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= Dissociative Identity Disorder (DID) =

Comprehension of trauma and dissociative disorders has rapidly increased in recent years as researchers target this historically misunderstood subject. This site conveys up to date information as reported by the International Society for the Study of Trauma and Dissociation, (ISSTD) as well as other current material. In 2012, some of the most notable members of the ISSTD created an impressive 74 page document which includes a definition of the three expert, accepted models of Dissociative Identity Disorder (DID). Each of the models state that DID does not arise from a "core personality" or "unified mind" that becomes shattered, instead DID results from a lack of integration in early childhood as told in this quote from the long document.

"In short,these developmental models posit that DID does not arise from a previously mature, uniﬁed mind or “core personality” that becomes shattered or fractured. Rather, DID results from a failure of normal developmental integration caused by overwhelming experiences and disturbed caregiver–child interactions (including neglect and the failure to respond) during critical early developmental periods. This, in turn, leads some traumatized children to develop relatively discrete, personiﬁed behavioral states that ultimately evolve into the DID alternate identities. (ISST-D Adult Treatment guidelines)"

All humans begin life with an unintegrated personality. The process of normal integration takes place in childhood and it lasts a few years - it is not instant. When there is enough trauma and a lack of nurturing during this time, then the normal process of integration is interrupted.

Everyone's personality is made up of states, but those with DID have barriers around theirs due to early childhood events, so the personality states are isolated and never integrated. Dissociative Identity Disorder (DID), [1] was known as Multiple Personality Disorder (MPD) in the United States until 1980, and still is in many parts of the world. The ICD-10 Classification of Mental and Behavioral Disorders [2] retains the label of MPD.

Why is DID so hard to understand?
It's been difficult for health care professionals to catch up with the current knowledge. Perhaps because this mental disorder is one of the most complex and demanding topics in psychology and easily the most complex of the fundamentally non-organic psychopathologies. It could also be because there is a small, fringe group of skeptics in psychology, that distort accurate information, making it more difficult for people to comprehend the concentric consensus of those who study DID. [6]

What is a simple explanation of DID?
Every human starts out with an unintegrated personality. The process of normal integration takes place in childhood and it lasts a few years - it is not instant. When there is enough trauma and a lack of nurturing during this period of time, then the normal process of integration is interrupted. [4] Everyone's personality is made up of parts (states), but those with DID have barriers around theirs due to early childhood events, so their parts are isolated and never integrated. [4] Therapy works to slowly dissolve trauma barriers and eventually coconscious between parts is gained, and then finally, after years of work, the parts of the personality will be able to integrate and can operate like a normal brain - which is not one part, but many parts of the personality working fluently together. [4]

Where can I find accurate information about DID ?
If you have been diagnosed with DID then you probably have many questions. Finding answers that are easy to understand, yet still in depth enough to not leave you wondering is currently quite difficult, but hopefully this site will be able to help. We consider the questions that both the person with a new DDx (diagnosis) might have as well as someone who has been in treatment for years. The questions and answers here will be reviewed by a health care professional who specializes and treats the dissociative disorders, including DID.

Is categorization by signs and symptoms or cause?
The DSM presents the minimum symptoms of DID that are needed to diagnosis it. Paul Dell, in his landmark 2006 study, has described all the known signs and symptoms of DID. Etiology is a whole other matter. The models of DID attempt to create a construct of why and how DID is caused. There are three models accepted as of 2012 and all are based on childhood trauma. [6] How many alters does a person usually have? The number of alters in a system can range from few to many. Systems that range in the teens is the norm. [5]

What is Polyfragmented DID?
Those who have DID and have over 100 alters are polyfragemented. "Extreme versions of DID occasionally develop in response to particularly horrific ongoing trauma with polyfragmentation encompassing dozens to hundreds of personality states. In general, the complexity of dissociative symptoms appears to be consistent with the severity of early tramatization." [29]

What is a sub-system in DID?
In very large systems alters can be separated into sub-systems. The organization appears to be unique to the individual. A system broken into these types of groups can have any arrangement and usually few alters know the other sub-systems exist until barriers begin to be broken down in therapy.

How common is DID?
DID is found in all cultures [23] and is probably more common than Schizophrenia. Studies report that DID has been identified in just over 1% of the general population. That means that if the worlds population is 7 billion and at least 1% of general population has DID, then more than 7 million people have DID. [23] Reasonable estimates suggest that 5 to 58 percent of psychiatric hospital patient [27] and 2 to 6% of the general population suffer from one of the DD's.

Can anyone really have more than one personality?
Everyone, even those with DID only have one personality, and everyone has multiple parts to their personality. In DID the parts are so dissociated, due to childhood trauma, that they meet the criteria for alters. As the brilliant author of the 2011 book, Understanding and Treating Dissociative Identity Disorder: A Relational Approach, Elizabeth Howell states, "it is the degree of dissociation between self-states...[5a] " (parts of the personality) that distant dissociative parts from normal parts of the personality.

Is any alter a complete personality?
DID is characterized by "identity fragmentation, rather than a proliferation of separate personalities." [1a] In other words, no alter is a complete personality.

Is the host a complete personality?
A common misconception is that the host is a complete personality, but it is not. It is simply another alter or dissociated state that needs all the other parts of the personality to communicate and work fluently so the whole can function normally.

Does the person with DID know it?
Those with DID are often unaware of their mental disorder and the alters are often unaware of each other. The alter (host) that is usually in control of the body is often the least aware. [5] Think of it this way: if you have heart disease, you can have symptoms without knowing you have the disease. Once you enter treatment, the symptoms become clear as you are educated and you begin to work on healing. This is as true with mental disorders as it is with physical disorders.

If I have DID do I need a specialist ?
As a patient, your task is to find someone who is proficient in diagnosing and working with your particular disorder - whatever that disorder may be. DD's are a specialty, no different from the fact that a cardiologist is a specialist. If you showed symptoms of cardiac disease, then your general practitioner would refer you to a cardiologist - a specialist. Make sure that if your therapist believes you have a DD, and they are not a specialist, that they help you find a qualified therapist to work with you. This specialist will have no problem distinguishing the various DD's from each other.

How do I find a specialist in DID?
This is not an easy task. Even therapist that work with trauma, PTSD and the array of dissociative disorders, often have not come in contact with a patient with DID. You can email the ISSTD and they will give you a list of professionals in your area that have completed educational requirements to treat trauma - however this does not mean that they know how to treat DID. This site is also beneficial. Also try searching for therapists in your area that treat DID by putting key words into a search engine such as Dissociative Identity Disorder, EMDR, ego parts therapy, etc...