The phrase “multiple personality disorder” has become known more of an insult or a joke than for the actual diagnosis, whose name was changed to Dissociative Identity Disorder some years ago. The idea that there could be different identities inside of one person is fascinating to a lot of people, and clients seem terrified that I’ll think they have it. “I don’t have multiple personalities,” they’ll blurt out as soon as I start to talk about dissociation. What’s the deal with this fascinating phenomenon?
In reality, everyone dissociates. Ever driven somewhere and when you get to your destination, you realize you don’t remember the drive? Welcome to highway trance, located on the mild end of the dissociation spectrum. Its neighbors are daydreaming, planning, and worrying. One way to think about dissociation is that it’s the opposite of mindfulness, and while mindfulness is necessary and beneficial most of the time, there’s reason to believe that sometimes we need to disconnect. Planning and worrying, while not helpful to those with anxiety issues, are actually necessary for survival and in therapy we only seek to decrease them if they’re interfering with someone’s functioning.
So let’s think of dissociation as being on a continuum, with more severe types of dissociation are further down the line. If things get severe enough, then the symptoms will merit that scary diagnosis, Dissociative Identity Disorder. The fact is, however, that very few people have this diagnosis, is associated with profound traumatic experience and is highly treatable, so there’s nothing that has to be scary about it.
So how does this occur? When faced with danger, we automatically go into fight or flight mode. Ideally, this is a literal response to get us out of danger. Unfortunately, there are a number of situations where we can’t actually eliminate the danger (fight) or get away from it (flee). But there are other ways to accomplish these.
Many survivors of injury or sexual violence report feeling that they had left their bodies during the event. When confronted with the reality that escape is not possible, the mind may check out for the duration of the danger. Another occurrence is that when fight or flight fails, then freeze will set in, which may be experienced as numbing or disconnecting. Many survivors of severe childhood trauma find that they are missing a lot of memories, even whole years of their childhood. When circumstances so overwhelm someone’s capacity to cope, then it’s possible for the circumstances to be blocked. Survivors must understand that these defenses probably minimized the damage that they experienced at the time.
However, it can be a lot of work to unlearn early coping strategies, even when they are no longer needed. This is especially understandable when you consider the fact that people who have experienced trauma severe enough to lead to this probably have a lot of other post-traumatic stress symptoms. The first step is not to see the symptoms as scary or evil, but just different ways the mind was trying to protect itself. Once someone is more accepting of their experience, then the work of integrating the mind and learning to stay present can begin.