Updated: Mar 2
Jessica Culp, MA, LPC
The term dissociation refers to a lack of connection to things that are normally connected. Dissociation levels operate on a continuum for all individuals, most of which involve losing time, losing sensation, and/or awareness of space, according to Abby Wong-Hefftner. On one end of the continuum are levels of dissociation that many of us experience – for example, “highway hypnosis” or daydreaming – but those with Dissociative Identity Disorder (DID) experience the highest levels of dissociation; occasionally severe enough to include a sensation of two or more personality states.
According to the International Society for the Study of Trauma and Dissociation (ISSTD), it is estimated that 1% of the population has DID. Of course, that percentage may present higher in clinical settings. The diagnosis of DID used to be called Multiple Personality Disorder (MPD) and has been a very controversial diagnosis in the past. Thanks to growing research in this area, including in the area of neuroscience, it is slowly becoming more normalized and understandable in both the field of psychology and the general population. We at Steadfast Center are committed to using best practices in treating dissociation on all levels of the spectrum, including DID.
DID diagnosis Many things make the diagnosis and treatment of Dissociative Identity Disorder (DID) a challenge. Often other symptoms that come along with Complex PTSD are more prevalent and easier to communicate to others, such as depression, anxiety, and relational challenges. Also, because the attributes of DID are experienced subjectively either as intrinsically normal or possibly embarrassing (for example, memory loss, voices), individuals can go many years without having their dissociation indicated and treated. The professionals at Steadfast Center are aware of the common connection between levels of dissociation and trauma. In fact, it is estimated that 73% of individuals who experience trauma will experience some level of dissociation. Therefore, our belief is that earlier awareness and normalization of dissociation will foster more accurate treatment goals and better outcomes for those dealing with dissociative disorders, including DID.
DID healing We at Steadfast Center operate under the core belief that healing happens in relationship with one another. We often hear that those who have experienced trauma have not felt heard, seen, or understood in the past, which has impeded the healing process. While the term healing can be tricky, we want clients to move forward in ways that are beneficial to them. We do this by mindfully using the three-phase model of trauma treatment starting with the establishment of safety and stabilization (which may take some time), moving on to re-processing in stage two, and then going on to the final third phase: consolidation, integration and reconnection. Healing really is possible for those who have DID. Potential and current clients often ask how long it takes, and that depends on many things, but it is possible with persistence and hard work.
DID myths Dissociative Identity Disorder (DID) is not bizarre or weird, or something that cannot be understood. These misperceptions are some of the reasons why individuals, including those experiencing the disorder, have not wanted to learn more about DID. Many myths exist about DID that need to be debunked, such as:
That people experiencing DID are violent and dangerous. In truth, according to Beauty after Bruises, “they are exponentially more likely to be victims of violence than perpetrators.”
That people experiencing DID are psychotic. In truth, “there are no symptoms of psychosis in DID criteria” according to Beauty after Bruises.
That people experiencing DID will suddenly just “switch personalities.” Beauty after Bruises points out that “[s]witches between alters can be imperceptible. In fact, only 6% with DID have identifiable switches on an ongoing basis... alters don’t typically make their presence known. It is a disorder of concealment and protection; detection defeats its function.”
“DID is not a personality disorder. It is dissociative disorder, [caused] by trauma.” – Beauty after Bruises
The truth is that dissociation is a way the brain protects someone from being overwhelmed, and from repeated trauma or neglect. Unfortunately, the adaptive dissociative measures one was forced to take can become problematic when the threats are no longer persistent. This doesn't mean that the person is incapable of healing; in fact, the creative nature of the brain of those with DID can be their greatest asset to healing and growth. We want to encourage those who experience symptoms of DID or any level of dissociation to discuss these symptoms with their therapist. If a therapist isn't sure how dissociation may be impacting the life of their client, we encourage them to learn more on the websites listed below or reach out to us at Steadfast Center.