How to help loved ones with dissociative identity disorder

How to help loved ones with dissociative identity disorder

What Is Dissociation? Definition, Symptoms, Treatment

Dissociation can be defined as disruptions in aspects of consciousness, identity, memory, physical actions and/or the environment. When a person experiences severe dissociation symptoms, they may be diagnosed with a dissociative disorder. The specific signs and symptoms of dissociation for any given person vary depending on the type of dissociative disorder they experience (list of dissociative disorders). When dissociation symptoms become severe, they can disrupt daily life.

Causes of Dissociation

The causes of dissociation typically include trauma, often prolonged trauma, such as sexual or physical abuse, in childhood. The stress of war or natural disasters may also cause dissociation. Dissociation is more common in children, which is why this particular behavior is often developed in childhood. Dissociation is a coping skill used to separate the person from the traumatic event(s) and memories of the traumatic event(s). Children find it particularly easy to “step out of themselves” as their identity is still forming. Dissociation may be worsened during times of stress, even in adulthood, in those who have learned this coping skill.

Symptoms of Dissociation

Symptoms of dissociation are different depending on the type of dissociation the person experiences. Some of the symptoms of dissociation as defined by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) are:

  • A major inability to remember personally-relevant events in a way that can’t be accounted for by regular forgetfulness or a medical condition (amnesia)
  • Confused and dazed wandering (known as a dissociative fugue)
  • Two or more identities or personality traits within a single person
  • Transfer of behavioral control to each identity
  • Feelings that objects in the external world are changing in shape and size
  • Feeling that people are automated and inhuman

When a person experiences a dissociative disorder, these symptoms cause significant distress or impairment in important areas of functioning such as at school or interpersonally.

Signs of Dissociation

There are signs of dissociation in addition to the above symptoms of dissociation. Signs of dissociation include:

  • Mental health problems such as depression, anxiety, and suicidal thoughts and actions
  • A sense of detachment from oneself; seeing one’s life as if it is a movie
  • An unclear sense of identity
  • Significant stress or problems in relationships, work or other important areas of your life
  • A presence of multiple people talking or living in your head, or a feeling of possession by another identity

Signs and symptoms of dissociation can happen for moments or last for years.

Dissociation Treatment

The primary treatment for dissociation involves psychotherapy (sometimes called “talk” therapy). During psychotherapy, your experiences of dissociation will be discussed and new coping techniques will be taught. Once new coping techniques have been learned and are effective, the initial trauma that caused the start of the dissociation symptoms will likely be discussed in an attempt to deal with it and move past it.

There are no Food and Drug Administration approved medications for dissociation but doctors will prescribe medications to help deal with some of the dissociation symptoms. Medications that may be prescribed are:

  • Anxiolytics (anti-anxiety medication)
  • Antidepressants
  • Antipsychotics
  • Anticonvulsants
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How to help loved ones with dissociative identity disorder

Multiple personality disorder is a common term for a psychological disorder properly known as dissociative identity disorder (DID). There is no known cure for DID, but treatment can be successful if the patient is committed to long term therapy. Psychodynamic therapy, hypnosis, and the use of appropriate medications are types of multiple personality disorder therapy that have proven successful for DID.

The most common treatment for dissociative identity disorder is psychodynamic therapy, also referred to as talk therapy. The goal of this form of multiple personality disorder therapy is to overcome and deal with the repressions typical of this disease. Beginning in childhood, individuals with DID start repressing traumatic memories that often result from physical or sexual abuse. To block them from consciousness, the individual creates multiple personalities or identities — alternative modes of thinking, being, feeling and acting. Psychodynamic therapy is used to try to access the memories that led to the formation of the different personalities.

In multiple personality disorder therapy, the use of hypnosis has also been shown to be a successful treatment. This form of therapy is also used to help the patient gain access to repressed memories. The main technique involved in hypnosis therapy is called “age regression.” While under hypnosis, the patient is asked by the therapist to go back in her mind to when the traumatic events occurred in her childhood. The belief is that accessing those traumatic memories will permit the patient to understand the threats from her childhood no longer exist in her adult life.

