DISSOCIATIVE IDENTITY DISORDER

^{_{Image Source: Medikka Journal, 2018, Cover Page (with the author's permission)
Model: Mmesoma Igbokwe}}

Even though psychology/psychiatry isn't exactly my niche, I decided to do this because I was inspired by @abigail-dantes. Added to the fact that in my part of the world, psychology and psychiatry do not get half the attention they deserve.

I'm certain that growing up, a lot of us may have heard of multiple personality disorder and at the time, it was just a good thriller story. But if you have seen the movie Split starring James McAvoy or read the 1998 novel, Tell Me Your Dreams by Sidney Sheldon, you start to understand that this condition could actually be more than just a good read.

A Personal Encounter

Growing up, I was quite the happy, cute, cuddly child and adored by all; whatever happened to all that?.
We lived in a small town in Kogi State, Nigeria. The town was built around a steel mine that was discovered a while ago. My dad was an engineer in the steel company, my mum was the principal in the township staff high school and her best friend was the headmistress in the primary school. Both my parents had a lot of friends and by association, so did I.

I had so many friends I'd often feel like I was their queen and they were my loyal subjects. Again, whatever happened to all that? Among my friends, one of them stood out. Her name was Chinelo.

Chinelo was so different from all of us. She was too quiet most of the time and a bit too chatty other times. She was extremely forgetful and had terrible grades. I remember how the teachers would flog her on a lot of occasions either for being too quiet or too loud or not remembering a subject that was taught just before break time. On countless occasions, her parents were summoned to the school on her behalf.
Really, nobody liked to associate with Chinelo.

Chinelo and I

Chinelo and I became friends under the weirdest of circumstances. Once, my parents traveled and left me home with our house helps. One of the house helps coincidentally also named Chinelo attempted to make me noodles like my moms and she failed woefully at it. It tasted horrible and I told her. This made her so mad she gave me a very dirty slap and asked me where my manners were, told me to be respectful to everyone around me. She packed my lunch box and handed it to me.

I was so sober that day. I wasn't the queen bee for an entire day. During the lunch break, I tried to eat the sandwich that "big Chinelo" made and as expected, I couldn't. I offered it to my friends but they all didn't want it. Just then, small Chinelo walked by and I asked her if she wanted it. Surprisingly, she did. I gave it to her and she gobbled it all up. I asked her why she never came to school with her own lunch and I clearly remember her response:

My mother took me to the pastor to pray for my forgetfulness and bad grades and the pastor told her to make me fast everyday for the next 3 months. As a result, I don't get to eat until 4pm everyday.

I was a kid at the time so I really didn't understand what that meant but, I got to understand was that Chinelo was very weird. We became really close after then. I'd often share my snacks with her and she was so grateful whenever I did but on some days, she would keep to herself and act like I was a stranger, leaving me to wonder if I'd done something wrong. Well, our good days were bright and sunny so we kept being friends.

I often tried to help her by putting her through some subjects especially my favourite; maths but I would get frustrated too at how easily she forgot things.
During one of our discussions, she stated point blank that she hated her family. Her mother flogged her for the smallest of things and her dad was both sexually and physically abusive. She made me promise not to tell anyone. I tried to make her feel like I had issues too so I told her I hated my own mother for not giving me a baby sister. I know, I was unbelievable.

Soon after, Chinelo began to come out of her shell and she started introducing me to people as her big sister. It seemed like a joke. Not long after, she began to strike out her surname from her books and replaced it with my surname. As you can guess, this worsened her case.
"Chinelo, don't you know your own surname?"
"Chinelo, what is the matter with you?"
Once the teacher called her out in front of the entire class and asked her for her surname.
"Ofoma" she replied. Everyone laughed. It really wasn't funny to me or my teacher.
The teacher brought out a cane and flogged her. Asked her again and in her teary voice, she repeated
"Ofoma" looking at me me like she expected me to say or do something.
I knew the beating wouldn't stop until she said "Okafor". Okafor was her surname and so when the teacher wasn't looking, I mouthed O-K-A-F-O-R. She repeated this to the teacher and she let her go. A crying Chinelo came back to my seat
"Why is she making me say my surname is Okafor when it's not?" Chinelo asked? "When we get home, I'll tell mummy" she added.
"Which mummy?" I asked feeling scared and confused.
"Our mummy" she replied.

