1. What is DID (Dissociative Identity Disorder)/MPD (Multiple Personality Disorder).
According to the Diagnostic Statistics Manual version IV (DSMIV) which is the main book of reference, used by professionals in identifying Psychiatric disorders, Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) is
* The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
* At least two of these identities or personality states recurrently take control of the person’s behaviour.
* Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
But what does that mean in everyday terms? Basically DID/MPD is an innovative and highly individualist survival technique. It is the creative attempt of highly traumatized children to protect themselves from what’s happening to them. (Example “This isn’t happening to me.”) When these children dissociate from the trauma, they become different personalities within one body. Only young children, around the age of eight and under have the flexibility and vulnerability to adapt to trauma by means of creating personalities. Each child is different; the abuse that causes one child to dissociate to the point of different personalities won’t be the same for another child.
2. I thought DID and MPD where two different diagnosis’s?
No, MPD and DID are the same thing. There was a problem that resulted from the publishing of the DSMIII R (Diagnostic Statistics Manual 3 Revised), which the ISSD (International Society for the Study of Dissociation) solved by having MPD renamed to DID because of the confusion that resulted from the word personality being used in the former name. DID/MPD has always been under the category Dissociative Disorders and was never found in the Personality Disorders section. The use of the word personality was confusing to not only professionals of mental health, but clients and laypersons as well.
3. Dissociation: How does a person “get” DID/MPD?
DID is caused by trauma during childhood. There is a dissociative spectrum running from everyday dissociation (example daydreaming) all the way to the other end, which is, DID/MPD. It can occur when a child is traumatized by physical, sexual, emotional, and/or mental abuse. It can also occur by not having their basic needs met; i.e. food, shelter, and/or love. It can also be caused by extensive and/or invasive medical procedures such as transplants, being born premature, on a ventilator, separation from mom and dad. Any combination of this can start the child moving down the dissociative spectrum. The longer the trauma or combinations of traumas exist the further down the spectrum the child can move. Children are different meaning that for one child one instance of trauma is enough to move them all the way to DID while for another child the same trauma only moves them a little way. For other children it takes multiple traumas to move them down the spectrum. But the movement down the spectrum no matter how slow or fast the first instance of trauma must take place before the child is 8-9 years old.
In psychological terms dissociation means “that a person mentally distances themselves from traumatic situations or emotional distress.” By using dissociation, a child can mentally remove him/herself from a dangerous, frightening and physically painful experience.
A child of say 5 years old does not have the knowledge or the ability to deal with a physical or sexual attack. Most likely by somebody s/he loves and trusts. The child cannot understand why this person whom s/he loves is hurting him/her in this manner. Most children during sexual abuse feel pain and pleasure. They have no way to comprehend that kind of pain or at times pleasure. So the child goes somewhere safe and happy inside their mind by dissociation. The mind creates an alternate personality (Alter) to come and deal with the abuse.
The more abuse the child experiences the more alters s/he may have. Each alter with its own “relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.” Dissociation to the point of forming Dissociative Identity Disorder is a sane and healthy response to an insane and unhealthy situation.
Dr Colin Ross founder of The Ross Institute for the treatment of Dissociative Disorders said, “Multiple Personality Disorder [This quote was given prior to the name change from MPD to DID] is a normal thing to have if you have suffered severe childhood abuse.”
4. “How common is DID/MPD?”
DID/MPD was once thought of as a strictly rare disorder, but as more and more reports of severe early childhood abuse come in the easier it is to understand that it is not rare at all. In fact it is estimated that about every 3 in 5 (60%) of children who are severely abused have some degree of dissociation. Whether they move to DID depend on the child. All children are different so the abuse or stressors it takes to cause one child to go multiple would not necessarily cause another child to go multiple.
5. “How impaired is the person with DID/MPD?”
The range of impairment across different persons with DID/MPD is best analogized to that of alcoholism. Impairment due to alcoholism
* Ranges from skid row bums to high functioning senators, doctors, and corporate executives.
* Alcoholics from one period of time to another can function through binges, different patterns of drinking, life stressors, etc.
It is much the same with DID/MPD. There are some multiples who are chronic state mental patients, others who undergo recurrent hospitalization due to self-destructive behaviour, and many more who raise children, hold jobs, in many areas such as lawyers, physicians, or psychotherapists.
6. How does being DID/MPD help?
Being DID/MPD helps a child survive traumatic abuse by allowing the memories to be stored away until such a time as the child is able to deal with the memories. Multiples inside family/alters, for the most part, are their good friends. They have come to rescue the child, endured pain, and they have hidden lots of feelings when it wasn’t safe for the child to have those feelings, for fear of further abuse or pain.
