Moving Beyond Myth to Understand a Complex Reality

For decades, Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, has been subject to sensationalized portrayals in media, often depicted as a rare and bizarre curiosity.¹ This has created a landscape of misunderstanding and stigma, leaving those who live with the condition feeling isolated and invalidated.³ The reality of DID is not one of spectacle, but of survival. It is a legitimate, though often hidden, psychological condition that arises as a creative and profound adaptation to overwhelming circumstances.¹

To understand DID, one must first understand the concept of dissociation. Dissociation is a disconnection between a person’s thoughts, memories, feelings, actions, or sense of self.⁴ This is a normal process that everyone has experienced to some degree. Mild, common examples include “highway hypnosis,” where one drives a familiar route and has no memory of the last few miles, or becoming so engrossed in a book or movie that the world around fades away.⁴ This capacity to mentally “check out” is a fundamental human ability.

In the face of severe and inescapable trauma, especially during the critical developmental years of childhood, this normal capacity for dissociation can become a life-saving defense mechanism.¹ When a child’s reality is too terrifying to bear, the mind can compartmentalize the overwhelming experiences, memories, and emotions. This allows the child to continue functioning, to form attachments, and to survive.¹ DID is the most comprehensive form of this protective, dissociative process. By starting from a place of understanding—seeing dissociation not as a sign of being “broken” but as an extension of a normal human capacity used for survival—we can begin to reduce the shame and fear that so often prevent individuals from seeking help.

This article aims to provide a clear, compassionate, and evidence-based guide to Dissociative Identity Disorder. It will explore the clinical picture of DID, offer a tool for structured self-reflection, delve into the complex but crucial overlap with other conditions like Autism and ADHD, and outline the established pathways toward healing and integration.

The Clinical Landscape of Dissociative Identity Disorder

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), DID is characterized by a specific set of criteria that paint a picture of a disrupted sense of self and memory.⁸

Defining DID: The Core Features

• Criterion A: Disruption of IdentityThis is the central feature of DID, defined as the presence of two or more distinct personality states, often referred to as “alters” or “parts”.8 This disruption involves a “marked discontinuity in sense of self and sense of agency,” which is accompanied by related changes in emotions, behavior, consciousness, memory, perception, thinking, and physical functioning.2 It is critical to understand that this is not a case of having multiple separate people living inside one body, but rather the fragmentation of a single identity.10 These alternate states are all manifestations of one whole person, developed to handle different aspects of life and trauma. This disruption can manifest in two primary ways:
  • Possession Form: The alternate identities are overt and appear to take control of the person’s body, leading to speech and actions that are obvious to others. This experience is typically involuntary and distressing.⁶
  • Non-Possession Form: This form is more subtle. The person may experience a sudden shift in their sense of self, feeling like an observer or a passenger in their own body—an experience known as depersonalization.⁴
• Criterion B: Recurrent Gaps in Memory (Amnesia)Individuals with DID experience recurrent gaps in their memory of everyday events, important personal information, and/or traumatic events that are far beyond ordinary forgetfulness.8 This dissociative amnesia is a hallmark of the disorder and results from the memory barriers between different identity states. It can manifest as:
  • Localized Amnesia: An inability to remember a specific event or period of time, the most common form.⁴
  • Selective Amnesia: The ability to remember some, but not all, of the events within a specific period.⁴
  • Generalized Amnesia: A complete loss of one’s life history and personal identity, which is rare.4In daily life, this amnesia can be profoundly disorienting, leading to experiences like finding new items among one’s belongings with no memory of buying them, discovering notes written in unfamiliar handwriting, not remembering major life events like a wedding or the birth of a child, or being approached by strangers who seem to know them intimately.8
• Criterion C & D: Clinically Significant Distress and Cultural ContextFor a diagnosis of DID, the symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning.4 Furthermore, the disturbance cannot be a normal part of a broadly accepted cultural or religious practice. For example, experiences of possession in some spiritual traditions are not considered a dissociative disorder.4

