DID MYTHS AND MISCONCEPTIONS
Dissociative Identity Disorder is by far one of the least understood mental illnesses out there. It is enshrouded in misinformation, outdated material and coursework for students and clinicians alike, and a seemingly unending barrage of attempts at defamation. The latter seems ridiculous, but probably shouldn't come as too much of a surprise when you consider that DID is caused by longterm, recurrent trauma in childhood - most often abuse. There is a rather hefty incentive for entire organizations to want to squash its credibility or deny its existence, particularly when some of the founders of such organizations were accused of child sexual misconduct themselves. But, that is NO excuse. In fact, it's a massive reason for why we exist at all and why we are so passionate about getting solid, credible information out there to everyone.
There will be no shortage of information here on what DID is not, coupled with clarifications on what it is, but let's at least provide a brief summary for those of you unfamiliar enough so that you can better follow along. DID is a dissociative trauma disorder in which a survivor has undergone longterm, repetitive trauma in early childhood. This trauma, combined with some other factors, results in a fairly dramatic interruption of psychological development - especially as it pertains to identity. This results in "differentiated self-states" - also known as alters/parts - who may each think, act, and feel considerably different from one another. These parts of the mind - who may have their own name, age and personality - can take executive control of the body leaving the survivor without any awareness for the time they were gone. These amnesic gaps in memory can be for just a few moments, a few days, or even entire chunks of their childhood. These alters exist to help the survivor cope with deeply painful and unconscionable trauma, holding it out of their awareness to the best of their ability. But often, once they begin to find safety and/or enter adulthood, this once supremely creative and protective mechanism can quickly become a maladaptive skill that causes real life consequences. And, all of this can be going on alongside the effects of PTSD (flashbacks, nightmares, hypervigilance, etc) or many of the other potential co-occurring disorders that frequent trauma survivors.
So, now that you know a bit more about the very basics of DID, LETS GO DEBUNK SOME MYTHS! Since this is a lengthy one, we divided them into three parts: myths the general public tends to believe, misconceptions that even those familiar with the condition still hold onto, annnnnd then some of the crazies ;) Let's do this!
Part One: The General Public
✘ Myth: DID is very rare.
Not even close. Its prevalence rate (~1.5%) is actually more common than young women with bulimia and even on par with well-known conditions like OCD. While it is very hard to gather statistics on a community of survivors who are built on secrecy, afraid to receive such a stigmatizing diagnosis, therapists who are untrained to recognize it, a condition laden with amnesia (leading many to be unaware something “is wrong”), and intense denial of trauma — it is still inarguable that it is anything but rare. It is a major mental health issue.
✘ Myth: People with DID are dangerous, villainous killers or have alters who do extreme harm.
Contrary to popular belief, survivors with DID are no more dangerous than those with any other mental health condition or the general public. The crime rate, violent use of weapons, domestic disturbances, etc. are no greater than (and often less than) the general population. In fact, due to survivors' prolonged exposure to trauma and violence, it is far more common for those with DID to be re-victimized and on the receiving end of violence and/or abuse than to perpetrate it. Many even take very staunch stances on pacifism after a lifetime of aggression and pain.
✘ Myth: DID isn’t real. It’s a condition created by therapists / exaggerated BPD / attention-seeking / HPD and compulsive lying / etc.
Research begs to differ. DID has distinct markers that separate it from all other disorders already in the DSM and it’s conclusive that DID results from longterm childhood trauma - nothing else. It’s the only condition that has such pronounced amnesic gaps ("missing time"), differentiated personality states, as well as unquestionable exposure to extensive trauma; it did not just materialize from thin air or without solid precedent. Iatrogenic cases (“therapist created”) do not present the same as authentic DID and can be distinguished (just as malingerers and factitious presentations can be separated). For more information on those: here.
As for the idea of it being “just attention-seeking”: It should be observed that ALL disorders, even physical illnesses, have groups of individuals who will pretend to have them. But DID has no higher rates of this than other conditions, and there is even a specific set of criteria that exists for clinicians to confidently determine if someone is faking the condition. But, primarily: there are far easier, more believable, more profitable, and more "rewarding" conditions to fake for attention or to garner sympathy than DID. DID is a condition riddled with stigma, vitriol, and people from all corners of the world eager to tell you that you're a liar, it's not real, or (even if they do believe you) still hurl a bunch of insults at you just because you’re a trauma survivor or have a mental illness. This is not what most are looking for when they hope to cultivate sympathy or attention. While some do try, many tire very quickly when they realize how many small quirks and minor details about their alters they must be able to recall and maintain seamlessly, and most are not trained actors to manage this. Then, there are much, much greater hurdles to clear for anyone trying to seek treatment or therapy (as opposed to just claiming it in their personal lives or online) - so most do not.