7. Don’t people with DID/MPD just use it as an excuse to get attention?
No because the large majority of people with it do not even know they have DID/MPD. For people with DID/MPD it is all about survival and staying hidden. Being multiple is what saved them as children and it is not something that would easily be shown or exposed to others. Fears of being insane or crazy stop many people with DID/MPD from seeking help or telling anyone about what’s happening in their lives.
The other reason why it is not attention seeking behaviour is because once someone is diagnosed with DID/MPD they often times believe there is something really wrong with them, that it’s proof they are crazy, they’re going to be locked up, and lose all respect in the families and/or communities. Richard Berendzen in his book, Come Here, stated it perfectly, “If your body were hurting, people would send you flowers, but if your mind is hurting they throw bricks.” Staying hidden is their only protection from persecution.
8. “Isn’t DID/MPD just an aspect of other parts of our personality? That every human has?
All humans have different aspects of their personality, but MPD/DID is not that because;
* people with DID/MPD have Post Traumatic Stress disorder.
* People with DID/MPD may have amnesia in regards to many daily activates.
* Those that do not have amnesia feel like they are trapped and being high jacked into something. They see their body doing an activity, but cannot stop it.
* An aspects cannot hide trauma or memories of abuse.
* An aspect cannot be abused individually.
* An aspect does not have its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
* an aspect does not have different IQ levels, educational likes, musical talents, political preferences, food preferences, eye glasses prescriptions, eye colours, allergies, etc
* different aspects cannot change how the brain accesses information.
* alters can and do all the above on a daily basis.
9. Is someone with DID/MPD crazy?
No, in fact it is the ability to dissociate which kept the child and then later the adult, sane. When someone is forced to endure trauma, dissociation is the normal thing to have happen.
10. Is DID/MPD and Schizophrenia the same thing?
No, MPD/DID is a Dissociative Disorder, where as Schizophrenia is a Psychotic Disorder. People with DID/MPD hear real voices inside their head because of trauma they have lived through. Schizophrenics have delusions, hallucinations, disorganized speech; grossly disorganized or catatonic behaviour and they hear people outside their head because they have a chronic form of psychosis due to a biochemical and or genetic disorder of the brain.
11. Is DID/MPD Iatrogenic (induced by therapists)?
No, DID/MPD develops long before a person ever sees a therapist. For most people with DID/MPD it has developed long before the age of eight. It is generally diagnosed around the age of 30 so the person on an average has had 25 years of being DID/MPD before they even see a therapist that can diagnosis them.
12. What types of inside family/alters are there?
I will take a moment here to mention that just as one person is not the same as another, no two people with DID/MPD will have the same mix of alter personalities within them. (In MPD circles we call the community of internal family members/alters a family/system). Each multiple (A nickname for someone with MPD) has a different history, so does each family member/alter within a multiples system. This is only a list of the most commonly found family members/alters. Some families/systems may not have all of these or may have some not even on the list.
The typical family members/alters that are found in a person with MPD include:
* Core: Almost all families/systems have a core personality. It is usually the “original child” who went away during the act of abuse that caused the first family member/alter to come out.
* Host: Usually scared, depressed and has no clue s/he could be DID/MPD.
* Protectors: Strong, angry family members/alters some have the responsibility to keep the children family members/alters safe. Others have the task of keeping the secret of the abuse.
* Internal Self-Helper (ISH): Who knows a lot about the internal family/system and wants to help everyone for the greater good of all. Sometimes they know a great deal of information about each family member/alter and are usually great help in the therapy process.
* Fragments: Not fully formed alternate personalities. They only have a single memory or two about specific abuse acts.
* Child Members/Alters: Range in all ages from an infant to age eight or so. Child members/alters behave like children. They want to play, colour and watch cartoons. Those that suffered abuse are often times destructive and depressed.
* Preteen (Tweens): Range in age from 9-12.
* Teenager: Members/alters are between 13 and 19 years of age. They are typical teenagers, smacking bubble gum, listening to loud music, wanting to go to parties and hanging out with other teens.
* Adults: Members/alters in the family/system over 20 years old. They are very individualistic and may have many talents the host does not have.
Within the categories of Child, Preteen, Teen and Adult members/alters they can be sub groupings of personalities that can be any of the following;
* Artistic/music: Members/Alters who enjoy music and artistic pursuits often times create beautiful works of art that the host has no idea where they come from. The host also has no talent him/her self to ever create such a thing.
* Cross-gender: Members/Alters who are the opposite sex of the physical body. They may or may not have a different sexual orientation than the host.
* Cross-coloured: Members/Alters that are different races then the physical body.
* Animal members/alters: Any form of animal, but mainly powerful fighters, born to protect. (Examples wolves or werewolves, dragons, tigers, vampires etc.)
