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Patricia is four years old.
She covers her face under the scoop-neck of her blue flannel nightgown.
She hides in terror under the covers in her white canopy bed. Now, decades later, she loses time and sometimes wakes up in the fetal position in her closet.
Patricia feels weak, small, and powerless.
Kat was sexually abused at 10 years of age by someone she adored. She was confused about the abuse, and decided to tell someone else, only to be re-victimized by that person, too.
It took decades for Kat to realize she had been sexually abused, naively believing that her love for her abuser somehow constituted her consent. She is a pathetic excuse of a woman, filled with shame and self-loathing. She is an enabler.
She is a rescuer. She is codependent, using the love of her abusers for validation.
Stephanie, a teenager, is an old soul with the spirit of eternal youth. She practises dance routines with her nieces on Sunday afternoons after church.
But by Monday, she is plagued by panic attacks so severe she doesn’t attend school. A boyfriend professes his love for her with flowers and gifts and pet names such as baby and b*tch and c*nt. He leaves bruises on her arms and burns her inner thighs with his lit cigarette. When he finds her hiding in the laundry basket, he leaves her there with a busted lip and a black eye.
She tells her sister he would never hurt her. He loves her. She fell.
Tina is 19 years old. She was sexually assaulted one night after taking a ride home from a trusted friend. She was drunk. She blames herself. Others blame her, too. Decades later Tina now has a severe phobia of driving, and she has never been drunk or trusted a man since. She is the guardian and protector of secrets.
Rachel is 30 years old. She is what one may call a “strong woman.” She’s spent the last 10 years advocating for women, children, the broken, and the marginalized. She is hypervigilant and always in control of her surroundings. She’s taken self-defence and kickboxing and practises them daily in the mirror.
One night, while out with the girls, a man appears outside her washroom stall. She’s frozen and cannot move or speak. He rapes her. Eighteen years of therapy, and she still cannot see his face. She’s filled with rage…toward herself.
Christina is 48 years old. She is a former psych nurse and current mental heath advocate. She is a divorced single mom of four incredible children. She suffers with severe depression and anxiety.
At 20 years of age, she packed away the traumas of her youth in a box marked “Fragile: Do Not Open.” And for 20 years, it stayed packed away in the deep recesses of her mind.
Until one day it opened, seemingly unexpectedly.
I am Christina, and I have Dissociative Identity Disorder, or DID.
I am also Patricia, Kat, Stephanie, Tina, and Rachel.
I have my own memories; I also have theirs. And although I hold all of these memories, for many, I do so from a distance. It’s watching them unfold as if they’ve happened to someone else.
I’ll always have the memories. What the others hold onto are the overwhelming emotions attached to the traumas.
And my body, well, my body has told my story all these years without us ever needing to utter a word. The body—it remembers everything.
When I was first diagnosed with DID, with secondary complex PTSD, I was in complete denial. I now understand it to be a defense mechanism for a child in danger. Accepting the diagnosis was the only thing that actually made sense.
Here are a few things people really need to know about DID:
What is dissociation?
I like to think of dissociation as a spectrum disorder.
At one end of the spectrum is daydreaming. At the other, complete amnesia. Many fall somewhere in the middle.
Nonetheless, we all dissociate on some level.
If you’ve ever driven home from work and not been able to recall the details of how you got there because your mind was elsewhere, you dissociated. If you’ve ever had a conversation with someone where you nodded and agreed, but your mind was thinking about what groceries you needed for the week, you dissociated.
Now let’s take this up another notch: A loved one unexpectedly dies. One moment, you are down on your knees crying. You are filled with grief so devastating you don’t know how you will get through it. But you do. Your brain takes your grief and unconsciously compartmentalizes it, so you can deal with necessary tasks, like planning the funeral, accommodating guests, and comforting your family. If you’ve experienced this, you dissociated.
Or, you were assaulted or perhaps in a car accident. You have no head injury but have trouble remembering the event. Your memory is foggy. You may be injured, and yet have no pain. It feels as though you’ve watched it happen, but it doesn’t feel like it actually happened to you. That is dissociation.
Now imagine you are a child being sexually abused, and your perpetrator has told you you can tell no one. You feel as though you have no one to turn to, so you turn inward, and that young child creates others in their mind who will endure the trauma—to survive, to live in the world.
This condition was entered into the DSM in 1980 as Multiple Personality Disorder, or MPD, which is now a controversial term that no longer exists in the DSM. In 1994, it was replaced with the term Dissociative Identity Disorder to more accurately reflect the condition, which is when an identity is splintered for self-preservation, rather than entirely new personalities being created.
What are alters or “emotional parts”?
Alter is a Freudian term used to describe alternate ego states or personalities. In DID, these states are referred to as identities or emotional parts.
