Dissociation
Dissociative Identity Disorder (which used to be called Multiple Personality Disorder), as the name indicates, falls under the category of dissociative disorders. Dissociation is a defence mechanism of the human mind used to protect itself against overwhelming traumatic experiences.
When you experience such events, you are unable to defend yourself against the intense fear, pain, and overwhelming emotions that accompany them, and you are left powerless. You cannot place or integrate these overwhelming negative experiences into your life and personality.
Officially (according to the DSM IV diagnostic manual), a dissociative disorder is therefore a disturbance in the integrative functions of identity, memory, or consciousness. The traumatic experience is not integrated, but instead stored in fragments. For example, images, sounds, smells, and feelings may all be stored separately in the memory. The traumatic experience is, as it were, “buried” in the unconscious mind. As a result, you may no longer have a conscious memory of it. The experience is stored separately, sometimes in a highly fragmented way. For example, at one moment you may remember only an image, without a story, feeling, sound, or smell. At another time, you may remember only a smell or a sound.
And although the trauma may seem completely forgotten because you can no longer consciously remember it, it can still affect you deeply through nightmares, fears, reliving experiences, and extremely emotional reactions to things that seem completely ordinary to other people.
Dissociation is therefore a way for the human mind to escape, to withdraw mentally and emotionally from overwhelming pain. For example, a child who is repeatedly sexually abused cannot physically escape from the abuse, and so over time may begin to psychologically and emotionally “leave” the situation so that she no longer consciously experiences it. When you dissociate, you withdraw yourself from painful memories.
How does DID develop?
Factors involved in the development of DID include:
- An ability to dissociate easily
- Extremely severe traumatic experiences from early childhood onward; in other words, overwhelming events that are experienced by the child as life-threatening, from which the child cannot escape and against which the child cannot defend itself. A clear example of this is sexual abuse.
- Neglect. The child is left completely alone and receives support from no one. The child grows up in an environment filled with violence, abuse, and mistreatment, and there is nobody to provide safety or comfort. Nobody to help the child.
When you truly consider this, it becomes clear that a child in such a situation needs a defence mechanism such as dissociation. A child would never be able to consciously process such traumatic experiences. Moreover, what is happening is completely incomprehensible and deeply confusing for a child. The child has no secure foundation on which to develop. The trauma is split off from consciousness, especially when the trauma is repeated regularly or when additional traumatic experiences occur. A part of consciousness then becomes separated and, under the pressure of the traumatic experiences, develops into a part (alter/personality part) of which the child is not consciously aware. In this way, the child is able to continue living without being overwhelmed by the memories of the traumatic experiences.
Characteristic of DID is that the first splitting of consciousness has already taken place before the child has had the opportunity to discover and develop his or her own identity. It can generally be assumed that someone with DID experienced such severe traumatic events before the age of five that he or she had already begun to split at that stage.
The personality has not been able to develop into a unified whole. The person has not had the opportunity to develop a sense of self, an awareness of “I.” Because of the extreme trauma, more and more parts of consciousness become separated, resulting in multiple parts (or identities) within the same person.The person is no longer consciously aware of the traumas, because those memories are “carried” by the other parts (or alters), which are separated from the host personality through amnesia (memory loss) relating to the trauma.
Official diagnosis
According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), the official criteria for DID (Dissociative Identity Disorder) are:
- The presence of two or more clearly distinct identities or personality parts, each with its own way of perceiving and relating to the environment and to itself.
- At least two of these parts regularly take control of the person’s behaviour.
- An inability to recall important personal information that cannot be explained by ordinary forgetfulness.
- The disturbance is not the result of the physiological effects of drugs or alcohol, or of a medical condition. In children, the symptoms cannot be explained by fantasy play.
Characteristics
A person with DID has “gaps” in their memory; he or she experiences amnesia (memory loss) for events from the past and is often unable to remember large parts of childhood or earlier life.
The person may also “lose time,” meaning that things happen in the present that he or she cannot remember afterwards. This occurs because the separation between the different personality parts is so complete that when another part (alter) takes control and does things, the person cannot remember what happened, even though time has passed. In that case, the person is not aware of the existence of the alters. Some alters may be in contact with one another, while others are not. This differs from person to person.
When there is a change from one personality part to another, this is called “switching.” Switching can occur through triggers, meaning that parts of the trauma are activated by things happening within or around the person. A situation may remind the person of the trauma, and it can happen that the person is no longer able to distinguish between past and present. In such moments, the alter that is needed in that situation may come forward.
Each alter may have its own history, self-image, identity, name, and so on. Alters may differ from one another in, for example, their name, gender (both male and female alters may exist within one person), age, way of speaking, vocabulary, general knowledge, or a particular emotion characteristic of that alter. Alters may also have different tastes in every respect. They may like different things, for example in clothing or home decoration, and what one alter enjoys, another may strongly dislike.
