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Common Myths Surrounding Dissociative Identity Disorder

Dissociative identity disorder (DID) is a highly controversial diagnosis. Doctors and therapists alike struggle with a lack of knowledge not because they do not want to know, but because they were not trained. On the average psychiatrists receive a few hours or days of training about recognizing and treating DID.

Because of all the controversy and how the media treating this enigmatic disorder as a plot for scary movies people are confused. They are left believing those who live with the diagnosis of dissociative identity disorder are dangerous. Worse yet,   

Some folks express a desire to form DID.

The Myths

This article is full of myth busting material to aid both those who live with the diagnosis of DID, and all who want to know more about it. It is meant to be an aid in describing dissociative identity disorder to anyone who does not understand. Please feel free to share it.

Also, please remember, one cannot place every person who has developed DID into the same box. Some of the symptoms may or may not pertain to all individuals.

Myth: DID is not a real diagnosis.

The American Psychiatric Association (APA), the leading group comprised of psychiatrists, has a bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Now in its fifth edition, the DSM is what psychiatrists and therapists use to help them diagnose mental health conditions. Dissociative Identity Disorder is a recognized mental health disorder and included in the DSM-5.

Myth: DID is well-portrayed in the movies and on television.

Movies cannot and do not accurately portray the struggles and lives of those living with the condition. When movies and tv portray those who live with DID, they often sensationalize it making their characters evil or deadly. The facts are that people living with DID live lives that are much more mundane than in the movies and television. They do not have any superpowers nor are they deadly or evil. They are just people with an extraordinary mental health disorder.

Myth: DID is the same thing as schizophrenia.

While related in the portions of the brain that are involved, schizophrenia and DID are two distinctly different diagnoses. Schizophrenia is a psychotic illness with symptoms that include delusions, hallucinations, paranoia, disorganized thoughts, speech and movements and social withdrawal. Schizophrenia does not involve alternate personality states or dissociation People living with the diagnosis of DID may experience some symptoms related to psychosis, such as hearing voices. However, DID involves alternate personality states and dissociative experiences.

Myth: people with DID are violent

While a small percentage of people living with the diagnosis of DID can be violent, that percentage is no more than any other demographic group. In fact, people who live with this disorder in their lives are far more likely to fall prey to violence than to perpetrate it.

Myth: DID alters are obvious and extreme

Although characters in movies and television programs appear to change wildly into other characters who are easily recognizable as being a different part, this is not the case for most people living with this condition. In fact, most switches are not noticed by the person’s closest family members or companions. Even therapists often cannot tell when their client has changed.

Myth: DID is only characterized by having alternate identity states

Although having alternate identity states (alters) is the best-known symptom of the disorder, it is not the only symptom. Because DID is the result of trauma, it is often accompanied by other highly disruptive disorders such as complex post-traumatic stress disorder, depression, anxiety disorders, eating disorders and conversion disorders. Persons with DID also have memory problems, physical pain, risk of suicide, and face enormous stigma.

Myth: Alters are imaginary friends.

Alters are dissociated self-states that can be highly differentiated from each other. They might have unique names, ages, gender identities, sexualities, memories, skills, abilities, and ways of viewing and interacting with the world. Alters can have different psychological disorders or physiological markers and reactions to stimuli, including “differences in visual acuity, medication responses, and allergies. The creation of alters is entirely unconscious and is the result of failed integration of thoughts, memories, emotions, learned behaviors, and traits because of extreme trauma during early childhood.

Myth: Individuals living with the diagnosis of DID are never aware that they have alters.

It is common for individuals with DID to have awareness of, hear and have general knowledge of the alters. Often, they are also aware of some of their activities. Also, many have known or at least seen signs of their alters throughout their lives.

Myth: Individuals with DID are never aware of what the alters do and cannot communicate with them.

While all individuals with DID experience some degree of unawareness of their alters, many become and remain co-conscious with them. (Co-consciousness is the ability for two or more alters to remain aware of each other or the outside world at the same time.)

