Is Dissociative Identity Disorder Real?

| By Paul | | TrackBacks (1) | Comments (28)

One of the more interesting, and also infuriating, debates is the question of whether dissociative identity disorder is real or not. Some say it should be subsumed under another disorder (usually borderline personality disorder is the most often mentioned) and that it's a harmful diagnosis and causes those labelled with it to unnecessarily suffer. Many of these people also say that the disorder is largely iatrogenic, meaning caused by the process of therapy or caused by a societal pressure.

15 years ago, I debated online about this in a largely naive and idealistic manner. I'm not so much naive or idealistic nowadays.

The issue can get quite complicated, in part because those of us with dissociative disorders commonly switch in and out of self states based on our level of internal presence or cohesiveness or external demands. It's not uncommon to be in a part of ourselves who thinks nothing is wrong. We have learned to partition our internal experiences so well for so long, that eventually it becomes not all that hard. Then we can more easily agree with those who say it's not real. But these are merely denial states. The denial or seemingly "completely well" states often give us a little reprieve, but they rarely last long. When they do last long, it usually means there is a significant crash of reality to come.

The debate in the psychiatric community is really a "no win" debate. Not only are there conflicts about the existence of the disorder, but I am sure you all know there are conflicts about the validity of repressed memories. But that's a topic for another day. Both debates are not strictly "winnable" because each side does have some valid points. And each side is beholden to their point of view.

I sometimes do get sucked into these debates internally, but it never ends up in a good place for me. The internal debate attempts to mirror the external ones. And it just ends up causing a mass of confusion. The best place to be is to avoid the external debate and be true to your own experience. That is, if you can do that.

About 6 months ago, I had a discussion with a psychiatrist I know about whether what I experience is "real" or not. She answered by telling a Chinese proverb:

A monk asked Zhaozhou, "Does the dog have a Buddha nature or not?" And Zhaozhou said "Mu", which can be loosely translated as "not" or "nonbeing" or "without", but it doesn't mean "No, he doesn't".

Then she said: "The interpretation that I read, said that the response was meant to negate the question, not to answer it. For centuries there has been debate and discussion of whether or not the dog has a Buddha nature. Just like there is debate and discussion about whether or not dissociative identities can actually exist. But I like the interpretation that says Zhaozhou intended to negate the question, because I think that theological hair-splitting wouldn't get the young monk any closer to enlightenment and that a wise teacher like Zhaozhou would have known that. Indeed, my favorite interpretation of this story says that Zhaozhou's answer meant 'It doesn't matter!'"

It's very hard to be in a place where you can just say "It doesn't matter." But, really, I think this is the answer. If we can trust in our own experience and keep working at trying to make sense of it, then this is all we can ask of ourselves. It's not for others to judge our experience or tell us it isn't so. There is a lot of suffering that those of us with dissociative disorders have to come to terms with; but the suffering doesn't lessen by forcing yourself to believe that your internal experience isn't real. Just because it doesn't manifest itself in a simple blood test, doesn't mean it's not real. I like to think our job is to work at becoming more whole. We can have a chance at doing this only if we acknowledge our internal reality. Our internal truth.

Others will debate it for many years to come. Let them do that. And let us heal!

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Jahda said:

Hey Paul,

This is just about the best thing I've read for a long, long time! I keep coming back to Buddhism and losing months (years?) researching the connection between DID and Buddhism without finding very much at all...

I think you nailed it here! :-)

Thanks for posting this!


Ivory said:

A few summers ago, I rented a small, unfurnished apartment only for 3 months for the purpose of taking a few summer classes at the University I attended. The apartment was 65 miles away from my home. It was a difficult decision to make because of DID, but with my therapists help, I got thru it. The only glitch was the Abnormal Psych class. I took an entire semester of it in 5 days. If that wasn't bad enough, when the Prof got to the part about DID, he related to the class that DID is dangerous and as soon as a person is diagnosed with DID, they are immediately put into a "ward" and treated with medication. I won't EVEN go into the problems that caused me. Later, tho, that week, parts of me began to experience the feeling of being "wrong" and only a week after that, I found out that DID was being removed from it's own category and would be on the PTSD scale. I realized that without that label, I felt unreal. My therapist reminded me that no matter what someone else called 'it', I would still dissociate... a rose by any other name. So after all that, Paul, I agree with you completely. Let all of them fight over what to call 'it', we know what happened to us and we are well aware of the consequences of the badness forced upon us - it doesn't matter what they call it.

