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 It is enshrouded in misinformation, outdated coursework (for students and practicing clinicians alike), and a seemingly unending barrage of defamation attempts. The latter sounds ridiculous, but probably shouldn't come as too much of a surprise once you consider that DID is caused by longterm, recurrent trauma in childhood - most often abuse. There is ample motivation 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 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 so that you can better follow along. DID is a dissociative trauma disorder in which a survivor has undergone longterm, repeated trauma in early childhood. This trauma, combined with other factors, results in a rather dramatic interruption of psychological development -- particularly as it pertains to identity. Through a process known as dissociation, this thwarted development 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 - are able to 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 one's childhood. The alters in a DID mind exist to help the survivor cope with deeply painful and unconscionable trauma, holding it outside their awareness to the best of their ability. However, often once the survivor begins to find safety and/or enter adulthood, this once supremely creative and protective mechanism can turn into a maladaptive trait causing real life consequences. Additionally, all of these experiences can be, and often are, happening alongside the symptoms of PTSD (eg. flashbacks, nightmares, hypervigilance, insomnia, etc), as well as symptoms of other co-occurring disorders commonly seen in trauma survivors.
So, now that you know a bit more about the 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 truly bonkers ;) Let's do this!
Part One: The General Public
✘ Myth: DID is very rare.
Not even close. Its yearly 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 trauma survivors built on secrecy; who can be afraid to receive such a stigmatizing diagnosis, have or have had therapists untrained to recognize their condition, are riddled with amnesia (leading many to be unaware anything is even "wrong”), and whose self-preservation often includes intense denial of trauma — it's still inarguable that DID 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, 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 / actually 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 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.) More very valuable research here on DID validity: ✓, ✓, ✓, ✓, ✓.
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. DID, however, has no higher rates of this than other conditions, and there is even a specific set of criteria that clinicians can use 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 call you a liar, say it's not real, or (even if they do believe you) hurl a bunch of insults at just because you're a complex trauma survivor. This is not what most are looking for when it comes to cultivating sympathy or attention. While some do try, many tire very quickly once 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. Furthermore, there are even greater hurdles to clear for anyone trying to seek treatment or therapy for DID (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 having them, 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. 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, photos, their wardrobe, reading old letters they don’t recall writing, and more.
✘ Myth: Switches in DID will be dramatic, obvious, detectable, or involving 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 DID population has an overt presentation 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 structured around concealment. Dramatic switches or changes in one's behavior or physical appearance 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 try their VERY best to mirror the host's presentation.
For some, in the presence of loved ones or others “in the know”, some of these acts of concealment can fall away and their alters may feel more free to express themselves individually - but it still won’t be anything like what you’ve seen on TV. Child alters, however, are sometimes the most distinct when fronting in survivors who are very "adult". They've even been know to win over some 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, especially in public settings. As for the act of switching itself, 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, just breathing). Switches can be detected if paying very close attention and while being aware of the condition, but it’s very, very rare for strangers or acquaintances to recognize one themselves. They’d sooner assume something else entirely.
✘ Myth: DID is a disorder of “multiple personalities” — that is what's "wrong" in 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 dysfunction lies in the complex trauma and the countless effects it had on the child’s mind and their neurology -- including flashbacks, nightmares, hypervigilance, dissociative amnesia ('losing time'), depersonalization/derealization, emotion dysregulation, somatic symptoms, and heightened vulnerability to a long list of other medical and mental health disorders. Most of the healing from DID revolves around the processing of traumatic memories and sifting through the layers and layers of pain, sadness, anger, betrayal, grief and trauma that each alter holds. Yes, therapy does also address the very unique, distinct challenges of having alters -- from how to get along with one another and work cohesively, to keeping the body safe when individual parts are struggling with self-harm, to how to keep child parts from popping forward whenever you pass the toy section at a store -- but DID is ultimately a trauma disorder, NOT a disorder of personality.
