Understanding Dissociative Identity Disorder

A practical guide to what it means to have Dissociative Identity Disorder.

Introduction: If you’ve recently realized you have DID

If you have recently come to believe you have DID, or you’ve been diagnosed, you may be feeling overwhelmed. You may feel like your world has become unsteady overnight. The purpose of this page is to explain some of the basics of DID and point you to additional answers and content on the website.

What having DID actually means

DID in plain language

People are sometimes surprised to hear that DID, as complex as it can be, is built upon two types of core symptoms. The first kind is what is called “identity disruption.” That’s a technical way of saying “having alters.” The second involves memory gaps. The technical term for this is amnesia. Everything about DID grows out of these two features, even though they can show up in many different ways. Ongoing and severe abuse or neglect during a specific window of early childhood development lays the groundwork for DID. To understand why DID looks the way it does now, it helps to understand how it began.

DID as a Developmental Adaptation

DID develops in early childhood as the result of ongoing and severe abuse or neglect. Typically, this involves a caregiver. Young children are completely dependent upon caregivers; without caregivers, children will die. Children face a fundamental problem when the caregiver they depend upon is sometimes also a source of fear. When this happens, children have two biologically wired instincts demanding opposite reactions simultaneously. One instinct says, “Turn to your caregiver for support and protection.” The other says, “Flee this threat!”

In such situations, these two opposing instincts are both present and activated within a single body. This poses a problem because they cannot both happen at the same time. The mind of some individuals has a creative and elegant solution: to have different parts of the mind respond based on whether they are interacting with the scary or threatening caretaker or the loving caregiver. One part of the mind specializes in connecting with the loving caregiver. The other specializes in coping with the threatening caregiver, such as learning how to minimize the danger by becoming quiet and not demanding attention.
You can see that this is not random fragmentation of the mind. It is purposeful adaptation to inescapable and demanding conditions. Technically, DID is a failure of the personality to become connected rather than to shatter as some people believe. This is why DID doesn’t happen beyond early childhood. After early childhood, the personality has already begun integrating. Trauma that occurs later may lead to other dissociative conditions, but it does not create DID.

The most important thing to understand about your DID is this: it was an intricate adaptation to extremely difficult circumstances. The DID developed as a survival response when no other survival response was enough to protect your life. I talk more about this in DID Didn’t Break You. It Kept You Alive if you’d like a deeper explanation of why this is not an exaggeration.

Why DID Doesn’t Get Noticed Until Adulthood

If DID develops in early childhood, many people wonder why they were unaware of it until adulthood. It can be diagnosed in childhood but rarely is. For one, children living in traumatic and abusive situations aren’t likely to be taken to a mental health professional, if for no other reason than fear of the abuse being discovered. DID behaviors such as switching can be written off as kids simply being moody or having big emotions they don’t yet know how to handle. Alters might be dismissed as imaginary friends. In many cases, symptoms are attributed to other conditions, such as ADHD, behavior issues, anxiety, or oppositional defiant disorder. And remember, DID is designed to remain unnoticed by fitting in to whatever the situation requires. This is one way it protects children in unsafe environments.

DID can be identified in adulthood for some of the opposite reasons kids are not. For instance, adults with big emotions and mood swings are likely to be assessed for a mental health diagnosis. Adults don’t have imaginary friends or report others inside their head having conversations or commenting on what is happening.

Adults with DID often live in very different circumstances than when they were growing up. They have much more control over their lives. Even if they don’t feel “safe,” the fact that their lives are safer can make it possible for the system’s dissociative barriers to decrease. As dissociative barriers weaken, symptoms become more pronounced. For instance, switching might occur more often and result in people not remembering conversations they had with others or buying possessions or clothes that now appear in their homes. Alternately, adult lives are often full of many stresses: financial, work, parenting, and so on. Stress levels can increase to a point where they overwhelm the system’s ability to maintain the dissociative barriers at their usual level. This leads to symptoms becoming less controlled and more noticeable. Therapy can lead to a discovery of DID even when it is focused on treating a different issue, such as anxiety or depression.

How DID Is Organized Internally

Alters

Alters (or “parts” as they are also called) are distinct self-states. With DID, the ongoing abuse and neglect create unpredictable conditions that the child had to be prepared to deal with. In the simplest form, the child needed a way to connect with a loving caregiver when they had the opportunity and to cope with a threatening caregiver when there was no way to escape. If you imagine a caregiver whose moods shift due to a mood or substance use disorder, you can begin to see how having different self-states (alters) who specialize in responding to each can be helpful. One alter might specialize in being happy for a depressed caregiver. Another might specialize in fawning or caretaking of an angry caregiver as a way to reduce the potential for harm.