With most cases of multiple personality disorder therapy, the patient is diagnosed with multiple psychological disorders, including other types of dissociative disorders, anxiety and depression. It is also common for patients with DID to have a diagnosis of post traumatic stress disorder, or PTSD. A patient with multiple personality disorder and PTSD or depression, for example, would receive treatment for DID as well as the depression or anxiety. Treatment for these disorders is usually in the form of anti-depressant medications or anti-anxiety medications. Neither type of medication will have a direct effect on DID, but in certain cases medications have been shown to lessen the symptoms of multiple personality disorder.

Last Updated: May 28, 2020 References Approved

This article was co-authored by Noel Hunter, Psy.D. Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.

There are 12 references cited in this article, which can be found at the bottom of the page.

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Dissociative Identity Disorder (DID), also known as multiple personality disorder, is a condition in which a person has more than two identities, each demonstrating different behaviors, moods, and emotions. Someone with DID may feel other people living within them or may hear voices. Sometimes, however, a person can be completely unaware that they have more than one personality. In addition, these different personalities can manifest themselves in very different behaviors or the changes can be very subtle and difficult for others to detect. [1] X Research source If you have a loved one that is experiencing DID, there are a number of things that you can do make living together easier.

Grief and dissociative identity disorder can be complicated. People experience grief at various times throughout their lives, often when someone passes away. These losses can be difficult to manage, and when you have dissociative identity disorder (DID), that grief can be even more complicated. Recognizing the complexity of grief and working through it is important for those with DID in order to get through times of loss.

How Different Types of Loss and Grief Relate to Dissociative Identity Disorder

There are different types of losses that people experience. Physical loss is the most widely-recognized, which occurs when someone dies or a relationship is severed (through divorce or parental alienation). There is also symbolic loss, a type of loss that affects many trauma survivors and people with DID. This type of loss will be discussed in future posts.

Grief in DID can be short-term or long-term. Many times, grief is resolved within a certain amount of time. Other times, grief is chronic and can lead to further difficulties (When Grief Becomes a Mental Health Issue). This type of grief is prevalent in those with DID, and can complicate the healing journey.

The Complexities of Grief in Dissociative Identity Disorder

A person with DID has multiple parts, or alters. These parts have different characteristics and different beliefs, including religious and spiritual beliefs. They can also have different ways of grieving, which complicates the grieving process even more for those with DID.

Since alters have different experiences of people in the outside world, alters can experience different levels of grief when a person dies. One alter could have been very close and attached to the person that was lost, and grieving that person may be intense. Another alter could have experienced abuse at the hands of that person, and may not grieve that person’s death at all. It is important that each alter’s grief is recognized.

Alters also process grief and loss in ways age appropriate to them. Even though the main person is an adult, younger parts can grieve in ways a child would. They may not have an adult understanding of death and loss because they are, essentially, children. It’s important to acknowledge these differences and work with alters in age-appropriate ways, as you would for any other person grieving a loss.

Death and Loss in DID Affects Each Person Differently

There is no right way for multiples to grieve a loss, just as there is no right way for a singleton to grieve, either. A person can feel okay one day and can be distraught the next (What is the Difference Between Depression and Grief?). Sometimes, a significant loss, such as the death of an abuser, can create chaos within the system and cause significant disability. No DID system is the same and loss affects each system differently.

My Experience Grieving Death and Loss with DID

I’ve been going through my own grieving process recently, with the loss of my father last month. He was involved in my past traumas, so I didn’t feel any connection to him even while he was living. I did not feel any grief when he died, so I assumed all would be okay.

I was wrong. While I was okay, I had some parts in fear that we caused my father’s death, a young part wanting to go be with him, and yet another part relieved that he was gone. My invisible grief turned to internal chaos, and I found myself overwhelmed trying to manage it all. I am working through it in therapy, and now that I recognize what’s happening, it’s been easier to cope and help my parts cope as well.

