Dissociative Identity Disorder and Identity Disruption

Identity DisruptionWhat is identity disruption? How is it experienced by someone with dissociative identity disorder? How is identity disrupted?

In the past, it was thought that traumatic events, especially repetitive ones, caused a child’s personality to fragment or split into different parts. Now many theorists instead conceptualize that trauma impairs the ability of integration of the self to begin with. This leads to the experience of having separate parts of the self, or personality states, each with their own independent way of relating, perceiving, thinking and remembering about themselves and their life.  They may experience themselves as people, with or without any awareness of each other. They may serve distinct roles in coping with problem areas or in holding traumatic memories and associated affect. In DID, these parts have not yet learned how to function together in a cohesive and flexible way. One task of therapy is to help all understand that they are actually connected, that all parts together make up a whole person and that they can learn to work together as a collaborative team.

Just like with amnesia, the way a person with DID experiences identity disruption varies greatly. Sometimes it is very subtle and sometimes it is very obvious to an observer, although the person with DID may not be aware that it is happening at all. They may just have a sense of losing time but no awareness of what happens during that lost time. The awareness of each other also varies across parts. There may be a part of you (sometimes referred to as the host or ANP) who does not know about the existence of any others. Other parts may know and communicate easily with at least some of the inner system. Some people may have parts that assume executive control, meaning that they are in control of the person’s body and behavior for a period of time. Other systems have parts that operate more behind the scenes. Some parts present with different names, mannerisms, gender identity, sense of age, etc. Even before you are aware of other parts, you may have glimpses or experiences that hint at their existence.

Those experiences can include things like:

  • Being a depersonalized observer of what you are saying and doing, feeling unable to stop or control what “you” are doing. Some clients describe this as floating above or watching from a distance.
  • Hearing voices, identified as coming from within. These voices may be unintelligible or  clearly understood. Sometimes instead of hearing a voice, a person with DID may experience intrusive thoughts that are experienced as “not mine”. The voices or thoughts can be experienced one at a time, or more often, many talking all at once.
  • Having strong impulses, feelings, speech, or behavior that seemingly come out of the blue. They are often described as confusing and ego-dystonic. You may have the sense that you did not chose to do something but could not control it happening anyway.
  • Feeling like your body is “not mine”. Different parts of the self may also report that their bodies feel and look different ( in size, age, gender).

Many different terms have been used to describe the separate parts of the self: parts, parts of the self, selves, identities, personalities, personality states, self-states, alter personalities, alters, alternate identities (see Van der Hart & Dorahy, 2009). This list is not exhaustive! In therapy, I want to know about the language a particular client uses. When necessary I may help them find language that acknowledges or moves us a bit closer to understanding the connection and interrelatedness of all parts.

Why does language matter? I see it as playing a role in how we approach the treatment of identity disruption that has resulted in dissociated parts of the self. If you understand that you are all in this together, that you are the sum of all your parts, you will be more apt commit to working as a team and cooperating. If you instead believe that you are each separate personalities or people a “every man/woman for him/herself” attitude may prevail with much chaos ensuing, or continuing.

References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 1 June 2013]. dsm.psychiatryonline.org
Van der Hart, O., & Dorahy, M. J. (2009). History of the concept of dissociation. In P. F. Dell & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders : DSM-V and beyond (pp. 3–26). New York: Routledge
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4 Responses to Dissociative Identity Disorder and Identity Disruption

  1. pepeshrimp says:

    Thank you for sharing. Cleared up a lot of questions and hinted my thoughts into the right direction!

  2. Hi Kathleen,
    Great post! So glad I found your site, not only the information, also your approach. In my case, many years ago I was, when I asked, given the opinion I had Schizoid Personality Disorder while another psychiatrist gave me an opinion of DID-NOS … neither felt ‘right’ to me.
    Finally, in 2003 I was diagnosed with Learning Disabilities affecting working memory and processing speed, followed by in 2007 a formal diagnosis of ADD, Inattentive type. When I asked that psychiatrist about the relationship of ADD to C-PTSD, he said they occurred in the same part of the brain, which, if true, made sense.
    Today, having done my own research and without formal diagnosis, I believe, underneath any or all diagnoses that a medical professional could tell me, without their own lived experience, I have coped daily with severe, untreated, long-term C-PSTD that started with trauma from in-utero experiences that escalated from infancy into neglect and verbal abuse throughout childhood, first from my immediate family in (unconscious) collusion, which I internalized into my personality and acted out since to one degree or another.
    Another important point because having enough money is not always the answer: the home I grew up in was financially affluent, and (my father was a medical professional treating people with learning disabilities) which actually added to the enormous pressure and guilt I was felt to meet exceptionally high performance and unrealistic expectations. In retrospect, the way my family worked, the way society in general works, too often children are set up to fail, to win in spite of circumstances of competition rather than because of cooperation. Maybe that’s why winning seems so precious and scarce when it doesn’t need to be, if we change the conditions we are creating it in.
    I am a 56 woman and have been in different types of therapy since 21. What has been most helpful to me has been meditation, homeopathy, exercise, eating healthy. And, saddest, the most helpful but rarest of all, resonant witnessing or empathy from another person, or at least curiosity and a willingness to listen and learn from others. Being truly present to another is the healing balm we all need.
    And yet still today there is still too much misunderstanding and lack of compassion for those suffering with disease, mental or otherwise. If the statistic of 1 in 4 people (in Canada) will deal with a mental health issue in their lifetime, and in the light of the potential reasons Robin Williams’ committed suicide, the way ‘civilized’ societies view illness, mental or otherwise, needs an overhaul: a more compassionate, wholistic approach. This may be starting in the form of Peer-Support Specialists being incorporated into traditional medical models, at least I hope so.
    Ever the optimist, Lee

    • Anonymous says:

      Well written Lee…it seems that you have more insight into your experiences than most/many mental health specialists…and I love your words ”resonant witnessing or empathy from another person”…..yes, so important. Another rare, but very helpful approach for trauma and dissociative presentations, is when the traumatised child parts are given an opportunity for expression and healing within a therapeutic alliance.

  3. Pingback: What Causes Dissociative Identity Disorder? | Dr. Kathleen Young: Treating Trauma in Tucson

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