Do we need to remember and process all traumatic memories in order to heal from dissociative identity disorder (DID)? When it comes to the complicated disorder of DID, there frequently are more questions than there are answers, and the explanation of the above question is no less difficult. Before I provide an answer, it is important to understand the way our emotional traumatic memories work and what it actually means to process and heal from them.
What is Dissociation?
As a person who experienced dissociation from trauma, I am thankful for dissociation even though it happens to this day. It can be difficult to be thankful for things when you have dissociative identity disorder (DID). When you have DID, you have experienced significant trauma that impacts your entire life. So what's to be thankful for when things seem to be so hard? Is dissociation from trauma something to be thankful for?
Dissociative identity disorder (DID) and other dissociative disorders go hand-in-hand with signs and symptoms of dissociation. You can find these signs of dissociation included in many lists, and in books like the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). But symptoms of dissociation aren't always so black and white. The reality of dissociation goes beyond the obvious signs and symptoms of dissociation that you read about. So what is dissociation really like?
Dissociative identity disorder (DID) is just one of several diagnoses listed in the dissociative disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Many people live with dissociative symptoms, but don't meet all of the criteria necessary for a diagnosis of DID. When this is the case, a different diagnosis -- other specified dissociative disorder (OSDD) -- can be more fitting. These diagnoses all have dissociation in common, so what makes them different?
Dissociation is an anxiety symptom that is part of dissociative identity disorder (DID). Sometimes dissociation is not splitting between personalities, but only losing touch with reality for a time. Many people who suffer from DID also experience other mental illnesses, or mental illness symptoms. One that I have noticed is anxiety. Dissociation and anxiety symptoms sometimes causes my panic attacks.
Over the past couple of months I’ve published a series of articles focused on normalizing dissociation. I've said repeatedly that I believe just about everyone can achieve a basic understanding of Dissociative Identity Disorder, provided it’s explained to them in a way they can relate to. But that doesn’t mean I think everyone should. In fact, normalizing dissociation isn’t about making other people understand DID. It’s about freeing ourselves from the need for other people to understand it.
The two dissociative symptoms that, once described clearly, are the easiest for people to relate to and understand are also the ones that have earned Dissociative Identity Disorder its undeserved reputation as a bizarre aberration. Identity alteration (experiencing the self as multiple) and dissociative amnesia (gaps in memory) are the two manifestations of dissociation that are mythologized the most. But it’s not because they’re too foreign for most people to grasp. On the contrary, in their mildest forms they’re downright normal.
One of the things that makes Dissociative Identity Disorder so difficult to recognize is that, contrary to popular belief, DID symptoms are not the stuff of science fiction. They are, in fact, severe amplifications of normal human experiences. I can think of nothing more normal, nothing more intrinsically human than identity confusion. Of the five primary manifestations of dissociation, I believe identity confusion is easily the most common. But it's also the one few people will acknowledge in any meaningful way. People are pretty dedicated to the idea that we should know who we are without question, and we fervently admire those who appear most convincingly to do exactly that. But despite appearances, no one gets to live a human life without struggling with their sense of self.
On Friday I went to the pharmacy to pick up some medication. It was a long wait, and I wasn’t feeling well. Around me I heard people talking, phones ringing, and the various noises of the grocery store that houses the pharmacy. The sounds seemed to come from a distance, and I felt profoundly disconnected from everyone and everything around me, as if I was an observer in a dream that wasn’t mine. It wasn’t a particularly comfortable experience but it certainly wasn’t an unusual one. I have Dissociative Identity Disorder, and I've lived with chronic, severe dissociation nearly all my life. The episode I described illustrates the combined forces of depersonalization and derealization, two forms of dissociation that often appear together. And despite the fact that I have DID and my dissociative experiences, taken as a whole, are decidedly abnormal, dissociation itself is something just about everyone experiences from time to time.
Depersonalization is a way of experiencing the self. It's a form of dissociation that manifests in a variety of ways that all boil down to a sense of detachment or separateness from one's self. And though depersonalization is a chronic part of living with Dissociative Identity Disorder, it isn't something only those of us with DID experience. For most people, episodes of depersonalization are transient, infrequent, and typically occur during periods of high stress.