As promised, here is last weekend’s OTHER Mental Health Month post. Tonight we’re talking about Dissociative Disorders.
You all know how this works: we talk about what the manual classifies as disorders, then we talk about the experiences. If you would like your mental health story (substance use and LGBTQ+ also!) shared on this site for Mental Health Month, contact me here, or reach me on my social media (linked below). People have seem to like reaching out through Instagram, and I enjoy talking with people. Feel free to contact me just to chat–that’s what’s been happening most recently.
Let’s dive into it.
Like Bipolar, this section is concise in the DSM-5 and tied deeply to studies in cognitive psychology, especially when it comes to the controversy of repressed memories. You’ll recognize the first diagnosis:
Dissociative Identity Disorder: This is not a light diagnosis to come by, although it has a wild history of it’s introduction into mainstream mental health. Formally known as “Multiple Personality Disorder,” DID is characterized with identity crisis. This means someone’s personality states are split into two or more, and can affect memory, behavior, perception, cognition, and other senses. This can be reported by others, or noticed by the individual themselves. Gaps in memory of trauma or everyday events may be obvious. This, obviously, must cause severe distress. We’ll talk more about this below.
Dissociative Amnesia: This is also related to trauma. The individual will be unable to recall autobiographical information related to a trauma or stressor. This is not the same as being stressed out and forgetting your keys. The forgetting must be above and beyond that of ordinary memory decay. This can be with or without dissociative fugue.
Depersonalization/Derealization Disorder: Depersonalization is feeling detached, or outside of your body observing your thoughts, feeling, and bodily sensations. Things feel unreal, your self is absent, and your sense of time is distorted. Derealization is a detachment with respect to what is around you: objects, people, feel unreal, wrong, or are distorted. You do not leave reality but this does cause distress and impairment in everyday life.
Other Specified Dissociative Disorder: Mixed symptoms of the above types.
Unspecified Dissociative Disorder: People experience characteristics of the above, but none of it meets the full criteria. Again, your normal is disordered.
Is Dissociative Identity Disorder Real?
This is the big question everyone asks.
I don’t refute people’s experiences. If someone tells me they have 25 different personalities, I’m not going to sit there and tell them they don’t; I’m not inside their body or their brain, and I haven’t lived their life. And it seems in the science community that experiences aren’t being question either, but rather the onset of symptoms comes into question. So, let’s talk about what we DO know.
- People are distressed by these experiences. Some lose control of their lives, bounce between hospitals, treatment centers, group homes. People are reliving traumas in their body and their mind. This is not a joke.
- Repressed memories, since their conceptual birth within Freudian times and psychodynamics, have never had any real conclusive studies. Behaviors can be studied of course; biological responses can be studied, of course, but whether or not someone’s memory is correct cannot be studied. If you ever take a cognitive neuroscience or psychology class, you will learn that memories are reconstructive. That is, our brains put memories together as we remember them. They are not snapshots of the past. We retain central ideas and key themes, but we will not remember incidents or scenes as they are. Flashbulb memories, those that are caused by sudden trauma, have been shown just as unreliable as our regular memories. Researchers have actually seen this process; new neurons branch and stimulate growth as we remember something–they are not pulling from neurons that are already there. Memory is not as simple as it seems and research on repressed memories is inconclusive.
- DID has a bad wrap. It got a bad wrap from people across the country back in the day opening treatment centers, holding people who are struggled with some sort of mental distress in their lives, tying them down, and telling them they have different people living inside of them. These centers were eventually disbanded for fraudulent billing (they got a lot of money for this breakthrough treatment) and got ousted as a cult. They kept people from their families, told them their families were the ones who had abused them, and ruined a lot of lives. It took years for those people to get real trauma therapy and realize their identity was intact. There’s a documentary on one of these centers that I watched in my Research course least year. If I find it, Ill post the link. The concert today, though, is whether this kind of literal brain washing is still happening.
- Planted memories are a little more solid than repressed memories. Again, our memories are reconstructed upon remembering, so it’s been shown that people are inclined to fill-in-the-blanks sometimes, remember something that was there that wasn’t.