The “Why”: DID as an Adaptation to Trauma

The evidence overwhelmingly indicates that DID is a developmental trauma disorder. It is strongly associated with severe, repetitive, and overwhelming trauma during early childhood, a time when the personality is still forming.² Research suggests that approximately 90% of individuals with DID have histories of childhood abuse and neglect.² In the face of unbearable pain, fear, or horror, dissociation becomes a brilliant, though ultimately costly, survival strategy. It allows the child to mentally wall off the traumatic experience, protecting their conscious awareness from the full impact. Different parts of the self may develop to hold the trauma memories (“trauma holders”), while other parts (“apparently normal parts”) continue to navigate daily life, such as going to school or interacting with family, often with no awareness of the abuse that is occurring.¹

Beyond the Obvious: Subtle Signs and “Passive Influence”

While media often focuses on dramatic switches between highly distinct alters, the day-to-day experience for many with DID is far more subtle.¹ The majority of individuals with DID do not present with obvious, observable changes in personality. Instead, they may experience a polysymptomatic mixture of dissociative, post-traumatic, and other symptoms like depression, anxiety, and panic attacks.¹²

A key concept for understanding this more subtle presentation is “passive influence.” This occurs when the thoughts, feelings, urges, or actions of one alter intrude into the conscious awareness of another, without a full switch of executive control.² This can be deeply confusing and frightening, leading to experiences such as:

• Hearing one or more internal voices, which might be commenting on actions, arguing, or expressing distressing emotions.⁸
• Feeling like a passenger or observer in one’s own body, watching oneself say or do things without a sense of control.²
• Experiencing thoughts, emotions, or impulses that feel foreign, intrusive, or “not mine” (known as ego-dystonic experiences).⁸
• The abrupt vanishing of thoughts or strong emotions from one’s mind.
• Sudden, strong shifts in attitude, opinions, or preferences that cannot be explained.

Recognizing these more subtle manifestations is crucial, as many individuals with DID may not identify with the more extreme portrayals of the disorder, causing them to remain undiagnosed and untreated for years.

An Informal Self-Screener for Dissociative Experiences

The following questionnaire is an informal educational tool designed for self-reflection. It is adapted from clinically recognized screening instruments, such as the Dissociative Experiences Scale (DES-II), to help you explore and put language to your experiences.

Important Disclaimer: This is not a diagnostic test. It is a way for you to get an idea of your experiences with dissociation. A high score does not mean you have Dissociative Identity Disorder, but it does strongly suggest that a conversation with a mental health professional specializing in trauma and dissociation would be beneficial. This screener cannot replace a comprehensive evaluation by a qualified clinician, which is necessary for any diagnosis.

The very act of reading these questions can be a powerful experience. For many, it is the first time they see their confusing and often frightening inner world described in concrete terms. This can be profoundly validating, helping to reduce the isolation that so often accompanies these experiences. The goal here is not just to get a score, but to begin a process of guided self-inquiry.

Instructions: For each of the following 30 questions, please consider how often the experience happens to you when you are not under the influence of alcohol or drugs. Select the percentage that best fits your experience.

