D.I.D. You Know?: A Brief Guide to Dissociative Identity Disorder (local copy)

by tigrin

The original comic.  Scroll down past the notes for transcript.

Artist's Notes

IMPORTANT DISCLAIMER - PLEASE READ:
I am not a doctor. I am not qualified to give medical advice or make a diagnosis. I'm not even a student. DO NOT attempt to use this information to make a diagnosis. Do not diagnose yourself or someone else. If you think you or someone else needs help, please seek professional advice. This is meant to be an EXTREMELY BRIEF guide to a very complex condition. All I know, I have learned from reading a lot of books, browsing a lot of websites, watching a lot of movies and television, and meeting a lot of people. Because this is a very controversial diagnosis, I have attempted to present a middle ground in terms of what DID is. The terms I have chosen are not official terms. While all this information is based on fact and the experiences of others, it is not meant to be "official" or used in research documents. It is ultimately my reflections on and opinions of the diagnosis, and should be treated as such. If you are interested in this condition, I highly encourage looking up more information, which I will post at the bottom of this description.

Why Dissociative Identity Disorder? Why not Multiple Personality Disorder?
In order to avoid moral and religious conflict, the diagnosis term was changed from "Multiple Personality Disorder" to "Dissociative Identity Disorder" in the United States. The term "dissociative identity" refers to the idea that personalities in a multiple system are not actually personalities. Instead, they are dissociated parts of a "core" personality, who lives with the delusion of having separate personalities. Personalities are actually just aspects of a single self that have been disowned and given another name. I have chosen not to present this definition of DID. While I do believe this to an extent, I believe that personalities can be more than just an aspect with a name, a delusional "dissociated identity". Sometimes there is no "core" personality, and sometimes personalities actually split off other personalities. I think the definition is too limiting, so I have chosen to present it in a more neutral light that is more sympathetic to the people who experience this condition. It is difficult enough for multiples to accept themselves without being told that their experience is a delusion. Personalities feel and act very real. If you meet a multiple, please do not try to convince personalities that they are not real, and should go back to being so-and-so. You wouldn't like it if I said it to you, and it does NOT help at all. Whether personalities are "real" or not is irrelevant... it's the experience that matters. Well, those are just my thoughts are anyway, and I'm certainly not forcing anyone to think differently.

About this Deviation:
Why did I make this? Firstly, because you won't believe how many people don't know a thing about DID, or even what schizophrenia is. Everyone knows about "multiple personalities", but no one knows what it really is. The things I do hear have been set up and fed by Hollywood bullshit. The worst for me is to see people talking about and presenting false information, especially in popular media that reaches a wide audience. Not okay. People need to know something that hasn't been filtered through corporate logos. They need somewhere to start, and this is as good as any.

Second, because there is practically no support out there for DID. People with DID are forced to hide in online communities under false identities because of the stigma of the label. Insurance companies won't support medications or therapy with dissociative diagnostic codes. DID parents can be considered incompetent and their children taken away, and employees can be fired. Some people with DID are so crippled by a combination of the diagnosis and outside stigma that they're forced to survive off disability, or be homeless. Also, very few therapists are familiar with dissociative disorders, and even fewer have the skills and the specialty to actually treat it. Having been around the system, I can say it's impossible to find someone without dropping a lot of cash... something most people just don't have. and even when you find someone, they might not have the right skills or attitude about the DID. Not to mention that therapists who do treat a dissociative case can be assaulted with criticism and their patients attacked with accusations of hypnotism and brainwashing. More people who are in the position to help others - therapists, psychiatrists, med students - need to know what this is really about. There needs to be more support out there.

I want to say right now that I do not care if you think that DID is a bunch of crap. If you have negative comments or criticism, you are welcome to note them to me. If they are rational enough, I will respond. but I will not argue with or try to persuade someone who does not want to be persuaded. I want you to believe what you want to believe. but I want you to make an informed decision.

I made this because I want something that is short, interesting, humorous, and generally easy for anyone to understand. Anyone should have the opportunity to understand this, and I hope people do get something out of this. I do encourage you to show this to whoever you'd like. You can link to it anywhere you'd like. Just do not alter it, slander it, or claim that you wrote it. That's not cool. This is the only time I'll ever, ever ask this: please favorite this. Even if you don't have a comment, favorite it. I want this to reach as many people as possible. Link to it in your journals, whatever you want to do. Any and all help is appreciated. I'm just one person but there's a lot of you.

If you happen to be proficient in another language and would like to translate the text, I would be more than happy to post up a translated version. :)

Here are the individual pages.. easier to print:
Page 1: [link]
Page 2: [link]
Page 3: [link]
Page 4: [link]

Translations:
Brazilian Portuguese: Page 1/Page 2/Page 3/Page 4 Thank you ~Halexandre!