✘ Myth: DID happens because the mind is so traumatized that it splits into tons 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 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 (most notably OSDD and its subtypes), and age may be a very slight influencing factor in the lessened alter differentiation and/or amnesia experienced there -- but most with those presentations were quite young for their trauma as well. There are also many reasons that 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 the symptoms, systems and experiences of OSDD survivors, 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 specific 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 where that boundary has been established beforehand), to "hit-or-miss" (dependent on the person, their intent, the state of things inside, being triggered forward but not actually wanting to be there, and so forth), to "never" (it’s either completely inappropriate and uncalled for, it's unsafe, they have a highly protective reason for staying inside, they can’t even hear you, they don't know how to come forward on their own, or some other very important reason). Survivors with DID are not a magic trick.
NOTE: DO NOT TRY TO CALL PARTS FORWARD UNLESS YOU ARE A TRAINED PROFESSIONAL OR HAVE THE SYSTEM’S IMPLICIT PERMISSION TO DO SO IN NECESSARY SITUATIONS. To not obey this is a serious violation of psychological and emotional boundaries.
✘ Myth: Communication with alters happens by seeing them outside of you and talking with them just like regular people -- a hallucination. (We can thank The United States of Tara for this one.)
Nope, 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 mainly the result of extreme dissociation combined with mental visualization that just FEELS incredibly real on the outside (as opposed to a true external hallucination of an alter).
For most survivors with DID, "seeing" and speaking to their alters happens internally - inside the mind - often including a landscape called an "internal world". Communication may happen through passively-influenced thoughts, face-to-face (in each other's respective bodies, via the internal world), or through “voice” communication heard in the mind. This is why DID diagnoses can so commonly be mixed up with schizophrenia; the discussions and differently 'voiced' thoughts can seem like “hearing voices”, particularly if you don't know what that sounds like. But, in DID, these voices and conversations are not actual auditory hallucinations. They are more like very “loud” versions of one’s own thoughts (versus, say, hearing the radio or microwave talking, or voices of those whom you know do NOT belong to you or share your life story). Alter communication is very much a part of you and stems from somewhere in your conscious mind, even if the thoughts, ideas and tones are considerably different from your own inner monologue.
Other frequent means of communication are things like: journaling, art, post-it notes, non-dominant hand writing, pictures; and, now more commonly, things like online blogging, social media, voice recordings, 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. (Not to mention that trauma 'took place' every single day, for a lot of years, for a lot of people). This can happen for some - and their parts’ names may even all 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 sky-high suicide rates, while warring against heartless stigma and lack of access to basic care -- they're just all lying? No, no annnd 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 are instead the ones living in fear of being cheated on, becoming inadequate, burdensome, or dissatisfactory to their partners that they're the ones who are 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 them 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 comorbid conditions. Medications to calm extreme anxiety, alleviate depression, lessen nightmares, stabilize mood, help with compulsions, quell 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.
Theme here: everyone is different. Integration into a single, individualized 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 everyone working toward a common goal - all 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 why someone might 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.
Part Two: Supporters, Therapists/Clinicians and Survivors Themselves
✘ Myth: The term alter stands for "alter ego".
Alter [most likely] stands for "alternate personality", though there has also been confusion about the phrasing of "alternate states of consciousness" and/or "altered state of consciousness". One was once used in patient charts (abbreviated) on trauma disorders units, and the other in sources online and in research that attempted to compare it with trauma-related dissociation, not label the actual trauma-related dissociation. The absolute origin of the term alter is hard to pinpoint, as is how and why the others found themselves into psychiatric hospitals and research papers without first having an identifiable source to pull it from. But, the most currently accepted understanding is that is stands for 'alternate personality'. However, "states of consciousness" is a term that is used interchangeably for alter/personality in various therapeutic circles. So, the first two are none too dissimilar.
"Alter ego", however, has zero relevance in DID whatsoever. It can stay with Beyonce and Fight Club.
✘ Myth: People with DID only have a few alters.