1. I have the experience of driving or riding in a car, bus, or subway and suddenly realizing that I don’t remember what has happened during all or part of the trip.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
2. I find that sometimes I am listening to someone talk and I suddenly realize that I did not hear part or all of what was said.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
3. I have the experience of finding myself in a place and have no idea how I got there.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
4. I have the experience of finding myself dressed in clothes that I don’t remember putting on.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
5. I have the experience of finding new things among my belongings that I do not remember buying.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
6. I sometimes find that I am approached by people that I do not know, who call me by another name or insist that they have met me before.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
7. I sometimes have the experience of feeling as though I am standing next to myself or watching myself do something, and I actually see myself as if I were looking at another person.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
8. I am told that I sometimes do not recognize friends or family members.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
9. I find that I have no memory for some important events in my life (for example, a wedding or graduation).(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
10. I have the experience of being accused of lying when I do not think that I have lied.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
11. I have the experience of looking in a mirror and not recognizing myself.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
12. I have the experience of feeling that other people, objects, and the world around me are not real.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
13. I have the experience of feeling that my body does not seem to belong to me.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
14. I sometimes remember a past event so vividly that I feel as if I were reliving that event.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
15. I have the experience of not being sure whether things that I remember happening really did happen or whether I just dreamed them.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
16. I have the experience of being in a familiar place but finding it strange and unfamiliar.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
17. I find that when I am watching television or a movie I become so absorbed in the story that I am unaware of other events happening around me.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
18. I find that I become so involved in a fantasy or daydream that it feels as though it were really happening to me.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
19. I find that I sometimes am able to ignore pain.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
20. I find that I sometimes sit staring off into space, thinking of nothing, and am not aware of the passage of time.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
21. I sometimes find that when I am alone I talk out loud to myself.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
22. I find that in one situation I may act so differently compared with another situation that I feel almost as if I were two different people.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
23. I sometimes find that in certain situations I am able to do things with amazing ease and spontaneity that would usually be difficult for me (for example, sports, work, social situations, etc.).(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
24. I sometimes find that I cannot remember whether I have done something or have just thought about doing that thing (for example, not knowing whether I have just mailed a letter or have just thought about mailing it).(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
25. I find evidence that I have done things that I do not remember doing.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
26. I sometimes find writings, drawings, or notes among my belongings that I must have done but cannot remember doing.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
27. I sometimes find that I hear voices inside my head that tell me to do things or comment on things that I am doing.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
28. I sometimes feel as if I am looking at the world through a fog, so that people and objects appear far away or unclear.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
29. I experience strong thoughts, emotions, or urges that feel like they don’t belong to me or have come out of nowhere.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)
30. I feel a sense of confusion about who I am, struggling to define my own interests, beliefs, or goals as they seem to shift dramatically.(0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%)

Scoring and Interpretation Guide

How to Score: To calculate your average score, add up the percentages you selected for all 30 questions. Then, divide that total sum by 30. For example, if your total sum is 900, your average score is $900 \div 30 = 30$.

The Crossroads of Identity: DID, Autism, and ADHD (AUDHD)

Diagnosing complex trauma disorders is rarely straightforward. The picture becomes even more intricate when considering the significant overlap between DID and the neurodevelopmental conditions of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD).¹⁶ When an individual is both autistic and has ADHD, this is sometimes referred to by the community term “AuDHD”.¹⁸ It is entirely possible for a person to have DID and also be neurodivergent, but the shared symptoms can create diagnostic challenges.¹⁷

Shared Symptoms, Different Roots

Several core experiences can be present in DID, ASD, and ADHD, but they often stem from very different underlying mechanisms. A skilled clinician must look beyond the surface symptom to understand its function and origin.

• Social Difficulties: An autistic person may struggle with social interactions due to difficulties interpreting non-verbal cues, understanding social nuances, or engaging in reciprocal conversation.¹⁷ An individual with DID may face social challenges for entirely different reasons: amnesia for past conversations, sudden shifts in mood or opinion mid-interaction as alters influence them, or the emergence of different alters with vastly different social skills and relationship histories.¹⁷
• Emotional Dysregulation: Difficulty managing emotions is a core feature of ADHD and is also very common in autism, often related to sensory overload or frustration with communication barriers.²¹ In DID, emotional dysregulation is often extreme and directly linked to trauma. A seemingly minor event in the present can trigger a traumatic memory, leading to the emergence of a highly emotional child-alter and a sudden, intense emotional reaction that seems disproportionate to the situation.⁸
• An Unstable Sense of Self: This is the defining feature of DID, where identity is fragmented. However, a person with AuDHD may also report feeling like they are “two different people.” This feeling can arise from the profound internal conflict between the autistic brain’s need for routine, predictability, and deep focus, and the ADHD brain’s craving for novelty, stimulation, and impulsivity.¹⁸ This internal battle can create a feeling of inconsistency and identity confusion that can mimic, and be mistaken for, the identity alteration of DID.
• Memory and Attention Issues: ADHD is characterized by challenges with working memory, organization, and sustained attention.¹⁶ An autistic person might have difficulty shifting their attention away from a topic of intense interest (hyperfocus) or may seem inattentive when overwhelmed by sensory input.²⁰ In DID, memory problems are not primarily about inattention but about structured amnesic barriers between identity states. One part of the self literally does not have access to the memories of another part.⁸

