Dissociative Identity Disorder (DID) is a wonderfully ingenious way to survive trauma! It is disappointing that it’s called a “disorder” because this is the brain doing exactly what it was designed to do to survive the unimaginable. People with DID have a phenomenal capacity for adapting, functioning, and going on with ordinary life even as they carry their buried memories of being shamed and powerless.
As the therapist, I have the luxury of holding tremendous respect and appreciation for the capacity of my clients with DID. However, my clients with DID have a wide variety of feelings about it and many of those are not warm and fuzzy. My clients often feel confused, frustrated, phobic of emotion, protective, overly responsible, frozen, and apprehensive of change. They wrestle with the biggest of existential questions: Do I have a right to exist?, Will I ever feel safe?, and Can I ever trust anyone? If you met my DID clients, you’d find them to be articulate, kind, competent, intelligent, insightful, and accomplished. If you sat and listened to every one of my clients for even 30 minutes, you wouldn’t be able to pick out who has DID and who does not. Most people with DID are living perfectly ordinary lives, as far as anyone can tell.
What is DID?
Let me start with a basic explanation of what happens neurologically for everyone when we experience traumas. When we get overwhelmed, the brain says, “Cool, okay, I know what to do. I’m going to disconnect these neurons that are holding the trauma from the rest of the brain. They will be disconnected from a sense of time, from the pre-frontal cortex (the forehead/the logic brain/that part of you that you probably like the most). That way, this isn’t going to bother the rest of the brain and this darling human can just keep moving along with their day.” Notice that I used the word “overwhelmed.” I use that word intentionally. In order for this process to happen, there doesn’t have to be a bad “traumatic” event. Humans, and especially children, can get overwhelmed, even when nothing exactly happened, but when comfort and connection were missing.
Disconnection
The brain can create different amounts of disconnection. Some people are naturally more dissociative than others. They have brains that throw those fragments of neurons far afield! Some people are naturally less dissociative. Their brains struggle to provide a clean disconnection. Then there’s the degree of the overwhelm. If the overwhelm is massive or even life-threatening, the dissociation can become so extreme that the individual might completely forget that something happened at all. The disconnection of neurons can become very complex. Sometimes the emotion for an event will be stored separately from the information about the event. Sometimes even the information about what happened will be broken into pieces and stored separately. Imagine storing your puzzles by putting a handful of pieces into each of your kitchen cupboards and drawers. I’ll bet you’d never expect that puzzle to be put together again.
There’s more information and a short video about dissociation in a blog posted here.
Hiding
That disconnection can lead to a feeling of safety. It can feel like hiding in plain sight. That’s the whole point of DID—hiding. DID helps keep the trauma hidden so that the person can go on with their life. Here’s the tricky thing about hiding as a safety strategy, though: it’s the best strategy for little kids. They can’t run, talk back, or think their way out of the dangerous moment. However, most adults have so many more ways to protect themselves and almost all of those are more protective than hiding.
How do I figure out who has DID?
DID is a survival strategy that doesn’t want to be found. Most people with DID don’t know that they have it and most psychotherapists have trouble spotting it.
Indeed, diagnosing DID can be tricky and can take lots of time to figure out. People often expect that they would see clearly different people showing up to session. Perhaps the person would have a different name and style of dress on different days. Maybe you have a character from a TV show or movie in mind and you expect real life DID to look like that. Some people with DID do have different voices, names, and identities for different parts, but it’s far more common that all the parts use the same name, have a similar style of dressing, and know the same basic information about themselves.
So, if I’m not expecting my client to show up as Mary one day and Martha the next day, then how do we know?
One of the main symptoms that shows up is amnesia for the present. That means that in the past week, there are spots of time totally missing.
They truly can’t remember if they ate a meal today and have to look in the sink for dishes to figure out if they ate.
They arrive at home and really don’t know where they’ve just been.
They might find something new sitting on the table and don’t recall whether they purchased it or it was given to them by someone else.
Something valuable went missing for days or even years, only to reappear in a perfectly ordinary place, like the kitchen table.
My clients often have trouble distinguishing between ordinary forgetting and the amnesia from DID. Ordinary forgetting is not remembering whether your friend said she’s available on Monday or Tuesday, not remembering what you had for dinner 3 days ago, or forgetting why you came upstairs. Amnesia for the present is more than that. Here are some more examples of amnesia for the present:
They recall that they had a doctor’s appointment scheduled for this morning. They can see it on their calendar. They remember getting ready to leave the house. But now it’s 2pm and they don’t have any memories at all of arriving there, talking to the doctor, or of coming home. They truly don’t know if they went to the doctor’s appointment.
Their friend, Sam, isn’t responding to their text messages today. Sam usually responds pretty quickly. They phone and Sam doesn’t answer. When they check the message history on their phone, it’s blank. It’s been deleted. But they usually text Sam every day. It seems like Sam is mad at them, but there are no clues about why.
They are sitting at home with a stack of work that their manager handed them. They can recall that this morning they were determined to say no to taking on the extra work. They had worked out precisely what they were going to say and felt okay about saying no. But now here they are with the stack of extra work again and they can’t even recall their manager asking or how they responded. When did that conversation even happen?
The brain is truly amazing! Even though there may be these gaps in daily life, most people with DID can still do consistent things like showing up for appointments on time, getting to work and performing their professional tasks, and caring for pets or children. I’m just amazed all the time!
I also want to note why I’ve been using the phrase “amnesia for the present.” It means that there are gaps in recent memory. Amnesia for the past is, as you would expect, gaps in past memory (such as childhood). Amnesia for the past is far more common than for the present. Amnesia for the past indicates that there may have been traumas that the brain has hidden away from you. (And sometimes it just means that nothing interesting happened so there’s nothing for the brain to report.) If it’s forgetting, then it’s a sign of dissociation, but it is not necessarily a sign of DID. Dissociation is a whole spectrum and is something that everyone experiences either lightly or strongly. At the DID end of the dissociation spectrum, there is probably amnesia for the present. Many people with DID find amnesia for the present to be highly annoying and are relieved when treatment progresses enough that they start to feel more continuously present.
This is just the tiniest slice of information about DID. Perhaps this information really hit home and feels like it might be you. Or maybe you experience some things that are similar to this, but aren’t quite the same. Either way, if you have questions, you are welcome to book a 15-minute consultation with Michelle Waters to help you decide if you’d like to start psychotherapy together. Life can get easier than this.