Mental health articles

A defining characteristic of individuals with a diagnosis of Dissociative identity disorder (DID) is that they behave as if they possess two or more distinct identities or personalities, known as ‘alters’. In contrast to the past, where people with DID (or multiple personality as it was previously known) reported relatively few alter personalities, the average number of alters now reported is about 15, and some individuals exhibit more than 100. According to DSM-IV-TR, the diagnostic criteria for DID are: the presence of two or more distinct identities or personality states, each with its own relatively enduring pattern of perceiving, relating to and thinking about the environment and self; at least two of these identities or personality states recurrently take control of the person’s behaviour; an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness; the disturbance is not due to the direct physiological effects, substance abuse or a general medical condition. The number of alters depends on a number of factors, such as the severity and time period of the abuse. Each alter has a job within the system. Most alters protect the host personality from memories of the trauma. It is common for each alter to guard a particular memory. Some alters are aware of other alters; others do not know of their existence. Most alters do not see themselves in the physical body they are in: children see themselves as 4 feet tall, women see themselves as girls, and so on. They may be of different nationalities and races. Some may speak different languages. Alters may have different facial expressions and different mannerisms. There are many different kinds of alters and all systems are different, but here are some of the more common types of alter described by someone living with a partner who experienced DID: Host: this person can either be the original birth child, or can be an alter that is the main personality presented to the outside world. Original birth child : this person may be awake and functioning, or said to be asleep. This person is sometimes referred to as the core personality. Child alters: child alters (or ‘littles’ as they are affectionately known) can range from the age of an infant upwards. These are the alters that took much of the abuse, and often carry a large number of memories. They display behaviour that is appropriate for their age. Often they carry much pain, both physical and emotional. Teens : most systems have teen alters. These alters were often the ones who went to school, and were out for those years. Gatekeepers : some systems have a gatekeeper, who directs and has control of the body. They may also control the length of time an alter is in body. They do not often come out themselves, but just seem happy to observe and direct the others. Internal self helpers : these internal self helpers keep the alters safe. They usually know all the alters and the details of the abuse the alters endured. They are very helpful in therapy, and help the therapist understand why a particular alter feels the way they do, or decide the action of a particular alter. They also decide what information is passed to other alters and to the host. Protectors: protectors protect (!) the system from outside threats. They can usually talk hard, or fi ght, or do whatever is necessary to keep the system safe. They often use anger as a defence. They are especially protective of the child alters. Switches between alters often result from some sort of stress or upset, which causes another alter, usually a protector alter, to emerge. Stresses can include comments by others, seeing the abuser, an unexpected touch, arguments and aggression – even having sex. Sel suggested that the individual has an ecosystem of alters who compete with each other to gain control over the output channels. The alter that most successfully maintains an emotional equilibrium is most likely to be best adapted. When the individual moves to a different context, different cognitive schemata may be more adaptive and the dominant alter will switch.

Tags: disorder, dissociative identity disorder