Parts is the word I feel we can relate to, because truth be told, we all have different identities. The person you are at work is not the same person you are when you’re at home with your family. And we all can relate to experiencing a sense of inner conflict within ourselves. For example, “A part of me thinks I should leave. But another part of me feels as though I should stay.” When we see things from this perspective, it becomes much more relatable.
Switching between parts is seamless, so much so that it is missed by not only the mental health professional, but even by the person suffering, so be leery of those popular YouTube videos that claim, “Switches caught on camera!”
Misconceptions and exaggerations are dangerous, and they delay diagnosis. Which brings me to my next point.
Why is there so much stigma around DID?
Let me start by saying movies and TV series have done a great disservice to people suffering from this condition.
I have never experienced clinical depression, been a criminal, been possessed, or committed evil acts.
But from movies like “Split,” to television series like “Bates Motel,” DID is both named and blamed for insanity and murder, even though there is zero evidence of any link between psychopathy and dissociative disorders.
DID is the handpicked mental health disorder used to portray crazy in much the same way that it’s almost always Catholics who require exorcism.
And here are the facts: DID is nothing to laugh about it. Almost all dissociative identity disorder occur as an advanced coping response to the physical, emotional, and/or sexual abuse of innocent children. It’s trauma so severe and disruptive to one’s forming psyche, that in order to survive it, a child’s mind creates other identities to hold the depth of their pain, fear, and despair.
How common are sexual abuse and sexual assault?
According to PubMed, one in three girls and one in five boys will be sexually assaulted before the age of 18.
The United States Department of Justice reports that 90 percent of child sexual abuse victims know or have some form of a relationship with their abuser.
Shockingly, the McGill Journal of Medicine states that the lifetime prevalence of PTSD for women who have been sexually assaulted is 50 percent.
The ACE Study of Adverse Childhood Experience ranks childhood trauma as an epidemic and the single greatest threat to mental and physical health that we know of to date: survivors of childhood trauma have a markedly increased risk of autoimmune disease, chronic illness, degenerative disease, and cancer, and a 20-year shorter life expectancy than those with an ACE score of zero.
It’s the evidence that is frightening, not the condition!
What are the facts about DID?
The prevalence of DID is considered to be rare, affecting one to two percent of the population.
That is 77 million people worldwide, that we know of.
And given the stigma, even in the mental health community, it is probably much more common because of its high correlation with PTSD. Many have yet to be diagnosed. Others have been misdiagnosed as Borderline, Bipolar, or even just moody, forgetful, or even malingering.
One need not look any further than the internet to find debates, even in psychiatry, as to its validity. Perhaps, it’s been easier for us as a society to blame victims and accuse them of making up stories, than it is to comprehend the magnitude and number of perpetrators of these heinous crimes. And that is a dangerous method, given that 70 percent of people suffering from DID will attempt suicide.
My doctor regularly reminds me that there are people in the world who still believe the earth is flat, and that believing it does not make it so. Dissociative disorders are a DSM diagnosis, as real as any other properly diagnosed medical condition.
And for those who want tangible evidence, the science is validating.
Functional MRIs of the brain, reveal a functional disconnect between the amygdala (the fear response center responsible for fight, flight, and freeze) and the engagement of the prefrontal cortex, necessary for advanced cognition. And according to Dr. Blair West, EEGs of the brain have shown distinct differences in the brain waves between identities.
Most recently, Jeni Haynes, a scholar from Australia serves as evidence. Jeni was diagnosed with DID after years of severe, unimaginable sexual abuse. She made history recently by testifying in criminal court against her father in her alternate identities, specifically three of the 2,500 personas, named Symphony, Muscles, and Little Ricky. Her father is awaiting sentence.
Despite her brilliance and 18 years of university education, she lives in poverty on a disability pension because of her abuser’s depravity. It is only by the grace of Haynes’ “60 minute Australia” interview, that I found the courage to write this today. Until now, only two other people know of my dissociative disorder, besides the physician who made the diagnosis.
Why is it so important to understand DID?
The answer is simple. It is the one mental health disorder, where we know the exact cause and effect. It is the one condition that holds the potential to be prevented and even eradicated.
How? By facing the deep discomfort of acknowledging the prevalence of childhood trauma—specifically sexual abuse.
It means changing the entire “village” of people who raise our children. It means our doctors—specifically paediatricians—using ACE as a screening tool for childhood trauma. It means educating our teachers, and every parent, to be able to spot the signs of abuse in our children.
It means dispelling rape myths and a complete overhaul of our justice system, from investigating officers to the highest judges in our nation.
It means changing our language and terminology of sex crimes to reflect, what they are truly about, which is not sex, but rather predatory, deviant perpetrators, using coercion, control, and exploitation as well as power, to abuse children.
It means unlearning and relearning everything we think we know about our children, and how to protect them.
It means admitting we have failed to do so, and DID just more proof.