Further Reading:
Books:
The Dissociative Identity Disorder Sourcebook by Deborah Bray Haddock - I read through this in a bookstore once and was really impressed by it.
First Person Plural by Dr. Cameron West - Of the autobiography/biography books I've read on the subject, this is probably my favorite.
Mahoraba - Of all the fictional accounts of "multiple personality" that I've seen, this is my favorite so far. It doesn't sensationalize it or anything; it's just a cute, fun read. It's not syndicated yet, but there are "scanlations" floating around the 'net.
Astraea's Bookstore - this is a massive list of books related to multiplicity/plurality with reviews... lots more books here, and some second opinions.

Websites
The Layman's Guide to Multiplicity - I often refer people to this site if they're new to the whole idea. Really well set up and explained.
Multiplicity: The Missing Manual - It's big, and it's a wiki!
The International Society for the Study of Trauma and Dissociation - They've got a lot of information about dissociation and lots of stuff for professionals who are new to the concept.
Mind.org.uk - a booklet on dissociative disorders
Dissociative Identity Disorder Questions and Misconceptions - lots of research and even history of the diagnosis.
Astraea's Web - a massive website that is the hub of healthy multiplicity and plurality. Lots of articles, a helpful terms section, etc. etc.
"You're Not Crazy & You're Not Alone" - Clips from a DVD about DID

Well anyways... any and all questions are welcome... if I get the same question a lot, I'll post it here... you can leave them in comments, note them to me, or e-mail them to me, doesn't matter... :) Thanks!

Almost forgot, credit for the silly but witty title goes to *Reich! Thanks for letting me use it.

Transcript

Beneath the title, to the left, there is a cute scribbly depiction of a girl with glasses and a labcoat--a female Dr. Jekyll. Next to her is a disheveled girl with a shredded shirt and ominous demeanor--a Ms. Hyde. At the far right, our girl with glasses has a little angel and devil over her shoulders.

Text: "Split personalities" is one of the most popular concepts in Hollywood. The classic struggle of Dr. Jekyll and Mr. Hyde is just one image in a slew of psychological drama. Audiences are endlessly fascinated by the idea of more than one person in the same body. But how much do people know about the real thing? Just what is this phenomenon really about? To find out, we'll have to start with the basics.

Subheading: What is "Dissociation"?

Panel: The girl is in her car, driving down the road. She looks confused, and the road sign reads Nowhere.

Text: Have you ever driven down a familiar road, only to "wake up" somewhere different?

Panel: The girl is reading a book in bed, next to her stereo. According to her clock, it's 5:02 AM in the morning.

Text: Or enjoyed a book so much that hours seem to pass in minutes?

The next panel is text-only, reading, "If you have, you've experienced something called Dissociation." (There's also a phonetic transcription of the word.)

In the following panel, the text is broken apart into individual words, which rain down on our glasses girl's head as she appears to mull over each one, as though trying to put it all together. The text reads, "Dissociation is a disconnection between thought, identity, reality, memory, and emotion in the mind."

Two panels: A much younger glasses girls plays with her stuffed animals in a box. Then, in the next one, she's an adult again, staring blank-faced at the wreckage of stuffed animals, which her very happy dog seems responsible for. It sits among the dismembered toys, wagging its tail.

Text: It is a helpful, normal ability that all people possess from a young age. It helps us daydream, or keep our heads through stressful situations.

The panels break for the moment, leaving only text. "It is the mind's best survival mechanism. When dissociation gets out of hands, it can interfere with daily life. Which leads to our next definition...

Subheading: What is a "Disorder"?

Back to comics!

Text: A "disorder" is a condition that impairs functioning or causes distress.

Panel: Glasses girl is bowed down with the huge weight of the word 'DISORDER,' which is big and dark and rests on her back.

Text: When dissociation starts to interrupt a person's quality of life, then we enter the realm of Dissociative Disorders: Dissociative Amnesia, Dissociative Fugue, Dissociative Identity Disorder, Depersonalization, Dissociative Disorder Not Otherwise Specified. Of these, the most well-known is Dissociative Identity Disorder.

Panel: Glasses girl is now dragging heavy iron balls that are chained to her ankle like a prisoner. The balls contain text inside them, asking questions like "Who am I?" "How Did I Get Here?" and "Who Are You?"

Subheading: What is Dissociative Identity Disorder?

Glasses Girl reads from the DSM-IV (the current edition, at the time this comic was made), "Previously known as 'Multiple Personality Disorder', Dissociative Identity Disorder (or DID for short) is an often misunderstood diagnosis, and its diagnostic criteria certainly aren't much help! Let's take a look. Although there is a lot of controversy over the term, let's refer to alternate identities as 'personalities'... just to keep things consistent.