* Inanimate members/alters: Objects void of feelings, seeing, hearing, speaking (i.e.: rocks, trees, walls)
13. Do alters ever have different physical characteristics?
Yes, it is not uncommon for alters to have different, eye site, eye colour, sense of smell, foods they like and don’t like, amount they eat, amount of energy they have, hand that is dominate, educational knowledge. When body scans are done of a multiples body it shows physical differences when they switch as well as different pathways for accessing information in the brain.
14. Are there medications specifically for DID/MPD?
No. DID/MPD is neither a chemical imbalance nor a psychotic disorder, because of that drugs for depression rarely work unless there is coexisting conditions. Anti psychotics never work because DID/MPD is not a psychotic disorder. People with DID/MPD can often times find relief with anti-anxieties such as Vistaril because those drugs effectiveness is not based on a chemical imbalance.
15. What is the difference between Cooperation, Spontaneous Integration and Planed Integration?
Cooperation and Integration are both finishing choices of healing. Each family/system has to make the choice together as to how they want to live. Spontaneous Integration is where the mind integrates one or more alters without warning or plans.
Therapists may tell you that in order to truly heal you must integrate. That is not true. I have known some people living in cooperation that were much healthier than those who had integrated and visa versa. How a family/systems decides to finish their healing is a choice to be made as they see fit. It will be there life when they are done not their therapists and how they want to live needs to be decided by the ones who will be living it.
Cooperation is a state of living in peace with everyone inside. Things are laid out and discussed with everyone. Choices are made with everyone being involved. All DID/MPDs need to reach this point in order to heal. But many decide to live out the rest of their lives this way.
Spontaneous Integration is where the mind integrates one or more alters itself. Many believe this to be the way to go over planed integrations. Based on the fact that the mind was smart enough to come apart to survive it will also know when it is safe to come back together. Families/systems that choose to go this way live in cooperation and does all the healing work. When each alter is totally done with their healing they spontaneously integrate. Many people ask, “Well how do I know when someone is done healing?” Spontaneous integration takes out the guess work of planed integration because it won’t happen until the alters are truly done.
Planned Integration is done towards the end of therapy. Where two alters will decide they don’t want to be separate anymore. They will blend together generally by walking into one another and meshing. This can be done as many times as is wanted by the family/system. Some only do this a few times and then the rest live in cooperation, while others will integrate down to one person. However planned integration is very hard to do. It takes very specific healing steps that have to be finished first. All abuse issues need to be taken care of and a level of stability has to be maintained for the persons left. Healthy coping skills have to be established and used daily or else the integration will come apart at the first sign of stress. A person with DID/MPD has established coping skills, which they have been living with for years; it takes a lot of work and commitment to establish a new way of life.
16. Does integrating mean that alters disappear completely?
No, if integration is successful the person that is left is a blend of all alters.
17. Why do I think DID/MPD is a gift?
Very simply stated it is a gift because being a multiple helped the child to stay alive. It allowed them to protect themselves and remain sane in the face of severe and often time’s long lasting abuse. It allowed them to endure the bad times and to keep their heart and soul safe from their abusers. I am very grateful for the others here with me. We have been able to survive unspeakable and unthinkable abuse together and come out on the other end strong and with a will to live.
Without DID/MPD myself and many of my multiple friends would, I truly believe, be dead right now. To me DID/MPD is like the dashing hero that pushes a child out of the way from a speeding car. Even though that action causes them to be hit by the car. They do it willingly. Just as society would rightly hold that hero in the highest regard, I hold my inside family members/alters and family/system which saved my life, in the same manor.
However, as much as DID/ MPD is a gift; it can still on some days be a difficult thing to live with. Just like in a “real community” there are “people” in my family/system that are good, a few that act inappropriately, some that understand what is going on, some that don’t, and some that do but refuse to believe it! Often times these other personalities will “switch”, and come out, taking control of the body and its activities. Sometimes things that were supposed to get done one day don’t. But we continue to learn and to grow together. Working hard each day to make sure that things improve and that the old unhealthy ways of life do not continue. Each day is new and we are able to start over and learn.
In conclusion, I’d just like to say that DID/MPD is a normal response to an insane situation. A person with DID/MPD is not crazy or psychotic. It allowed them to protect themselves and remain sane in the face of severe and often time’s long lasting abuse. It allowed them to endure the bad times and to keep their heart and soul safe from their abusers. As family and friends of people with DID/MPD I urge you to be supportive and non-judgmental. I know it can be hard to believe, accept and process, but the person with DID/MPD will heal and grow with or without you. I know that from the statements of myself and others we would much rather do it with the support of family and friends then without it.