Dissociative Identity Disorder

DID flag by scoobies

### Related Term(s)

Multiple Personality Disorder (former name), Other Specified Dissociative Disorder

### Community

Clinical/psychiatric term

Dissociative Identity Disorder (or DID) is a **trauma-based dissociative disorder** that was once previously known as Multiple Personality Disorder (or MPD). The previous name was changed because it often misled people to believe that DID is a personality disorder.

A person with DID does not actually have multiple personalities but rather a lack of one integrated identity. This is caused by compromised brain development, which results from chronic trauma in childhood.  The alternate identities in DID are actually segmented parts (the ego states) that were unable to integrate together as one singular identity.  These dissociated parts in DID are most commonly called alters, but some people might use other terms like headmates, others, etc.

## Diagnostic Criteria

> "A. Disruption of identity characterized by two or more distinct identity states, which may be described by some as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
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> B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
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> C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
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> D. The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.
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> E. The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures)."
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DID is categorized by dissociation in the form of identity alteration and amnesia, as well as distress or impairment. These symptoms are not attributed to culture, religion, fantasy, non-pathological multiplicity, substance abuse, or other medical conditions.

## Dissociation

Dissociation is a defense mechanism where the brain disconnects from reality. As a defense mechanism, dissociation protects the brain from threats when physical escape is not possible.  Some researchers theorize that dissociation can occur in milder forms, like getting lost in a good book for example. Other researchers believe that milder forms are not comparable to pathological dissociation and would not fall under the definition of dissociation to begin with.

There are five main types of pathological dissociation: depersonalization, derealization, dissociative amnesia, identity confusion, and identity alteration. Identity alteration, which is when alters take executive control of the body, is a form of dissociation that is only experienced in DID or OSDD-1.

People with DID experience all types of dissociation to some degree.

## Multiplicity

A DID system can have as few as two alters and as many as hundreds. Alters can be very distinct and differentiated from each other, but this isn't always the case. Every DID system is different!

When alters take executive control of the body, this is usually called switching. For DID, there is amnesia associated with switches. The amnesia in DID can be mild or severe, often ranging on a spectrum.

On top of dissociation and alters, DID is also associated with PTSD symptoms since it is a trauma-based disorder.  People with DID are also likely to have comorbid trauma-based disorders, eating disorders, anxiety disorders, personality disorders, and other mental illnesses alongside their DID.

While DID *is* caused by trauma and dissociation, most DID systems go for a long time being amnesiac of their own trauma and unaware of their symptoms.  Because of that, it's not unusual for someone with DID to mistake their experiences for something non-pathological like imaginary friends, spiritual possession, or non-pathological forms of multiplicity like an Endogenic System.

Since the multiplicity in DID is pathological, it shouldn't be treated in the same way as non-pathological forms of multiplicity. Doing so can be harmful to the DID system and increase their dissociation.     Alternatively, treating any form of non-pathological multiplicity in the same way as DID can be just as harmful, too.

**More can be learned about DID and alters on these websites:**

> 1. The International Society for the Study of Trauma and Dissociation (ISST-D) [1]
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> 2. Sidran Traumatic Stress Institute [2]
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> 3. Positive Outcomes for Dissociative Survivors (PODS) [3]
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> 4. DID-research [4]
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> 5. Traumadissociation [5]
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## Flags and Symbols

Many different flags and symbols have been designed over the years relating to support/awareness of dissociative identity disorder.

### Scoobies DID Flag

The gradient of black to white represents dissociative symptoms while the lines of color represent dissociated identities, or alters.

### Bastard System DID/OSDD-1 flag

Grey is for trauma/dissociation, blue is for undiscovered systems, green is for systems aware of their multiplicity, and yellow is for recovery.

### Entropy System DID flag

Black represents people who don't yet know that they're a part of a system or still have a lot of trouble communicating with their system. Orange represents systems living with functional multiplicity. White represents systems that have achieved final fusion. Designed for System Pride Day on February 23. Due to the Halloween-themed colors triggering ritual abuse survivors as well as for other reasons, the flag is controversial.

### Grey Skies DID flag

Orange was chosen for its association with Halloween and as an attempt to reclaim the stereotype that people with DID are "scary". Purple was chosen as a color to complement the orange and also works as another Halloween color. Due to similar reasons to the Entropy System's flag being triggering, the flag may trigger ritual abuse survivors and is therefore also somewhat controversial.