"Criteria 1. Two or more personalities are present. Most everyone acts differently around different people. So what makes DID different? A person with DID experiences life as two or more distinctly different people."

Two comics panels help illustrate the concept: First, Glasses Girl talks to a man, who asks, "How are you?" She replies, "Good, how are you?" Then, she talks to another woman with a big grin and blond hair. When the blond girl asks, "What's up?" she replies, "Your mom."

Text: While you may be more respectful towards a teacher than a friend, you still have the same values and qualities that make you, you. A person with DID experiences attitudes and behaviors that clash or are distinctly different from their own.

Another two-panel comic shows the difference. A guy with ice cream asks Glasses Girl, "want some ice cream?" She holds up her hands and says, "No thanks. Don't like ice cream." In the second panel, though, she clings to the guy's hand, saying, "Is that ice cream? Can I have some? Pleeeease?" The ice cream man looks confused.

Text: Though personalities can be simple or complex, they act different from one another, and experience their own range of emotions. They can be any age, gender, or race. The number of personalities in a group can be as little as two, or as much as several thousand.

A panel contains pictures of many system members--a happy little girl looking at a butterfly, Glasses Girl, a person with crossed arms, a figure in black who looks alarmed, a little girl curled in a miserable ball in the corner, a small person sitting with crossed legs, a parental sort of figure in a dress holding a baby with alarm, and another figure pointing and laughing at them.

Criteria 2. At least two personalities control the body's behavior. Typically with DID, at least one personality controls the body at any given time.

Text: "Triggers"--environmental cues--cause a "switch" between personalities.

Panels: Glasses Girl sees a teddy bear, and switches to the butterfly girl, who has a white dress and black pigtails.

Text: This can be quick and dramatic, or subtle and hard to see.

Panels: Butterfly Girl pounces the teddy bear with a grin in one, demonstrating the dramatic switch. In the more subtle example, she just sidles up next to the bear, enjoying being near it.

Text: One analogy is to think of one's body like a car. The personality at the wheel is at the "front".

Panel: There is a car, with a driver in it. Only the driver and the exterior of the car is visible.

Text: When two or more people are in the car, or helping drive, this is "co-consciousness" or "co-fronting."

Panel: Now we're inside the car, looking not just at the driver, but at the other passengers, who are talking, giving directions, and apparently annoying the driver.

Text: Personalities can have different mannerisms...

Picture: a system member holds a finger to her mouth.

Text: ...tone of voice...

Picture: another system member talks on the phone.

Text: ...handwriting...

Picture: A note with every line in different handwriting: "of stupid [illegible]" "COOKIES" "[illegible] "I like cookies too." "Liar." "IT TRUE (sadface emoji)".

Text: ...even physical condition.

Picture: a person is at the doctor's office, wired up to a display panel showing her bio rhythms.

Text: They might not even be aware of each other.

Panel: Two figures stand apart from each other.

Criteria #3: Memory gaps or inability to recall personal information.

Text: People with DID might experience gaps in their memory, too extensive to be ordinary forgetfulness.

Two figures stand in their own little room panels. One is just hanging out; the other plays paddle-ball. They are separated, by the text, apparently unaware of each other.

Text: If you were in a completely different building form your friend, would you remember what they did? Neither would a personality who is not around at the same time as another.

Two new panels show Glasses Girl. The panels are separated by a black block with white text. In the first panel, she stands next to a teddy bear, and the clock reads to be two o'clock. In the next panel, it's 2:30 and she's holding the bear, looking perplexed as to how she got there.

Text: "Blackouts" can cause a person to "lose time"... anywhere from seconds to years!

A long thin panel, separating Glasses Girl from another figure with a block of text.

Text: Similarly, you wouldn't know the name or birthdate of someone across the room you didn't know. You probably wouldn't say your name was theirs, either, if your names were different. Neither would a personality in a DID system.

Criteria 4. Symptoms are not caused by drugs or a medical condition.

This one's kind of self-explanatory. Disturbances of consciousness caused by drugs, or certain medical conditions such as epilepsy, have many symptoms similar to DID. These have to be ruled out before a diagnosis of DID.

Subheading: How is it caused?

Glasses Girl stands holding a broken heart, looking sad.

Text: How do people develop DID? No one is really sure. It's not biological, or a result of chemicals going funny. However, the majority of people with Dissociative Identity Disorder have experienced a degree of trauma. What's traumatic depends from person to person, but it's always unpleasant and harmful to a person's physical and mental health. It can be physical, sexual, or emotional. Children without support suffer the most lasting effects of trauma. They must rely on their own minds. The classic "trauma model" is one of the most well-known explanations for how DID develops.

Text: A person experiences a trauma.

Panel: A little scribbly figure in black holds an ice cream cone, but the ice cream has fallen off the cone onto the ground.

