Imagine having an illness that TV and film spent decades labeling as “dangerous” and “crazy”. This is what happened with Dissociative Identity Disorder or DID – it used to be called multiple personality disorder and you probably only know about it from the media. It’s stigmatized, misunderstood, and under-diagnosed. DID is one of the most controversial psychiatric disorders. Some doctors refuse to believe it exists, despite well documented cases and its place in the DSM-5. Because of this stigma, it’s not surprising that people often feel like they need to hide their DID diagnosis, but if you only know about it from TV it could be surprising to you that DID might not be so easy to identify. We’re talking to Nicole, who lives with DID. They are a three-part system and they’re going to introduce us to each identity that lives in their brain. They’re also going to tell us what it’s really like to live with multiple identities and how different it is to what we’ve been shown in the media. Nicole didn’t even realize they had DID until they were married and their partner started to notice something wasn’t quite right. Brains don’t just create new identities for no reason, at least as far as we can tell. DID appears to be a defence mechanism. We’re going to find out how a brain can experience trauma so bad that it decides “someone else needs to deal with this”, and then creates that person in the form of another identity. Shari Botwin is the author of “Stolen Childhoods: Thriving After Abuse”, and a clinician who has spent over 25 years working with people that have DID. That book is full of real conversations between clinician and patients looking to understand how childhood trauma affected their adult lives, so she’s going to help us understand the effects of trauma on a person, a brain, and on an identity… or identities. Shari’s been on her own journey to recovery from childhood trauma and post traumatic stress disorder, so she knows it better than most. Dissociative Identity Disorder sparks the questions… What even is an identity? How do we define who we are as a person? Living with DID is about figuring that out, and recovering is about bringing all those frayed threads back together into a cohesive whole. DID is not about picking your favourite part and ditching the rest, it’s about learning to love your whole self.
The term “dissociation” is a hot topic amongst those who study the brain. An example of dissociation that most of us can relate to is when you’re reading or scrolling through social media and you realize that your mind is elsewhere, that you haven’t actually absorbed the information in front of you. Some researchers have termed these momentary and fleeting moments “normative dissociation”.
However, when dissociation begins to disrupt or interrupt the integration of behavior, memory, identity, consciousness, and more, so much so that a person loses recollection of random times in their day-to-day life, this might be a sign of a dissociation disorder. While some skeptics argue that these disorders are related to fantasy proneness and suggestibility, research supports dissociation as a psychobiological state that functions as a protective response to traumatic or overwhelming experiences.
While there are three main dissociative disorders, the focus of this episode of Playing with Marbles is on dissociative identity disorder, or DID for short. DID is characterized by a person having two or more distinct identities as well as difficulties with remembering personal information, learned knowledge, or important parts of their childhood. Importantly, there is neurobiological evidence supporting DID as an extreme form of post-traumatic stress disorder caused by exposure to severe and chronic trauma in childhood. One study investigating the link between different symptoms of DID and the hippocampus, a part of the brain that is important for memory, learning and emotion, found that those with DID who experience the symptom of dissociative amnesia (that is, issues with recalling information about yourself or events and people around) have reduced hippocampal volumes. This study also demonstrated an association between emotional neglect in childhood and reduced hippocampal volumes, suggesting an interplay of these factors in the severity of dissociation.
In this episode, our guest Nicole walks us through their experience with DID and introduces us to their different “parts” that they’ve named “Kay” and “Stripe”. You will hear about Kay, who acts child-like and plays with their cat, and Stripe, who, when they take over, causes Nicole to behave alarmingly and have lapses in memory. Shari Botwin, LCSW and Trauma Therapist, explains that, in many DID cases, these different parts can take on different personalities that embody the roles of a perpetrator, enabler or protector, they can have different genders, and even come from different age groups. Despite this, the switching from one part to another can still be subtle which can make DID hard to detect at times. Both Shari and Nicole present us with an uplifting perspective on DID that dissociating into different parts is the brain’s creative and protective way to survive in a situation that one might not have made it through was it not for this splitting into different parts.
Shari Botwin's new book, Stolen Childhoods: Thriving After Abuse comes out May 7.
Fast Facts
Support
If you’re struggling with your mental health, you’re not alone.
If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.
Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.
Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website.
The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here.
The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website.
Multiplied By One provides a vast list of support, resources, and information for those who struggle with dissociative identity disorder, or those who are interested in learning more about the condition.