Some can only have a couple or a few, but it's more common to be around the teens. It's also extremely common to only be aware of a few for some time, and then discover many many more as therapy progresses and it is safe for them to be known by the others. Systems in the 30s and 40s are not uncommon either. For those with backgrounds of human trafficking, organized violence, ritual abuse, or mind control, it's well-observed for systems to be well into the hundreds, or even impossible to count. System size does not validate or invalidate a survivor. There is also no direct correlation to system size and severity of trauma.
✘ Myth: All systems have specific types of alters (i.e. “The Rebel Teen”, “The Promiscuous Alter”, “The Loving Mother”, “The Adorable Child”, “The Evil Introject”, etc.)
Sure, some do have these alters, and it’s often for good reason and due to themes that exist in abuse, not necessarily themes within the disorder. Many will have none of these alters, others have completely reversed takes on them, and so forth. While it makes for easy book and film-writing - and some survivors absolutely do find themes within their system and another's - there is no universal recipe for a DID system. Additionally, getting too specific or trying to categorize alters into specific role subtypes can be quite damaging and lead to a whole host of new issues (none too dissimilar to the complications that arise from trying to fit regular humans into boxes or “types”).
✘ Myth: All alters will be (or should be) the same gender/race/sexuality as the survivor.
As mentioned before, different genders, sexualities, and even races can exist within one system. Sometimes this happens at complete random, others develop from from positive childhood influences, and then other times these changes were bred out of traumatic necessity.
✘ Myth: Inhuman alters are impossible (robots, wolves, ghosts, cats, etc).
Not impossible at all and instead very common. For many children, being a human is scary. It gets them hurt. Being invisible or incapable of feeling, becoming a terrifying entity, a loving creature, or even a shapeshifter can feel infinitely safer and more protective of the whole than fragile humanity. Note: Alters do not come about by conscious choice or planning. They happen within a child’s mind, through their understanding of the universe at the time, unconsciously, and by way of a heavily dissociated surreality. Anything that seems even moderately safer than their current state is fair game inside their survival escapism. Just as human alters can be deaf, blind or have no voice to speak, even within an able-bodied system, inhuman alters who are unable to do similar tasks are just as real, valid and important as the humans. They are protective and significant, not weird or unbelievable.
✘ Myth: All “littles” are broken and damaged. Or, Inversely, all littles are happy, bubbly kids that hold the survivor's “innocence”.
*re-accessing our theme here* All humans, systems, and alters are different. Some child parts are deeply traumatized and hardly able to function. While, others' kid parts are the most innocent, endearing, and happy little angels. But there is also every shade in between, and some systems have TONS of kids - up to hundreds even - each vastly different from the other. Happy, sad, energetic, daring, lonely, scared, adventurous, genius, precocious, disabled, shy, athletic, mean, messy, giggly, pristine, posturing, infantile, newborn, brave, hidden, exuberant….. the possibilities are endless in child parts, including their capacity to grow, change and transform.
✘ Myth: “Introjects” are inherently evil and are just like the abuser(s) in that person’s life.
The word introject refers to any alter who is modeled off an outside individual - mirroring their personality, behavior and sometimes even going by the same name and visual presentation. These individuals may be positive or negative influences in the survivor's life; some are even fictional characters. (Remember: Alter development is not a conscious process and takes place within a young, traumatized child's mind. Pulling from fiction makes complete sense to little minds.) Most notably, though, are abuser introjects -- alters who are so prevalent in DID systems that the term introject itself has nearly become synonymous with “the bad guys”. That said, it is extremely important to remember that these introjects serve a very important, valuable purpose, and(!) they are NOT the actual abuser. They are a victim, a single part within a large beautiful mind, bred from the survivor's essence. They are just copying behaviors shown to them by bad people, not harboring the intent, sadism or immorality of the actual perpetrators. Most are even trying to protect the system at large. Antithetical as it sounds, these introjects can truly believe that hurting the body or internal system members, can still be ultimately protective, misguided as that is.