When this happens early enough, these self-states remain unintegrated. In people without a dissociative disorder, similar self-states eventually integrate and feel like “parts of me” rather than separate others. It can help to think of it like this: many people wear different “hats” throughout the day. There is an employee “hat,” a parent “hat,” a little league “hat,” and so on. They all feel like you, but they are versions of you focused on a particular role. Self-states are similar, except even though they are all parts of you, they do not feel like “you.” They feel separate.

Your alters developed at different times and hold different roles or functions. That is why some alters seem very young, perhaps even so young that they can’t speak, while others are teens or adults. In people who already have DID, additional alters may form under extreme stress later in life. Alters tend to specialize in particular roles, with some holding trauma memories so that others can cope with daily life unaffected. Some alters or parts are protectors, others manage the system, and others may focus on handling daily life. In some systems, the parts may become even more specialized, with one or more who handle work, others who socialize, and others who manage the home and kids.

One helpful way to understand alters is through the Structural Dissociation model. In simple terms, alters often fall into two broad patterns: those who manage daily life and those who protect the system or hold traumatic experiences. Alters who protect use different instincts to do so. Some alters protect by fighting (or being angry). Other protect by being scared and hiding or fleeing. Some protect by fawning and caretaking. And so on.

Alters are not imaginary. Research using brain imaging has found measurable differences in activation patterns between alters in people with DID. In contrast, when individuals without DID attempt to simulate alters, those patterns do not appear in the same way.

Hosts & System Variation

Systems are unique. However, there are some common variations. Many people wonder if they can have DID if they have no clear host or if the host seems to rotate among several alters. DID does not require a single host. Some have a single host at any given period but who hosts changes every few months. Others have several alters who share hosting duties as needed. In some systems, there may be no host; in these cases, the alter best suited to the immediate need fronts and handles the situation. And, of course, there are systems with a dedicated host.

How alters communicate

As with hosts, there are some common variations in how systems communicate:

Voices
The form of communication within a system that is best known is that of hearing voices.
Thoughts
Communication may also come in the form of thoughts which the person has but which do not feel like “theirs.” Thoughts can also be repeated or even intrusive and be attempts at communication.
Emotional surges
Some communication happens without words. One such form is to feel emotions which may not feel like your emotions. Sometimes when the emotions feel like yours but do not match the situation, this can be an alter communicating.
Impulses
Experiencing an impulse or urge to take an action can be a form of communication from other alters in your system.
Silence
Silence isn’t always a refusal to engage. Sometimes it is communicating a message, such as the part doesn’t feel safe enough to respond.

How awareness is shared

Awareness within a system can range from little or no shared awareness to full co-consciousness. Some parts have no awareness of other members of the system. Parts may share partial awareness or memories with some parts but not others. On the other end, some alters may experience co-consciousness.

Co-consciousness can also vary. Two or more parts may be aware at the same time. One may be fronting while others observe. Sometimes information is shared. Sometimes it is not. In some systems, whoever is fronting can hear conversation or commentary in the background; this is also a form of co-consciousness.

Blending

Blending can be a form of co-consciousness and is often confusing. In some instances when blending occurs, two alters are aware of each other but unable to identify what is the other and what is themselves. The identities blur together and emotions overlap. In other instances, the blending is more subtle and may look like the individual who is fronting feeling emotions which don’t seem to make sense. These would be the emotions of the other alter, blending with the consciousness of the fronting alter. This can be confusing to the alters involved. Note that while this has some similarities with the idea of fusion, this is a temporary occurrence and not a structural change within the system.

Why DID can feel more intense after you realize it

Becoming aware of having DID can sometimes feel like symptoms are becoming more frequent or more intense. In most cases, these symptoms are being noticed for the first time. Before this, those same experiences existed, but they were in the background and part of the person’s “normal.” A realization of DID causes people to take a closer look at their experiences and begin noticing them more.

DID was designed to not be noticed. Through the use of dissociative barriers, experiences are kept segregated so that only particular alters have access to them. Alters without access are often unaware that there is information they are missing. When healing begins, these dissociative barriers begin to lower and allow some content into awareness. This new awareness can feel destabilizing and may be mistaken for DID worsening.

As awareness of others within the system grows, alters may increase attempts to communicate or may react to the changes in the system. For instance, protector parts may increase their activity. Trauma-holding parts may move closer to awareness or attempt to share memories before the system is ready. This can feel chaotic, or as though the DID is becoming worse, but it is a predictable part of the healing journey.

Many people are surprised when realizing they have DID leads to more doubt instead of less. Doubt increases because awareness comes and goes. The amnesia inherent in DID means that symptoms may feel undeniable at one moment and absent the next. Doubt does not disprove DID and is a common part of the experience of coming to terms with having DID. For a deeper exploration of the doubts common to diagnosis of DID, see the Doubts SIAP.

