“As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on ... It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make sense of it.”
― Deborah Bray Haddock, The Dissociative Identity Disorder Sourcebook
Dissociation is defined by the American Psychiatric Association (APA) as a disconnection between one’s conscious awareness and aspects of one’s environment, experiences, or perceptions (2013). Dissociation is very common, so much so that some claim that it is the third most common mental health symptom (Cattell and Cattell, 1974). Individuals can experience dissociation for many reasons. Causes or triggers can vary from temporary stress to clinical anxiety to chronic childhood trauma (Brown, 2006; Cattell & Cattell, 1974; Holmes et al., 2005; Lochner et al., 2004; Mula, Pini, & Cassano, 2007; Spiegel et al., 2011). In some cases, dissociation can serve as a coping mechanism and buffer individuals from overwhelming life circumstances. However, when dissociation is severe or long lasting, it can be disabling (Spiegel et al., 2011).
The Diagnostic and Statistical Manual (DSM-5) includes five dissociative disorders. These are dissociative identity disorder (DID), dissociative amnesia (DA), depersonalization/derealization disorder (DPDR), other specified dissociative disorder (OSDD), and unspecified dissociative disorder (UDD). However, these are not the only conditions in which dissociation plays a prominent role. Somatic symptom disorder, conversion disorder, trauma-and-stressor-related disorders, and borderline personality disorder can also be conceptualized as primarily or often dissociative in nature. Additionally, dissociation has been found in many individuals with anxiety disorders, mood disorders, eating disorders, schizophrenia spectrum disorders, and obsessive-compulsive disorders (Lochner et al., 2004; Mula, Pini, & Cassano, 2007; Van der Hart, Nijenhuis, & Steele, 2006).
Despite this, dissociation is poorly known and poorly understood. Neither the general public nor most mental health practitioners know much about dissociation, how to recognize it, or how to treat it (Steinberg, 2000). As a result, many individuals with clinical dissociation or dissociative disorders suffer in silence.
Out of all of the dissociative disorders, DID is perhaps the best known and yet the most poorly understood. Previously known as multiple personality disorder, DID is plagued by myths and misconceptions that are spread by the media, general public, and professionals alike. Though a wealth of evidence supports that the disorder results from repeated childhood trauma, DID is frequently portrayed as the result of fantasy, the need to repress socially unacceptable desires, a single moderately traumatic childhood experience, or adult trauma. Though DID is in no way related to schizophrenia or bipolar disorder, the media consistently confuses these conditions. Focus is always aimed at the most unique aspect of dissociative identity disorder, the numerous alternate personalities that it results in, but attention is rarely ever given to symptoms of derealization and depersonalization, to co-morbid posttraumatic stress disorder or depression, or to the intense feelings of denial, shame, betrayal, and isolation that are so common among survivors. Time loss is a well known symptom of DID, but passive influence is not. Doubt in the disorder is treated like a personal position on the validity of a myth instead of a sign of pervasive ignorance that emphasizes the need for current research to be more widely shared and understood.
This site aims to fill a void of comprehensive yet accessible resources pertaining to trauma and dissociation. It serves to promote awareness and understanding of a variety of topics pertaining to dissociative identity disorder, other dissociative disorders, trauma, and trauma's effects as well as to present current research and validated sources to the general public in a more easily understandable form. A secondary aim of this website is to promote connecting dissociative trauma survivors to research studies in order to contribute to scientific progress on these subjects.
Sources on this page
American Psychiatric Association. (2013). Dissociative Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). http://dx.doi.org/10.1176/appi.books.9780890425596.dsm08
Brown , R. J. (2006) Different types of “dissociation” have different psychological mechanisms. Journal of Trauma & Dissociation, 7(4), 7-28.
Cattell, J. P., & Cattell, J. S. (1974). Depersonalization: Psychological and social perspectives. In S. Arieti (Ed.), American Handbook of Psychiatry (2nd ed., pp. 766–799). New York: Basic Books.
Holmes, E. A., Brown, R. J., Manselld, W., Fearone, R. P., Hunterf, E. C. M, Frasquilhoe, F., & Oakley, D. A. (2005). Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical Psychology Review, 25, 1-23.
Lochner, C., Seedat, S., Hemmings, S. M. J., Kinnear, C., J., Corfield., V. A., Niehaus, D. J. H., ... Stein, D. J. (2004). Dissociative experiences in obsessive-compulsive disorder and trichotillomania: Clinical and genetic findings [Abstract]. Comprehensive Psychiatry, 45(5), 384-391. doi: 10.1016/j.comppsych.2004.03.010
Mula, M., Pini, S., & Cassano, G. B. (2007). The neurobiology and clinical significance of depersonalization in mood and anxiety disorders: A critical reappraisal. Journal of Affective Disorders, 99(1-3), 91-9. doi: 10.1016/j.jad.2006.08.025
Spiegel, D., Loewenstein, R. J., Lewis-Fernández, R., Sar, V., Simeon, D., Vermetten, E., … Dell, P. F. (2011). Dissociative disorders in DSM-5. Depression and Anxiety, 28, 824-852.
Steinberg, M. (2000). Advances in the clinical assessment of dissociation: The SCID-D-
R. Bulletin of the Menninger Clinic, 64(2):146-63.
Van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. New York: W.W. Norton.