Dissociative Identity Disorder

Commonly known as multiple personality disorder, but recently renamed as the dissociative identity disorder (DID) in 1994, is a rare condition found in 1-1.5% of adults in the general public (Mitra, 2023). Though this disorder is often gone undiagnosed it is not a very common disorder. Many people hold misconceptions of the disorder and use representations like the film Joker in 2019 starring Joaquin Phoenix as their reference as to what they think DID is. Though the character Arthur Fleck, Joker, has many attributes of the DID, the violence perceived is a common misconception associated with DID (The “Joker” Movie and the Public Perception of Mental Illness | Psychology Paper Example, 2024). DID is a disorder that causes there to be a split in personalities, also known as “alters”, one with DID holds two or more alters and struggles to control the switch. The switch is caused by an entire shift in personality and causes an “amnesia” effect to the actions that occurred in the antecedential identity, or identities. This disorder is commonly seen amongst people that experienced a need to block out traumatic events, and abuse. The “violent” misinterpretation found amongst people with DID comes from the fact that a common individual that struggles with DID may be a past convict that experienced many struggles in prison, the DID did not cause the violence but the violence and imprisonment did. Many people “dissociate” from traumatic events, this causes either a lack of memory or an altered memory of a traumatic event, someone with DID uses an alter to hide the trauma. Other psychologists have stated “In situations like these, a person may dissociate the memory of the place, circumstances or feelings about the overwhelming event, mentally escaping from the fear, pain and horror” (Spiegel, 2024). Though DID sometimes may be confused with BPD, they are not entirely related. One with DID also tends to hear voices, due to the internal conflict and communication amongst the personalities, DID is commonly felt as an outside of body experience and detachment of reality (Spiegel, 2024). Later in this paper there will be more examples as to what DID truly is, how it is caused, the different types of DID, and how psychologists have tried to “fix” it. 

DSM-V

In the mental health world coming up with a diagnosis as to what is actually going on within the brain is important, but even more important to be accurate as medicating and treating symptoms and issues vary depending on the mental illness one may struggle with. Many psychologists and researchers have worked to create a profession manual to help diagnose and specify different mental illnesses. This manual is classified as the DSM-V and was officially published and revised from past versions after 13 years and was finished in 2013, the most recently updated and revised with very specific details is the DSM-V-TR that was published in 2022. This manual is used by all sorts of psychologists to help and understand different difficulties carried within the minds of the people they work with. This manual or handbook has many specific types of disorders,  consisting of over 900 pages. According to PsychCentral they state that “the DSM is a tool and reference guide for mental health clinicians to diagnose, classify, and identify mental health conditions.” (Spiegel, 2024). Starting on page 292 the book describes dissociative identity disorder as a shift in personality so much so it seems to be a type of possession. The handbook states that one with this disorder holds many gaps in recall of memory, they may not have great memory of traumatic events, they hold a pattern that is abnormal to the average loss of memory. Those with this disorder often have a difficult time in social settings, like school and work. In children it may be seen as imaginary friends and this disorder may at times be seen as a cultural norm. Some of the effects may be related to substance use or medication, it is important in the diagnosis process to rule out these possibilities (American Psychiatric Association, 2013, p. 292). Though this disorder can be seen as mood swings, OCD, possession, or other disorders, it is important to note the onsets to this disorder, as most individuals were not born with it and it can become prevalent at any point in one’s life. According to the DSM-V “Psychological decompensation and overt changes in identity may be triggered by 1) re­moval from the traumatizing situation (e.g., through leaving home); 2) the individual’s children reaching the same age at which the individual was originally abused or trauma­tized; 3) later traumatic experiences, even seemingly inconsequential ones, like a minor motor vehicle accident; or 4) the death of, or the onset of a fatal illness in, their abuser(s).” (American Psychiatric Association, 2013, p. 294). 

