Dissociative Identity Disorder (DID)

Helping you recover from trauma

The term Dissociative Identity Disorder (DID) better describes the condition previously known as multiple personality disorder. Lack of understanding has led some to believe that an individual can have two or more different personalities and an ability to switch from one to another. Dissociation is better described as the lack of connection in an individual’s consciousness which occurs as a psychological defence against previous traumatic experiences; the dissociated parts, therefore, operate independently as a coping mechanism for the main part by allowing the different aspects of the experience to be separated and therefore more manageable.

The creation of different personalities, or parts, is subconscious and the individual has no control over them. These parts can be similar to their usual personality and others will be completely different. They can differ in gender, age, tolerances, likes and dislikes, voice sound and other features.

Dissociation can occur as brief, transient episodes where the person appears distracted or can be more severe leading to a diagnosis of DID requiring specialist treatment. People with DID can experience depression and anxiety and they may have periods of amnesia and trance-like states.

Someone with DID may find themselves behaving differently; doing things they would not be able to do usually. When people with DID start to experience increased memory loss, confusion about who they are and become distressed and worried about themselves; or other people find their behaviours unusual, they seek help. If any of this seems familiar or resonates, we are here to help.

What is dissociative identity disorder (DID)?

People with a dissociative identity disorder (DID) describe a feeling of being detached from themselves and seeing their body as a vehicle for their many personalities. Others describe it differently, but commonly they understand that they are the same person but have different identities that emerge at different times; particularly in times of stress and feeling unsafe. They have little control of which personality is at the fore and what they are like; although some may speculate that they are characters/people they wanted to be like when they were young.

Someone with DID may find themselves behaving differently; doing things they would not be able to do usually like a criminal act like theft or being riskier than they would be. Some personalities have specific roles and some do not. Where people start to feel distressed and worry about themselves, is when they are confused about their identity and experience long periods of upsetting memory loss.

Personalities can differ in gender, age, tolerances, likes and dislikes, voice, and other features. The personalities can stay at the same age or age over time.

Symptoms of a dissociative identity disorder

The following mental health symptoms may be present:
  • Depression
  • Mood swings
  • Delusions, auditory and visual hallucinations/visions
  • Suicidal thoughts and feelngs
  • Sleep disorders (insomnia, night terrors, and sleep walking)
  • Anxiety, panic attacks and phobias (flashbacks, reactions to stimuli or "triggers")
  • Alcohol and substance misuse
  • Eating disorders
  • Obessesive Compulsive Disorder (OCD)

Causes of a dissociative identity disorder

Dissociative identity disorder (DID) is relatively uncommon but still effects 1% of the population. It is likely that it is caused by three things which can be experienced in isolation or together in different combinations and occur in a child’s early years (usually before the age of 6 years old). They are:
  • Trauma
  • Problems that cause significant stress, and
  • Relationships that feel unsafe and threatening in some way

Diagnosis: How we identify DID?

It can take time to diagnoses someone with dissociative identity disorder (DID); it may not be clear to start with what is going on for someone as symptoms can be similar to other mental health conditions. Prior to being admitted to our specialist DID Unit in Schoen Clinic York, you will already have a history with mental health services and have been diagnosed. Our specialist team are very skilled at being able to confirm the diagnosis or indeed discover that the diagnosis is incorrect.

Safe, supportive and specialist

We aim to keep you safe and understood so you can reduce the negative impact on your life that facilitates increased self-awareness and skills development to help you live your life with more certainty.

Some people do very well with a therapist, working over a period of time. At Schoen Clinic York we have a very specialist service specifically to help people who are experiencing dissociative identity disorder (DID). Specialist treatment for DID takes on average of 5-10 years to complete and the best outcomes are achieved when the majority of this is completed within the community setting. Work completed on the unit is therefore just one part of this overall journey of treatment. The work will be focused around learning to understand your experiences and difficulties and developing ways to interact and manage these in order to function how you would wish to day-to-day and be able to progress to community approaches/therapy. You will complete both a talking and an art-based approach to the trauma work.

Our specialists will work with you to help you feel safer and reduce the impact of past traumas. An intensive relational approach is used with 1:1 work and group programmes.
Care is delivered in a phased approach:
Phase 1: Assessment, formulation, engagement, care planning and safety.
Phase 2: Development of personal understanding, skills and resilience.
Phase 3: Discharge, onward care planning and transferring skills.

Inpatient care

Multidisciplinary team
We work in a multidisciplinary team that has specialist knowledge and experience of working with people with dissociative identity disorder (DID). This includes a Consultant Psychiatrist renown in the field, nurses, psychotherapists, occupational therapists, art therapists and psychologists. They will assess your individual needs and develop with you your care plans. The therapeutic approach encourages you to fully participate and have a say about the way we work with you and how the unit operates it’s therapy programme. They will meet you regularly and review progress.

Psychological therapies
Trauma and relational life experience, in particular during growing up can affect our physical and sensory development as well as our psychological/emotional development.

The DID unit therapeutic stance draws heavily from attachment and relational theory, interpersonal psychotherapy (IPT) and looks to use a relational approach to create an environment and relationships which are supportive of recovery, promote positive relational functioning and relationship development.

We aim to foster an atmosphere which is non-judgmental, curious and empathic in the hope that this containing relational space will enable you to explore your sense of self, your difficulties and the relationships you have with others and within yourself. During the course of your admission, we aim to help you to improve your day-to-day functioning and reduce the impact of presenting symptoms and making these more manageable (with particular emphasis on risk episodes, trauma and dissociative symptoms).

Our treatment programme
To do this, we provide a group programme focused on the difficulties that arise from the experiences of complex trauma and dissociation, with a particular focus on the interpersonal and relational aspects, that includes individual & group psychological therapeutic and specialist individual and group social occupational and psychological recovery interventions. Other groups are psychodynamic in construct and explore the interpersonal relationships that are difficult due to the DID.

We aim to increase understanding and acceptance of emotions and the importance of their role, increase flexibility and choice in relation to the experience of emotions, develop skills in understanding, recognizing and responding to emotions in helpful ways and to be able to then use positively use the experience of emotions to guide and assist us in achieving positive interpersonal functioning.

You will also have individual and key working sessions with members of the team.

Medication for anxiety and depression symptoms

There is no medication prescribed for dissociative identity disorder (DID) but medication is used to alleviate symptoms such as anxiety and depression where indicated as helpful.

Our specialists

Our DID unit