Grief is a process. Don’t be afraid to ask for help.

APA Reference
Matulewicz, C. (2016, August 4). Grief and Dissociative Identity Disorder: Death and Loss, HealthyPlace. Retrieved on 2021, June 3 from

Author: Crystalie Matulewicz

Crystalie is the founder of PAFPAC, is a published author and the writer of Life Without Hurt. She has a BA in psychology and will soon have an MS in Experimental Psychology, with a focus on trauma. Crystalie manages life with PTSD, DID, major depression, and an eating disorder. You can find Crystalie on Facebook, Google+, and Twitter.

I found this article very helpful! My son (who is 37)has DID, and is having a lot of trouble coping right now. I think it is because his sister is in hospice, tho’ he won’t/can’t recognize that. He lost a half brother when he was around 11-12, and a step brother committed suicide this past year. He has a lot of denial about his sister, to the point of thinking she is causing her illness in her mind. Thanks for posting this!

I am going to show this to my therapist who does not believe in multiples thank God for this article and yes I had a diagnosed PTSD with DID it took 13 years to even get a handle on this

What Is Dissociative Identity Disorder (DID)?

Dissociative identity disorder (DID), previously referred to as multiple personality disorder, is a dissociative disorder involving a disturbance of identity in which two or more separate and distinct personality states (or identities) control an individual’s behavior at different times. When under the control of one identity, a person is usually unable to remember some of the events that occurred while other personalities were in control. The different identities, referred to as alters, may exhibit differences in speech, mannerisms, attitudes, thoughts and gender orientation. The alters may even present physical differences, such as allergies, right-or-left handedness or the need for eyeglass prescriptions. These differences between alters are often quite striking.

A person living with DID may have as few as two alters or as many as 100. The average number is about 10. Often alters are stable over time, continuing to play specific roles in the person’s life for years. Some alters may harbor aggressive tendencies, directed toward individuals in the person’s environment or toward other alters within the person.

At the time a person living with DID first seeks professional help, he or she is usually not aware of their condition. A very common complaint in people affected by DID is episodes of amnesia, or time loss. These individuals may be unable to remember events in all or part of a proceeding time period. They may repeatedly encounter unfamiliar people who claim to know them, find themselves somewhere without knowing how they got there or find items that they don’t remember purchasing among their possessions.

What Are The Symptoms Of DID?

Often people living with DID are depressed or even suicidal and self-mutilation is common in this group. Approximately one-third of individuals affected complain of auditory or visual hallucinations.

While the causes are unknown, statistics show that DID occurs in 0.01 to 1 percent of the general population. DID is a serious mental illness that occurs across all ethnic groups and all income levels. It affects women nine times more than men.

In addition to experiencing separate identities, individuals living with DID may also experience many other symptoms. Some of these symptoms include:

  • Depression.
  • Suicidal tendencies.
  • Anxiety, panic attacks.
  • Alcohol and drug abuse.
  • Confusion.
  • Memory problems.
  • Delusions.
  • Headaches.
  • Flashbacks.
  • Eating disorders.
  • Personality change.
  • Selective loss of memory.
  • Disorientation.

What Does Treatment For DID Look Like?

Treatment for DID consists primarily of psychotherapy with hypnosis. The therapist attempts to make contact with as many alters as possible and to understand their roles and functions in an individual’s life. In particular, the therapist seeks to form an effective relationship with any personalities that are responsible for violent or self-destructive behavior and to curb this behavior. The therapist aims to establish communication among the personality states and to find ones that have memories of traumatic events in an individual’s past. The goal of the therapist is to enable the individual to achieve breakdown of the patient’s separate identities and their unification into a single identity.

