I live with Complex Post Traumatic Stress Disorder (PTSD) and Dissociative Identity Disorder (DID). Both are difficult disorders to live with and make life very complicated for both myself and my family. Through psychyotherapy I have learnt strategies for learning how to cope with my complex ptsd.
Alternate personalities, known as alters in dissociative identity disorder (DID), are a fundamental part of the disorder. And while most people can’t imagine more than one identity living within the same person, that’s exactly what alters in DID are. People with alters often refer to themselves as “we,” due to the multiple alters within the single person. (Dissociative Identity Disorder Controversy: Is DID Real?)
These personality states must each have their own enduring pattern of perceiving, relating to and thinking about the environment and self. These personality states can be thought of as alters. Alters involve marked discontinuity in sense of self and sense of agency, accompanied by related changes in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.
DID alters can have different physical affects, accents, memories, ages, names, functions, genders and other traits. Collectively, all the alters together are known as the “system” in dissociative identity disorder. The dissociative identity disorder alter who has executive control over the body most of the time is known as “the host.” The host personality may or may not be the individual’s original personality.
Dissociative identity disorder alters are commonly of specific types. The following are common DID alter types:
- Child and adolescent alters – young alters are often the first discovered in therapy and are the most common type of alter. These alters emerge to handle the abuse that the original personality couldn’t tolerate. A DID alter may be referred to as a “little” if the alter acts seven years or younger.
- Protector or rescuer alters – these alters can be of any age and were created to save the original person from intolerable situations. These DID alters are often tougher and braver than the original personality.
- Persecutor alters – these DID alters are modeled after the abuser. Persecutor alters create negative messages blaming the original identity for the abuse and telling them they need to die or pay for it. Often the host will act on these negative messages and self-harm or even attempt suicide. This is often when the person is first introduced to the mental health system.
- Perpetrator alters – also modeled after the abuser, these dissociative identity disorder alters direct their hostility outward rather than inward towards other personalities.
- Avenger alters – this dissociative identity disorder alter holds the rage from the childhood abuse and may seek retribution from the abuser. They tend to express the anger of the entire system and can be hostile.
While those are the common DID alter types, other alter types occur as well.
The most difficult condition for me to manage at the moment is DID. With the help of my psychotherpist these are the methods we are implementing to try and manage my very difficult and dangerous alters.
Recognize the nature of my illness. I am a single, whole individual with different identities. Each separate identity (or “alter”) is my own, even if I feel that I have no control over them. Recognizing this basic fact will give me a sense of personal identity and help me learn how to manage my condition.
Identify the cause. DID is most common in women, and it is almost always connected to childhood trauma, often in the form of brutal and sustained abuse. As painful and difficult as the process might be, understanding the cause of my dissociation may help me to heal.
Accept that my alters are real, at least for the time being. Others may tell me that my alters don’t exist, that I created them myself. To a certain extent, this is true – they are aspects of my own personality, not independent people. However, if I am living with DID, these alters feel very real. For the time being, it may be best to acknowledge their apparent reality and learn to cope with their existence.
Expect to experience amnesia. Because I have DID, I may have two kinds of amnesia. First, I may have forgotten or blocked out painful or traumatic life experiences; recall that many people with Dissociative Identity Disorder had such experiences as children. Second, I may develop amnesia and a sense of “lost time” whenever one of my alters takes over my consciousness.
Know that you may experience fugue states. Because one of my alters may take over at any given time, I may find yourself away from home, unsure of where I am or how I got there. This is called a “dissociative fugue.”
Understand that depression is common in people with DID. Because I have Dissociative Identity Disorder, I may also experience symptoms of depression: disturbed sleep and appetite, persistent sadness, and, in some cases, suicidal thoughts.
Be aware that anxiety is also common in people with DID. Because I have Dissociative Identity Disorder, I may also experience symptoms of anxiety. I may notice that I feel very worried or panicked, sometimes without understanding why.
Look for other mental health symptoms. In addition to amnesia, fugue states, depression, and anxiety, I may notice other psychological symptoms: mood swings, for example, and a sense of numbness or detachment from reality.
Watch for auditory hallucinations. People with DID sometimes hear voices, which may cry, comment, criticize, or threaten. I may or may not understand, at first, that these voices are coming from inside my head.
Understanding all of the above helps me to understand and live with DID and realise I am not alone in my experiences.