This is a logical viewpoint of “DID” through the lens of professionals and most laymen. The views presented here do not necessarily reflect the views of the entire system, ‘my’ system, or the medical community. In order to be fair and logical, I must present them.
First, DID is not well understood, occurs more frequently in women than men, and is more prevalent in developed countries, indicating it may be more of a cultural affection than a psychological affliction. Some professionals consider DID a delusion created by a solitary mind in an effort to distant one’s self or one’s ego from events in the past. Negative vents may be assigned to a certain “person” or “alter” within that person’s mind; positive or neutral events to another.
The person may also begin to build personalities based upon cultural circumstances; e.g. a persona for their parents, a persona for school, one for their peers and/or friends, another for someone or something else. Over time these ‘personalities’ may evolve and become endowed with traits which are not shared by other personas in the patient. This can be caused by the repeated reinforcement or belief that another ‘person’ exists in their head and by a consistent and uniform assignment of specific types of events and/or emotional states to “that person”. Like a path, the more it gets used the more apparent and ‘real’ it becomes to the patient.
Each “person” in a DID system is different; and serve purposes related to the survival (mental or physical) of the whole. How the mechanism of psychotic amnesia works is not well understood, however, it is assumed that the person, after ‘switching’ to an alternate personality, stores events which occur after the switch in a part of their mind which they then unconsciously or consciously ‘shut off’ or refuse to acknowledge when they ‘switch’ back. MRI studies show that there may be different parts of the mind active during ‘switching’, which indicates various (and different) areas of the mind may be ‘mapped’ during each personality change. This would also explain the requirement by some DID sufferers to “awaken” a part of themselves in order to access the memories of the activities performed by that ‘self’ of which they may not be aware.
The fact that most DID patients are able to function in an overall coherent fashion indicates there must always be some cross-communication between various ‘personalities’, which indicates the function may be more psychological than physiological, though the DID patient may not be aware of it and may even go so far as denying such a connection exists. The fact is such a connection must exist in order for the patient to perform a continuous task while or during ‘switching’ (e.g. driving or watching a movie). This underlying communication between the ‘alters’ or ‘system’ indicates there is one mind at work; therefore, all the others are fictitious fabrications which the original mind (or core) is aware of, since it created them to hold certain memory sets, emotions, behavior patterns, and/or contexts.
An example of such cross-communication can easily be seen when a DID person “finds” purchases made by an ‘alter’ in their own home – proof the “other alter” knows where home is, can find their way there, and know where such purchases go (e.g. clothes in the closet); or by an “alter” knowing which is “theirs” despite never purchasing said item.
The mechanism for developing DID appears to be imaginative and often appears in abuse victims who, finding the abuse “too much to bear” created a persona to ‘hold’ said memories so that they, the original person or core would not be affected by them. Thus many DID patients may have trouble accessing memories of abuse or certain regions of their past.
That DID is a fictional ailment cannot be discounted; however, the fact that the patient believes in the fiction makes it real – to them. Many professionals and laymen do not and can not conceive of or understand that for these patients, there are different “people” in their head.
Treatment options are many, but success rates are low. In the past therapists made an attempt to integrate the multiple personas into “one person” by making the client understand that all these “people” were just themself. In more recent times therapists have learned that when a DID patient comes to them they are best ‘playing along’ with the patient’s delusion in order to get them to accept the different facets of their own self instead of rejecting and compartmentalizing them as ‘persons’.
In most cases the patient will have assigned “blame” for certain life events and/or decisions on a certain ‘alter’ as a way of distancing themselves from their own actions and/or events. It is easier for them to believe “someone else did it” than for them to believe they did it themselves. This assignment of blame often results in a person harming themselves in order to punish the “one who is bad” or brought the perceived ‘shame’ on the whole being.
There is no one cure or treatment option for DID patients. The prognosis for integration in DID patients with a long history of symptoms is low. Early detection and treatment is recommended in order to avoid those neural pathways regarding the delusion of “many selves” from becoming too firmly entrenched and/or established within the patient’s mind. A patient needs to be told that it is “all you” no matter what, and administered drugs to stabilize them if needed, or until such symptoms disappear.
In most ‘cured’ DID patients it has been noted that they are emotionally flat or shallow and not given to wide ranges or depth of emotion, rendering them stable.
This is called “cured”.
*Note: There is much more to this disease than noted here; however, most people are unable to read articles over a thousand or so words, so I kept it short. If you have any questions, there is plenty of information on the internet. There is no “one-liner” explanations nor cures. Sorry about that, you ADD/ADHD crowd. You gotta read more – if you wanna know – and since you can’t – you’re screwed. Plus: I am not a professional so I don’t care. I just know what I know about this; “us”, et all. A few Sources: http://www.medicinenet.com/dissociative_identity_disorder/article.htm