Causes of Dissociative Identity Disorder

Monday, March 14 2011 Holly Gray

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.

word-cloudThe Causes of Dissociative Identity Disorder Are Unique in Definition

There’s a lot we don’t yet know about dissociative disorders. One thing we do know is that an overwhelming majority of adults with DID report chronic, severe childhood trauma. It’s safe to assume, as we currently do, that trauma is the most consistent factor. But it isn’t the only factor. To illustrate what I mean I created the word cloud to the right, representing the factors I believe contributed to my development of DID:

  • Denial - If you live in the midst of a raging storm that no one ever acknowledges, your brain may develop a way to make you believe it isn't there.
  • Trauma - As we already know, dissociation is a common way for human beings to cope with a wide range of emotional and physical traumas.
  • Age - Our identities are highly malleable in early childhood. Subject a very young child to repeated trauma and the dissociation may begin to wear grooves, and eventually barriers into their psyche.
  • Sensitivity - Someone with a low physiological threshold for sensation may experience more profound traumatic stress than their less sensitive peers.
  • Comfort - Dissociation is a kind of self-hypnosis, and may become a source of soothing comfort for a child left to navigate traumatic situations on her own.

Aside from trauma, the causes of Dissociative Identity Disorder are many and varied. Therefore your word cloud would likely look much different from mine.

The Causes of Dissociative Identity Disorder Are Unique in Size

My word cloud is a visual weighted list, meaning the size of each word represents how large of a role I believe each of these factors played in my development of DID. But every situation, every individual is unique. This exercise may produce something more like this for someone else:

word-cloud-2

For this person, trauma was the single most powerful factor in their development of DID. Fear, isolation, and age are noted as contributing factors, but their impact is cited as far less powerful than the impact of trauma.

Understanding the Causes of Dissociative Identity Disorder Helps Us Understand DID Itself

I bring all of this up because I often hear things like, 'but I didn't suffer enough to have DID,' from people diagnosed with it. Those comments speak to a misunderstanding of the causes of Dissociative Identity Disorder - namely that it's caused by the most horrific trauma possible. In fact, many people grow up in nightmarish circumstances and never develop DID. As long as we continue to assume that the severity of trauma is not a subjective thing, and that severe trauma is the only contributing factor in the development of DID worth mentioning, confusion about the diagnosis will remain.

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Author: Holly Gray

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Causes of Dissociative Identity Disorder

Suede
says:
March, 15 2011 at 8:02 pm

Thanks again Holly for being brave and sharing your thoughts.

Sensitivity is a big one for me. I did experience more trauma in my years of life then not. But I also know I am a very intuitive, empathetic like person. Walk by me in a crowd with something heavy on your mind I will notice.

Not in a psychic type way but for whatever reason I am wired to pick up on every little thing about someone that most say they miss. This causes me to spend as much time in a controlled environment as I can cause I will just get drained otherwise.

I also think what happens to each of us is relative to us. One person may react to something a different way then another. It was very natural for me to escape inside myself. For another pushing out may be there reaction. I do think you need more then just trauma to develop DID.

I wonder if there has ever been a study of DID in introverts vs extroverts. I am willing to guess the introverts would have a tendency to develop DID more under similar circumstances above the extroverts. That would be pretty elemental information but interesting anyway.

In reply to by Anonymous (not verified)

Holly Gray
says:
March, 17 2011 at 7:13 am

Hi Suede,

I really relate to what you're saying about empathy and sensitivity to subtle environmental cues. I suspect, at least for me, that some of that is innate and some is fostered by environment. In other words, a person might learn to observe their environment more discerningly if said environment is unpredictable, frightening, and potentially dangerous. Of course, my ability to interpret those subtle environmental cues is not always spot-on. ;)

"I also think what happens to each of us is relative to us. One person may react to something a different way then another. It was very natural for me to escape inside myself. For another pushing out may be there reaction. I do think you need more then just trauma to develop DID."

Yes! Part of the mythology surrounding DID is that this diagnosis = Worst Trauma Possible, to the extent that many people seem to view diagnosing DID as diagnosing terrible trauma, not severe identity fragmentation. In other words, "Dissociative Identity Disorder means you're one of the most traumatized, wounded people alive," rather than, "Dissociative Identity Disorder means your identity is so fragmented that you experience yourself as many people rather than one." That's a truly unfortunate misunderstanding for a lot of reasons, not the least of which is that it minimizes the very real struggles of others.

"I wonder if there has ever been a study of DID in introverts vs extroverts."

I'd be interested in that. Though I'd imagine it'd be hard to assess. I know that, for instance, parts of my system are highly extroverted, yet overall - as a whole - I am a textbook introvert.

