MPD is a survival tactic. It is the creative attempt of highly traumatized children to protect themselves from the trauma and abuse (e.g.: "It isn't happening to me.") When these children dissociate (block) trauma, their "compartments" of trauma become "separate personalities/parts within their one self". Only children have sufficient flexibility (and vulnerability) to adapt to trauma by means of creating alter personalities.



Q: What Is Dissociation?

A: Dissociation is a mental process which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. During the period of time when a person is dissociating, certain information is not associated with other information as it normally would be. For example, during a traumatic experience, a person may dissociate the memory of the place and circumstances of the trauma from his ongoing memory, resulting in a temporary mental escape from the fear and pain of the trauma and, in some cases, a memory gap surrounding the experience. Because this process can produce changes in memory, people who frequently dissociate often find their senses of personal history and identity are affected.

Most clinicians believe that dissociation exists on a continuum of severity. This continuum reflects a wide range of experiences and/or symptoms. At one end are mild dissociative experiences common to most people, such as daydreaming, highway hypnosis, or "getting lost" in a book or movie, all of which involve "losing touch" with conscious awareness of one's immediate surroundings. At the other extreme is complex, chronic dissociation, such as in cases of Dissociative Identity Disorder (MPD) and other Dissociative Disorders, which may result in serious impairment or inability to function. Some people with DID(MPD)/DD can hold highly responsible jobs, contributing to society in a variety of professions, the arts, and public service. To co-workers, neighbors, and others with whom they interact daily, they apparently function normally.

There is a great deal of overlap of symptoms and experiences among the various Dissociative Disorders, including DID (MPD). For the sake of clarity, this brochure will refer to DID(MPD)/DD as a collective term. Individuals should seek help from qualified mental health providers to answer questions about their own particular circumstances and diagnoses.



Q: I thought MPD/DID and Schizophrenia were the same thing?

A: MPD is NOT schizophrenia! Most people thing that schizophrenia means "split personality." Actually, this is totally incorrect. "Split Personality" is MPD, not schizophrenia. Schizophrenia is a chronic form of psychosis due to a biochemical/genetic disorder of the brain. SCHIZOPHRENICS DO NOT HAVE OTHER PERSONALITIES. Schizophrenia is not caused by trauma, and does not involve amnesia and flashbacks. MPD hear voices on the inside. Schizophrenics hear the voices from the outside.



Q: When can a person get MPD?

A: MPD arises in childhood, mostly ages 3 to 9 years. There is juvenile diabetes and adult onset diabetes, but there is no adult onset MPD. Only children have sufficient flexibility (and vulnerability) to respond to trauma by breaking their "still-coalescing" self into different, dissociated parts. Adults do not have the capacity to adapt to trauma by forming alter personalities. (The exception is that adults who became "multiples" in childhood can continue to make more alters during adulthood.)



Q: How Does DID(MPD)/DD Develop?

A: When faced with overwhelmingly traumatic situations from which there is no physical escape, a child may resort to "going away" in his or her head. This ability is typically used by children as an extremely effective defense against acute physical and emotional pain, or anxious anticipation of that pain. By this dissociative process, thoughts, feelings, memories, and perceptions of the traumatic experiences can be separated off psychologically, allowing the child to function as if the trauma had not occurred.

DID(MPD)/DD is often referred to as a highly creative survival technique, because it allows individuals enduring "hopeless" circumstances to preserve some areas of healthy functioning. Over time, however, for a child who has been repeatedly physically and sexually assaulted, defensive dissociation becomes reinforced and conditioned. Because the dissociative escape is so effective, children who are very practiced at it may automatically use it whenever they feel threatened or anxious -- even if the anxiety-producing situation is not abusive.

Often, even after the traumatic circumstances are long past, the left-over pattern of defensive dissociation remains. Chronic defensive dissociation may lead to serious dysfunction in work, social, and daily activities. Repeated dissociation may result in a series of separate entities, or mental states, which may eventually take on identities of their own. These entities may become the internal "personality states," of a DID(MPD) system. Changing between these states of consciousness is described as "switching."



Q: Who Gets DID(MPD)/DD?

A: The vast majority (as many as 98 to 99%) of individuals who develop DID(MPD)/DD have documented histories of repetitive, overwhelming, and often life-threatening trauma at a sensitive developmental stage of childhood (usually before the age of nine), and they may possess an inherited biological predisposition for dissociation. In our culture the most frequent precursor to DID(MPD)/DD is extreme physical, emotional, and sexual abuse in childhood, but survivors of other kinds of trauma in childhood (such as natural disasters, invasive medical procedures, war, and torture) have also reacted by developing DID(MPD)/DD.

Current research shows that DID(MPD) may affect 1% of the general population and perhaps as many as 5-20% of people in psychiatric hospitals, many of whom have received other diagnoses. The incidence rates are even higher among sexual abuse survivors and individuals with chemical dependencies. These statistics put DID(MPD)/DD in the same category as schizophrenia, depression, and anxiety, as one of the four major mental health problems today.

Most current literature shows that DID(MPD)/DD is recognized primarily among females. The latest research, however, indicates that the disorders may be equally prevalent (but less frequently diagnosed) among the male population. Men with DID(MPD)/DD are most likely to be in treatment for other mental illnesses, for drug and alcohol abuse, or incarcerated.



Q: Why Are Dissociative Disorders Often Misdiagnosed?

A: DID(MPD)/DD survivors often spend years living with misdiagnoses, consequently floundering within the mental health system. They change from therapist to therapist and from medication to medication, getting treatment for symptoms but making little or no actual progress. Research has documented that on average, people with DID(MPD)/DD have spent seven years in the mental health system prior to accurate diagnosis.

This is common, because the list of symptoms that cause a person with DID(MPD)/DD to seek treatment is very similar to those of many other psychiatric diagnoses. In fact, many people who are diagnosed with DID(MPD)/DD also have secondary diagnoses of depression, anxiety, or panic disorders.