Retrieving and dealing with memories of trauma is important for a person living with DID, because this disorder is believed to be triggered by physical or sexual abuse in childhood. Young children have a pronounced ability to dissociate and it is believed that those who are abused may learn to use dissociation as a defense. In effect, the child slips into a state of mind in which it seems that the abuse is not really occurring to him or her, but to somebody else. In time, such a child may begin to emotionally and cognitively split into alternate identities. Research has shown that the average age for the initial development of alters is 5.9 years old.

In individuals where dissociation is thought to be a symptom of another mental illness such as borderline personality disorder (BPD) or posttraumatic stress disorder (PTSD), treatment of the primary cause is of upmost importance.

Children affected by DID may experience a great variety of symptoms, including depressive tendencies, anxiety, conduct problems, episodes of amnesia, difficulty paying attention in school and hallucinations. Often these children are misdiagnosed as having schizophrenia. By the time the child reaches adolescence, it is less difficult for a mental health professional to recognize the symptoms and make a diagnosis of DID.

Moderator: Johnny-Jack

Help for loved ones of partners with DID

by NiennaLadyOfTears » Sat Jul 16, 2011 9:34 pm

Does anyone know some resources that can help me? Any forums or pages on how a partner or spouse can learn to adapt? I’ve suspected this for years but my husband was just recently diagnosed with it.

A little bit about him:

Tom was never sexually abused but he was emotionally neglected by his parents who didn’t speak to him because he was “strange.” They did things like tear up his art work instead of featuring it on the fridge regardless of the fact that his two sisters had their art displayed on the fridge all the time. He has Asperger’s and doesn’t understand how to interpret body language and so he doesn’t understand why people think he is weird. As a child he spent every day after school up in his room with his alters, some of which have faded or split into others. He was also verbally abused. Later when he was 300 pounds he was placed on a starvation diet to get him down to 150 (he’s 6 foot tall.) His father called him gay because he enjoys cooking, cleaning, organizing and interior design.

Host: Tom, Ministry student. Christian. Wants to be a preacher. Late twenties.

Jim (split into Toby) This alter came out when Tom was living in a basement apartment with nobody to talk to. He did not have a phone, TV, or computer available for six months. This alter can show his anger physically and if in a fight with Toby then a lot of mental chaos ensues.

Toby: Protector, Atheist, Brutal nihilist. (Tom was the subject of a lot of emotional, verbal, and spiritual abuse within church or those who claimed to be Christian.) By far the most active alter; comes out almost every night, especially if Tom is too tired to restrain him and the others are also sleeping. Best way to deal with Toby is for Tom to just go to bed, but Toby balks at the idea and continues swearing and spewing out non-Christian ideas and philosophies, and often uses Tom’s knowledge of the bible or experiences with Christians to throw it in Tom’s face to get him to leave Christianity. So far it hasn’t worked.

Mortimer: Came out about the same time as Jim to restrain Jim from splitting into Toby. He is primarily a peaceful mediator between Toby and Jim, as both of these alters have explosive personalities. He uses force when needed but then feels guilty for hurting his friends.

Tanok: ISH/Gatekeeper Tanok comes from another world than the other three alters called Yma. He is an elf (as in Lord of the Rings style elf, not as in Keebler elf.) This world has been inside Tom since middle school. It is a complex world with three fully thought out languages. This alter mainly comes out when Yma is being typed on the computer but sometimes shows up when Tom is too weak to restrain Toby on his own. Shares some similarities with Mortimer but the two don’t know about each other. He is a few thousand years old. He has friends from outside the system.

Vice: More of a fragment than anything else.

He also hears the people who were the abusers. It’s as if he relives everything they say. I can’t tell him it’s in the past as it’s very real even though it was almost two years ago now that he last contacted them.

By Allie Cotterman

How to help loved ones with dissociative identity disorder

Have you ever been driving and suddenly realized you didn’t remember the last ten minutes of your drive? Have you ever been in a conversation and recognize you haven’t heard a word the other person just said? Ever daydreamed through a lecture at school? Almost everyone has had their “autopilot” activated at some point in their life. It is a regular function of the human brain to be able to detach from reality and cling to something reassuring to avoid anxieties.

