One of the reasons we wanted to start writing about Dissociative Identity Disorder after we received our diagnosis is the massive amount of misinformation out there. Having this diagnosis is highly stigmatized and many doctors and even mental health professionals still perpetuate these harmful beliefs about dissociative identity disorder.
We wanted to write an article specifically calling out a bunch of the harmful and inaccurate beliefs that many people diagnosed with DID and OSDD have to deal with from friends, family, medical professionals, and strangers on the internet. Here is a list of those false statements and a little bit about why they are harmful.
CN: extensive discussion of false, offensive, and harmful mainstream ideas about DID and OSDD, and of neglect or dismissal by medical professionals; brief discussion of childhood and sexual abuse, a convicted serial rapist, the symptoms of BPD, and full-fusion; mention of self-harm
“DID is Extremely Rare”
If DID is recognized at all, it is dismissed as so rare that most mental health practitioners may never encounter it in their practice. In reality, current studies show that DID impacts about 1.5% of people; a number that stays consistent across countries. That’s almost the same amount of the population globally that has red hair! DID rates can even be as high as 6% in areas with particularly high rates of childhood and sexual abuse. And OSDD, which includes a subset of patients who experience DID-like symptoms, affects as much as 8.3% of the population.
This belief is likely one of the main reasons that on average, DID patients will spend 6-12 years in the mental health system before receiving a correct diagnosis. Despite having consistent access to mental health support and good therapists, it took us 13 years to be diagnosed. When dissociative disorders were raised as a possibility, our therapist at the time asked other practitioners at her clinic if they had the expertise to contribute that she did not, and not a single one had significant knowledge of dissociative disorders. This system-wide lack of professional knowledge likely contributed to our long wait for a diagnosis.
“DID Isn’t Real! You’re just Faking Having Alters for Attention”
Possibly one of the most common hateful comments that systems receive is various accusations of faking: You’re faking DID; you’re making up your alters and just acting different when you feel like it; you don’t have different alters, you have different moods, etc. There are similar beliefs within the mental health field that patients can pretend to have DID well enough to be diagnosed with it.
Incredibly, a study called “Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers” actually found that there was physical, biological evidence that could be used to reliably diagnose DID patients and distinguish them from the participants pretending to have DID, up to 74% of the time!
I’m hoping that most people reading this article already know that accusing someone of faking a mental or physical illness is very problematic. It carries with it all sorts of assumptions about the nature of being sick: The idea that the attention you receive around the knowledge of your illness must be all positive (and not full of harassment as is actually the case); The idea that you can’t possibly know yourself and your own mind/body; The idea that being healthy is so much the default, being sick at all is inherently unlikely.
But for DID, fake claiming is particularly harmful. Denial is, itself, a symptom of DID: Prior to treatment, systems usually have at least a few members who are not allowed to know about the rest of the system, and mental patterns of denial are relied on heavily to conceal things that otherwise wouldn’t add for. For months after we received our diagnosis, we’d suddenly think, “I can’t have DID! That’s not true! That can’t be real!” like our brain was trying to shove this knowledge back into the locked box it used to be in. Accusing someone of faking can trigger them into no longer believing their diagnosis to be real, and to avoid getting the treatment they need.
“Your Alters Are a Delusion”
Closely related to the belief that someone is faking alters is the idea that alters are a form of delusion or hallucination. We all know the joke, “Talking to the people in my head” is almost always meant to paint a picture of someone disconnected from reality, trying to interact with people who aren’t there. DID systems often get lumped under this idea as well.
But alters are not a hallucination or a delusion. They are not some sort of invasive, untrue thought plaguing your brain. They are part of you. Calling alters a delusion is a little bit like saying that because I act differently when I am in “work mode” in a meeting than I do when I am relaxing at home, I must be delusional while I am at work. Work-Mode-Me is still me, but in DID, the divisions between these versions of self are more extreme.
The Host is the “Real One” or the “Main One”
The host of a system is typically (but not always) the one who identifies with the body’s name, the one that is outward facing the most, the one who handles all the day-to-day life stuff, while often being protected from the trauma memories that the other alters carry. Friends and family typically get to know the host best, and not be aware of the other identities.
Because the outside world’s perception of a system is oriented around the host, I think singlets think of alters as this external, invasive presence, rather than a bunch of pieces that used to all be part of the same self. As a result, singlets can talk about hosts as if they are “the main person” or that the host is the actual person and the others are “just alters”. But hosts are one of the alters in the system.
Our favorite analogy to respond to this belief we learned from The Entropy System: When you peel an orange and pull apart the segments, which segment is the “main” segment? Which is the real one? Which is the “original” orange? None of them and all of them. All of the pieces were needed to make up one orange. Some of those segments might be bigger or juicier than others, but none of them is more or less important.