Let's learn why.
Introjects are only able to model outside individuals so well because they’ve spent copious amounts of time with them. So, in the case of abuser introjects, it typically means that those alters were the most abused by them. By “becoming them”, they not only get to deliver themselves from that powerless dejection, they get to decide what is allowed and what is not. They write the rules. Their intimidation, bullying and posturing as the voice you fear most in this world can make you far less likely to talk in therapy, to tell a family member or friend; to seek justice, file a report, go back to school/work, and more. ….anything your real abuser threatened great harm against you for even considering. Introjects' verbal insults may leave you timid and embarrassed, afraid to “put yourself out there”. They may feel this is the only way to protect you from the 'inevitable' pain, rejection, betrayal or loss that comes from making connections. Even healing from your trauma can feel too threatening or unsafe. By being a relentless, menacing part who terrorizes your mind and body, you stay sick, which keeps you safe from whatever those "threats" are. ...but only by adding new threats to your safety. Helping them see this paradox can be the first step in getting them to take pause, and eventually become an alter you can work with instead of fearing implicitly. Some of these introjects are even extremely young child parts who just posture as these ‘big bad adults’ for some semblance of control and power. It's helpful to keep all of this in mind when you're under siege.
It is especially important to remember that they are not evil. They’re usually extremely traumatized and were given a highly manipulated understanding of safety and love. But also, YOU as a whole are not evil just because these parts live inside of you. They are not the actual abuser and they are just reenacting behaviors/thought patterns that were taught to them by bad people for years and years. It's all they know. But, the difference is that deep down they believe they're keeping you safe from something they believe to be absolutely unbearable. You just need to figure out what that is.
✘ Myth: Alters who persecute (via bodily self-harm or harm to other parts inside) are bad and should be tamed/gotten rid of/ignored/killed/etc.
In a similar vein, most of these parts are doing these things for a reason - a reason they feel is extremely important or keeps everyone safer (even if that just means safe from having to feel any PAIN if they're profoundly suicidal). It’s important to keep in mind that just because these things may not make sense to YOU (since you can clearly see all the destruction and harm it's causing elsewhere in life), they aren’t working with the same information, life experiences, or emotional connections to the world as you. If you were locked in a dissociative barrier for years, only able to pull from a select number of life experiences (most that were utterly horrifying), you might not be the most empathic or understanding person either. Moreover, many system members adopted their concepts of “safety” when the body was a child. ..a traumatized child. What they consider safe isn't always going to make sense.
Ignoring them, trying to shut them up or restrain them, punishing them, or any of the various attempts at “getting rid of them” will not only never work (their needs will only become greater and louder), they’ll become more and more traumatized as you confirm to them their every belief about the world. You can’t actually “get rid of them” anyway, so it’s far better to try and understand them.
✘ Myth: You can kill alters.
Even if mock deaths or temporary experiences of alters “dying” from old age (or other means) have been acted out in some systems, they aren’t actually dying. You cannot kill off a collective part of the conscious mind like you can a person. Their thoughts, memories, emotions will all still be there, so they must be as well. The part may have gone into extreme hiding, been momentarily immobilized, or merged with another part of the mind, but they most assuredly did not and can not disappear entirely or “be killed”.
Above all: THIS IS EXTREMELY DANGEROUS AND TRAUMATIC TO EVEN ATTEMPT. Do not do it.
✘ Myth: Alters can’t have their own mental health issues if the main survivor doesn’t have them.
They actually can, and many do. It’s extremely common for individual alters to battle depression, anxiety, OCD, bipolar, eating disorders, self harm, etc., while other members of the system experience no such thing. Some extremely differentiated systems may even need that system member to come forward and take medications that the rest of the system does not need and will not get. ..and their brain’s neurology responds accordingly.
