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DID Flag

A DID flag designed by GS.[1]

Dissociative Identity Disorder (or DID) is a trauma-based dissociative disorder that was once previously known as Multiple Personality Disorder (or MPD). A person with DID does not have multiple identities, but rather a lack of an integrated identity. [1] The "personalities" in DID are actually the result of one full mind that has segmented into dissociated "self states." [2] The dissociated self states in DID are most commonly called alters. Some people might use other terms, however.

The most well accepted understanding on how DID develops is called Structural Dissociation. According to Structural Dissociation, DID develops because chronic childhood traumatization and dissociation can compromise brain development, resulting in an unintegrated mind segmenting into alters. [3]

Diagnostic Criteria Edit

"A. Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.

B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.

E. The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures)." [4]

DID is categorized by dissociation in the form of identity alteration and amnesia, as well as distress or impairment. These symptoms are not attributed to culture, religion, fantasy, non-pathological multiplicity, substance abuse, or other medical conditions.

DissociationEdit

Dissociation is an instinctual, involuntary survival mechanism where the brain disconnects from reality. As a survival mechanism, dissociation protects the brain from threats when physical escape is not possible. [5] Some researchers theorize that dissociation can occur in milder forms, like getting lost in a good book for example. Other researchers believe that milder forms are not comparable to pathological dissociation and would not fall under the definition of dissociation to begin with. [6]

There are five main types of pathological dissociation: depersonalization, derealization, dissociative amnesia, identity confusion, and identity alteration. Identity alteration, which is when alters take executive control of the body, is a form of dissociation that is only experienced in DID or OSDD-1. [7]

People with DID experience all types of dissociation to some degree.

MultiplicityEdit

A DID system can have as few as two alters and as many as hundreds. Alters can be very distinct and differentiated from each other, but this isn't always the case. Every DID system is different!

When alters take executive control of the body, this is usually called switching. For DID, there is amnesia associated with switches. Many people often think of DID amnesia as always having complete blackouts, but blackouts are actually a less common form of amnesia. The amnesia in DID can be mild or severe, often ranging on a spectrum since there are five different subtypes of dissociative amnesia (localized, selective, systematized, generalized, and continuous). [8] [9]

On top of dissociation and alters, DID is also associated with PTSD symptoms since it is a trauma-based disorder. [10] People with DID are also likely to have comorbid trauma-based disorders, eating disorders, anxiety disorders, personality disorders, and other mental illnesses alongside their DID. [11]

While DID is caused by trauma and dissociation, most DID systems go for a long time being amnesiac of their own trauma and unaware of their symptoms. [12] Because of that, it's not unusual for someone with DID to mistake their experiences for something non-pathological like imaginary friends, spiritual possession, or non-pathological forms of multiplicity like an Endogenic System. [13]

Since the multiplicity in DID is pathological, it shouldn't be treated in the same way as non-pathological forms of multiplicity. Doing so can be harmful to the DID system and increase their dissociation. [14] [15] [16] [17] Alternatively, treating any form of non-pathological multiplicity in the same way as DID can be just as harmful, too.

More can be learned about DID and alters on these websites:

1. The International Society for the Study of Trauma and Dissociation (ISST-D) [2]
2. Sidran Traumatic Stress Institute [3]
3. Positive Outcomes for Dissociative Survivors (PODS) [4]
4. DID-research [5]
5. Traumadissociation [6]


ReferencesEdit

  1. https://information.pods-online.org.uk/a-brief-guide-to-working-with-dissociative-identity-disorder/
  2. https://books.google.com/books/about/The_Haunted_Self.html?id=PPpxN70YLQEC
  3. https://link.springer.com/article/10.1007/BF03379560
  4. https://www.google.com/books/edition/Diagnostic_and_Statistical_Manual_of_Men/-JivBAAAQBAJ?hl=en&gbpv=1&dq=dsm+5&printsec=frontcover
  5. https://information.pods-online.org.uk/what-is-dissociation/
  6. https://www.isst-d.org/resources/dissociation-faqs/ #8
  7. https://www.isst-d.org/resources/dissociation-faqs/ #1-5
  8. http://traumadissociation.com/dissociativeidentitydisorder#amnesia
  9. https://books.google.com/books/about/The_Haunted_Self.html?id=PPpxN70YLQEC
  10. https://books.google.com/books/about/Treating_Trauma_Related_Dissociation_A_P.html?id=l_B_DQAAQBAJ
  11. http://dx.doi.org/10.1176/appi.books.9780890425596.dsm08
  12. http://did-research.org/did/basics/presentation.html
  13. https://www.isst-d.org/wp-content/uploads/2019/02/childguidelines-ISSTD-2003.pdf
  14. https://www.isst-d.org/wp-content/uploads/2019/02/GUIDELINES_REVISED2011.pdf
  15. https://information.pods-online.org.uk/a-brief-guide-to-working-with-dissociative-identity-disorder/
  16. https://books.google.com/books/about/Treating_Trauma_Related_Dissociation_A_P.html?id=l_B_DQAAQBAJ
  17. https://books.google.com/books/about/The_Haunted_Self.html?id=PPpxN70YLQEC
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