When the Mind Splits
Dissociative identity disorder affects millions of people, most of whom are former child abuse victims. Why do some psychologists doubt that the condition even exists?
By Sam Levin
....I met Elyse a few weeks after she sent me an email, stating that she has was trying to find a journalist to help her raise awareness about dissociative identity disorder, or DID (pronounced D-I-D), a misunderstood and stigmatized condition that is far more common than most people realize. Elyse was officially diagnosed with DID two years ago at Stanford University Medical Center, but she said she has had the condition for much longer.
"The majority of the public knows little to no correct information about DID, and even those in the professional field of psychology debate whether or not this disorder is even real," Elyse wrote to me over the summer. "But it is. It is very, very real, and so I am working hard to spread awareness."
Research has increasingly demonstrated that DID is a trauma-based disorder that typically emerges among people who have experienced childhood sexual or physical abuse. Dissociation occurs when people mentally detach themselves from their surroundings, a common coping mechanism for a child victim of abuse. When the abuse continues over a period of time, that dissociation can become extreme and lead the victim to develop distinct, dissociated parts of himself or herself that exist to withstand the abuse.
Experts on DID say that roughly 1 percent of the population suffers from the condition, making it as common as bipolar disorder or schizophrenia.
....Every year, child protective service agencies in the United States receive more than 3 million reports of child abuse. In 2012, there were nearly 63,000 documented cases of child sexual abuse, according to US Department of Health and Human Services data. And experts believe that the number of cases reported and investigated represents just a small fraction of the abuse and trauma that children suffer across the country.
"When they are reported, they are not dealt with well," said David Spiegel, associate chair of psychiatry and behavioral sciences at Stanford University School of Medicine and an expert on dissociative identity disorder. Some research has suggested that two-thirds of child trauma cases aren't reported, he said. "These children have to live with it. How do you live with it? ... You act as though it isn't happening or it's happening to somebody else that isn't you."
Cases involving the most severe and disturbing trauma — prolonged physical and sexual abuse by parents, other family members, or caregivers — are especially likely to go unreported. And so children in these cases develop their own ways to survive. "You can't run away. You can't fight it, so you go away in your head," explained Bethany Brand, a clinical psychologist and professor of psychology at Towson University in Maryland, who recently completed the world's largest study on the treatment of dissociative disorders. "That makes it easier to disconnect from the body in pain."
When a young mind repeatedly enters these dissociative states in response to ongoing abuse, the coping mechanism can evolve into DID. "It's an interesting paradox of sort of breaking apart, so that you don't break," explained Janelle Salah, a Berkeley-based therapist who treats DID patients.
....A 2006 Journal of Psychiatric Research study concluded that 1.5 percent of the general population has DID. And a 2011 epidemiological overview of DID studies — which stated that "dissociative disorders constitute a hidden and neglected public health problem" — said the disorder exists in 0.4 to 3.1 percent of the general population, and in roughly 5 percent of psychiatric patients. That study also stated that dissociative patients are more likely to report childhood psychological trauma than people suffering from any other psychiatric disorder.
When The Mind Splits: Processing Dissociative Identity Disorder Through Art
by Sam Levin
In this week's cover story, I profiled Elyse Winter-Volkova, a 21-year-old San Leandro woman who suffers from dissociative identity disorder, the condition formerly known as multiple personality disorder. Experts believe the disorder, also known as DID, affects roughly 1 percent of the population and most often emerges in people who have experienced severe childhood trauma, typically prolonged physical or sexual abuse. One of the leading DID experts featured in my story is Bethany Brand, a professor of psychology at Towson University in Maryland, who conducted the world's largest study on the treatment of dissociative disorders. In addition to discussing her extensive research with me, Brand helped connect me to two women in Maryland who also have DID.....
DID most often develops as a highly complex coping mechanism in the face of intense abuse and trauma, meaning a child mentally detaches from his or her surroundings, and eventually develops distinct, dissociated parts (or personalities) that exist to withstand the abuse. The challenge for people living with DID is to develop a functional system of communication between different personalities or identities (sometimes called "alters"), with some sufferers working toward "integration" — that is, the fusion of different identities into one. While integration is not always the ultimate goal for people with DID, Elise told me that she is working toward integration — an incredibly difficult process of trying to merge different parts of herself that carry different memories and perspective on her past abuse. "I would like to come back together as much as possible," she said....
When the Mind Splits
from East Bay Express
Elyse Winter-Volkova has been diagnosed with dissociative identity disorder, but instead of hiding it, she openly talks about her condition online, with the people in her life, and as a guest lecturer in college psychology classes. She hopes to raise awareness and advocate for greater acceptance of people with mental illnesses.
Dissociative identity disorder (formerly called Multiple Personality Disorder or MPD) is defined in the DSM-IV-TR as the presence of two or more personality states or distinct identities that repeatedly take control of one’s behavior. The patient has an inability to recall personal information. The extent of this lack of recall is too great to be explained by normal forgetfulness. The disorder cannot be due to the direct physical effects of a general medical condition or substance.