I was fascinated to read Julia’s blog entry entitled Many Children Hear Voices Yet Remain Mentally Healthy. I was also fascinated by the article she referenced.

As someone recovering from dissociative identity disorder (DID – formerly known as multiple personality disorder), I always question whether these studies about “hearing voices” are accurate because there is a big difference between hearing auditory voices, as is experienced by some with schizophrenia, and “experiencing loud thoughts,” which is what those of us with DID experience. I am not sure that those conducting the study understand the difference, much less the seven- and eight-year-old subjects of the study.

From what I understand, those with schizophrenia hear audible voices. My mother has many symptoms of schizophrenia but has never chosen to be evaluated for it. One of her symptoms is “hearing God” talk to her. Especially when she is under enormous stress (such as after my father passed away suddenly), “God” will “talk” to my mother, and she claims to “hear” him as if a person was in the room with her. This is very different from what those with DID experience.

An embarrassing part of healing from trauma can involve the involuntary loss of control of bodily functions. This generally happens during a flashback or, in the case of a child with dissociative identity disorder (DID), when a particular alter part is triggered.

For example, let’s say the abused child was tortured to the point that he eventually vomited. When he experiences a flashback of that particular event, his body might react the same way that it did when he first experienced the abuse. So, as he recovers the memory through a flashback, he might get a very strong urge to vomit.

The same thing can happen with bladder or bowel control. If the abused child was terrorized to the point of wetting her pants, then a flashback of that event can cause her to wet her pants again. This is true even into adulthood. If a seventy-year-old child abuse survivor was only 8 when abused, then she is going to revert back to feeling like she is 8 when experiencing the flashback.

A reader asked the question, “Why is Dissociative Identity Disorder (DID) hard to diagnose?” The answer to this question is multi-faceted.

In my opinion, the main reason DID is so hard to diagnose is because children with DID are masters at hiding who they really are. The entire point of having DID is to survive severe and ongoing abuse. Children must have begun enduring the severe abuse before age six in order to develop DID, so they learn to hide themselves extremely well at a very early age.

Unlike what you see portrayed in the movies and on TV, DID switching is seamless. It has to be in order to protect the child. The child needs to replace the host personality (the “innocent” part that is unaware of the abuse) with an alter part to endure the abuse without the abuser(s) being able to tell. The child must then be able to switch back so that the “innocent” part protects the secret as the child goes out into the world (at school, with friends, etc.).

Another reason that DID is so hard to diagnose is that the medical community still does not understand the disorder very well.

On Trauma Thursday, I wrote about traumatized adopted children with Dissociative Identity Disorder (DID). Today, I would like to focus on recognizing DID in a traumatized adopted child.

DID is very difficult to recognize unless you know what you are looking for. Even then, it can be hard to see. If you are concerned about DID, the best starting point is understanding the profile of a person with DID.

DID only occurs in people who have suffered from severe trauma from an early age (generally beginning before age six). Children with DID tend to be people-pleasers, which is the whole point of DID – being able to “be” who the child is expected to be in different settings. Children with DID also tend to be highly intelligent.

Children with DID might generally seem one way most of the time, and that “one way” is usually very passive and obedient. However, if the child becomes triggered, he can suddenly act very differently. For example, he might usually allow other people to take advantage of him but then, out of nowhere, suddenly stand his ground very firmly or even in an “over the top” way.