Research has even shown that there can be physical differences between alters, such as eye colour, tolerance for pain, sensitivity to allergies or asthma, and visual ability. The host personality may need glasses, while a particular alter may see perfectly well without them and even see better without glasses. Certain medical problems may apply only to some alters and not to others.
It is also possible that the person is aware of the existence of the alters. In that case, the person remains conscious while an alter takes control and can see and hear what is happening, but has no control over it and cannot intervene.
Some alters may experience pseudo-epileptic seizures or attacks.
Different alters emerge in different situations, depending on their function—for example to protect the person—or because the person finds themselves in a situation that reminds them of particular traumatic experiences.
Some alters are stronger than others and are more easily able to take control, sometimes at the expense of other alters.
A person with DID often hears voices. These voices may come from the different alters, or they may be relived memories of things perpetrators said to them, or commands with which they were programmed.
People with DID often have a great fear of looking in the mirror because they do not recognise themselves. They do not have a stable sense of self and cannot understand that the person they see in the mirror is them. Each alter may also have its own self-image, a clear inner image of what he or she looks like, and this often does not match what they see in the mirror.
“That’s not me.”
Many people with DID are startled when they see themselves in the mirror.
The same can apply to the body. A child alter who sees the body may become frightened because it is an adult body, while she herself is still a child.
This can be extremely frightening and confusing, and often leads to even greater alienation from the body.
“Those legs are far too big. They are not mine.”
It may be that the DID was clearly present during childhood because of the severe trauma the child was exposed to, but became less obvious as the child grew older, until memories begin to return to consciousness and the person once again finds themselves reliving traumatic events from the past through flashbacks and body memories.
During the intervening years, the DID may remain hidden, but the person still lives with amnesia and therefore has no memory of what happened during childhood.
DID is often accompanied by symptoms such as:
Soorten alters
Er zijn verschillende soorten alters te onderscheiden en ik wil er hier een aantal noemen:
Baby’s, die vaak alleen maar huilen van kou, pijn en honger
Kinderen van beide geslachten (ontstaan al naar gelang dat nodig of veiliger was tijdens het misbruik of in andere traumatische situaties)
Helpers die kunnen beschermen tegen gevaren en deze zo vroeg mogelijk kunnen herkennen en af te weren of de gevolgen ervan innerlijk te verzachten
Alters die de herinneringen aan de verschillende trauma’s bewaren
Alters die een bepaalde functie vervullen, innerlijk, naar buiten toe of bijv. in de maatschappij
Waarnemers, die vaak alles weten wat er is gebeurd en overzicht hebben over wat er van binnen gebeurt, maar zelf niks voelen
Alters die zich met de dader(s) vereenzelvigd hebben, die gevormd zijn naar het voorbeeld van de dader(s) en in het innerlijk verdere schade aanrichten of anderen aandoen wat hen is aangedaan
‘Cult alters’, d.w.z. alters die een bepaalde taak in de sekte moeten vervullen en geheel ten dienste staan van de sekte.
Verhaal van een overlevende
Laura hield haar adem in en luisterde naar het kraken van de trap. Haar hart bonsde in haar keel. Ze kroop diep onder de dekens en begroef haar hoofd in het kussen.
De deur piepte toen hij werd geopend en Maria kroop verstijfd tegen de muur. Ze voelde hoe de dekens van haar werden weggetrokken en iets zwaars haar dwingend aanraakte en naar zich toetrok.
Piep schreeuwde van binnen, maar er klonk geen geluid. Haar oogjes waren stijf dicht en ze voelde een diepe steek in haar buik. Piep kon zich niet bewegen. Als een kleine pop lag ze stil en bevroren op haar rug. Het zware boven haar was verstikkend. Piep hapte naar lucht, maar kon geen adem krijgen. In haar hoofdje werd alles zwart en Piep gleed langzaam weg in het zwarte niets.
Maria rilde toen ze alleen en verlaten in haar bed zat. Het bed was nat en vies en tussen haar benen zat bloed. De kamer was donker en het huis was stil. Maria stond op en trok de vieze lakens van het bed. Ze waste zich en deed wat gedaan moest worden. Maria had geen pijn. Maria dacht en voelde niets. Ze kroop diep onder de dekens en probeerde in slaap te vallen. Maria had het koud, maar hoe diep ze ook wegkroop, ze kon niet meer warm worden.
Laura werd wakker van de harde bellen van de wekker. Ze gaapt en het kost haar moeite om wakker te worden. Snel maakt ze zich klaar om naar school te gaan en ze rent de deur uit.
Stilletjes kijkt Laura uit het raam als ze de uitkomst van haar som niet weet. Haar hoofd staat niet naar sommen vandaag. Alles wat er in komt lijkt er net zo hard weer uit te vliegen vandaag. De juf kijkt en gauw buigt Laura zich weer over haar schrift. Ze bijt op haar potlood en schrijft gauw het antwoord op.