We do not disbelieve the existence of eating disorders, cancer or OCD merely because some people fake it, do we? ...even though the rates of malingering or factitious disorders for those conditions are higher. Why should DID be any different?
✘ Myth: If you have DID, you can’t know you have it. You don’t know about your alters or what happened to you.
While it is a common trait for host parts of a DID system to initially have no awareness of their trauma or the inside chatterings of their mind, self-awareness is possible at any age. Particularly once starting therapy, receiving a diagnosis, or becoming familiar with the condition, the entire path to healing relies on gaining access to all of that information, as well as establishing communication with parts inside. But, even without therapy, some can be aware of a few traumatic experiences, be able to recognize the signs of switching, or learn about themselves through old journal entries, self-photos, reading back old letters shared with loved ones they don’t recall writing, and more.
✘ Myth: Switches in DID will be dramatic, noticeable/detectable, or involve parts who want to wear different clothes/makeup, etc. “If you really had DID, everyone would know it.”
*buzzer noise* False. Only a very, very small percentage of the population with DID have overt presentations of their alters or switches (5-6%). While some hints of detection can be seen amongst friends and therapists, most changes are passable as completely normal human behavior. DID is a disorder built around concealment. Dramatic switches and changes in exterior or behavior would attract far too much attention, which could be dangerous for the survivor. Alters learn how to blend in, and many who do have considerably different personality traits, mannerisms, accents, etc. often do their VERY best to mirror the host's behaviors instead. In the presence of loved ones, or those “in the know”, some of these acts of concealment can fall away and alters may feel freer to express themselves individually - but it won’t be anything like what you’ve seen on TV. Child alters, however, are sometimes the most distinct when fronting in a survivor who is very adult, and are often what wins over even the most stern of DID-doubters — but this is one of the primary reasons that DID systems tend to keep these parts away from the front at all costs in public settings. As for switching, it can often look like an inconspicuous fluttering of the eyelids, a little muscle twitch or facial tic, or some other small movement of the body that looks like anyone repositioning themselves (or, y’know, breathing). Switches can be detected if paying very close attention while being aware of the condition, but it’s extremely rare for strangers or acquaintances to ever recognize one themselves. They’d sooner assume something else was responsible entirely.
✘ Myth: DID is a disorder of “multiple personalities” — that is all that's going on for the person afflicted and is what makes it an illness.
Having separate identities is merely the byproduct of something greater, not the sole disorder. The real “disorder” lies in the complex trauma and the effects it had on the child’s mind and neurology. Most of the healing from DID revolves around processing traumatic memories and digging through the layers and layers of pain, hurt, sadness and anger that each part holds. Yes, having alters poses very distinct challenges which are often tackled in therapy, too, but DID is a trauma disorder - NOT a disorder of personality.
✘ Myth: DID happens because the mind is so traumatized that it splits into all kinds of alters. The mind just shatters into pieces under all the pressure of trauma.
This was a long-believed model for DID, and one still held by many therapists today who have failed to update themselves with the current understanding of dissociation and identity development. The Theory of Structural Dissociation states that DID results from a failure to integrate into one identity, NOT a whole that breaks, shatters or splits. We have a more detailed (but also very “layman-friendly”) explanation here: You Did Not Shatter.
✘ Myth: DID can develop at any age.
DID only develops in early childhood, no later. Current research suggests before the ages of 6-9 (while other papers list even as early as age 4). Prolonged, repeated trauma later in life (particularly that which is at the sole control of another person, or breaks down a person’s psyche and self-perception) can result in Complex PTSD, which does have some overlapping symptoms, but they WILL NOT develop DID.
It should be noted there are also other dissociative disorders, some that even mirror DID very closely (OSDD and their subtypes), and age may be a very slight influencing factor in the lessened alter differentiation and/or amnesia experienced there -- but most are quite young for their trauma as well. And, there are many reasons one may present as an OSDD-type system instead of a DID system, but they are a conversation for another day! Understanding DID is tough enough for most! Still, many of these myths will also apply to many of their symptoms, systems and experiences, too.
✘ Myth: Survivors with DID can switch on demand if needed for a task or someone just simply asks for them.
Plainly put, this is just not possible. Sure, for some there are moments where they can call upon certain alters for certain tasks, but there are no guarantees or absolutes (and, for any number of reasons). When it comes to outsiders trying to call upon parts, this could range anywhere from "sometimes possible" (particularly in therapy or in extremely safe relationships), to "hit-or-miss" (depending on the person, their intent, the state of things inside, being triggered forward but not actually wanting to be there, and so on), to "never" (either because it’s completely inappropriate and uncalled for, it’s unsafe, they have a highly protective reason for staying inside, they can’t even hear you, or some other very important reason). Survivors with DID are not a magic trick.