A Recommendation for Comprehensive Assessment

Because of this complex overlap, it is crucial for anyone who scores highly on the DID screener and also suspects they may have Autism and/or ADHD to seek a comprehensive evaluation. This assessment should be conducted by a clinician or a team with expertise in complex trauma, dissociative disorders, and adult neurodiversity. A thorough diagnostic process is essential to create a treatment plan that addresses all aspects of a person’s experience accurately and effectively.

Pathways to Healing: Evidence-Based Treatment for DID

The journey of healing from DID is often long and challenging, but it is a journey toward wholeness and a more peaceful life. It is essential to state clearly that recovery is possible. With appropriate, specialized treatment, individuals with DID can learn to manage their symptoms, improve their ability to function, and live rich, fulfilling lives.⁴

The Gold Standard: Phase-Oriented Trauma Therapy

The internationally recognized standard of care for DID is a long-term, structured approach called phase-oriented trauma therapy.²⁵ This model recognizes that before deep trauma work can begin, a foundation of safety and stability must be built.

• Phase 1: Safety and StabilizationThis is the foundational and most critical phase of treatment.26 The primary goal is to establish both internal and external safety. This involves reducing or eliminating self-harming behaviors and suicidal ideation, and helping the client develop the skills to manage overwhelming emotions and dissociative symptoms without resorting to maladaptive coping mechanisms. This phase focuses heavily on building a strong, trusting therapeutic alliance and teaching practical skills like grounding techniques (to stay present), mindfulness, and emotional regulation strategies.25
• Phase 2: Confronting and Processing Traumatic MemoriesOnce the individual has achieved a reasonable degree of stability and has a robust set of coping skills, the therapy can move into the careful processing of traumatic memories.26 This work is done slowly and cautiously to prevent re-traumatization. The goal is to help the individual understand and grieve their past experiences, connecting the memories to the parts of the self that hold them. This helps to reduce the power of the trauma and lessen the frequency of flashbacks and intrusive symptoms.26
• Phase 3: Integration and RehabilitationThe final phase focuses on the integration of the different identity states into a more cohesive and collaborative whole.26 The goal of “integration” is often misunderstood. It does not mean “getting rid of” or “killing off” alters. For many, these parts have been essential for survival, and the therapeutic approach must be one of respect and compassion. Integration means lowering the amnesic walls between parts, fostering internal communication and cooperation, and developing a unified sense of self that can hold all of one’s life experiences. For some, this may lead to a final fusion into a single identity state. For others, the goal may be “functional integration,” where the parts continue to exist but work together harmoniously. Both are valid and successful treatment outcomes. This phase also focuses on helping the individual build a meaningful life in the present and look toward the future.26

Adjunctive and Specialized Therapies

Within the phase-oriented framework, therapists often incorporate other evidence-based modalities:

• Modified Eye Movement Desensitization and Reprocessing (EMDR): Standard EMDR can be destabilizing and even harmful for individuals with DID if used prematurely.²⁹ However, when adapted by a highly trained specialist, EMDR can be a powerful tool for processing trauma in Phase 2. Modifications include ensuring all parts of the internal system consent to the work, focusing on stabilization first, and using techniques to keep the client grounded and within their window of tolerance.²⁴
• Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT): Skills from DBT, such as mindfulness, distress tolerance, and interpersonal effectiveness, are exceptionally useful for the stabilization work of Phase 1.²⁶ Trauma-focused CBT can help individuals identify and challenge distorted beliefs about themselves and the world that developed as a result of trauma.²⁶

The Role of Medication

It is important to note that there is no medication that directly treats DID itself or cures dissociation.⁴ However, medications are often used to manage co-occurring conditions or distressing symptoms. For example, antidepressants may be prescribed for depression, or anti-anxiety medications may be used to help manage severe anxiety or panic attacks.⁶ Medication is considered an adjunctive treatment, supporting the primary work being done in psychotherapy.