Dissociation may be a normal phenomenon, but like everything in life, all in moderation.

For some, dissociation becomes the main coping mechanism they use to deal with the effects of a trauma response in anxiety disorders, such as PTSD, or other disorders, such as depression. It can present itself unconsciously and feel out of the person’s control. When dissociation becomes the go-to is when it becomes a problem.

There are a few textbook varieties of chronic and disabling dissociation that may call for an official diagnosis. However, not everyone who experiences dissociation fits into an exact category and may therefore be labeled “dissociative disorder not otherwise specified (DDNOS). Dissociation can also be a side effect of other mental illnesses rather than its own unique condition.

As nice as it may seem to “check out” of difficult situations, chronic dissociation comes with a plethora of undesirable side effects, the worst of which being that you are no longer in the driver’s seat of your reality. Your brain ultimately learns how effective it is as keeping you “safe” from a trauma response by detaching from your surroundings, so it keeps doing it — often whether you like it or not.

So what do family and friends need to know when a loved one is dealing with chronic dissociation? While every person is different — and every experience of dissociation is different — here are the top five things to keep in mind based on my personal experience with DDNOS.

The person dissociating is not dangerous

Dissociative disorders, such as dissociative identity disorder (formerly known as multiple personality disorder), often get a bad reputation in the media. We see movies and read books about people who dissociate and commit horrible crimes under the control of a villainous personality. The truth is, when people dissociate, they are doing it not because theyare dangerous, but because they perceive danger toward themselves.

A person experiencing dissociation is typically closed off from others, possibly catatonic. When someone detaches so deeply from reality, it may result in an inability to break out of this shell. In such a state, most people couldn’t hurt a fly, even if they wanted to. Dissociative identity disorder may be the exception, since their alters often are able to act while the person has dissociated, but this does not make them dangerous.

Reality is not an option

Trying to reason with someone who has dissociated is not going to be effective. Reality is exactly what their brain is trying toescape. Bringing it to their attention may only cause them to retreat more.

Anger is not helpful

Anger is another experience that may cause the person dissociating to furtherretreat. They are already reacting to a perceived threat, and anger will only build on that threat. If you must speak with them, use a calm voice and don’t be surprised if they do notrespond.

Additionally, do not attempt to argue. If someone has dissociated, they are not available for this type of interaction. You are talking to a person who cannot reason with you. The person might be able to hear you, but regardless, they may be unable to respond. And if you try to argue long enough, you could rouse their inner child — this is especially likely if the dissociation began when they were young. This will not help anyone, so stay with being supportive.

Acceptance is key

Accept them. Try to understand them. Ask kind questions about what they think would help. Make them comfortable. Tell them they are safe. Protect them.

Grounding techniques can help

“Grounding” refers to the process of physically and mentally connecting with the world around you — the ground you can feel beneath your feet, the scents you can smell in the air, etc. — which can re-establish a sense of reality. Grounding can be beneficial for people experiencing panic attacks and other forms of anxiety, as well as dissociation.

If someone you know experiences dissociation, you can help them learn grounding techniques and be there to facilitate the steps during an episode. Even though people can usually feel the onset of dissociation, it can be difficult to “ground” without help. Having a friend or family member there can make the process more effective, as they can offer support by remembering or reading the necessary steps. There are many techniques to try, so it’s important to find what works for a specific person.

As with any mental illness, people need patience and kindness. They need a break from the stigma of their disorder or symptoms. They need to know they aren’t alone.

And now, here is the good news: dissociative disorders can often be treated, given the appropriate mental health care, a safe environment and support of friends and family. As a person who no longer uses dissociation as her main coping mechanism, I can vouch for that.

