(Image by: Roxanne Pasibe)
I frequently find myself watching videos by Special Books by Special Kids– a non-profit run by special needs advocate Chris Ulmer who uses primarily his YouTube channel as a platform to raise awareness of disability diversity and to promote equality. One of his interviews particularly caught my interest because of how rare yet complicated this disorder is. As a society we frequently romanticize (and demonize) this disorder as seen in the 2016 film Split. Dissociative Identity Disorder (DID) formerly known as Multiple Identity Disorder (MID), is a chronic condition in which two or more personality states develop and coexist in an individual. These personalities can take over the individual’s ‘main’ state of being and for some people like Lauren in the interview, these voices can have an active conversation with her inside her mind.
DID is commonly referred to as a posttraumatic disorder due to its development as a defense mechanism against severe abuse and other traumatic events. Not only does the disorder affect the individual’s identity, but there is also the experience of amnesia and other forms of memory loss. In class we learned primarily about two types of amnesia: retrograde and anterogradewhich prevent the retrieval of specific kinds of information due to brain damage. It is fascinating to consider that a psychological trauma like DID can create as much of an impact on the brain as a physical disruption like a lesion.
To understand this, it’s important to delve a little into the neuroscience aspect of the disorder. Usually occurring during childhood, DID develops when the brain is at its most plastic. The central nervous system and cognitive functions especially, have not fully matured yet. This exposes the malleability of the brain to long-term impairments such as the development of a mental illness. Additionally, the ability to process emotion and retain memory of the traumatic event are disrupted so as not to cause further damage to the brain by the extreme stress of the event. For some individuals the inability to recall the traumatic situation and abnormal coping methods result in the development of new personalities to handle high levels of stress that the brain sometimes recognizes from the initial trauma. Lauren explains in the interview that her twelve personalities developed as defensive shields. In first or second grade she experienced a traumatic event that she can no longer remember, and the blockage of the memory was replaced with a “fragment” or new personality.
The loss of Lauren’s memory is an example of dissociative amnesia which is a result of psychological trauma rather than physical damage as explained above. What separates Lauren from those who simply experience repressed thoughts is the unique disruption in memory she’s experienced concerning the traumatic event from her childhood. Her other thoughts appear to be intact from childhood and while her brain reacts similarly to stressful situations and creates new “fragments” to deal with them, her memory as a whole appears to remain complete. Compared to repressed memories where the growth retention interval leads to memory decay, the psychological amnesia completely extinguishes that specific memory. The distinctiveness of this disorder is apparent even when compared to other psychological traumas. Psychological trauma is often associated with Posttraumatic Stress Disorder (PTSD) in which the memories of a distressing event are commonly recalled and a source of severe anxiety. Swinging into the opposite side of the spectrum is DID which loses memories as an alternative method to avoid anxious feelings.
There is a section in our textbook that discusses ‘undoing’ memory loss with methods such as hypnosis. For some people recognizing repressed memories and coming to terms with upsetting events is an important process of healing and developing positive coping strategies. I personally don’t believe that something like this is appropriate nor possible for individuals with DID. The disorder is recognized to have amnesia as a side effect- the memory cannot be recalled due to psychological damage to the brain- and even if there was the possibility of remembering the trauma, unraveling the development of multiple personalities would take years upon years of intense therapy to basically reestablish a personal identity.
I would like to see more research conducted on not only the specific neurological causes of DID but also the exploration on all the cognitive processes beyond just memory which are impacted. For example, how exactly is attention impaired when there are conversations constantly buzzing in the mind or what is the degree that judgement and the ability to make rational decisions are distorted? As with many disorders, especially those as rare as DID, more research is needed to understand the full extent of the disorder. However, it is people like Chris and Lauren who aid in the advocacy and ‘normalization’ of disability education so that further research opportunities can be explored in the near future.
(And in case you were wondering, yes Freud knew about this disorder and yes, he had a field day with it).
Kluft Richard P. (1996) Dissociative Identity Disorder. In: Michelson L.K., Ray W.J. (eds) Handbook of Dissociation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0310-5_16
Myers, Lynn B. (2010). The importance of the repressive coping style: findings from 30 years of research. Anxiety, Stress & Coping, 23(1), 3-17.
Thomas-Antérion, C. (2017). Dissociative amnesia: Disproportionate retrograde amnesia, stressful experiences and neurological circumstances. Revue Neurologique, 173(7-8), 516-520. https://doi.org/10.1016/j.neurol.2017.07.007
Ulmer, Chris. (2018, January 23). Living With 12 Personalities (Dissociative Identity Disorder). Retrieved from https://www.youtube.com/watch?v=YAtK2s_SDnA
Van der Kolk, Bessel A. (1987). Psychological Trauma. Washington, D.C.: American Psychiatric Publishing, Inc.