Is Dissociation a Coping Skill or a Dysfunction in DID?
My doctor questioned my dissociative identity disorder diagnosis because dissociation is a coping skill for me. Dissociative disorders are described as having dissociation as a dysfunction that impairs living life in some way. But I don't think that is always the case. While some view dissociation as a dysfunction, many view dissociation as a positive coping mechanism that actually helps them get through the day. For me, dissociation is the very thing that allows me to function. So is dissociation a coping skill or is it dysfunction?
Dissociation as a Positive Coping Skill
Dissociation is a skill, most often developed in childhood, in response to trauma -- physical, psychological, and/or sexual abuse, medical trauma, war or natural disasters (Trauma and Dissociation). Dissociating allows the person (child or adult) to separate themselves from the trauma as a way of coping with the stress. Especially for children, they may not know any other way to cope, so dissociation becomes their go-to coping skill. Without dissociation, it would be difficult (and in some cases, impossible) to manage the trauma.
For those with dissociative disorders, including dissociative identity disorder (DID), dissociation is considered severe and substantial enough to cause significant impairment in levels of functioning. This impairment in functioning is actually one of the criterion for a dissociative disorder diagnosis, according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).
There are many people with DID that struggle with functioning. They may not be able to work, they have trouble with relationships and social functioning, and have difficulty succeeding in school. Others have difficulty with even the everyday tasks and need assistance getting their needs met. Some experience their DID as a disability. This is completely understandable and okay. Dissociation and DID affect people in so many different ways. Symptoms vary, and so do levels of functioning.
My Dissociation Is Not My Dysfunction
I recently came into contact with a psychiatrist who questioned my experience with dissociation. I explained that I dissociate quite regularly throughout the day, as I have for most of my life. The psychiatrist then suggested that I would not be so functional if I was dissociating. I wouldn't be able to hold a job or be successful in school. He believes that dissociation automatically causes dysfunction.
But the truth is it because of my dissociation that I have been able to function the way I have been. I've been able to work because I can dissociate when it gets to be too much. I've done well in school because my parts help with schoolwork when I'm too tired to take it all on. My dissociation allows me to get up on the mornings when I've lost the will to do anything. My parts and I work together so we can function in the world. Dissociation is the glue that keeps it all together.
Dissociation saved my life in childhood. It allowed me to mentally escape the abuse and trauma I endured for most of my life. Dissociation enabled us to live rather than die. It's still serving that same purpose today. Without dissociation, I wouldn't be able to get through the day. I'm not even sure I would have made it this far without it.
So while many believe that dissociation is dysfunction, I'm here to tell you -- dissociation is my function. It's that way for many others with DID, too. And that's okay. We know our truth, even if others don't always see it the same way.
Matulewicz, C. (2017, February 8). Is Dissociation a Coping Skill or a Dysfunction in DID?, HealthyPlace. Retrieved on 2019, June 24 from https://www.healthyplace.com/blogs/dissociativeliving/2017/02/dissociation-is-not-always-dysfunction