Even though dissociative identity disorder (DID) is considered a dissociative disorder according to the Diagnostic and Statistical Manual of Mental Disorders or DSM-5, many people refer to it as a trauma disorder. Much like in posttraumatic stress disorder (PTSD), people with DID often have a history of trauma and/or abuse. But is trauma always a requirement for DID?
A dissociative identity disorder (DID) diagnosis is complex and sometimes people blame themselves for their dissociative identity disorder. When people learn that they have DID, they tend to have a lot of questions, and unfortunately, there aren’t always as many answers. People want to know what caused their DID. People want to know who is to blame. Sometimes that blame ends up turning inward. So what can you do when you start blaming yourself for your dissociative identity disorder?
There is an undeniable link between dissociative identity disorder (DID) and child abuse. Child abuse can lead to mental health problems that occur in childhood and can continue into adulthood. People often relate childhood abuse to depressive disorders, anxiety disorders, and posttraumatic stress disorder (PTSD), but dissociative identity disorder has the most significant connection to childhood abuse and neglect, so much so that the connection between DID and child abuse cannot be ignored.
I developed dissociative identity disorder in much the same way that many people do. I grew up with an abusive father and a loving, but oblivious, mother who inadvertently taught me how to pretend that what was happening to me wasn’t happening at all. I was an imaginative child and dissociation came easy to me. Telling the truth about what was going on in my home, however, has never been easy. So, when I told you not to go around saying that child abuse causes dissociative identity disorder, I didn’t do it because I wasn’t abused; I did it because I was.
All of the misconceptions about Dissociative Identity Disorder bother me because they create barriers to diagnosis, treatment, and support. But there’s one myth that bothers me for more personal and, up until today, private reasons. And that’s the assumption that child abuse causes Dissociative Identity Disorder.
Dissociative Identity Disorder is caused not just by trauma, but a number of factors that come together at just the right times, in just the right places, over and over again. I’ve discussed in some depth the factors that I believe contributed to my development of DID. But those factors might be different for you. Furthermore, each contributing factor carries its own weight. In other words, the causes of Dissociative Identity Disorder are unique to each person in both definition and size.
If I’d kept quiet about my brush with hospitalization a couple of weeks ago, my doctor would have been the only person who knew anything was seriously wrong. I missed a blog post the following Monday, but easily could have feigned some other, less embarrassing emergency. We were in the midst of moving and still managed, with a great deal of help that would have been necessary either way, to get the old place emptied and the new one full. Even my family didn’t realize the jeopardy I was in. How is it possible to be desperately unwell and no one know? Dissociative Identity Disorder makes passing as normal not only possible for me, but nearly unavoidable.
As a little girl, I loved going to bed at night. Alone under the covers, the room dark and quiet, I went away. I wasn’t asleep, though I drifted off eventually. I was just gone. It was the most glorious relief. It was my secret trick, this disappearing act. I didn’t know then that it’s name is dissociation, or that it took many forms and existed to meet my needs. I called it “thinking.” Even today, when someone brings me back from another place with a question or comment I often reply, “Oh sorry, I was just thinking.” Even today, my ability to disappear is my greatest comfort. And it was born of an enormous need. This unmet need for comfort, The Comfort Factor, is one of the reasons I have Dissociative Identity Disorder.
Dissociative identity disorder (DID) is a trauma disorder usually caused by childhood abuse, but we don’t often talk about the age factor in the development of DID. I struggled for a number of reasons to accept my DID diagnosis, not the least of which is the hyperfocus on trauma (to the near total exclusion of all other developmental causes of DID) in popular understanding of DID. I couldn’t make sense of the fact that I knew people who survived truly horrific circumstances and didn’t have DID. Now I know that although trauma is the key ingredient, without which DID – it would seem – simply doesn’t manifest, it isn’t the only ingredient.
Monday’s blog focused on the role physiological and psychological sensitivity played for me in developing dissociative identity disorder. Today we tackle denial. The second of my four categories of causation, The Denial Factor, postulates that the chronic refusal to acknowledge trauma has a direct dissociative effect on the malleable identity of a child. I believe that for me and countless others, denial was a harbinger of dissociative amnesia and a potent force in the journey from trauma to DID.
Michele HaleMichele Hale
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