Your Journey of Self-Discovery and Recovery

Understanding Dissociative Identity Disorder is a journey from myth to reality, from stigma to compassion. DID is not a character flaw or a choice; it is a complex and creative survival strategy born out of unbearable childhood trauma. The path to understanding your own experiences begins with self-reflection, and tools like the screener in this article can provide a language for what has felt unspeakable. Recognizing the potential overlap with neurodivergent conditions like Autism and ADHD is a critical step in ensuring you receive a diagnosis and treatment plan that honors the totality of who you are.

Healing is possible. The road is not easy, but through specialized, phase-oriented trauma therapy, individuals with DID can move from a life of internal chaos and amnesia to one of internal cooperation, stability, and hope. Taking the step to explore these possibilities is an act of immense courage. If you see yourself in these words, know that your experiences are valid, they make sense in the context of what you have survived, and a more integrated, peaceful life is achievable. The next step is to reach out to a qualified professional who can walk with you on this journey of recovery.

Disclaimer

The information provided in this article, including the informal self-screener, is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. The screener is not a formal evaluation but a tool to help you organize your experiences for a discussion with a healthcare professional. This is not medical advice. Do not disregard professional medical advice or delay in seeking it because of something you have read in this article. If you are in crisis or believe you may have a medical emergency, please call 988 in the U.S. and Canada, or your local emergency number, or go to the nearest emergency room.

Resources and Citations

Resources

• International Society for the Study of Trauma and Dissociation (ISSTD): https://www.isst-d.org/
• Sidran Institute: Traumatic Stress Education & Advocacy: https://www.sidran.org/
• National Alliance on Mental Illness (NAMI): https://www.nami.org/about-mental-illness/mental-health-conditions/dissociative-disorders/
• Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357)

Citations

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). (https://did-research.org/did/basics/dsm-5/)
• Cleveland Clinic. (2024). Dissociative Identity Disorder (Multiple Personality Disorder). (https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder)
• American Psychiatric Association. (2024). What Are Dissociative Disorders?. (https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders)
• Carlson, E. B., & Putnam, F. W. (1993). Dissociative Experiences Scale (DES-II). (https://traumadissociation.com/des)
• Myrick, A. C., et al. (2022). Effectiveness of phase-oriented treatment for trauma-related dissociative disorders: A systematic review. Psychological Trauma: Theory, Research, Practice, and Policy. (https://pmc.ncbi.nlm.nih.gov/articles/PMC1240619/)
• Marich, J. (2023). EMDR Therapy and Dissociative Identity Disorder (DID). EMDR International Association. (https://www.emdria.org/blog/emdr-therapy-and-dissociative-identity-disorder-did/)
• Brand, B. L., et al. (2016). A Naturalistic Study of Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified Patients Treated by Community Clinicians. Journal of Nervous & Mental Disease. (https://www.ncbi.nlm.nih.gov/books/NBK568768/)
• Good Health Psychological Services. (n.d.). Autism and Dissociative Identity Disorder: Can They Coexist?. (https://goodhealthpsych.com/blog/autism-and-dissociative-identity-order-can-they-coexist/)
• Unruh, A. (2022). ADHD Symptom Spotlight: Dissociation. Verywell Mind. (https://www.verywellmind.com/adhd-symptom-spotlight-dissociation-5270278)
• International Society for the Study of Trauma and Dissociation. (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation. (https://www.carolynspring.com/blog/emdr-in-the-treatment-of-dissociative-disorders/)