System responsibility and Dissociative Identity Disorder

When a person has Dissociative Identity Disorder, or a similar form of Other Specified Dissociative Disorder (known as DDNOS-1) responsibility gets complex. DID can only be diagnosed if alter identities exist and can take control of the body, they usually act in a different way to the person normally in charge, sometimes in a child-like way, or a protective way. In DID this can cause difficulties because an alter identity may behave in a way which is unacceptable to you (ignoring friends, being rude to people), or may do something which is illegal (for example, a hungry child alter could steal someone else’s candy). The amnesia present between different identities may mean that others are not aware of what has happened, or they may be able to “watch” as it happens but not prevent it, which is known as co-conciousness. An important concept in healing is for all alter identities to begin to communicate and work together, and this involves taking collective responsibility for the actions of any other identities. The treatment guidelines also advice this:

“…the patient is a single person and generally must hold the whole person (i.e., system of alternate identities) responsible for the behavior of any or all of the constituent identities, even in the presence of amnesia or the sense of lack of control or agency over behavior.” – Dissociative Identity Disorder Adult treatment guidelines

By being willing to take responsibility (and accept any consequences) as a result of an alter identity’s actions, it may (over time) lead to an internal discussion about behavior, responsibility and consequences. Shame should not be part of this – switching identities, and losing control to another alter is a symptom of DID. Going back to an example of a child alter stealing candy, does the child alter know that this is both wrong and illegal? Does he/she know what the consequences of doing this again are? Does the child alter know how to find food or prepare food? Is there something that an adult alter can do in advance to make sure the child alter does not go hungry? In taking responsibility for actions of all alters/parts greater co-operation and stability can be achieved for all.

Dissociative identity disorder – the crime myth

Dissociative identity disorder is strongly associated with being the victim of a crime (especially child abuse or sexual assault), and recent research found that mental illness was not a cause of crime. The study look at all “Axis I” mental disorders, which includes all dissociative disorders. What is associated with crime is malingering, which means intentionally faking a mental or physical health condition for personal gain (for example to avoid criminal charges, or evade other responsibilities like military service). Several studies now identify how malingers (people knowingly faking a disease or disorder) can be distinguished from people with Dissociative identity disorder, including Thomas (2001) and Brand & Chasson (2014). Dissociative identity disorder (unlike psychosis) is rarely (if ever) successful as a legal defense. The diagnostic descriptions and symptoms of Dissociative Identity Disorder often described “self-destructive” behaviors, but do not refer to any violence toward other people.[See Kaplan & Sadock (2008), DSM-5]

Dissociative Identity Disorder (multiple personality) and system responsibility / crime

Top 5 posts from the After Trauma blog

Check out these top 5 posts from Sara Stagg’s popular blog After Trauma.

Empathy’s Relationship to PTSD
5 Things To Know About EMDR
Why Do Flashbacks Happen?
What is Complex Trauma and Dissociation: Interview with Bethany Brand
5 Dimensions of Self Care


The Layers of Halloween Weekend

A minority of people with Dissociative Identity Disorder or a similar form of complex dissociative disorder were abused in ritual ways (ritual abuse). Halloween can be a particularly difficult time for survivors because it is a trauma anniversary for many who were raised in abusive cults.

Read Kathy’s post about The Layers of Halloween Weekend.

Powerlessness is the very essence of trauma. But we are powerless no longer.

Recovery is My Best Revenge

Depersonalization Disorder – a personal experience of treatment

This blog was inspired by an excellent blog post describing elements of living with chronic Depersonalization, which is now known as Depersonalization/Derealization disorder. Read Sandy’s blog to find her experiences of treatment Dreamchild – Therapy and Medication.

Diagnostic Criteria

Depersonalization/Derealization Disorder description

Depersonalization disorder is a Dissociative Disorder. Depersonalization is an experience that can occur within a schizophrenic, depressive, phobic, or obsessive-compulsive disorder, or Dissociative Identity Disorder, as well as being a separate disorder.

Certain substances can also cause these effects, so these are excluded in the diagnostic criteria. Depersonalization often includes Derealization experiences (DR); they are now considered a single disorder.

The Stranger In The Mirror

Art from Known as DP or DPD, Depersonalization Disorder can be difficult to treat. One example of depersonalization is being unable to recognize yourself in a mirror. Dissociation expert Dr Marlene Steinberg’s reflected this in the name of her classic book, The Stranger in the Mirror, Dissociation – The Hidden Epidemic, and the art work here.

Artwork from

Can Complex PTSD Be Cured?

Can Complex PTSD be fully cured? How long does it take to even reach stability?

Dr. Kathleen Young: Treating Trauma in Tucson

Recently a reader asked a version of this question in response to my post about Complex PTSD:

…I have been told by many doctors, therapists, psychitrists, and psychologists that I will always have PTSD. I have only found one person willing to help with complex ptsd. I am starting to feel angry that I have to live with the consiquences of someones distructive behaviors. I am starting to feel like their is little hope of ever having this cptsd to stop.

I would like to know the length of therapy that is expected for Cptsd.
I wish I could feel normal again and not relieve tramatic events, have issues with relationships, abandoment issues, and mental health issues….

My short answer to this question of cure is a resounding “Yes!”

My longer answer involves first mentioning that I am not a fan of the word “cure”, as I feel it…

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