Dissociative identity disorder

Dissociative identity disorder has often been confused with schizophrenia by the public and because of Hollywood movies such as, “Psycho” and, “The silence of the lambs”; a film in which the villain, Dr. Lector refers to his cellmate as both, “schizophrenic” and as “multiple migs”. These diagnoses however are very different from one another as DID has been shown to be a direct result of traumatic experience (Van Der Kolk, 2014), whereas Schizophrenia can be purely biological in its origins.

A person who suffers with Dissociative identity disorder, will have experiences throughout their day or week of spacing out and periodically losing time. Losing time means that they will suddenly find themselves reading a book or taking a bath and not remember how they got into that situation, or what they might have been doing before. It is similar to the blackout of an alcoholic but without the alcohol. The problem however is that do not experience this as spacing out and will also not see it as close family or loved ones see it.

People with DID are often misdiagnosed as having ADD or ADHD, when in fact they are dissociating (spacing out a lot as a defense mechanism). That’s right spacing out is a defense mechanism. If you grow up in a household where horrible things are always happening, things over which we have no control, and are often forced to participate in, our best defense is to go away in our minds and in our bodies to a fantasy place. Our best defense is not to be in the present, not to be in our bodies, in order not to experience pain that might be happening.

The reason we dissociate is to avoid feelings or sensations within the body. For a person with DID, feelings or body sensations that you focus on or that get triggered by something in the environment can lead to flashbacks, so it is best not to have them. The remedy or coping strategy then becomes dissociation. Dissociation, for your garden variety people, means spacing out into non-essential details, other people’s lives, projects, etc.

Dissociation is the polar opposite of mindfulness. However, for someone with DID, dissociation means not only spacing out at times, but not feeling ones body, not being present in certain types of physical experiences, avoiding emotions at times, and not being present for shifts in consciousness that happen. Someone with DID will often shift out of one personality (called alters by therapists) to another. This is often not happening consciously by choice but more as an unconscious survival strategy to cope with anxiety and the different threats or situations in life. Creating sub-personalities appears to a be a common strategy for young children who are experiencing extreme trauma as a way of coping with the unbearable experiences of pain, or rather, to be in the experiences of pain but to not be present with their experience.

Working with Trauma requires a different set of skills than working with other types of issues. Dissociative identity disorder is a serious form of trauma and a very controversial diagnosis. According to numerous studies over the last 20 years, many which are cited by Dr. Bessel Van Der Kolk and others; methods such as, Cognitive Behavioral Therapy and Exposure therapy are completely ineffective at resolving trauma. And while they may reduce a few related symptoms, they cannot resolve trauma.

Some of the most effective treatments used for Trauma, PTSD, and DID today are shown to be Somatic Therapies, also known as body based therapies (Soma is the Greek word for body). Somatic therapy studies the relationship between the mind and body in regard to a person’s psychological past. The theory behind somatic therapy is that trauma symptoms are the effects of instability of the ANS (autonomic nervous system). In other words, our past traumas disrupt the ANS.

According to somatic psychologists (Ogden, 2015; Levine, 2015), our bodies hold on to past traumas which are reflected in our body language, posture and also expressions. In some cases past traumas may manifest physical symptoms like pain, digestive issues, hormonal imbalances, sexual dysfunction and immune system dysfunction, medical issues, depression, anxiety and addiction. Some studies show up to fifty percent of people entering into addiction treatment having some form of trauma.