting around difficulties. Unfortunately, this very effective strategy can also be the thing that causes them distress or causes functioning to break down; for example, alters who have different career goals, fall in love with different people, want children or not, belong to different religions, have different groups of friends. From the outside, you may see a very conflicted individual who is always changing his or her mind or trying new things, but on the inside he or she is wrestling with the wants, needs and demands of a group of different “I’s and me’s.”

It’s common on TV or in movies to portray different alters vastly differently. A “switch” is usually shown on screen with a dramatic physical display like a tremor or a seizure (which can occur in a small percentage of cases), followed by the alter immediately rushing to change into “their” clothes, rearranging the environment, or having a bewildered “where am I, how did I get here?” moment. In reality, changes are much more subtle and your only clues that a switch has happened might involve the way words are pronounced, differences in vocabulary, different posture or hand gestures, different facial expressions, or a different sense of humor.

But then WHY do I see people on talk shows, YouTube, message boards, and in movies who can’t seem to function from one minute to the next?

People struggle with all sorts of things, and DID is one of them. Chances are, those with DID who have developed ways (“healthy” or not) to manage their internal struggle are not the ones putting out cries for help via the Internet; they’re spending time with friends and family, focusing on school or careers, or pursuing the wide range of hobbies, interests and skills that different parts tend to bring to the table. The population segment of people with DID who are needy and attention-seeking is probably about the same as the needy, attention-seeking segment of any other mental health population -- but it might be more entertaining to “see someone switch on camera” than to listen to someone talk about their depression.

Is there a cure for it? (Or, “When are you going to go back to being ONE PERSON again?”)

The person with DID usually appears to friends and family as one person, because 1) we are very good at covering our tracks and 2) most of the conflicts over identity and with other parts happens inside or when no one else is around. So a “cure” may seem as simple as “just ignore all the noise in your head” or “just stop acting like those other people.” Ignoring the others does not wish them into existence (at one point, most of us have probably tried this).

There is an effective treatment model for DID, though. This approach involves a therapist who is willing to work individually with each part and with the patient as a whole person to resolve the underlying trauma that caused the splits, as well as any issues that exist between parts that are still causing amnesia, or “lost time.” As parts learn more about each other, they share knowledge, memories and skills, and it becomes less necessary to be separate in order to function. This positive step toward healing is commonly called co-consciousness or co-awareness in which more than one part can be present at the same time. Some may choose to work toward an outcome of integration, which is a dissolution of the “separateness” between parts -- others find this idea threatening and terrifying, and prefer the idea of a shared, co-functioning life.



Are people with DID dangerous? (Or, “If alters can act without their knowledge, can your alter murder, rape, steal, etc. and you would have NO IDEA?”)

People with DID are not any more or less dangerous than people without DID. While it’s theoretically possible for an alter to commit a crime without the knowledge of any other alter in the system, most people with DID have an agreed-upon internal code of conduct with consequences for acting outside of this code or breaking rules. Unfortunately, Hollywood loves the idea of the “rogue, violent alter” and has spread this belief throughout our culture so that it’s literally become a cliche. In reality, most people with violent alters have other alters whose job it is to de-escalate or contain them.

How should I treat someone with DID?

You should treat them like the friend or family member they have always been. The difference now is that they’ve trusted you to know them on a deeper, more true, level.

Should I address an alter as a separate individual? (Or, “Won’t calling you by different names just encourage you to keep acting this way?”)

Alters ARE separate individuals (we aren’t “acting,” believe me I’d have gone into theater if I were any good at it.) The best rule of thumb for interacting with a person with DID and their alters is to talk openly about it with them, ask questions, and find out how they prefer to be treated and addressed. Some alters would give anything to be addressed by name; others have never wanted their own name. You won’t know until you ask. But bear in mind that phrases like “who am I talking to now?” and “who is this?” wear out fast. It’s much kinder to notice an alter’s quirks or her smile, and then confirm with “This is Sarah, right?”