Thanks for your thought provoking comment, Suede!

kate edwin
says:
March, 16 2011 at 8:02 am

as a scientist, contributing factors are different from causes. the only known cause of DID in particular is childhood trauma. this does not mean that trauma is what adults think trauma is. it's like, giving an adult three doses of an iron supplement wont hurt them but if you give it to a small child it could be dangerous. same thing with trauma, perceived danger is the key, what a child sees as danger, or a "big" trauma" may seem to an adult incidental or a "little" trauma.

I know there are a couple others causes of other dissociative disorders such as heavy "recreational" drugs, but childhood trauma is indeed he mot prominent

In reply to by Anonymous (not verified)

Holly Gray
says:
March, 16 2011 at 8:14 am

Hi kate,

While I agree with you that what we - adults or not - think of as trauma may not always represent the wide spectrum of experiences that can be traumatic, it is inaccurate and misleading to say that trauma is the only cause of Dissociative Identity Disorder. If you'd like, we can classify external denial of reality, what Jennifer Freyd calls "betrayal trauma," as trauma. I wouldn't disagree with that. But right now the most common, widespread belief about the causes of DID is that trauma - horrific, nightmarish child abuse, specifically - is the single cause of DID. And that is not true. Period. To begin with, trauma itself can be defined in a variety of ways - what is traumatic to one person may not be to another, for instance. Second, trauma severity is a subjective thing. And lastly, it's simply not true. The insistence that it is does far more harm than good.

castorgirl
says:
March, 16 2011 at 12:40 pm

I once asked a therapist why I developed DID, when I knew of people who had lived through wars and had been raped as part of the war crimes inflicted against them. Her response was that those people probably had a cushion to fall back on. They had a solid sense of themselves before, during and after the abuse because they had a cushion of love to fall back on. So when something horrific happened to them, they could go back and talk about it, grieve over the losses and acknowledge what had happened. That's not to say that those people went psychologically unscathed, but rather their traumatic experiences presented in other ways.

There are many factors which can contribute to any of the traumatic disorders, DID amongst them. It's rarely positive for anyone to make comparisons as to the severity of trauma.

In reply to by Anonymous (not verified)

Holly Gray
says:
March, 16 2011 at 1:14 pm

Hi CG,

I like the idea of the cushion. I have come to see dissociation that way, as a cushion. And it makes sense that people who have suffered severe trauma, even in early childhood, might not develop Dissociative Identity Disorder (or any other trauma related disorder) if they had support, treatment, and care that allowed them to heal and grow.

"That’s not to say that those people went psychologically unscathed, but rather their traumatic experiences presented in other ways."

Thank you for that point. I wish DID weren't considered the worst case scenario with regard to the potential long-term consequences of trauma. We all cope in different ways and DID is not across-the-board more or less painful than other disorders like PTSD or DDNOS.

"It’s rarely positive for anyone to make comparisons as to the severity of trauma."

Agreed. Severity is subjective. The only time I find it helpful, for me personally, is to gain perspective. Days when I'm feeling particularly self-pitying it does help me to remember that hey, I have all my limbs, I'm healthy, I have a roof over my head and food on the table. In the same way, it does bring me a sense of balance to recognize that there are plenty of people who've survived (or haven't) much, much worse than I have.

Jason R
says:
March, 20 2011 at 6:20 pm

I did develop DID through a nightmarish childhood with severe emotional, physical and sexual abuse, including a beating that caused a NDE. A therapist said it was the closest thing he ever heard to Auschwitz.. I am a writer and I wonder if part of the refuge in so many characters is that I have a very good imagination. I am writing a novel and it feels great being all the characters. It's a far-out idea but I wonder if at least one of the contributing factors is a strong imagination. I have recovered but some of the alters had incredible gifts and they introduced me to music that I would have never heard....and lots of life experiences that I might not had any other way...writing this feels strange because only one person ever guessed I had DID...

In reply to by Anonymous (not verified)

Holly Gray
says:
March, 23 2011 at 11:37 am

Hi Jason,

Thank you for your comment.

"It’s a far-out idea but I wonder if at least one of the contributing factors is a strong imagination."

I don't think that's far-out at all actually. The ability to dissociate is the ability to separate oneself from reality or some aspect of reality. And imagination is the ability to create new realities or aspects of reality. They work very well together. And Dissociative Identity Disorder began as a very serious game of pretend, in a way. 'This isn't happening to me,' kind of thing. Bottom line, I'm inclined to agree that imagination plays a role.

I'm glad you had the gift of dissociation to help you survive, Jason. No child should ever suffer like that.

Suede
says:
March, 23 2011 at 1:21 pm

Hey Jason,
A big yay your a writer I bet it will be amazing.
We come from the same kind of places you and I and really some of my me's have been so amazing I am speechless I don't even feel equal to speak with them. Of course that is part of my problem too ! :)

Anyway I look at it as phantasmal gone wild in a child put in a place that no other option was present. Makes it so much more full of awesomeness that way! I am not taking away the seriousness of it but looking at it that way for me helps me tolerate it. I have a super active imagination, I keep getting older waiting for it to diminish it never does.