One note about some disorders, however. Non-verbal, poor eye contact, savant-like, or sensory-processing-disorder alters CAN be extremely common in DID systems. However, it’s important not to just jump to calling these parts “autistic” if the system as a whole is not autistic. It’s possible for alters to behave in ways that mimic their understanding of SYMPTOMS in disorders they know about, while not actually possessing the neurology for them. This is a complicated subject we could try to elaborate more on at some point, but it’s just an encouragement to pause and not automatically label certain parts as having certain conditions just because they show a few traits from them. It can cause a great deal of conflation and misrepresentation of those illnesses.
But, make no mistake, most expressions of mental illness amongst alters are incredibly real and valid and should be treated as such.
✘ Myth: It’s impossible for alters to have different vision, health conditions, talents, and so on. "Those are physical. Even if the mind is different, the body stays the same."
Not impossible at all, and instead, extremely normal. We must remember that the mind and body are not only extremely connected, but that DID also isn’t just “in the mind”. There are all kinds of changes that take place neurologically to encourage these harsh separations. Some alters can operate on entirely different neural pathways of the brain, and that determines a lot of what the rest of the body will experience, feel and tells the other organs to do. This may mean allergies to different foods, different glasses/contacts prescriptions, over- or under-production of various hormones, and so forth. The brain is incredibly powerful; it not only tells the rest of the body how and when to operate, but can completely change how it will interpret and respond to cues, sensations and feedback based on which areas of the it are most active at the time. Much of this is still being studied because it's so fascinating, but there's no shortage of anecdotal examples, or the several others within published research.
✘ Myth: Anyone can treat a DID patient. All trauma-informed therapists are capable of seeing a DID client through to healing.
DID is extreeeeemely complex. Even specialists can struggle with the sheer volume of curveballs and knowing they must remain vigilant to any and all unforeseen complications. Most psychology curriculums that lead to a degree in clinical practice only spend about a week or two on DID and other dissociative disorders. To add insult to injury, the majority of the information is out-of-date. Trauma-informed classes rare enough and are something most passionate MH professionals must go out of their way to find. Then, they invest extra time, coursework and continued education just to be able to competently and confidently treat a trauma survivor. Depending on the program, many of these folks are still unfamiliar with the nuances of dissociation, personality differentiation, system dynamics, common pitfalls of therapy, memory-processing, and alter integration (if that’s what a patient desires). While a clinician who's missing these skills may still be able to bring a PTSD patient through to wellness, these are an absolute must when it comes to rehabilitating a patient with DID.
When patient safety is often in jeopardy (either due to self-harm, eating disorders, drug/alcohol use, or ongoing abuse), and suicide attempts occur as frequently as they do in this population, there is limited room for error. And, just sitting with that knowledge can be extremely (and justifiably) upsetting for many therapists. This may leave them feeling anxious, desperate, or even becoming quite protective over their client - which only increases the opportunity for unintended mistakes. Specific training in DID, or at the very least a sincere dedication to learning it (and quickly) while working with a patient, is highly advised. Not just anyone can treat this condition, and trying to do so ill-equipped can be catastrophic.
Part Three: The Bizarre and the Out-There
✘ Myth: People use DID as an excuse to get away with crimes -or- people with DID can commit all the crimes they want and just blame it on an alter.
Very rarely is this ever used as a criminal defense, and when it is, it’s almost always publicized because it’s preposterous. Despite what Primal Fear may have taught you, no, people don’t really lie about DID just to get away with crimes (if for no other reason than it’s very easy to prove they don’t truly have the condition, nor do they demonstrate any of the behavior consistently). But, oh wait! There's an even bigger reason: this is not a viable defense in a court of law. DID is NOT insanity. Regardless of what any alter does outside of one’s awareness, the whole person is still responsible for their crimes and will be prosecuted accordingly. If someone uses that as their defense, it will fail them.
✘ Myth: People with DID are possessed by demons.