When I got home that day, I was so scared I told my mother about this incident and everything that had been happening with Chinelo. My mum called her bestfriend and asked that Chinelo and I be separated. She also called Chinelo's mum and talked to her at great length, asked her to take Chinelo to a psychiatrist.

The next day at school, Chinelo refused to speak to anyone. Not even the teachers. She was punished as always but didn't buldge. I even tried to talk to her and she just stared blankly at me. The headmistress saw us together and called me, asked me to stay away from Chinelo or she'd move one of us to a different class.

I never saw Chinelo after that day, the last thing I heard was that she was taken to the U.S to see a shrink and was diagnosed with Multiple Personality Disorder. I didn't know the meaning at the time, none-the-less, I was happy she was finally getting the help she actually needed and that everyone would see that my friend had a condition with a name and would no longer be called 'possessed'

How was I to know? I was just a happy 10-year-old.

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What is Dissociative Identity Disorder?

Dissociative Identity Disorder(DID), formerly known as Multiple Personality Disorder is a condition where an individuals identity is fragmented or split into two or more distinct personality states that alternately take control of the individual's actions. These identity fragments are called alters and the process by which the different alters are brought to light is called switching

DID was called multiple personality disorder till 1994. The name was changed as the condition was better understood as a fragmentation of identity rather than a proliferation of separate identities.

Usually, there is a primary identity that carries the individual's birth name and this primary identity is suppressed, guilty, and depressed; causing a particular alter to emerge.

Each personality or alter may be experienced like it has a distinct history and identity. The characteristics of the alter; such as name, age, gender, vocabulary, and mood are very different from those of the primary identity.

Certain traumatizing circumstances or psychosocial stress can cause a particular alter to emerge just to get through the said circumstance.
The various alters may or may not have knowledge of one another and sometimes even appear to be in open conflict.

Some identities may manifest as behaviours that appear as though a spirit or other supernatural being has taken control of the person.

These "spirits" usually have a striking similarity to the cultural or spiritual practice in the patient's society and only become a disorder when they are either unwanted, cause distress or impairment, and are not generally accepted.

Causes of DID

DID is actually a reflection of a failed attempt at integrating the different aspects of identity, memory, and consciousness into a single individual entity.

While the exact cause of is not known, there are a few predisposing factors that have been seen constantly in people with DID over the years.
They include:

1. Severe abuse especially in childhood: People who are severely abused, both sexually and physically are found to be quite depressed. In children, this depression is usually accompanied by a feeling of helplessness. In a bid for survival, the weak or depressed personality is subdued and a new alter springs forth. The new alter is believed to be stronger and more fit to handle traumatizing situations.
2. Iatrogenic causes: In some school of thought, DID is caused by the suggestion or probing of the psychiatrist/psychologist.
   Iatrogenic = caused physician or surgeon in the course of medical treatment or diagnostic procedures.

Symptoms of DID

1. Memory gaps: There are unexplainable gaps in details of personal history including people, places, and events, for both the distant and recent past.
   For example, a DID patient may discover that he/she has traveled with no memory of the trip or the experience. These gaps are not consistent with ordinary forgetting.

2. Distinct identities: The individual experiences distinct identities, each with its own pattern of perceiving, relating to, and thinking about the environment and self.

3. Voices: Some DID patients have admitted to occasionally hearing voices. Sometimes the voice of a child, and sometimes a spiritual voice.

4. Depression

5. Suicidal tendencies: Imagine the feeling of being alive but not in control of yourself. People with DID often resort to suicide to put an end to the apparent internal conflict.

Treatment

• Primary treatment: Long-term psychotherapy to deconstruct the various personalities and unite them.

Other treatments include:

• Cognitive and creative therapies.
• Talk therapy or psychotherapy
• Hypnotherapy

There are currently no medications specifically for this disorder but antidepressants and anti-anxiety drugs may help control the associated mental health symptoms.

100% cure is rare but with proper treatment, there is an improvement in the ability of DID patients to function in their personal and occupational lives.

Images

2, 3 and 4 were gotten from pixabay.com

REFERENCES

• Psychology Today | Multiple Personality Disorder
• Wikipedia | Dissociative Identity Disorder
• Web MD | Mental Health