Until 1994, Dissociative Identity Disorder (DID) was known as Multiple Personality Disorder. These conditions are one-in-the-same, though understanding of it is developing through studies based on experience with those who have it, as well as technology, such as brain scans.
In order to be diagnosed with DID, one must have at least two distinct identities, commonly referred to as alters, or parts. There must be periods of amnesia for actions or awareness between parts, and there must be a degrees of distress concerning the symptoms.
While there can be amnesia between alters, there can also be co-conscious states where two or more states are either sharing the ability to function, or one is aware of what the other is doing, as it is happening.
Hearing inner voices is common, while sometimes, it is possible to see an alter within the mind, or in a sense, projected in front of the person.
Dissociative Identity Disorder is now understood under what is known as "Structural Dissociation."
Research studies thus far reliably indicate a correlation between repeated childhood trauma before the age of 9, and with those experiencing DID. This leads to DID placed as the highest on the severity spectrum of PTSD.
In structural dissociation, it is explained that everyone comes into the world in states of alter ego's. These ego states perform different functions within a baby, toddler, or child, though, in the early years of life, a healthy mind will merge to become one whole.
These ego's in themselves are not alters as consist those in DID. They are normal and healthy development of mind. These ego's do not become alters without the circumstances that create them.
With a combination of repeated trauma, emotional neglect, and no one to turn to for safety, the trauma induced dissociation creates distinctive walls between the parts that form the whole, but do not become whole. Dissociated parts experience independently, remember different experiences in different ways, and with unique feelings or perspectives.
By developing within separate parts of the mind and basing their feelings on individual complexities, these alters form their own ages, genders, opinions, likes, dislikes, or dispositions. They may exhibit unique tones of voice when in control of the body, or they may hold their own postures.
Dissociative Identity Disorder is a recognized mental health diagnosis in the Diagnostic Statistical Manual (DSM-5) and has been since the third edition. Despite this, there are clinicians who remain skeptical of the conditions existence, or of its frequency.
Doubts on the validity of DID stem partly from massive media attention that the disorder received since the second half of the 1900s. Movies were filmed depicting what were said to be true, but that later, there were claims that Shirley Masson of Sybil was untruthful and making everything up. Was she?
While Shirley wrote a letter that stated that she lied about everything, perhaps, that in of itself, was merely a symptom of the disorder. Denial of the condition is part of the condition, it is said. DID is hidden to even the person themselves. While we cannot state in one direction or another in terms of Sybil as a true story, we do present that many of those who truly have DID find themselves certain on occasion that they must have made it up, or their mind played tricks.
We also argue that for some who were diagnosed, or self-diagnosed to have DID, this may not always be the case. Mistakes can be made, especially with self-diagnosis or an overly rushed therapeutic evaluation. As at one time, there may have presented instances where clinicians were eager to diagnose the condition, though, this was not where the disorder stems from.
The history of Dissociative Identity disorder did not begin with "Sybil" or "The Three Faces of Eve." Case studies or references of the condition go back hundreds of years, to even Jeanne Fery in 1584.
Jeanne recounted an exorcism performed on her in detail. Her symptoms of alternate identities match those known today to be DID.
Dissociative Identity Disorder has a history of being mistaken for possession, as those who live with it share a mind with alters that can take control of the body's actions. The voices of these alters can also be heard communicating within the head. This concept of possession when it comes to DID is a misconception. There is clear separation in the DSM as to the disorder being a matter pf psychology; not spirits.
There was a time when the conditions were further confused due to the use of the term "split personality." Schizophrenia means, "split mind," which is a reference to a split from reality; not to the person experiencing alters.
With Schizophrenia, the auditory hallucinations are heard 'outside' the head; whereas, with Dissociative Identity Disorder, the voices are dissociations that are heard 'inside' the head.
This can be heard in the form of sounding like a thought that is made by an alter and not the part hearing it. Another possibility is to hear voices within the mind that sound like a unique tone of speech, which may belong to a child, woman, man, or other forms of non-human alter states.
Another difference is that with Schizophrenia, there may be one or two common voices at most, and these speak directly to the person who is split from reality. With DID however, the voices can consist of an unset number, and they can be any age, or gender of those ages, while they also converse with each other. Hallucinations do not tend to converse with another hallucination.
The answer to this can be unique to each system of alters. For the purpose of allowing room for sharing an experience, we will explain a few common points with the use of our story.
My name is Melissa, and I'm part of a system of alters that I refer to as Headmates. Together, we are The Bag System.
From my perspective, for most of my life, living with Dissociative Identity Disorder felt like living as most anyone else. I lived with recurring symptoms of Complex-PTSD and was aware of memory gaps or events that I could not recall, though, I was unaware of the others within the same mind. While I occasionally had my suspicions, I always brushed them off as quirks.
I look back now, after our diagnosis, and I can pinpoint several instances of switching to a Headmate taking control that I simply could not explain at the time.
Most of those with DID do not know it until later in life. The average age of diagnosis is 30 years. A system of Headmates will work together to prevent who is known as a "Host," or the alter that fronts the most often, from awareness of the condition or of the others sharing a mind. The alters will most often try to blend in, so that those around them are unaware of the changes. In 94% of cases, switches between Headmates in a system are covert, which means that they are barely detectable.
My system makes up part of that 6% whom are overt, which means that it's generally obvious when a Headmate takes control or exhibits passive influence that changes behaviour or thoughts.
There was a time when I heard the others only occasionally. Now, it's rather commonplace. I catch 'windows' where dissociative walls become thin, and I hear sentences, or conversations within. These can be words, or they can be a man's laughter, or a child's cries. These can be phrases about my actions, in if they approve, or disapprove. It may also be general day-to-day chatter to which I do not know the context, but this sounds like their reasonable way to pass the time together.
I will sometimes feel my feelings or thoughts, while simultaneously feeling theirs, which can be contradictory in nature. For example, I might consider something to be negative or neutral, while a Headmate grows excited and happy. In these cases, I am aware of which of the two or more 'streams' of consciousness are mine, and which are theirs.
I am a grown woman. I feel that I am. I am aware of my individuality and my opinions or capacities. This changes however, in what can be a slow transition, or a very sudden switch to a 4-year-old child state who happened to see a bright blue popsicle, then begins to burst audibly in joy and excitement. This involves childlike bouncing, facial expressions, and tone of voice.
What is it like for me to return to myself following such an obvious and sharp contrast in age and temperament? I try my best to take this in strides toward acceptance and love for these parts of me that I've grown deeply fond of. At the same time, I may sometimes fail to live up to my standards for myself to be okay with this type of utter loss of control.
While out of respect for my young headmates, I hesitate to refer to these scenes as embarrassing, I do find myself quite self-conscious; on one instance, to the point of tearful grief.
If you wish to learn more about a few of my Headmates, I invite you to visit our profile page, or to listen to our The Bag System podcast.
To Learn More
For additional research and information regarding Dissociative Identity Disorder, did-research.org is rich in information and resources.
If you wish to figure out if you or a loved one are living with DID, we created a podcast episode on the topic of the signs, symptoms, and treatment.
However, as any other condition, while the Information Age is useful, it is really just that; information. For the best route in finding the answers to your experiences, then a qualified psychiatrist or psychologist are more than merely recommended.
While others may mistake our symptoms for Borderline Personality, or Psychosis, so may the person themselves. In order to receive the proper treatment, or your appropriate course from here, a professional opinion, verified by proven testing is the only way to truly know the source of the signs you are living.