Dissociative identity disorder is a controversial diagnosis that, despite all the stigma and discrimination, is slowly becoming better understood in the world of psychiatry.
Dissociative identity disorder (DID) was once known as multiple personality disorder. Why did they change the name? Wasn’t the old name sufficient?
This article will explore the above questions and offer an explanation of what DID is and how it affects those who have it.
A Brief History of Multiple Personality Disorder
There have been cases of multiple personality disorder throughout United States history beginning in 1811 with the case of Mary Reynolds who exhibited three alters and baffled the modern-day psychiatrists of her time.
Mary Reynolds would go into a deep sleep that might last for hours and then wake up acting like a different person such as a child or other adult. The alters had no memory of each other and each time Mary would “fall asleep” she would awaken with no knowledge of previous events when she acted “strangely.”
In 1812, a hypothesis put forward by Benjamin Rush stated that he believed that since vision is a double organ so too may be the mind occupying two hemispheres and producing the “doubling” phenomenon.
In the decades that followed, multiple personality disorder was diagnosed often and found not to be rare in the world and United States population. The diagnosis fell out of favor with the advent of the diagnosis of schizophrenia and Sigmund Freud’s work with hypnosis.
In the twentieth century, in 1973, the book Sybil was published forcing multiple personality disorder into the light once more. Although the diagnosis had not completely disappeared before, now experienced a rebirth and an increase in the number of people diagnosed with the disorder and the number of alters in each system.
Multiple Personalities and The Diagnostic Manual of Mental Disorders
In 1952, the Diagnostic and Statistical Manual of Mental Disorders (DSM) was first published, and it included a section for dissociative disorders. The following diagnoses were listed:
Dissociative disorders were included as psychoneurotic disorders that were expressed and felt directly or unconsciously by defense mechanisms.
It wasn’t until the third edition of the DSM that dissociative was introduced as a class of disorders. However, with the publication of the DSM III-R, the problem was described as having essential features of disturbance in the normally integrative functions of identity, memory, or consciousness. Since the DSM is the bible of the psychiatric world where all mental health professionals pull their diagnostic criteria, the explanation in the DSM III-R was too broad and perhaps responsible for many of the diagnoses of DID at that time.
In 1994, the new DSM-IV was published with a new name for multiple personality disorder to better describe the disorder in better terms. Finally, multiples were allowed to self-report their experiences without having to show their alters in action by switching to a doctor’s or therapist’s office.
No one has more than one personality, not even multiples. That statement may surprise, shock, or even anger some who do not understand this simple fact. However, it is true, all humans have only one personality.
All children are born with a splintered sense of self as is evidenced when watching very young children play. They may have adventures with other make-believe people or conjure a big dog to make them feel safe when they are stressed.
The term dissociative identity disorder means that those with DID have a disconnected or separated identity. Indeed, when we were children our personalities never had the chance to pull themselves together during childhood milestones into one cohesive self-identity. This disconnection from missed childhood milestones meant our pieces of who we are never came together like other children due to a mixture of severe trauma and the stress hormones that flooded our bodies from it.
There are no “multiple personalities” involved, thus the name change from multiple personality disorder to dissociative (disconnected, separated) personality disorder.
Dissociative Identity Disorder in a Nutshell
I know some of the following information may be something many readers already have read and know, but it is vital to keep repeating it for those who are just beginning their healing journey.
According to the DSM V, people with DID have distinct personality states referring to the different and separate identities that appear to be different personalities. These separate identities are called alters, parts, and any number of other titles.
Alters are not obvious in the majority of people who are living with dissociative identity disorder, and this makes it difficult for practitioners to diagnose without visibly seeing a switch between alternate states. Mental health professionals instead depend on those living with DID to self-report their symptoms and experiences.
Dissociative identity disorder is a diagnosis that causes a loss of sense of self and a loss of sense of self-agency. I shall explain both.
Sense of self. Sense of self refers to the perception of the collection of characteristics that define who a person is with their personality traits, likes, abilities, and belief system. These traits all contribute to the self-image of the individual and give them their unique identity as a person. With DID, survivors have lost or never developed their sense of self.
Sense of self-agency. The sense of self-agency is the awareness of initiating, executing, and controlling one’s actions. Self-agency is the knowledge of the fact that it is you who are executing your bodily movements. Sense of self-agency is lost in those who live with dissociative identity disorder as we experience alters taking over the body and lose control over what we do.
However, it is vital to remember that all you do, no matter which alter does it, is your responsibility. If an alter steals from a store, you are totally and completely responsible for that action whether you remember it or not. For some, these words sting as they would prefer to push all responsibility for what they say and do off on an alter as though they were separate beings. They are not separate beings they are all you and you are them. If one goes to jail, you all do.
Dissociative identity disorder was once known as multiple personality disorder but that all changed in 1994 when the title was changed to reflect the fact that no one has more than one personality.
There has been much controversy about DID but the only way to combat the lack of understanding and the stigma attached to the diagnosis is to understand what it is and spread the word.
It is my sincere hope that writing these articles on my blog opens eyes and allows more practitioners and survivors to recognize DID as the true diagnosis it is as described in the DSM V.
“As long as you keep secrets and suppress information, you are fundamentally at war with yourself…The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage.” ~ Bessel van der Kolk
“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” ~ Albert Einstein