Understanding Dissociative Identity Disorder: Phenomenology and Inner Experience

This essay discusses the related gaps in the understanding phenomenology of DID and inner experience of the patient. It covers the symptoms, risk factors, prevalence, and different opinions on dissociation as a defense mechanism. The essay concludes that dissociation works as a defense mechanism for a person suffering traumatic events but in severe conditions, it may also cause long time serious impact on memory and other physiological problems such as suicide.

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Running Head: DISSOCIATIVE IDENTITY DISORDER 0
Dissociative Identity disorder
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DISSOCIATIVE IDENTITY DISORDER 1
Dissociative Identity Disorder
Dissociative identity disorder found to be a severe health condition where two or
more different identities or states of personalities are there in an individual. Each personality
takes control alternatively. Some of the people considered it as a possession. This disorder
also associated with memory loss that is far different from ordinary forgetfulness. This
disorder is characterized by the identity fragmentation instead of the proliferation of separate
the personalities. Until 1994 it was considered as multiple personality disorder and then the
term was changed for the better understanding of this condition. The failure of identity,
memory, and consciousness has been reported in various patients with this disorder
(psychology today, 2018). The DID is a complex disorder which can be caused by various
factors including severe trauma in childhood (Webmd, 2018). Dissociative identity disorder
previously considered a rare disorder and frequency diagnosed in the 18th and 19th century
(Paris, 2012). There are still some gaps in understanding the DID phenomenology and the
real experience of the patient. In this essay, the related gaps in the understanding
phenomenology of DID and inner experience of the patient will be discussed. Another major
concern will also be argued that is dissociation is the defensive reaction in the condition of
trauma and a difficult satiation to live with.
The symptoms associated with DID are Memory loss, feeling of being detached from
ourselves and from emotions, distorted and unreal feeling about the surrounding environment
and people, stress and problems in relationships, unable to cope up with emotional and
professional stress, depression, anxiety, and thoughts related to suicide. The risk factors of
DID includes people who are abused sexually and emotionally for a longer time, people who
experience other events such as war, natural disasters, torture and kidnapping (Mayo Clinic,
2018).

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According to a report published in Medscape (2018) it was estimated that nearly 2000
children die every year because of abuse. Traumas are the main cause of death due to
physical abuse. Girls are abused more than boy’s with the ratio of 10:1. The prevalence of
DID was estimated between 0.1 % - 2 %. DSM-5 reported the 12 months prevalence of this
disorder as 1.5 % of total population of adult Americans (American Psychiatry Association,
2013). It was determined that did affect between 7.5 to 10 % people in the inpatient setting.
Particular in Canadian hospital did affect nearly 6 % of psychiatric inpatients which is similar
as in the American outpatient setting (DID Research, 2016). Almost 1/3rd of the population
with dissociation revealed that they occasionally feel that the seen themselves in a movie, 7
% people may have suffered from this disorder once in a life. But these diseases are not easy
to identify and remain undiagnosed for many years (Mental Health America, 2018).
The understanding of dissociative identity disorder is distinctive among people.
Dissociation is the adaptive response to a threat and is a form of freezing. It is a mechanism
that is used when there is no option of running and fighting (fleeing). The person shut down
themselves and draws less attention to them. In extreme situation play dead by leaving their
body and shut down mentally and emotionally (Trauma Recovery, 2013). According to
Nijenhuis, Vanderlinden, and Spinhoven (2005), the complex dissociative condition remains
in alternating psychological situations such as discrete, resistance against integrative
tendency and discontinues. Patient living with this disorder may cause confusion and distress
situations. The people with DID may experience amnesia and multiple personalities may take
place that causes the patient forgot the other personality. These conditions are difficult to
understand. The different patient suffers different symptoms and situations caused by DID
and they have a different experience of having dissociative identity disorder. A report
published by Tracy in healthy place (2018) reported the experience of some patient suffered
from DID where a women explained her conditions before the diagnosis and she stated that

DISSOCIATIVE IDENTITY DISORDER 3
she convinced herself that things happen to her were totally baffling and unexplainable, she
asked herself that did not everyone loose the track of time, their belonging s and people? Did
not everyone forget to money spent they could not recall?. One other patient with DID
experience nightmares and hallucinations but still manages to do their best and fir with other
people. The patient stated that he/she started having nightmares most of the time in the night,
used to see things that are really not there, the things that were happening out of is control so
he/she decided to pretend to be normal. Further, he/she was suicidal for a time.
One of the other 25 years old patient, Sandra hospitalized for changes occurs in her
behavior suddenly and suffered a poor memory. She was unable to remember the things
happened in past and she even believed that she was admitted to a hospital which is 800 miles
far from the place where she was actually admitted. She was diagnosed with schizophrenia,
antisocial personality disorder, bipolar disorder and substance abuse. There was a different
component of her identity reported, who named herself Mary, calmly stated to cutting her
legs with the knife. She said that Mary has done that to punish Mary. Sandra was treated with
various treatments such as psychotherapy and tranquilizers use and she was benefited from
these treatments (American Psychological Association, 2018).
Another case of multiple identity disorder was Louis Vivet. He was one of the first
cases of multiple personality disorder. He was born to a prostitute and neglected as a child at
the age of eight. He has turned himself towards criminal activities due to an adverse
condition. At the age of seventeen, he started working in a vineyard and his left arm was
wrapped out by a Viper. This situation terrified him so much that he became paralyzed from
waist. After a period of time, he recovered and seems to behave totally like a different person.
When he was 18 years old he has diagnosed with10 different personalities.

