Dissociative Identity Disorder (DID) is a mental health issue caused by severe trauma in childhood, often physical, sexual and emotional.
Most of us dissociate from time to time. We may become lost in thought or gaze dreamily into space. Dissociation is an altered state of consciousness that separates us from our feelings. In life threatening circumstances such as fire dissociating can help us to save lives by acting automatically without becoming overwhelmed by fear.
Children who are experiencing intense trauma may protect themselves from overwhelming emotional and physical pain by dissociating. Perhaps by imagining that they are somewhere else. They might lose touch with reality to the extent that later they do not remember the abuse. Children who are repeatedly abused may eventually dissociate automatically.
Under extreme stress from abusers, with no power to escape and no one to save or soothe them, alternative identities known as alters may emerge to help children cope. This is the best option in the situation.
Alters have their own functions, one alter may hold the memories of a traumatic incident keeping them out of conscious awareness. Another alter may take over when it is time for school. When there is a certain trigger a particular ‘alter’ may take over. For example a strong boy alter might deal with a perceived threat.
Each alter is an element of the same person known as the host. The host may not be aware of having alters although alters might know about each other.
Living with Dissociative Identity Disorder (DID)
Experiences of Dissociative Identity Disorder vary. If you have DID some of the following may be familiar:
Time loss and blackouts
You would not choose to wear some of the clothes in your wardrobe – they belong to ‘someone else’
Some things, such as a particular colour terrifies you although you do not know why
You have flashbacks and nightmares
You experience depression, mood swings, anxiety, panic attacks, difficulties with eating and food, self harm, drug and alcohol abuse
Sometimes you are suicidal
You do not like to be touched / have problems with sexual intercourse.
You have hallucinations, headaches and physical symptoms that seem to have no cause.
You try to appear the same as everyone else and often achieve this when necessary e.g. whilst at work.
Your symptoms have been misdiagnosed more than once.
Counselling for Dissociative Identity Disorder
A consistent and supportive therapy relationship with clear boundaries is often healing. Therapy may continue over several years as the sufferer discovers memories that have been buried away.
Clients can work with emotions such as anger, fear and shame and the feelings of powerlessness and loss of control that childhood abuse can cause. Releasing their emotions can reduce the client’s stress and might help with problems such as headaches, insomnia and panic.
During counselling sessions people with Dissociative Identity Disorder can also work with the social and practical effects of living with DID, for example maintaining friendships and holding down a job.
Some clients with DID work towards integrating each alter within themselves to function as a single person. Other clients prefer to live their lives more harmoniously whilst continuing to have alters. Integration is generally a long process. There can be feelings of loss and loneliness in losing alters who have their own personalities and who have been companions to the host for most of their life.
Childhood abuse is extremely disempowering, children have no say and no power to change their situation. In contrast I see counselling as an opportunity for clients to develop self-trust, enabling them to make their own decisions.
I therefore believe that whether or not to integrate should be the client’s choice and that if chosen integration needs to proceed at the client’s pace.
BooksToday I'm Alice by Alice Jameson (2009) Sidgwick & Jackson
A Fractured Mind by Robert Oxnam (2005) Hyperion