Paul Author Profile Page replied to Ivory:

Thanks Ivory and Jahda, This was not a formal connection between DID and buddhism; just an example which could be applied here. And I think it's an excellent one. I keep coming back to it. I still think DID will be part of the DSM-V. But, yes, if it's not, it will be a blow, but not that big a blow to me.

katie said:

what a great post, paul. i like this part especially:

"If we can trust in our own experience and keep working at trying to make sense of it, then this is all we can ask of ourselves. It's not for others to judge our experience or tell us it isn't so."

i do not have DID, but i think what you have written here applies to healing from abuse in general and probably many more kinds of mental health issues. i think validating our own experience internally and trusting ourselves is a huge part of healing. if we depend too much on how we are "seen" through the eyes of others, that can definitely make things more difficult.

thank you for this post~

Paul Author Profile Page replied to katie:

Thank you Katie! I appreciate your coming by. While I could say this yesterday, it's very hard in reality to hold onto this view. Acceptance of our own reality is constantly being tested by outside forces.

castorgirl said:

I struggle with this debate greatly... I get pulled into it through my fears over how I'll be treated by mental health professionals and the denial states that you talk about. Realistically, I know there is no winning this debate, there are too many emotions (and professional reputations) involved from both camps. But, I still get caught up with whether DID is real and therefore whether my experiences are real... I allow the external debate to influence my view of myself and my experiences. I know this isn't productive, but it's what my brain does. I'm not able to get on with healing, because part of me considers that I have nothing to heal from...

This is what I consider to be the issue with the debate, the harm it can do to those caught in cross-fire. When I'm strong, I can see the wisdom of your interpretation of Zhaozhou's statement about the debate not being worthy of concern. But, more often, I'm caught up in an internal struggle about it and my past.

Thank you for this post, sometimes we all need to be reminded of the real reasons and motivations for doing all of this - that being to heal.

Take care,

Paul Author Profile Page replied to castorgirl:

Hi CG, Yes, the "debate". The internal struggle is to be expected. I have come to accept that there is a natural denial response that we stray in and out of, and we do it in a spiral fashion, slowly getting to the place where we need to be. As Katie so wisely said this is struggle not just for those with DID but with any trauma history (or even any mental health issue, perhaps excepting depression). In many ways, the external public validation of all of these is limited. So, at some point, I will take off on this and talk more generally about mental health issues. As far as internal denial, though, while I am a believer that this is a natural protective response, we just have to be very careful that we don't stay in that state for too long. Thanks for a great comment!

Shen said:

I've tried several times to comment and for some reason, they are not showing up...
I wanted to say how much I appreciated your take on DID. I happened to be writing about almost the same thing the same day you posted this... and I see you have now seen my post.

It was such a surprise when I came in here and saw this right after writing my blog, that day.

Paul Author Profile Page replied to Shen:

Shen, I'm very sorry about the comment not coming through. Sometimes I hear people have trouble with the CAPTCHA (those letter/number combinations you type in when you make a comment). When I removed that, I was flooded by spam. But I'll see if I can find another solution.

Shen said:

It's okay, Paul. I don't know what happened. Both times, I did the captcha correctly and got the "your comment will be visible after approval" note - not the "your comment did not go through" note, so I was surprised when it didn't show up here.

Surprised and paranoid and assuming all kinds of things... lol but what else is new.

Paul, thanks for doing this post. I am learning about DID from blogs like yours. It doesn't surprise me that there are people who deny its existence. I am sad to see the effect that it has on those who do have it. Denial in any form is just another way to victimize the survivor, in my opinion. It is another way to silence us from speaking out about the abuse. One day we will see an end to the denial when enough of us speak out.

Patricia, I would like to think you are correct. But I really do think the denial is endemic to who we are as people.

OneSurvivor said:

I try to not look real hard at labels, to not embrace them much. What is important to me is who I am and what I go through. I don't want to be pigeonholed. Sometimes the questions we ask are merely distractions that take our focus off the more important thing---healing.

Paul Author Profile Page replied to OneSurvivor:

Hi OneSurvivor! I hear what you are saying. Being able to not worry about the labels and focus on the healing is a great place to be. The labels, I think though, somewhat guides how we work on our healing. Thanks for coming by.

OneSurvivor said:

So true, Paul! Labels can be useful so long as we don't get hung up on them or allow them to define us or lock us into being something we are not.

Paul Author Profile Page replied to OneSurvivor:

Yes. The point about being locked in is well taken. My take is that for those with DID, we can become much less DID and even heal from DID. So, the label is always changing... as are we!

OneSurvivor said:

I like that idea...that we are always changing. :-)

Danakx said:

I appreciate when you say, "If we can trust in our own experience and keep working at trying to make sense of it, then this is all we can ask of ourselves."

