It’s the disorder that robs people of their ability to feel whole.

When it comes to the disorder that can splinter people into discrete and fractious personalities, it’s important to note that this complex disorder is not uncommon.

Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is often misdiagnosed. For the sufferer, the experience can be deeply confusing, with a distorted sense of self and long periods of time lost to dissociation.

Caused by childhood abuse, incest and neglect, the disorder often develops as a coping mechanism. It allows young kids to compartmentalize abuse so they can survive when caregivers or family members make them feel unsafe.

DID is described as a complex form of post-traumatic stress and dissociation, which causes a discontinuity in one’s self of self.

Professor Warwick Middleton is a leader in research and treatment on the disorder and has been working in the field for decades. Speaking to News.com.au, he recalls first writing a paper on the condition in 1991.

DID can be categorized as a developmental disorder, where a person’s personality fails to integrate as they develop.

It’s defined as an “identity disruption” and you may know it as “multiple personality disorder.” In some cultures, it may be identified as spiritual or demonic possession.

How do you identify dissociative identity disorder?

They have symptoms that you might have seen depicted in movies like “Sybil” or TV shows like “The United States of Tara.”

Sufferers of the disorder have a complex system of dissociation, which Middleton describes as “splitting off at different times into different identity states.”

“The individual might experience this as internal or external voices, which may argue and which may be associated with particular behaviors. Alternative handwritings. A whole spectrum of things,” he said.

What Middleton describes is a form of dissociation where the sufferer splits off into what appears to be a completely different “personalities.” Sufferers usually have at least two distinct personalities at some point in their life, some may have many more.

Middleton says that the majority of sufferers also fulfill criteria for post-traumatic stress disorder, major depression and somatization, while many of them have eating disorders and social phobias.

“Typically they present in their thirties, having bounced around the system for quite a while,” he said. “Because they hear voices … they’re given antipsychotics. From our research, about 20 percent of them are diagnosed with bipolar disorder.”

“If you look a bit closer they don’t have bipolar. That was just someone identifying them switching between different personality states.”

Losing large periods of your life

People who suffer from DID often have trouble remembering things.

In the autobiographical memory of their life, there are gaps where they have no recollection of what happened or what they did — and not in a regularly reported way, like when you drive home and arrive at your door with little recall of your journey.

It’s about losing big parts of your life to your other “personalities” who take over, commandeering your consciousness. While it might sound like the stuff of movies, the disorder is very real.

From Middleton’s research, he suggests it occurs in about 1.1 percent of the adult population. He describes this as being a “relatively common” condition.

What are people with DID like?

“(People with DID) range in a spectrum — (there) are people who sort of live on the fringes of existence who are chronically mentally ill, bouncing around services to people who are very high achieving, who may work in mental health services themselves.”

Sufferers often report weeks or months of their life passing by them where they have no memory and feel no agency over what transpired in that period.”

In the early nineties, the disorder was not often diagnosed and hardly at all identified by mental health professionals. These days it is much more commonly diagnosed.

Treatment for the disorder

Middleton says his interest in the disorder developed because there was “very little clinical awareness” and it wasn’t a diagnosis routinely made.

The other problem was that the issue of family assault and “incest” wasn’t properly acknowledged within Australia, where he is based, at the time.

“We now know that incest is, unfortunately, very common,” Middleton said.

“Basically in every country in the world where systematic research is done into childhood trauma and the presence of dissociative disorders we get very similar patterns.”

He said with standard treatment like cognitive behavioral therapy, the outcomes are very poor for sufferers of this disorder.

Treatment options with good outcomes include phase-orientated treatment.

Middleton was the first person, along with his colleague Dr. Jeremy Butts to publish research linking childhood trauma with the presence of DID. This paper was published over 20 years ago in the Australian and New Zealand Journal of Psychiatry.

He’s been a long-term director of the Society for Trauma and Dissociation.

Their findings showed that across the world, almost all sufferers of DID had, during childhood, suffered from some form of abuse, be it physical, sexual or neglect.

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