“You Need to Stop Talking to Your Alters”
Many a time I have seen comments on Youtube videos about DID say versions of, “You really need to stop talking to your alters. They’ll never go away if you don’t.” This false belief is sort of a combination of several of the previous ones: It’s based on the idea that the host is the “true” identity and that the other identities are made up or just fantasies used as coping mechanisms.
But stopping communication with your alters in order to treat DID would be like saying you should stop playing guitar or making to-do lists for work. Denying or cutting off your alters is ultimately a form of self-harm and actually increases the likelihood that other alters in the system will act out in ways that make your life harder, in an attempt to reclaim their autonomy. Establishing communication and collaboration is a central part of the treatment of DID.
“Switches Are Overt and Obvious”
In interviews about the movie Sybil, the director said that at the start of Sally Field’s audition, she started with a fairly flat, quiet, monotone voice that was so boring, he actually began falling asleep. He was then jarred awake by a loud, harsh, grating voice, so polar opposite from the previous one he thought he must have slept through the end of her audition and a new actress was reading for him. But no, they were both Sally.
This story matches the stereotypical concept of what switching looks like in DID, thanks to the movies: It’s big and dramatic, the actor looks disoriented and confused, there are special effects to make the screen blurry or to sway back and forth. And once the switch is complete, the new alter is visibly and audibly different in every way from the previous one.
But in reality, a switch may look like nothing at all. When we switch, it typically looks like we’re zoning out or becoming unfocused for a few moments, and then there might be a slightly sudden intake of breath, a small head shake, and then re-focusing on what’s in front of us. That’s it! Our voice and body language may only change in subtle ways too. Because in reality, DID is developed as a survival mechanism, and there are a great number of circumstances where it would be dangerous for the process of switching, or for the emergence of a new alter, to be visibly obvious.
But people are so attached to this fantasy of switching, that videos of DID systems with non-dramatic nature switches are full of, what? Accusations of faking!
“I Would Know if Someone Had Alters”
Related to the last belief is the idea that surely you would be able to tell if someone in your life was walking around with a bunch of identities. But the truth is the vast majority of DID systems are covert. Many of our alters seem very similar until you get to know them more closely. And this is further complicated by the fact that we are all trained in how to act as if we are one, integrated personality. Many alters develop the skill of pretending to be the host so as to not call attention to the disorder.
“Every System Includes a Violent or Dangerous Alter”
In September of 2021, Netflix ran a series on the serial rapist Billy Milligan– the person “Split” was inspired by. Billy Milligan was a genuinely dangerous person who had DID and he successfully used this diagnosis as a defense during his trial: He didn’t commit these crimes, his alters did. He was acquitted as a result. The important piece of information that this story leaves out is that he is the only person to ever have successfully used a DID diagnosis to avoid legal punishment. He is not in any way representative of trauma-based systems overall. Because of this and many other terrible media representations of DID, people associate the idea of having multiple personalities with the threat of a dangerous alter that takes over the body and harms people at random.
These presentations do not reflect the behavior of the average system. While old studies with small samples and no patient self-reporting reported high rates of sexual coercion or intimate partner violence perpetrated by patients with dissociative disorders, the most recent studies put those numbers at only 4%. In contrast, several studies have demonstrated that more than half of the alters in DID systems who displayed any violent tendencies directed this violence exclusively toward other members of the system, ultimately revealing a form of suicidal ideation or self-harm. And in the United States, Canada, and Europe, 90% of DID patients had experienced abuse or neglect in childhood. As with the vast majority of mental illnesses, we are far more likely to be victims of violence than we are to perpetrate it.
Characterizing an illness as inherently dangerous or violent is dehumanizing and actually makes DID patients more likely to be targeted for violence by others.
“DID is Caused by Therapists”
A not insignificant number of mental health professionals reject the idea that DID and related dissociative disorders are caused by abuse or trauma. They instead insist that it is iatrogenic, which means that the disorder is only created through manipulative therapists influencing suggestible patients who were already prone to fantasies and implanting false memories of abuse in their minds. Because I’m not a mental health professional, I’ll let them explain one of the many reasons we know this idea is untrue. From, “Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder”:
“Contrary to the popular belief that probing questions will either instill false memories or encourage lying, especially in dissociative patients, of our 12 subjects, not one produced false memories or lied after inquiries regarding maltreatment. On the contrary, our subjects either denied or minimized their early experiences. We had to rely for the most part on objective records and on interviews with family and friends to discover that major abuse had occurred.”