Allie Cotterman is a mental health advocate, who has been herself dealing with the effects of mental illness her whole life. She has degrees in psychology and teaching, and loves to help inform others on ways to drop the stigma of mental illness. She specifically likes to write about bipolar disorder, dissociative disorders, anxiety disorders, anorexia and borderline personality disorder, as those are her own personal experiences. Educating the public on the difficulties of these diseases will forever be a passion of hers.

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Dissociative identity disorder (DID) can take shape in a variety of ways, they are not all the same. If you or a loved one is facing symptoms of dissociative identity disorder it may be time to get the help you need and deserve.

Dissociative identity disorder is often characterized by a lack of sense of identity and may stem from childhood trauma or environmental factors. For more information, read more about dissociative identity disorder below.

There are numerous ways to get help out there for DID and one quick way to start is this dissociative identity disorder (DID) test to get more information about your symptoms and what the next steps may be to address DID.

What is Dissociative Identity Disorder?

Most experts agree that dissociative identity disorder, sometimes shortened to “DID”, is one of the most unusual and dramatic personality disorders, posing lots of challenges and unanswered questions for both researchers and clinicians.

Formerly known as multiple personality disorder, dissociative identity disorder is characterized by the presence of two or more distinct identities or personalities.

Most often, people with dissociative identity disorder have a primary personality which can be passive, hesitant, depressed, and dependent. However, his or her alternative personalities may be at the opposite pole, displaying extraversion, openness, and charm.

Furthermore, alternative personalities may have different genders or ages and exhibit different preferences, interests, beliefs, behaviors, and feelings in someone with DID.

These personalities take over successively, changing the person’s entire attitude towards himself or herself, others, and the world. When one personality ‘takes the wheel,’ the rest remain on ‘standby.’

In other words, if a personality is on standby, it dissociates or detaches itself and does not know what happened while it was on standby. And that’s why people with this condition can struggle to recall significant portions of their everyday life.

The impact that dissociative identity disorder has on one’s personal and professional life depends significantly on the number of existing personalities. But as you can probably imagine people who suffer from dissociative identity disorder face numerous challenges.

Signs of Dissociative Identity Disorder

Experts agree that even though DID occurs during childhood, symptoms become obvious during adolescence and may worsen when the person reaches adulthood.

The main signs of dissociative identity disorder are:

  • Presence of dreams and painful memories
  • Lack of focus
  • Seizures – especially in response to trauma or unpleasant memories
  • Unexpected changes in clothing, activities, and preferences
  • Feelings of detachment and dissociation
  • Memory loss
  • Lack of sleep
  • Dizziness and confusion
  • Lack of temporal and spatial awareness
  • Pesence of two or more personalities which trigger behavioral and emotional changes that may be labeled as ‘bizarre’ or ‘baffling’ by others.

Aside from the symptoms mentioned above, one reliable indicator of dissociative identity disorder is dissociative amnesia. In other words, the person is unable to recall recent important or stressful events. Dissociative amnesia can result in anxiety and depressive symptoms.

How is Dissociative Identity Disorder Treated?

DID can be a severe mental illness that wreaks havoc into the lives of those who are dealing with it. Unfortunately, there are no treatments designed specifically for dissociative identity disorder at this time.

However, mental health professionals can use a wide range of pharmacological and therapeutic approaches that can help people manage the unpleasant effects of this condition and enjoy a relatively stable life.


Although there are no drugs that target this condition, psychiatrists often prescribe antidepressants or anxiolytics to help with the anxiety and depressive episodes associated with dissociative identity disorder.


Psychotherapy is the most popular form of intervention for dissociative identity disorder. Depending on the severity of the symptoms and number of alternative personalities, people with this condition could stay in therapy for years before reaching the point where they can take full control over their life.

It’s important to remember that the primary goal of therapy isn’t to reduce all personalities to one but to teach the person to handle all personalities and make them work harmoniously toward the same personal and professional achievements.

And so the purpose of therapy is to help the client understand their condition, increase awareness, control emotions and impulses, cultivate stable interpersonal relationships, and manage stress.