### Multiple personality awareness symbol by Bluejay Young of Astraea System

Created to promote awareness that MPD/DID is a real condition and that multiples can live productive lives. The interlocking symbols represent different alters.

### DID awareness flag by Redrock System

The teal represents dissociative identity disorder, the white dissociation and other symptoms, the black ring represents childhood trauma, those lost to the disorder and stigma, and the gold represents allies, support, acceptance and recovery.

### DID awareness ribbon by Coping in Crazyville

Inspired by a patchwork quilt, "a lot of pieces patched to make something new", and uses the jigsaw analogy found in the autism awareness ribbon.

### DID/OSDD/UDD Family Pride Flag by parenting-flags

Flag for a family made from members of a dissociative system. Colors are taken from Grey Skies' DID flag and a chosen family flag.

DID flag by Bastard SystemDID flag by Entropy System for System Pride DayDID flag by Grey SkiesDID flag by scoobiesDissociative systems family flag by parenting-flags
## References

1. ↑ https://books.google.com/books?id=YBSqjV6wFQQC&lpg=PA488&ots=NQy5\_8bU7k&dq=%22There%20were%20two%20main%20reasons%20for%20changing%20the%20name%20from%20multiple%20personality%20disorder%20to%20dissociative%20identity%20disorder.%20First%2C%20the%20older%20term%20emphasized%20the%20concept%20of%20%22many%22%20personalities%2C%20whereas%20the%20current%20view%20is%20that%20the%20main%20problem%20of%20these%20individuals%20does%20not%20involve%20having%20a%20number%20of%20personalities%2C%20but%20failing%20to%20have%20the%20sort%20of%20complex%2C%20multifaceted%2C%20but%20unified%2C%20personality%20that%20most%20of%20us%20have.%22&pg=PA488#v=onepage&q&f=false
2. ↑ https://information.pods-online.org.uk/a-brief-guide-to-working-with-dissociative-identity-disorder/
3. ↑ https://books.google.com/books/about/The\_Haunted\_Self.html?id=PPpxN70YLQEC
4. ↑ https://www.google.com/books/edition/Diagnostic\_and\_Statistical\_Manual\_of\_Men/-JivBAAAQBAJ?hl=en&gbpv=1&dq=dsm+5&printsec=frontcover
5. ↑ https://information.pods-online.org.uk/what-is-dissociation/
6. ↑ https://www.isst-d.org/resources/dissociation-faqs/ #8
7. ↑ https://www.isst-d.org/resources/dissociation-faqs/ #1-5
8. ↑ http://traumadissociation.com/dissociativeidentitydisorder#amnesia
9. ↑ https://books.google.com/books/about/The\_Haunted\_Self.html?id=PPpxN70YLQEC
10. ↑ https://books.google.com/books/about/Treating\_Trauma\_Related\_Dissociation\_A\_P.html?id=l\_B\_DQAAQBAJ
11. ↑ http://dx.doi.org/10.1176/appi.books.9780890425596.dsm08
12. ↑ http://did-research.org/did/basics/presentation.html
13. ↑ https://www.isst-d.org/wp-content/uploads/2019/02/childguidelines-ISSTD-2003.pdf
14. ↑ https://www.isst-d.org/wp-content/uploads/2019/02/GUIDELINES\_REVISED2011.pdf
15. ↑ https://information.pods-online.org.uk/a-brief-guide-to-working-with-dissociative-identity-disorder/
16. ↑ https://books.google.com/books/about/Treating\_Trauma\_Related\_Dissociation\_A\_P.html?id=l\_B\_DQAAQBAJ
17. ↑ https://books.google.com/books/about/The\_Haunted\_Self.html?id=PPpxN70YLQEC
18. ↑ Flag meaning on beyond-mogai-pride-flags
19. ↑ New System Pride Flag! on r/OSDD
20. ↑ What is System Pride Day? by Entropy System
21. ↑ Flags of Plurality
22. ↑ DID flag by Grey Skies
23. ↑ If This Has Happened To You by Bluejay Young of Astraea System
24. ↑ Multiple personality awareness symbol on Wikimedia Commons
25. ↑ DID awareness flag meanings by Redrock System
26. ↑ Awareness Posters & Ribbons on traumadissociation.com
27. ↑ The Autism Awareness Ribbon
28. ↑ DID/OSDD/UDD Family Pride Flag by parenting-flags