Indeed, 95% of individuals with DID report hearing child voices, 90% report hearing persecutory voices, 89% hear voices arguing with each other, and 95% hear voices commenting on their life or activities. Even those with poor internal communication can communicate through leaving notes, drawing pictures, or leaving messages through journaling.

Myth: Child abuse is the only cause for DID.

The causes of DID are long-term and repeated childhood trauma, not necessarily including child abuse. Other causes include living in a war zone, having repeated medical procedures performed on their person. All cases of dissociative identity disorder form in early childhood before the age of seven and older children and adults cannot form DID.

Myth: Therapists cause DID.

There are multiple research sources supporting the fact that DID is not caused by therapists (iatrogenic). If someone forms DID as an adult in a therapist’s office, they do not have a true case of DID.

Myth: DID is rare.

Between 0.1 and 2% of the world population live with the diagnosis of DID. In fact, the DSM-5 places prevalence of the disorder at 1.5% or 71 million people worldwide.

Myth: DID is an American and western civilization phenomenon.

DID is found worldwide with research performed in countries such as the Netherlands, Turkey, Puerto Rico, New Zealand and China.

Myth: Dissociative identity disorder did not exist before the movie Sybil.

The first recorded case of DID was that of Jeanne Fery in 1584, long before the Three Faces of Eve or Sybil.

Myth: DID is easy to fake.

While there are documented cases where people have faked DID faking DID happens no more than with other mental health disorder. In fact, Professionals who have been trained to recognize dissociative identity disorder will know if their client has DID or some other diagnosis such as Borderline Personality Disorder.

Myth: DID is the same thing as borderline personality disorder.

While there are similarities between DID and BPD, they are two distinct disorders. Both are projected to be caused by severe childhood trauma and insecure, disorganized attachment can be explained by the theory of structural dissociation.

However, those living with the diagnosis of DID experience themselves as having multiple distinct parts while those with BPD experience themselves as poorly defined and fragmented.

Both disorders have dissociative features, and both have difficulties maintaining healthy attachments to others. However, borderline personality disorder does not involve alternate identity states, dissociative states, or fugue. Those living with the diagnosis of DID are less likely to view the world in black or white terms and have intense fear of abandonment.

One can have BPD and DID as comorbid disorders.

Myth: Individuals with DID can choose to get rid of, kill off, or immediately integrate alters.

Alters are not separate entities, but rather parts of the same personality. As such, alters cannot be rid of or killed by the host. In fact, if one part dies, the entire person dies because they are the same person.

Integration is a process that takes several years of working with a therapist. DID cannot be cured but the negative effects of living with are often mitigated through psychotherapy.

In Conclusion

I am sure there are plenty more myths that need busting about dissociative identity disorder. However, I hope the ones above and their rebuttals have helped.

Dissociative identity disorder will continue to be a controversial diagnosis until better methods and more examining of the brain occurs. Interestingly, there are papers out there that describe how using fMRI studies, they have found differences in the brains of those with DID opposed to those who do not (Hoshino, 2016) (Reinders, et al. 2019).

In the meantime, advocates like myself will keep instructing all who will listen about the realities of dissociative identity disorder.

“I’m not here to be small, to compare, to judge (myself or you), to fit in or to be perfect. I’m here to grow, to learn, to love, to be human.” ~ Sue Fitzmaurice

“Be yourself….and make the world adjust!” ~ Germany Kent

References

Hoshino, T., & Takeno, J. (2016). Robot science discussion on the onset of dissociative identity disorder (DID). Procedia Computer Science88, 52-57.

Reinders, A., Marquand, A., Schlumpf, Y., Chalavi, S., Vissia, E., Nijenhuis, E., . . . Veltman, D. (n.d.). Aiding the diagnosis of dissociative identity disorder: Pattern recognition study of brain biomarkers. The British Journal of Psychiatry, 1-9. doi:10.1192/bjp.2018.255

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