This sounds like something to laugh at, but one short gander in DID communities online and you will find all KINDS of people who firmly believe this and will offer unsolicited advice and/or demands for survivors to be exorcised. Regardless of your faith, this is NOT what is happening in DID, and research has provided us with a complete explanation of what is happening inside the mind and why. Demonic possession, even if you believe, would not present in such a highly organized, specific, and intelligent way, while also happening to meet all the criteria for a well-documented mental health condition. And, attempts at exorcisms, “praying it away”, or even the mere suggestion of something more sinister existing within them can be extraordinarily damaging and traumatic to the already-suffering survivor. This was a somewhat understandable explanation in like, the 1600 or 1700s — but in 2017, this projection onto survivors who simply switched? Is absolutely inexcusable.
✘ Myth: This is just something the Americans made up.
Patently false. It’s been found worldwide, and some of the leading research in the field has come from countries that are not the United States.
✘ Myth: DID and schizophrenia are the same thing.
Not even a little bit. There aren’t really even any universally overlapping symptoms from person to person. Schizophrenia is a neurodegenerative disorder (frequently labeled a psychotic disorder - which carries its own unfair stigma to overcome); Dissociative Identity Disorder is a trauma disorder. It is PREVENTABLE. No medication can make it better.
✘ Myth: Films like Split, Sybil, Three Faces of Eve, and Frankie and Alice taught me everything I need to know about DID! And, The United States of Tara is amazing representation!
Hardly shocking that media can be extremely inaccurate, but when it comes to Split, Sybil, Three Faces of Eve, Frankie and Alice, etc, you'd think that most would know they're pretty awful. ...but, just one look around and you'll find that disproven rather swiftly. These films are not just abysmal in terms of representation, they severely damage and inhibit the public's understanding of DID. And, sadly, it’s not just the general public who seem unsure of their accuracy. I recently heard a mental health professional, who treats both C-PTSD and DID, refer to some of these as “good” and “informative” -- a reference point for those who are new to the condition. Sadly, knowing just how harmful they are is not “a given”, even in the MH community.
Even when it comes to The United States of Tara, while it is absolutely better than the others, it is not “good representation” by any stretch. Yes, it did touch on some important topics, but most of those are moot when it also displayed the most commonly stigmatizing and damaging tropes in droves and got so dark by the end that many with trauma histories couldn’t even finish it. A simple scroll back through these myths and you’ll find MOST of them in the show. (She was violent to strangers, abusive to her family, cheated on her husband, and was deemed unsafe to even be around children. Her switches were SUPER dramatic, alter differentiation was the most extreme, and they used very predictable tropes for her alter characterization. She introjected a therapist without any trauma or major life event to necessitate the addition, sought extremely toxic "therapy" without the show ever defining it as such, and safety was dealt with so irresponsibly that it was disturbing. There much more to add.)
We could write an entire article on this alone (and we may even do so one day), but for now, let’s just squash the myth that USoT is “positive representation”. I know that as survivors we tend to think of anything that isn’t actively hurting or abusing us as being GREAT! But, just because something isn’t a total disaster or has some redeeming qualities does not mean that it’s positive. At all. And we shouldn’t accept it as such. USoT is great for some laughs and entertainment, but it is not good DID representation. We save our choice words more for films like Split, but hey, we even managed to exercise some restraint there while discussing it in this article here! :)
No doubt there are far more myths than this. We encourage you to add some of the most wild things you've heard in the comments. What are some misconceptions you held onto or believed when you first heard of the condition? What are some things you still hear from those around you or online? ...possibly even from clinicians? While none of these are a laughing matter, and we hope that we've educated significantly, it's still okay to get a laugh from things now and then, especially when they're so absurd. If we didn't, we'd all go a little bonkers
We sincerely hope this was very useful to you, and we hope to see you sharing it with anyone who needs some clarity!
MORE INFORMATIVE POSTS YOU MAY FIND HELPFUL:
- Did You Know?: 8 Things We Should All Know about C-PTSD and DID
- Grounding 101: 101 Grounding Techniques
- Nighttime 101 and Nighttime 201: Sleep Strategies for Complex PTSD
- Imagery 101: Healing Pool and Healing Light