It is simple really to me. If you are going to escape or fade away you have to have a place to go and something to replace you so no one comes looking.

I am an awesome playwright in my own head though! Just have to remember to look back out sometimes.

By the way I sound so much more accepting of DID then I am, its a say it till you accept it kind of thing.

Dr Musli Ferati
says:
March, 25 2011 at 9:19 pm

The explanation of causes of Dissociative Identity Disorder, indicates the complexity of etiology and pathogenesis to any psychiatric entity, especially those with neurotic phenomenology. Up to date achievement in neuroscience investigation, didn't give still an exact and convincing clarification on causes of these enigmatic diseases as well as immense medical inaptitudes. Therefore remains many cloud words about the essential nature of these problematic illnesses. In this blind-alley, well-comed are the oneself subjective viewpoints of mentally ill patient. The same plays a great role in the treatment of persons with mentally disorders. All the more when it is known the fact that most of psychiatric diseases are treating symptomatically and not causally. With this acquaintance in psychiatry we should to look mentally ill individual and not as isolate morbid entity.

kerri
says:
March, 28 2011 at 2:56 am

Hi Holly, I've been really thinking about this issue a lot lately, and I just want to thank you so much, because in coming closer to understanding how and why I developed DID, I'm also unearthing truths about how I reacted to my childhood experiences, and who I was as an "individual" amidst the sea of events that swirled around me. I always thought that my childhood abuse was the cause of every problem in my life, and that it was an entity unto itself, but never really looked at the interaction between those events, and the unique child that I was. Certainly from when I was very young, I was easily intimidated by people, and I found other children very hard to understand. I kept very much to myself and lived a lot inside my own head. If there was ever any tension around me I always pulled inward, and when overloaded, imploded silently. But then again, like you I lived in an environment full of silence and denial, so it's hard to tell if being unto myself so much and not speaking up, was because of who I was innately, or if it was something I learned from my parents and siblings. What I do know is that I was a very anxious child, and it didn't take much to scare me. Also when distressed, it took a long time for my emotions to come back to an even baseline. And at least now I know that I was a factor in the mix of my life, not the invisible entity I thought I was. This is important because it means I was a unique individual with a personality unto myself, even though for most of my childhood and teenage years I didn't experience myself as a definitive singular entity. This topic has really pushed me to look deeper for some of my truths, and that for me is a very good thing. So again thanks for writing such interesting posts.  

In reply to by Anonymous (not verified)

Holly Gray
says:
March, 28 2011 at 10:37 am

Hi kerri,

I'm so glad this was helpful for you. So often when I talk about the causes of Dissociative Identity Disorder, people think I'm minimizing trauma, which isn't the case at all. I try very hard to be clear and I'm really pleased that it pays off, even if only occasionally!

"But then again, like you I lived in an environment full of silence and denial, so it’s hard to tell if being unto myself so much and not speaking up, was because of who I was innately, or if it was something I learned from my parents and siblings."

Yes, the chicken-and-egg thing. Ultimately I think it doesn't much matter which came first. Because the development of Dissociative Identity Disorder is a process, not a happening. We interact with our environment, responding to it and to our own internal perceptions and needs. We become who we are over time. And that's true for anyone, not just those of us with DID.

"And at least now I know that I was a factor in the mix of my life, not the invisible entity I thought I was."

Yes! I feel exactly the same way ... that we are a part of our own development of DID. Unfortunately when I say that there's usually someone that hears that as victim-blaming. And that's never my intention.

kerri
says:
March, 28 2011 at 8:51 pm

I totally agree with you Holly, I too am not blaming myself in any way, but rather am learning that the development of DID is a cumulative process with an interactive dynamic occurring over time. Also I have found that focussing too much on what has come first the chicken or the egg issue, only leads me to down pathways that divert my attention. So instead of trying to determine the exact source of my anxiety and nail down to a tee what percentage of genetics and environment had a hand in it, I now look at what being anxious meant to me. How it drove certain thoughts and behaviors of mine, and what it meant in regards to how I saw myself and the world around me. This way I validate what I felt and deal with the impact it had, and still has. This seems to work better for me at the moment.

In reply to by Anonymous (not verified)

Holly Gray
says:
April, 3 2011 at 3:48 pm

Kerri, I agree so much with this approach:

" ... I now look at what being anxious meant to me. How it drove certain thoughts and behaviors of mine, and what it meant in regards to how I saw myself and the world around me. This way I validate what I felt and deal with the impact it had, and still has."

My impression is that, in general, there is far too much focus on "what happened?" in DID therapy and even in discussions of what the disorder is. It's not that what happened doesn't matter, it's just that we can't ever know precisely what happened, DID or not. And ultimately, what happened is only one part of the equation anyway. I really like your approach.

Yiska
says:
March, 12 2016 at 3:25 pm

Very well written post.

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