The paper also covers the many studies done showing the direct connection between a childhood history of trauma and dissociative disorders, and the existence of DID symptoms in patients from countries where DID is not a cataloged diagnosis and the cultural knowledge of the disorder is limited. To emphasize just how disproven this myth is, this section of the paper also said, “Space limitations require that we provide only a brief overview of this claim” which was followed by nine paragraphs of relevant information.
“DID is Just Borderline Personality Disorder Misdiagnosed”
The theory that DID is actually just BPD makes some amount of sense, as there is some amount of overlap between the two disorders: Unstable sense of identity, sudden shifts in emotional states or behaviors, and dissociation are all quite prominent in both disorders, and a high percentage of patients from both groups experience suicidal tendencies and core emotional issues around abandonment.
But more recent research has demonstrated some key differences between the two groups. For example, BPD patients experienced emotional and behavioral fluctuations primarily in response to external circumstances, and they did not tend to experience amnesia or a feeling of disconnect toward the behaviors they exhibited during previous times of high emotion. In contrast, DID patients felt as if the actions performed while they were dissociated were performed by someone else, and as if they had no agency over those behaviors.
I am not a therapist and so I can’t speak to the technical distinctions between the two disorders. Many of the criteria of BPD that we experienced in the past have significantly decreased since we started getting treated for DID. And personally, we think there is a big difference between an unstable sense of identity and the experience of multiple identities. Individually, our identities are not unstable. They are consistent within themselves. There just so happens to be more than one of them.
“The Terms “Multiple Personality Disorder” and “Dissociative Identity Disorder” are Equivalent”
DID was originally called “Multiple Personality Disorder” or MPD in the DSM and this is the name that has stuck around in most media representations of the disorder. This name was changed to “Dissociative Identity Disorder” in the DSM in 1994.
The name change reflects the disorder much more accurately. Personality Disorders are a specific category of mental illness, but it refers to disorders in which the person’s distorted mental patterns and unregulated emotions lead to serious problems in behavior, self-harm, and difficulty interacting with others. This is not the main issue in regard to DID.
Rather, DID is a dissociative disorder. It revolves around the use of dissociation in order to cope with emotional stress and past memories of trauma. And what is being dissociated from? Your identity. In contrast, having the word “Multiple” in the name implies that the primary problem is the fact that more than one identity is present, rather than the problem lying in dissociation, trauma, and amnesia.
There is one key exception to this point though. It is common among disabled and chronically ill people for their diagnoses to be more than just a condition they have, but to be actually part of their identity. We certainly feel this way about EDS. As a result, some patients who were diagnosed with MPD when that was the term being used feel a sense of connection to the term and do not wish to give up calling themselves MPD systems. This is a context in which the term should be respected. (Additionally, MPD and the old term for OSDD– DDNOS– still appear in plenty of medical literature.)
“Systems Should Strive to Become One Personality Again”
In DID, the opposite of “splitting” or forming a new alter is “fusion” which is when two or more alters combine their essences, sometimes into a new identity, sometimes into a modified version of one of the original identities. “Final Fusion” refers to the process of fusing all identities in the system into one. If you are viewing DID from the perspective that the main aspect of the disorder is the fact that you have more than one identity, then it is logical to think that successful treatment of DID would result in fully re-integrating all those identities into a single “whole” one.
But this is a misunderstanding of what DID is. The existence of multiple identities can certainly cause people distress, but for many systems, the disordered aspect of their neurodivergence is the trauma, the dissociation, the amnesia, the difficulty maintaining functional continuity in everyday life, and the unresolved conflicts between system members. Like other forms of neurodivergence such as ADHD or Autism, the goal is not to get rid of the different wiring or to successfully pretend that your wiring is neurotypical. The goal is to improve quality of life.
For some systems, pursuing an increased quality of life does look like final fusion, either as a treatment path or as an incidental result of treatment. But other systems pursue something called Functional Multiplicity, which is where you no longer suffer from PTSD symptoms, amnesia, or dissociation, but you continue to exist as a collective system of identities, that functionally communicate, collaborate, and share their contributions to achieve a happy fulfilling life. Like with many disabilities, not all DID systems want to be “cured” of all the things that make them functionally different from the rest of society.
Being such a stigmatized disorder, this is not even an exhaustive list of myths and misrepresentations of DID and OSDD that are out there!
If you are part of a system or know someone who is, what myths have you heard people say? Let us know in the comments below!
About the writer: Kella Hanna-Wayne is the creator, editor, and main writer for Yopp. In addition to creating a collection of educational resources for social justice, she works as a freelance writer specializing in content about her experience with disability, chronic illness, mental health, and trauma. Her work has been published in Ms. Magazine blog, The BeZine, Betty’s Battleground, and Splain You a Thing. You can find her @KellaHannaWayne on Facebook, Twitter, Medium, and Instagram.