Dissociative Identity Disorder (DID)
4th October, 2011
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 personality states recurrently take control of the person’s behaviour. Inability to recall personal information that is too extensive to be explained by ordinary forgetfulness and not due to the direct effects of a substance (e.g. blackouts or chaotic behaviour during alcohol intoxication) or a general medical condition (e.g. complex partial seizures). (American Psychiatric Association 2000)
Dissociation is a brilliant piece of creative resilience, which allows some protection over traumatic forms of abuse. However, like many childhood survival strategies the mechanism itself can become maladaptive when the abuse ends, with personality fragmentation continuing.
The majority of people use some level of dissociation, simply letting the mind wander, day dreaming and fantasising. However while creating these threads we can remain aware of a continued sense of a core personality.
In its most extreme form, dissociation causes the fragmentation of the identities within one person. The complexity of the splitting of personalities is usually related to the developmental stage of the child when the traumatic abuse has occurred, this being earlier rather than later in childhood.
A major problem for those affected by dissociation is its lack of clear clinical definition. NICE (National Institute for Clinical Excellence) have not as yet produced any clear working guidelines. There has in the past been no compulsory specialist training for psychotherapists or counsellors who may well be working with those affected by dissociation.
The British Association for Counselling and Psychotherapy (BACP) is the first major umbrella organisation for this group of practitioners in the UK to take seriously the ethical difficulties in working in this area when professionals have not been adequately trained.
A goal, for therapists in the past has been the re-integration of the fragmented personalities. This practice is now under question from some practitioners who embrace a more valuing approach to the multiplicity of the individual as a whole.
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