NOTE: DO NOT TRY TO CALL PARTS FORWARD, ESPECIALLY IF YOU ARE NOT A TRAINED PROFESSIONAL OR DO NOT HAVE THE SYSTEM’S IMPLICIT PERMISSION TO TRY IN NECESSARY SITUATIONS. This is a violation of psychological and emotional boundaries.
✘ Myth: Communication with alters happens by seeing them in front of you and talking to them just like outside people -- a hallucination. (We can thank The United States of Tara for this one.)
Not so much. This is a very rare, inefficient, and an extremely conspicuous means of communication. It also relies on a visual hallucination, which is typically a psychotic symptom that most with DID do not have. However, it IS a possibility, and some do experience this; but it’s typically due to extreme dissociation and mental visualization that just FEELS incredibly real on the outside - as opposed to a true external hallucination of an alter. For most, survivors tend to view and speak to their alters internally — sometimes through thoughts, face-to-face communication inside the mind in their respective bodies (many have an internal world), or through “voice” communication heard in the mind. This is why DID diagnoses can so commonly be mixed up with schizophrenia because these internal conversations can SEEM like “hearing voices” (especially if you have nothing to compare it to), but they aren’t actual auditory hallucinations. Instead, DID voices are very “loud” versions of one’s own thoughts (versus, say, hearing the radio or microwave talk to you, or voices of those whom you know do NOT belong to you in any way). Alter communication is very much a part of you, even if the thoughts, ideas and tones of it are considerably different than your own inner monologue.
Other frequent means of communication are things like: journaling, art, post-it notes, online blogging; and now more commonly things like social media, voice memos, videos, and more.
✘ Myth: Parts in a DID system are all just variations of the host at different traumatized ages of their life.
Nope. Parts can be any age, gender, or personality type. They can have entirely different outlooks on the world, faiths, sexual orientations, political views, etc. Many are even associated with no specific trauma at all but still have a very important and necessary role inside the mind. Alters are NOT merely “frozen” or “stunted” aspects of the host, marked by when trauma took place (and trauma "took place" every single day for years for a lot of people). This can happen for some - and their parts’ names may all even be similar or variations of the survivor’s name - but even then they typically show a great deal of variation from what the survivor was like at those ages. Personality differentiation is a hallmark of the condition. Without it, it's not DID.
✘ Myth: Because 'x' person lied about having DID, they’re probably all lying.
Generalizations have never gotten us anywhere in life. Do some people lie about having DID? Yep. Do some ignorantly use it as a crutch to try and excuse bad behavior? Sure do. Does that mean the millions who are struggling every day just to go on after an entire childhood of trauma -- who are fighting an uphill battle of perseverance to overcome the sky-high rates of suicide, while warring with heartless stigma and the lack of access to even basic care -- they're just all lying? No, no and no. Does it instead make the people who lied the ones we should be shaming? ..the terrible jerks who appropriated someone else’s suffering for their own gain? Definitely.
✘ Myth: People with DID will inevitably cheat on you/be unfaithful because their parts will just go be with someone else.
I know it’s hard to believe, but everyone is different. What one person does, their system does, or television leads you to believe will be inevitable DOES NOT apply to everyone. Many exist in highly exclusive, monogamous relationships and instead live in fear themselves of being cheated on; becoming inadequate, a burden, or dissatisfactory to their partners to the point that they are the ones to be left. DID survivors tend to be more concerned with just finding a healthy, non-abusive, communicative relationship than to "go wild" with the "promiscuous alters" (but more on those later).
✘ Myth: You can treat DID with medication.
There are zero medications to treat DID. There are, however, medications that can be helpful in managing some of the symptoms of PTSD or other co-occurring disorders. Medications to calm crippling anxiety, alleviate depression, lessen nightmares, stabilize mood, help with compulsions, aid in severe insomnia, etc. can all be helpful at various points in a survivor’s treatment. But nothing exists to help the symptoms associated with DID, and many can even make them much worse. Be extremely wary of anyone suggesting they can help with your dissociative symptoms or switching. They are most likely misinformed, or possibly even lying to you.
✘ Myth: Integration is a “must”, or is everyone’s goal in therapy.
As will be a theme here, everyone is different. Integration into one individual identity IS the goal for some. But it is not, and does not have to be, for everyone. It is possible to achieve full healing by processing memories, establishing communication across the whole mind, lowering dissociative barriers, and showing aptitude in all working toward a common goal - without actually integrating. Others may choose to integrate SOME parts, or "downsize", but still leave a small system to go about their life. There are many, many reasons for why someone may choose any of the above. But integration is NOT a must, and anyone insisting that it is or refuses to accept your decision to remain distinct, does not have your best interests in mind and heart.