A child abused by a family member faces an ongoing dilemma: this beloved figure is inflicting harm, pain, and humiliation, yet the child is both emotionally and physically dependent. Some continue to feel detached and dis-integrated for weeks, months or years after trauma.Ībuse by a trusted authority figure such as a parent creates special problems. Sexually or physically abused children often report seeking comfort from imaginary playmates or imagined protectors, or by imagining themselves absorbed in the pattern of the wallpaper. Many rape victims report floating above their body, feeling sorry for the person being assaulted below them. During and in the immediate aftermath of acute trauma, such as an automobile accident or a physical assault, victims have reported being dazed, unaware of serious physical injury, or experiencing the trauma as if they were in a dream. The mental imprint of such frightening experiences sometimes takes the form of loss of control over parts of one’s mind-identity, memory, and consciousness-just as physical control is regained. The essence of traumatic stress is helplessness-a loss of control over one’s body. DID can be thought of as a chronic, severe form of post-traumatic stress disorder. Roots in TraumaĮvidence is accumulating that trauma, especially early in life, repeated, and inflicted by relatives or caretakers, produces dissociative disorders. But new research has helped us understand the origins of this tragic condition, as well as how it is reflected in the brain. It affects some 1 percent of people in the United States, 0.5 percent in China, and 1.5 percent in Turkey and the Netherlands, according to various studies in these countries.Ĭontroversy has swirled around the disorder, in part because it is extreme and dramatic. They cannot remember or make sense of parts of their past.ĭissociative symptoms involving alterations in identity, memory, consciousness, and body function are seen in cultures around the world, described as “ ataques de nervios” in many Hispanic cultures and as states of trance and possession in China, Japan, and India. They find many parts of their experience alien, as if belonging to someone else. They have difficulty integrating their memories, their sense of identity and aspects of their consciousness into a continuous whole. People with dissociative disorders are like actors trapped in a variety of roles. In fact, the problem is not that they have more than one personality, but rather that they have less than one-a fragmentation of self rather than a proliferation of selves. We normally act like “different people” at work and at a party (hopefully), but we have continuity of memory and identity across the differences. The problem is not that there are “multiple personalities” existing in one body, as the old name of the disorder implied, but rather that the brain fails to integrate our different personae. Such memory loss is often asymmetrical-one identity may be aware when another is prominent, but not vice versa. Mary was frightened and mystified about the injury. One “identity” may inflict physical damage on their body as “punishment” for another “personality” state, such as the patient who carved “I hate Mary,” another of her identities, into her forearm with a knife. ![]() But they are the victims, not the authors, of their own fragmentation. Sufferers experience sudden loss of episodic memory, change from a sad, dependent, and helpless personality state to an angry, demanding, hostile one in seconds, and may find themselves in situations that they cannot understand. ![]() ![]() Some people do have what scientists now call “dissociative identity disorder” (DID), a name change made official in 1994, when the American Psychiatric Association published the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders. This article is written to set the record straight, to explain what this disorder is and what we understand about its causes, both in early life experience and in the brain. However, these and other common perceptions are mistaken. Some believe that the disorder is the creation of credulous and overeager therapists. On TV crime shows and in movies the “split personality” is used as a dramatic excuse for mayhem or is feigned to evade criminal responsibility. In pop culture, “multiple personality disorder” is often portrayed as involving strategic, dramatic, and seductive battles among personalities that are uncomfortably sharing one hapless body.
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