Disruption of identity” observed in clinical settings
The disruption of identity in DID observed in clinical settings is
somewhat different from what is alluded to in the criteria found in DSM or ICD
that we saw above. Two or more identities
could be aware of each other’s presence or behaviors, and occasionally there
might be disruptive interaction of communication. However, they might not be disturbed
by each other in any particular ways most of time. Their prominent experience and
difficulty is their being amnestic for some periods of time in their daily life.
When the switching occurs, a personality loses consciousness and experiences a
lapsus of time until he or she “comes to”. Does the experience of A or B indicate
that they have serious impairment of their sense of identity? Their experiences
are rather like our experience of getting to sleep for several hours and wake
up in the morning, something that every one of us experiences. Obviously, there
are cases where A, B, and other personalities can be “awake” and active simultaneously.
Some of them might experience intrusive experiences from other personalities in
a direct way, but some of them do not. It is often observed that two or three
personalities are awake independently and converse or interact with each other,
like two or three people engaging in conversation. They of course heavily influence
each other, but not in a way that their sense of self is threatened by other’s
intrusion, like the “made” experience. Their experience is rather assimilated
to that of Siamese twins, where two individuals sharing a single body converse
and negotiate to achieve their common objectives.
Let me show you an example of a situation frequently observed
clinically among DID individuals. Suppose that a person has personalities A and
B. A interacts with a person C. Then another personality B resents their
relationship and feels left out, and asks C for a time for his own with him. C
is not altogether agreeable with this request as he does not feel as close to B
as to A. B then gets frustrated and tension between A and B mounts.
This type of conflict
happens quite frequently among individuals with DID. Let us consider what kind
of disturbance of the sense of self can be found in this relationship.
Let me be more concrete and give my own clinical example. A is a
female young adult and B is her boy personality. C is his fiancé, a young male.
A is only aware of the existence of C, mainly informed by her fiancé C, except
that he has a queasy feeling in her stomach occasionally while interacting with
C. B himself reports that he is “asleep” (B’s own expression) most of time, but
sometime is awake and observe A’s interaction with C “from inside”. B personally
never feels that he is intruded upon by A herself.
