Dissociative Identity Disorder (DID) Uncovered
Many of us are familiar with the tale of Dr Jekyll and Mr Hyde, where the amiable and friendly Dr Jekyll “transforms” into the shockingly evil Mr Hyde, committing crimes and terrorising the town. While this household character comes from the world of fiction, his condition is similar to one suffered by a rare few around the world: Dissociative Identity Disorder (DID).
What is Dissociative Identity Disorder?
Dissociative Identity Disorder is a psychological disorder characterised by the presence of two or more different identities within a person. These identities each possess different traits and a unique history and can arise at different times within the person. This may lead to symptoms such as amnesia and hallucinations; as this results in one losing his/her connection with reality, DID is classified as a dissociative disorder.
DID is considered an uncommon condition, affecting an estimated fraction of the population. Females are considered more vulnerable to DID than males and are often more likely to be diagnosed. Prevalence estimates vary because Dissociative Identity Disorder is frequently misunderstood and sometimes misdiagnosed, especially in settings where trauma is under-recognised.
Is DID the Same as Multiple or Split Personality Disorder?
Yes, Dissociative Identity Disorder was previously referred to as Multiple Personality Disorder. However, the word “multiple” was replaced with “dissociative” to better indicate the absence of a singular identity, rather than the mere presence of several. Additionally, “personality” suggests stable, enduring traits; “identity” better reflects the shifting sense of self and memory that people with DID experience. Understanding these nuances helps reduce stigma and improves empathy for those living with DID.
Occurrence with Other Conditions
It is possible that other conditions can arise in tandem with DID. Such disorders include:
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive-Compulsive Disorder (OCD)
- Sleeping Disorders
- Personality Disorders
- Eating Disorders
Co-occurring conditions can intensify distress, complicate daily functioning, and make assessment more complex. A trauma-informed, non-judgmental evaluation is key to distinguishing DID from look-alike presentations (for example, psychotic disorders, seizure disorders, or borderline personality traits) and to building a safe plan for care.
Causes of Dissociative Identity Disorder
Most mental health professionals attribute DID to the experience of significant trauma, particularly during early development, such as:
- Physical Abuse
- Sexual Abuse
- Severe Psychological Abuse
- Natural Disasters
- War
The possibility of developing DID increases when such trauma is experienced during childhood, a period when a child’s sense of self and memory systems are still forming. Dissociation can emerge as a protective strategy—an adaptive way to endure overwhelming experiences by “compartmentalising” memories, sensations, and emotions. Over time, this coping response can become entrenched and distressing.
What are the Symptoms of Dissociative Identity Disorder?
DID is characterised by the emergence of “alters”, alter egos to the person’s original personality, otherwise known as the “core”. Alters may differ in age, voice, posture, handedness, language proficiency, interests, and even sensory thresholds (e.g., pain tolerance). Some alters may serve specific functions—protective, managerial, childlike, or caretaker roles—often linked to the person’s trauma history.
The emergence of an “alter” can be noticed from the following signs:
- Sudden changes in behaviour or mannerisms (e.g., voice, handwriting, posture)
- Claims to be a person of a different ethnicity, gender, age, etc.
- Engagement in different activities (e.g., sports, hobbies, or preferences the core identity does not share)
Outside of such behaviour, people with DID may also experience:
- Amnesia (gaps in memory for daily events, personal information, or traumatic events)
- Hallucinations or internal “voices” (often experienced as communication among alters)
- Anxiety, panic, and phobic avoidance
- Suicidal Thoughts and Self-Harm
- Somatic symptoms (e.g., headaches, “time loss”, or pseudo-seizures)
These symptoms can begin in childhood, but may be misattributed to learning issues, behavioural challenges, or “acting out”. In adults, Dissociative Identity Disorder is sometimes mistaken for psychosis or mood disorders. Careful history-taking focused on trauma, dissociation, and memory is essential.
How DID is Assessed and Diagnosed
A thorough, trauma-informed clinical assessment usually includes:
- Detailed history of trauma, memory gaps, “time loss”, and identity shifts
- Screening tools for dissociation and structured interviews (where available)
- Evaluation for co-occurring conditions and medical causes of dissociation
- Risk assessment for self-harm, suicidality, and safety planning
Diagnosis is based on established criteria that emphasise identity disruption and amnesia, not on sensational portrayals. Collaboration with medical professionals helps rule out neurological conditions (e.g., epilepsy) and substance effects.
Daily Life and Functioning with Dissociative Identity Disorder
Living with DID can affect work, school, and relationships—missed time, unexplained purchases, or unfamiliar messages can be confusing or embarrassing. Many people develop practical strategies: shared journals, calendars, and ground rules among parts; supportive routines; and a network of trusted allies. With appropriate therapy, many individuals increase cooperation among alters, reduce distress, and improve stability and quality of life.
Treatment of DID
DID can be treated with psychotherapeutic techniques like Cognitive Behavioural Therapy (CBT) or Dialectical Behavioural Therapy (DBT). Many clinicians use a phased, trauma-informed model:
- Phase 1: Safety and Stabilisation — improving day-to-day functioning, establishing routines, building skills for grounding, emotion regulation, and distress tolerance, and developing internal cooperation among alters.
- Phase 2: Trauma Processing — gradually, gently engaging with traumatic memories in a way that prevents re-dissociation, using approaches suited to the person’s capacity (e.g., titration, imagery rescripting, parts-informed work).
- Phase 3: Integration and Rehabilitation — strengthening a cohesive sense of self (which may or may not mean “fusion”), reducing amnesia, and reclaiming life roles, relationships, and goals.
Therapy does not aim to erase parts but to reduce distress and improve cooperation and continuity of memory. Psychoeducation for clients and families about dissociation, grounding skills, and crisis planning is crucial. In cases of comorbidity where other disorders arise together with Dissociative Identity Disorder, medication is usually prescribed to reduce the symptoms of these other disorders as well (e.g., depression, anxiety, sleep disturbance). There is no specific “anti-dissociation” medication.
Skills and Self-Help Strategies
Alongside therapy, people often benefit from practical tools:
- Grounding — 5-4-3-2-1 sensory check-ins, temperature shifts (cool water), or paced breathing to anchor in the present.
- Internal communication — journaling, scheduled “team meetings”, and respectful negotiation among parts about boundaries and goals.
- Safety plans — crisis contacts, soothing object lists, and step-by-step actions for moments of overwhelm.
- Healthy routines — regular sleep, meals, gentle movement, and limited alcohol or substance use.
Supporting a Loved One with Dissociative Identity Disorder
Offer validation (“I believe you”) and curiosity (“How can I support you right now?”). Avoid pressuring for details of trauma. Learn grounding techniques together, help maintain consistent routines, and support access to trauma-informed care. If self-harm or suicidality emerges, seek urgent help immediately.
When to Seek Urgent Help
Seek immediate support if there are thoughts of self-harm or suicide, loss of consciousness, uncontrolled seizures, or inability to care for basic needs (e.g., not eating, not sleeping). Crisis lines and emergency services can help ensure safety while you connect to ongoing care.
We recommend This Video to those who wants to learn more about Dissociative Identity Disorder Therapy.
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