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A study conducted by Dell (2002) among 167 people to examine dissociative
phenomenology by using Dissociative Experience Scale contains 28 questionnaires to
quantify dissociative experience. The study investigated 34 patients with the dissociative
disorder, 23 with a nonspecific dissociative disorder, 52 patient with the psychiatric disorder,
and 58 normal people. The patient with DID scores higher than other three groups. Patient
with nonspecific dissociative disorder scored higher than other two groups. That study has
two implications for dissociation. First one was, individual with DID do not manifest more
dissociation compare to other individuals. The dissociative person has a pathological disorder
that does not occur in non-dissociative persons. Second, suggested that the phenomenon such
as pathological dissociation, amnesia, trance, depersonalization, derealisation, and voices are
no different type of dissociation. The study also revealed that dissociation is the natural type
of unifactorial type which has different aspects or epiphenomenon’s, and this indicates that
the person with DID should experience a wide range of the dissociative phenomenon. The
results of this study further revealed that DID patients manifest depersonalization, memory
problems, derealisation, identity confusion, ego-alien, trance and passive influence
experiences such as child voices, persecutory voices, voice commenting, conversing, time
loss and fugues.
According to Ross and Halpern (2011) dissociation is the defensive reaction to trauma
defined as disconnection of two or more reactions that were once linked to each other. It
occurs when someone detached from some part of himself or the environment. It can be
occurred by different events such as emotional disconnection from someone, memories, body
sensations and senses. A common phenomenon can occur in mild forms even in absence of
stress. Dissociations are considered a vital part of our survival system. Dissociation is a
reaction that takes place in fighting with the stressful situation, which may be overwhelmed
in the absence of dissociation. It is not pathological and it is in build reaction. When the

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trauma occurs dissociations might be disconnected to a higher degree to protect the person
form traumatic event, emotions, body sensations and memories that result in an overwhelmed
situation.
Dissociation associated with trauma occurs in different degree. For the person with
trauma, dissociation may help to survive the circumstances that might be intolerable in the
absence of dissociations. Dissociations may help an affected people feel as if events, his or
her sensations, and emotions are muted and distorted that is why he or she can then put
herself of himself in autopilot mode and may survive the extreme situations, and other
circumstances when trauma is still there. But the events occur for longer time dissociations
can become stable and automatic. In this case, it is difficult for the brain to integrate
memories and it continues to send messages of danger, even after the trauma is over. This can
be continuing for years after the traumatic situation. The five symptoms of dissociations are:
Amnesia; it is associated with loss of memory for short term or long term and forgetfulness
about the past events or an incident, Depersonalization; it is the feeling of separation from our
self, body parts and the emotions such as robotic feeling, Derealisation; feeling of detachment
from the surroundings and the people, identity confusion; feeling of uncertainty and conflict
about own, identity alterations; behavioral and personality alterations that can be noticed by
others (Pollock, 2015).
People living with dissociative identity disorder often find themselves in multiples.
DID can protect the person from a traumatic event but if occur at the severe level than it can
affect mental health, relationships and ability to do normal tasks. Living with dissociation
identity disorder may be frustrating, isolating and scary sometimes. Majority of the people
do not take it seriously and avoid diagnosis until they are young, which indicates that they
might suffer frightening symptoms for years without even knowing why. Sometimes the
personality occurs in DID do not cooperate with the other one. But sometimes both the