DID is difficult to diagnose as it revolves heavily on people understanding their own emotion and trauma. Women tend to over exaggerate symptoms causing them to be overtreated when in reality it is only an acute disturbance that is an internal amnesia effect. Whereas men struggle to explain the true difficulties they are experiencing or the trauma they have gone through, this will result in either a mis-diagnosed negative or mis-diagnosed antisocial identity disorder causing them to not receive enough help resulting in them becoming more violent and susceptible to imprisonment (Facts About Dissociative Disorders, n.d.). Many that struggle with DID tend to lack the ability to hold normal relationships as they often don’t recall needed information, like the fact they have children, or where they are trying to go. Psychologists have stated that they find DID to be fascinating, a form of proof that the brain will do anything it can to protect itself even if it disturbs the person. The brain has many regions that communicate causing a person to perform the way they do, with someone that struggles with DID it is found that when the personality is altered it is due to the inactivity in the prefrontal cortex. This is what causes the out of person effects of DID. Along with the prefrontal cortex the amygdala tends to be over active as a trauma response, it also may be seen as underactive resulting in the emotional numbness some have. The effects of memory within DID are clearly related to the hippocampus, this relation is a deregulation of the hippocampus’s ability to manage memories. As stated on psychology today “These disruptions also explain why some identities hold specific memories while others do not.” (Shimiaie, 2025). Others claim that specific chemicals like glutamate are seen to be overactive resulting in emotional imbalances. 

Though DID is incurable it is possible to manipulate symptoms and try to control the effects allowing for the possibility of a more normal lived life. Seventy percent of people that suffer with DID have attempted suicide on multiple accounts, treatments and therapies can help these moods and help stabilize innocent individuals affected by DID. In order to help an individual with DID the psychologist needs to understand whether the individual is affected possessively or non-possessively, the difference here is that possessive form is a very obvious shift in alters that is noticeable by others and non-possessive is noticed within oneself as a true out of body experience and is not as noticed by other people. Though there are no true medications specifically for DID, psychologists can treat symptoms such as depression and anxiety with medications. They do have specialized therapy for individuals with DID such as “Psychotherapy (cognitive behavioral therapy or dialectical behavioral therapy)… Therapy for DID focuses on: Identifying and working through past trauma. Managing sudden behavioral changes. Merging separate identities into a single identity.” (Dissociative Disorders – Symptoms and Causes, 2023). 

Case Study

Some case studies like Herschel Walker and Kim Nobel are interesting as they feel as if treatment has helped them disintegrate their illness entirely. Kim has over 20 personalities and claims that each have their own artistic style. Her illness comes from early childhood trauma and as a child she was diagnosed with schizophrenia and depression. In adulthood, she suffered with DID, through work with her psychiatrist she learned to manage her struggles. According to researchers they stated, “What her story shows is that appropriate dissociative identity disorder treatment can be essential to achieving stability and meaningful life.” (Real DID Cases And Treatment Insights From Psychiatrists, n.d.). Herschel Walker was a well known football player that ran for senate in Georgia, he claimed to have completely been cured of his DID. Psychologists proved this to be impossible however he struggled with DID due to childhood trauma of physical and psychological bullying. He had about 12 alters and each were different forms to help him mask his true emotions, he later used football as a form of therapy. When he was done with football is when his symptoms truly ruined him. His wife at the time stated he had threatened to kill her, played Russian roulette with himself, and paid for an abortion which he also claims to want illegalized. Though he had many struggles he used years of therapy and hypnosis to help him control and merge his personalities. Though he can go through years of being symptom free, high stress can cause small episodes, however the violence has been dissipated (Stolberg, 2022). Cases like these prove that symptoms are caused by early life trauma and can be almost cured through therapy. 

Covid negatively but directly affected people with depression, anxiety, suicidal thoughts, and substance abuse. Those with DID tend to have all of these characteristics, and sadly the percentages were increased during covid. (The Implications of COVID-19 for Mental Health and Substance Use, 2023). Also due to the lack of therapy routine many struggled to work with their emotional imbalances. 

Dissociative identity disorder is a struggle for 123,000,000 people in the world. People from everywhere are mis-diagnosed all of the time, and due to many films there is a misconception of the people that struggle with DID. It is important for people to understand how to allocate this disorder and treat it effectively. 

Disclaimer: This Paper was originally written for a research paper in an Intro to Psych college level class at Canandaigua Academy.