I experience a similar thing to what you've described in this post, with burnout, where there is no official diagnosis, and a lot of my experiences look, to the outsider, like depression or anxiety, or some other diagnosable thing, or maybe even like I'm just imagining it. Sometimes (often?) I question myself, too. Fortunately, I'm blessed with an understanding husband, who reminds me of what I do know about my experience, and what I've learned in the past.

I also struggle with triggers from intense, but subtle, mental abuse I suffered in a previous marriage. Sometimes, because there was so little "bad behavior" from my husband to make sense of how destroyed I was being, I still get a little crazy inside, wondering if I imagined it. But when I back up and remember what is, and also realize that the triggers I have are real and flow out of experiences that were also real, even if not highly visible, it helps a lot.

I'm appreciating reading around on your site. Thanks.

Paul Author Profile Page replied to Danakx:

Thank you for your kind words Dana. I hope you find the rest of the site helpful, or at least that it speaks to your experience. It's funny because I don't often reflect on older blog posts. This one, however, is one that is particularly relevant to what's happening with me right now.

Inner Family said:

my counselor says "your experience is your experience and it doesn't have to be anything more." i used to hate myself and wanted to do harm but when i learned about the others inside and they reached out to me and cared in a way no one else did, then i was so grateful and loved them too much to do any harm. it was because of them that i got better. d says even if a dozen clinicians said i was delusional it would only mean that a dozen clinicians had no idea what they just misdiagnosed. i am so thankful for having others inside because they saved my life and it doesn't matter how many letters someone has after their name, they can't take that away from me.

Paul Author Profile Page replied to Inner Family:

Hi Inner Family. Welcome here. I see you stumbled on one of my more favorite personal posts. I like what your counselor said. I think it's very wise advice. I don't always have the experience of compassion for inner parts. I struggle with that so much, especially when it comes to safety and self-harming.

Persephone said:

The more I get into your blog, fascination is getting a grip on me. Everything, every comment is so smart and logical that I can't but agree.

A long time ago I was given a book to read by a friend. I can't remember the title, but I do remember the doctor's name who in a most amazing way healed a student in Canada. Some names we don't forget in life, so for me this one, Dr. Lionel Solursh.

The student with triple personality was healed. There are other books I have read to this topic as well. I'll come back to this for the forum next week.

Since when do you have this blog, Paul?

Have a peaceful weekend,


Paul Author Profile Page replied to Persephone:

Thanks Persephone. I'm not sure I agree with your glowing assessment of what I write. I think that I contradict myself a lot and waffle. The blog will celebrate two years in April.

OneSurvivor said:

I just came back to this and the thing that really stood out to me was your last sentence:

Others will debate it for many years to come. Let them do that. And let us heal!

That statement and the paragraph leading up to it really sums it up pretty nicely, I think.

Paul Author Profile Page replied to OneSurvivor:

It's really interesting when people comment on old posts of mine. I then go back and look at them. And they are nice to read sometimes. When I linked to this post in the new one, I didn't actually read it to be honest. But, yes, this is a good sentence. I like it too... (I'm patting myself on the back!)

OneSurvivor replied to Paul:

As well you should, Paul! :-)

Holly said:

Great post, Paul.

"I sometimes do get sucked into these debates internally, but it never ends up in a good place for me. The internal debate attempts to mirror the external ones. And it just ends up causing a mass of confusion. The best place to be is to avoid the external debate and be true to your own experience."

I think for some that last truly is the key. But there's something very enriching (for me - I understand this is not true for everyone) about engaging externally and genuinely challenging my own beliefs and perceptions, without creating internal confusion. There was a time when that simply wasn't possible for me. Now it is. And the difference is incredibly profound. No longer are these discussions dangerous for my stability, no longer do they create enormous self-doubt and confusion. And I'm so very glad, because I truly love, and have always loved, provocative discussions. They get my brain moving!

Really love the proverb. Also this:

"I like to think our job is to work at becoming more whole. We can have a chance at doing this only if we acknowledge our internal reality. Our internal truth."

I think you really hit the nail on the head there.

Paul Author Profile Page replied to Holly:

Thanks Holly. Yes, I do see that you are able to have these debates. For me, and for some others, we can have these debates and they are helpful but only to a point. At some point they always lead to destabilization inside. So, yes, I try to challenge myself. But I have to be very careful. For me the opposite is true. Years ago I could have these debates and they would not destabilize me. Now, with more awareness of different responses inside, things seem to get more complicated.

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