Trauma’s role in dissociative identity disorder

Dissociative identity disorder (DID) is a rare condition where a person experiences disruptions in their identity, often presenting as distinct personality states. It affects about 1% of the U.S. population, and researchers are still working to understand what causes it. We know that certain factors, like environment and genetics, may contribute to its development. 

However, dissociative disorders like DID often manifest in the aftermath of trauma. Specifically, children who endure ongoing physical, emotional, or sexual abuse and people who survive natural disasters or the violence of war may be at greater risk of developing DID. 

So if you or someone you care about is living with the effects of trauma and DID, don’t hesitate to seek support. With integrated care that addresses both concerns at the same time, people experiencing these challenges can learn to manage their symptoms and improve their quality of life.

Can dissociative identity disorder be a trauma response?

Yes, DID is frequently associated with severe and prolonged childhood trauma. While it’s not a conscious choice, trauma survivors may use dissociation as a way to mentally and emotionally “escape” the trauma when there’s no physical way to remove themselves from the situation. They may retreat to an altered state and assume an alternative identity in an attempt to protect themselves. While this might provide some relief in the moment, repeated dissociation can lead to the onset of DID.

Can dissociating cause DID?

No, dissociation itself doesn’t cause DID. It’s important to remember that dissociation is a common part of the human experience, and it’s not always unhealthy. For example, daydreaming is an example of dissociation because it represents a temporary (and usually harmless) detachment from reality. 

Similarly, have you ever arrived at a destination only to realize you don’t remember driving there? This is sometimes referred to as “highway hypnosis” or being on “autopilot,” and it doesn’t mean you have a mental health condition. There’s a big difference between experiencing occasional dissociation and having DID. 

What do dissociation and trauma feel like together?

The overwhelming majority of people living with DID have a significant trauma history. In fact, it’s estimated that at least 79% of people with DID also meet the diagnostic criteria for PTSD. 

While each person’s experience of co-occurring conditions is unique, people living with PTSD and DID may be more prone to:

• Feeling detached from others and the world around them
• Emotional numbness
• Memory loss
• Problems with concentration and focus
• Derealization (feeling like the world isn’t real or they’re living in a dream)
• Sudden mood changes
• A loss of identity
• Other mental health conditions, like depression or anxiety

Can you have dissociative identity disorder without trauma?

Technically, it’s possible to develop DID without experiencing trauma. However, it’s incredibly rare. Once referred to as “multiple personality disorder,” the history of DID as a diagnosis is complicated, and controversy remains about how best to classify the condition. 

Some experts believe DID is a trauma response, while others have proposed that it has a neurological basis and arises due to structural changes in the brain.     

How are dissociative identity disorder and trauma treated?

Treatment for DID and trauma typically involves a combination of therapy and medication that addresses both concerns at the same time. Adults with co-occurring DID and PTSD may benefit from attending therapy one to three times per week over the course of several years. However, children and adolescents may need less time to experience positive results from treatment. 

While each person’s DID and trauma treatment experience will be based on their unique needs, the following approaches may be especially helpful:

• Cognitive behavioral therapy (CBT)  
• Dialectical behavioral therapy (DBT)  
• Hypnosis (when conducted by a trained clinician) 
• Internal family systems (IFS)
• Eye movement desensitization and reprocessing (EMDR)
• Sensorimotor therapy

Keep in mind that, regardless of the specific form of therapy your provider uses, all DID treatment involves an integrated, trauma-informed approach. This means you’ll spend time building trust and establishing security with your therapist before working toward other goals. Building a strong therapeutic alliance is a critical first step in increasing stability, reducing symptoms, and processing trauma for people with DID. 

Find care with Rula

DID is a rare mental health condition where a person experiences multiple distinct identities. While we don’t fully understand the cause of DID, we know that it’s often tied to trauma, especially in childhood. For people with DID, dissociation is often a response to trauma they can’t otherwise escape. It’s a way of exiting their physical reality and an attempt to protect themselves from further harm. 

So, in order for treatment to be effective, providers must address the role that trauma plays in DID. With this approach, people living with the effects of trauma and DID can integrate their identities, heal from trauma, and lead more balanced lives.

When you need trauma-informed support for co-occurring conditions like DID and PTSD, look no further than Rula. With a network of over 10,000 providers, we can help you access affordable, in-network care in just a few clicks. To get started, head over to our therapist-matching platform, where you can sift through your options and find the right therapist or psychiatric provider for you. Once you make your selection, you can schedule your first live video appointment for as soon as tomorrow.

Get started with Rula today