I am continuing the conversation about dissociative identity disorder (DID) and characteristics that make up the diagnosis. I want to address amnesia, what it looks like in DID, and the function it serves. Of course, not everyone with amnesia has dissociative identity disorder. Remember, the first two criteria, different self states and amnesia, must exist together for a DID diagnosis to be made.
According to the DSM-5, there are three primary ways amnesia present in people with dissociative identity disorder:
1) gaps in remote memory of personal life events (e.g., periods of childhood or adolescence; some important life events, such as the death of a grandparent, getting married, giving birth); 2) lapses in dependable memory (e.g., of what happened today, of well-learned skills such as how to do their job, use a computer, read, drive); and 3) discovery of evidence of their everyday actions and tasks that they do not recollect doing (e.g., finding unexplained objects in their shopping bags or among their possessions; finding perplexing writings or drawings that they must have created; discovering injuries; “coming to” in the midst of doing something) (Dell 2006; Spiegel et al. 2011).
Many other trauma survivors also experience the first type of amnesia. In fact, about 10 percent of people with trauma histories have extensive memory loss for trauma that they later remember. Some trauma survivors dissociate and “forget” traumatic events, life experiences, even years of their life as a coping mechanism. The second two examples of forms of amnesia are related to the existence of separate parts of the self.
Why would lapses in dependable memory (things like doing work tasks, driving, reading) occur and what would that look like? It also is important to clarify if we are talking about how this is experienced by the person with DID or by others in their life. How you experience this (or if you experience it at all) depends upon how much awareness you have of other parts. In systems that are very separate, you may not even know that there are other parts, let alone the specifics of their abilities and roles. You may, in a sense, have amnesia for amnesia! This is one reason DID can be difficult to identify and diagnose.
From the other perspective, people in your life may notice that in some occasions you are not able to do things you usually do with ease (like the above mentioned work tasks, driving, reading). Or they may notice that you do not remember something they saw you do or say. This type of amnesia can also include not answering to your legal name (because the part that is present has another name) or not recognizing a spouse, children, or close friends. Many people with DID have inner safe guards to prevent things like this from being observed. However, systems do not function as well under stress or when there are unexpected triggers. It has also been my experience that for many with DID the functioning of their systems deteriorates at some point. Hearing feedback from others, that you usually do something different, or have a skill you are unaware of, may be your first introduction to the possibility that you experience this form of amnesia.
What about the third form of amnesia? This clearly relates to the other diagnostic criteria, the existence of separate parts of the self. You may be aware that you are experiencing dissociation: spacing out, losing time, feeling numb. What you may not realize is that “you”, some part of you, is continuing to live life during that lost time! Finding writings, things you don’t remember buying, even noticing that you are wearing clothes you don’t remember putting on are all clues that there are parts of you beyond your current awareness.
Every person, and inner system is different! The level of awareness of amnesia varies. Some systems are quite walled off from each other. Some may be more aware of each other but not share all historical information about childhood events. Some parts might hold painful emotions like shame, fear, or anger so that others do not have to. Some parts of your system may not know that others exist and may avoid seeing the symptoms of dissociation. Have you gotten good at making excuses (to yourself and others) for the things you don’t remember and the evidence you find or hear about? If this is all you have known, how can you know that not everyone has these experiences?
The goal of therapy is to first help you accept what is, all the ways you experience dissociative amnesia, so that you can then work together within yourself to lessen it. It is also important to acknowledge the protective function of amnesia: as a child you needed to not know things, to separate yourself and your experiences, in order to survive. As an adult, with the help of your inner system and a therapist with expertise in treating DID, you can develop different coping skills and capacities. You can help each other learn to face the past and thrive!