DISSOCIATIVE IDENTITY DISORDER 6
personalities with together to help the person to cope with everyday situations. Some of the
people with DID can also develop social stigmas (National Alliance on Mental Illness, 2018).
Some of the other studies also supported dissociation as a defense strategy of the body.
According to an article published by Brown (2012) dissociation is technically
considered as defense mechanism which is helpful in the case of trauma and one can get
trained to dissociate and use this mechanism against ourselves. Jepsen, langeland, and Heir
(2013) stated that severe forms of dissociation including memory and identity which further
leads to a poorer outcome after the impatient treatment. A person can achieve health
multiplicity when he/she has multiple identities but does not show clinically distress or
symptoms as a result of the dissociative identities (American Psychiatric Association, 2013).
A report published by Sidran traumatic stress institute (2010) also argued about the
dissociative disorder and stated that dissociation can help an individual to tolerate traumatic
experience such as accident, disaster, crime victimization but the severity of this disorder
leads to serious pathology. It was also stated that in children who experienced sexual abuse,
dissociation works as the self-protection technique Dissociative identity disorder is a
psychological disorder where a person shows two or more identities and each personality
takes control alternatively. Earlier it was considered as multiple identity disorder in1990s.
People with this disorder show symptoms such as memory loss, detached from ourselves,
distorted and fake feelings and stress, depression, and suicidal thoughts. Risk factors for
dissociative identity disorder include abuse for a longer time, events such as war, disasters,
torture, and kidnapping. The disorder affects 2000 children's every year. Various studies
argued on dissociation and show different opinions. By analyzing various case studies of
people suffered from DID it was found that the people with this psychological conditions
suffered a variety of experience and phenomenology. Understanding of this disorder is
distinctive in different people. Majority of studies revealed that dissociation has positive and

DISSOCIATIVE IDENTITY DISORDER 7
negative impacts on person’s personality. It works as a defense mechanism in case of trauma.
People living with this disorder may feel frustrating, isolating and scary. After reviewing
various studies it can be concluded that dissociation works as a defense mechanism for
person suffer traumatic events but in severe conditions, it may also cause long time serious
impact on memory and other physiological problems such as suicide.

DISSOCIATIVE IDENTITY DISORDER 8
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association.
American Psychological Association (2018). Patient Story: Dissociative Disorder. Retrieved
from: https://www.psychiatry.org/patients-families/dissociative-disorders/patient-
story
Brown, S. (2012). Dissociation isn’t a life skill: dissociation is technically a defense
mechanism. Retrieved from: https://www.psychologytoday.com/us/blog/pathological-
relationships/201211/dissociation-isnt-life-skill
Dell, P. F. (2002). Dissociative phenomenology of dissociative identity disorder. The Journal
of nervous and mental disease, 190(1), 10-15.
DID Research (2016). Prevalence. Retrieved from:
http://did-research.org/did/basics/prevalence.html
Jepsen, E. K. K., Langeland, W., & Heir, T. (2013). Impact of dissociation and interpersonal
functioning on inpatient treatment for early sexually abused adults. European Journal
of Psychotraumatology, 4(1).
Mayo Clinic (2018). Dissociative disorder. Retrieved from:
https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/symptoms-
causes/syc-20355215
Mental Health America (2018). Dissociation and dissociative disorders. Retrieved from:
http://www.mentalhealthamerica.net/conditions/dissociation-and-dissociative-
disorders

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Mescape (2016). Dissociative identity disorder. Retrieved from:
https://emedicine.staging.medscape.com/article/916186-overview
National Alliance on Mental Illness (2018). Dissociative Disorders. Retrieved from:
https://www.nami.org/Learn-More/Mental-Health-Conditions/Dissociative-Disorders
Nijenhuis, E. R., Vanderlinden, J., & Spinhoven, P. (1998). Animal defensive reactions as a
model for trauma-induced dissociative reactions. Journal of Traumatic Stress, 11(2),
243-260.
Paris, J. (2012). The rise and fall of dissociative identity disorder. The Journal of nervous and
mental disease, 200(12), 1076-1079.
Pollock, A. (2015). The brain in defense mode; how dissociation helps us survive. Retrieved
from: https://www.goodtherapy.org/blog/the-brain-in-defense-mode-how-
dissociation-helps-us-survive-0429155
Psychology today (2018). Dissociative identity disorder (multiple personality disorder).
Retrieved from: https://www.psychologytoday.com/us/conditions/dissociative-
identity-disorder-multiple-personality-disorder
Ross, C., & Halpern, N. (2009). Trauma Model Therapy: A Treatment Approach for Trauma,
Dissociation and Complex Comorbidity. Richardson, Texas: Manitou
Communications.
Sidran Traumatic Stress Institute (2010). What is a dissociative disorder? Retrieved from:
https://www.sidran.org/resources/for-survivors-and-loved-ones/what-is-a-
dissociative-disorder/

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Tracy, N. (2018). Dissociative identity disorder case: famous and amazing. Retrieved from:
https://www.healthyplace.com/abuse/dissociative-identity-disorder/dissociative-
identity-disorder-cases-famous-and-amazing
Trauma Recovery (2013). Dissociation. Retrieved from: http://trauma-recovery.ca/impact-
effects-of-trauma/dissociation/
WebMd (2018). Dissociative identity disorder (Multiple personality disorder). Retrieved
from: https://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-
personality-disorder#1