Text: To deal with overwhelming feelings, they dissociate.

Panel: The figure cries, and a little stick figure above its head runs away from a cartoony brain.

Text: A new personality deals with the experience. The memory and feelings are "split off" into the new personality.

Panel: Another figure, in gray this time, scoops up the fallen ice cream, throws it away in a trash can, and goes to get a new ice cream cone.

Text: Control returns to the "original" personality.

Panel: The figure in black is back. It looks surprised to have a brand new ice cream cone in its hand.

Text: Life goes on...

Panel: The figure smiles happily at its new ice cream.

Text: ...until that person dissociates again.

Panel: Oops. The new ice cream has fallen off its cone, just like the last one.

Text: Repeated experiences over time increase the separation between personalities. Eventually a person gets so used to dissociating that they will dissociate even in response to mild triggers, such as smells or sounds. Switching personalities start to disrupt daily life. That is one theory of how Dissociative Identity Disorder develops.

For people with DID, dissociation is a coping mechanism for living with attitudes or feelings that threaten survival. In order to live with parents that are abusive, for instance, a child might create a "bad" personality. This personality would hold the child's anger and negative feelings so that they might live a normal life. A DID system is complex and built to ensure survival.

Subheading: How is it Treated?

The broken heart is now patched up with a Band Aid.

Text: The treatment for DID is a long and complex process. The goal of therapy is to help a patient function and be healthy, either as one person or as multiple personalities.

Text: Therapy requires lots of talk and self-help.

Panel: Glasses Girl is in a therapy office, sitting on a couch, talking to her therapist. A box of Kleenex is next to her.

Text: Journals can help personalities communicate with one another and express themselves in a healthy way.

Panel: Glasses Girl is writing in a journal.

Text: There is no medication to treat DID, only other conditions that might be "co-morbid", such as depression or anxiety.

Panel: Glasses Girl looks at a pyramid of medication bottles, stacked in a neat tower on a counter.

Text: "Integration" is a popular form of therapy for DID.

Text: According to this theory, personalities are created to hold traumatic memories.

Panel: The figure in black holds a box with something vague inside it.

Text: When these memories are freed, the personalities lose their purpose, and go back to being one "whole" person.

Panels: The figure in black hands its box over to someone else, but then stands there blankly, as though uncertain what to do without the box. The final little panel shows a simple equation: Black figure plus white figure equals a larger gray figure!

Text: Integration might help some patients, but can be harmful if forced on a patient.

Subheading: Hollywood Myths (drawn in the style of the famous Hollywood Sign.)

Image: Glasses Girl is now wearing a hockey mask and wielding a chainsaw.

Myth: Multiples are dangerous, psychopathic serial killers. This image has been popularized both by Hollywood horrors and famous "inasnity plea" cases. While this scenario might make for an entertaining and bizarre thriller, a multiple is just as likely to be a chainsaw-wielding psycho as any other person. Being multiple doesn't mean that you are a danger to anyone else.

Image: Two glasses girls are standing next to each other; one seems to be saying something sarcastic to the other.

Myth: Multiples are psychotic/"hear voices." Wrong. Dissociative Identity Disorder is not a psychosis, and multiples are not crazy or delusional. Personalities are rational and genuinely experience life as different people. Most multiples do not experience personalities as being outside the body in physical form, and do not experience auditory or visual hallucinations. DID is not schizophrenia, and there is no "Split Personality Disorder".

Image: Glasses Girl looks at a picture on the wall, which seems to show her riding a giant hamster. She says to herself, "I don't think that happened..."

Myth: All multiples experienced horrific child abuse. While this is certainly true for some people, it's not for everyone. It is dangerous to assume that someone experienced severe trauma and just "doesn't remember". Do not attempt to supply or dig for "hidden traumatic memories".

Image: Glasses Girl stands with a shrink, who offers medication and reads from a chart.

Myth: Multiples are rare, and they're all like Sybil. Most cases of DID are not nearly as extreme as Sybil's. All DID cases are different. The majority of multiples would fit under the "Dissociative Disorder Not Otherwise Specified (DDNOS)" label. For instance, a multiple with two or more personalities, but no time loss, would be DDNOS. So multiplicity is actually rather common; it's DID that is uncommon. Also, dissociative disorders can go undetected and misdiagnosed for years. Very few therapists are familiar with dissociation and how to treat it.

Subheading: Conclusion.

Text: Life with Dissociative Identity Disorder can be both rewarding and frightening. The biggest obstacle on the road to a healthy life is denial. It is difficult enough for a multiple to accept themself without living in a world that is ignorant and hostile. There is little support out there. Learn more and share what you know... but please, do not attempt to diagnose yourself or someone else. If you think you or someone you know might have DID, seek a professional opinion.

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