So, in the spirit of respecting those who know this to be their experience, and also respecting cognitive science which shows it may be possible to create these personalities in therapy, I looked up an article that compared the two causes of DID: Trauma Or Fantasy? I can’t link the study because I downloaded it from my school’s database, but if you’re interested in reading it, contact me.
Researchers compared four different groups: Genuine DID diagnosed individuals, DID simulating individuals (people acting), people with PTSD, and a healthy control group (“healthy” meaning unaffected by a condition). Long story short, results showed that those in the Genuine DID group were not more prone to suggestive memories nor were they more likely to generate false memories. There are some limitations with this study, one being that it was a small group of people and that their malingering results came back inconclusive; I didn’t see them list any reasons for this. They used reliable and valid testing measures, but didn’t experiment, which is a big problem if they’re really trying to challenge the fantasy model of DID.
The point of all this scientific arguing? People’s experiences are people’s experiences. I honestly don’t care if a therapist put it in your head or if you actually went through a horrific trauma. The point is you’re distressed, you’re suffering, and no one needs that in their life. As far as experience is concerned, DID is as real as any other condition.
Does Your Trauma Need To Be Severe?
This is a hard question. When it comes to DID, it’s highly unlikely those series experiences are going to come after something like your verbally abusive dad. I’m not saying it can’t, we don’t know everything there is to know about the brain or how it processes things that harm us, but it is unlikely. However, derealization and depersonalization are common in people with anxiety and PTSD.
My second depersonalization episode happened when I was 15. I remember (and there’s a chance I’m remembering incorrectly, remember?) sitting in the passenger seat of my mom’s car as she drove me to school. I usually rode my bike or walked, but it was raining particularly hard that day. I felt myself floating, my spirit, and I was leaving my body. The inside of the car didn’t feel real, my arms didn’t feel real, and the experience of life wasn’t real. I told my mom, I said, “see, there it is again, none of this feels real. The car doesn’t feel real. It’s weird.”
I don’t remember if she said anything. But from that point on, dissociation became synonymous with living for me. I walked across four lanes of traffic and the three miles home with friends shouting at me, shaking me, calling my name, and I was lost in a void. I don’t remember them shouting at me. I don’t remember them touching me or that I’d narrowly escaped death. What I do remember is blackness. Becuase that’s all I saw.
It wasn’t painful.
It felt ethereal almost. I’d shed my physicality. I’d shed my ego, my anxiety, my worry, my fear. I’d shed my anger, and I had a lot of it back then. I’d shed my need for escape. I’d shed my uncomfortable reality. And, as strange as this sounds, it felt damp and warm, the blackness did. I couldn’t feel it how we feel, say, water on our skin, but I felt it in a purely infinite, internal sense. I felt spread across eons and for the first time I felt complete.
In our world, we diagnose this as dissociation, but I have not been convinced. This felt like I experienced raw life, real life, what we are outside of these meat sacks. But that’s a whole other conversation.
I remember walking through the door of my apartment and my dad asking me how school was. That, and the void.
I was never sexually abused or physically beaten to the point of hospitalization. I’ve never been in a car accident or a house fire. By big trauma event standards, I’m pretty low on the scale. I have endured repeated emotional and verbal abuse, some physical violence, homelessness, schooling terrors, and an alcoholic/drug addict parent while growing up. There are painful memories and a lot has stuck with me. So, the answer to the above question is, no. If something hurts you, your body and mind respond in the best protective coping mechanisms it can. Sometimes it needs to yank you out of the physical world and remind you who you are.
Does Excessive Day-Dreaming Count?
By DSM standards, no.
But, if your day-dreaming becomes so distracting that you find yourself struggling day to day, it’s worth talking about.
Thank you all for coming down this road with me. Mental health isn’t just my job or my personal affliction, it’s also my passion to share my experiences and knowledge, and to be apart of this kind of writing community. I am terrified of speaking and haven’t yet climbed over that hurdle, so writing is the next best way for me to be active in mental health advocacy. Thank you for being there with me.
This Thursday, Friday, and Saturday, we will continue with Gender Dysphoria, Neurodevelopmental Disorders, and Personality Disorders. If you have a story you’d like to share with me, here are my social media handles. *Feel free to just chat with me, it’s been great getting to know all of you* My email info is linked above as well.
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