All of this together can make early awareness of DID a challenging time. Increased switching, exhaustion, information overload, and emotional intensity are common at this stage. For many systems, this early destabilization settles over time. As you increase your understanding of your system, the experiences can become more predictable and manageable over time.

What is normal in early DID awareness

So many experiences in DID, especially early in awareness, can seem unusual or even disturbing. It can help to know what is normal in this phase.

Some experiences may appear to become more frequent or more intense. For instance, you might think you are switching more often than before. In many cases, you are simply more aware of switching that was already occurring.

You may also notice an increase in internal conflict. This may reflect your new awareness of the system. It may also be that parts are becoming more aware of each other than they were previously, creating more opportunities for disagreement. Either way, you may feel unsettled and worry that your DID is worsening. Often, what looks like worsening reflects dissociative barriers beginning to shift, the same process described earlier when awareness increases.

Early in DID awareness, you may find yourself on an exhausting merry-go-round of emotional whiplash, doubt, and fear that you are somehow making it all up. All of this contributes to the exhaustion that is common at this stage. As dissociative barriers diminish and awareness increases, there is simply more to consciously manage. Attempts to communicate internally and closely monitor your system can add to the fatigue.

Finally, you may feel compelled to deeply research DID, searching for evidence that disproves it or finally eliminates your doubt. In this process, you may be exposed to social media content that is inaccurate or sensationalized. It can be hard to tell. Comparing yourself to what you see online may increase fears that you are not “DID enough.” Remember that DID presentations vary widely. Differences do not invalidate your experience.

What DID is not

There are many misunderstandings about DID. This is a brief overview of some of them.

DID is not the same as Schizophrenia
People confuse hearing voices in DID for hearing voices in Schizophrenia. The quality of the voices is quite different. In Schizophrenia, the voices are hallucinations. In DID, they are from other self-states (alters) in the system. Many people are surprised to learn that hearing voices is more common in DID than in Schizophrenia.
DID is not the same as psychosis
With psychosis, a person is no longer in contact with reality. People who have DID are firmly in touch with reality. They can tell you what is real and what is not.
DID is not Borderline Personality Disorder
BPD can involve big emotions and sudden, big mood changes. DID can be mistaken for BPD if the cause of the big emotions and mood changes isn’t noticed. Oftentimes, switching explains the sudden changes in mood or emotion in DID, which is not the case in BPD.
DID is not attention seeking
While there may be people who fabricate having DID intentionally in order to get attention or feel special, people who truly have DID are not seeking attention. In fact, it’s quite the opposite: DID works hard to go unnoticed by everyone.
DID is not inherently dangerous
Some people equate DID with the risk of violent behavior. As is true with most mental health conditions, people who have DID are far more likely to be the recipient of violence than the person delivering it.

What healing generally looks like

It’s important to know that healing DID is not a quick process. Treatment is typically talked about in terms of years rather than months. Treatment for DID is typically three phases. To learn more about those phases, you may want to view The Three Phases of Trauma Therapy.

The first focus of treating DID is stabilization. This means increasing safety and reducing self-harming or risky behaviors. This phase includes increasing internal awareness of the system, developing system communication, and increasing cooperation within the system. Improved communication and cooperation contribute to stabilizing the system. For instance, protectors may no longer feel their only option is to take drastic action once they can communicate with the system and arrive at reasonable compromises. This phase includes skills building and identifying coping strategies that work for you. Although some systems do not advance to the next stage, there is still great benefit to the stability this stage brings.

The next stage is what people often imagine happens when therapy starts: trauma processing. Trauma processing done before stability is achieved and skills are developed can lead to decompensation, the clinical word used to describe a drastic worsening in functioning. Decompensation can be a psychological emergency. If you are interested in learning more about decompensation, you might want to look at What Is System Collapse in DID?

The final stage of recovering from DID can be described as integration. That is, this stage of healing focuses on coming to terms with how different your situation is after the trauma processing. The way you experience life and understand your past may be dramatically different. In this stage you focus on integrating your new understandings and also on learning skills you likely weren’t taught growing up, such as how to make and hold boundaries or how to determine if someone is trustworthy.

It is important to note that, at CommuniDID, fusion is not the only form of healing viewed as valid. Functional integration is also seen as a legitimate and worthy outcome. In fusion, all of the alters become “fused” into a single identity. In functional integration, all alters remain as individual self-states but they function together as a whole through communication and cooperation. Each system should choose the outcome that they believe is best for them.

Finally, it can help to know that healing DID can be messy and irregular. Progress is not linear. Progress can be followed by temporary setbacks or destabilization. Sometimes after periods of growth it seems that all progress stops. These plateaus may seem like a time of no healing externally. But within the brain, plateaus are times when new learning and healing is consolidated and deepened, setting the stage for further healing in the future.