Tuesday, March 22, 2011

Is DID a lifelong diagnosis?

Q: Is the diagnosis of DID a lifelong diagnosis? - Anon

A: It depends on what your goal is in treatment (integration or healthy co-functioning). When many people ask this question what they are really wanting to know is if the trauma ever heals. Do the bad memories ever stop being so close to the surface?

"Time heals all wounds" can seem like a vicious lie when you are a survivor or have Dissociative Identity Disorder. One of the main problems with that saying is that time doesn't move normally when you have trauma in your life. It's hard to " just forget" or " move on" when parts of your brain are actually functioning as if they are still in the middle of the traumatic experiences. And research on PTSD and Trauma that looks at trauma processing and neurological functioning show this to be the case.

Recovery is slow and usually incremental. It may be hard to realize how far you've come in recovery. But those around you may see dramatic differences because they aren't living inside the chaos everyday. Add to that the issues that you face AFTER you get through therapy to process the trauma, learn to not rely on dissociation to cope, and then the time you may spend seeking integration. These can include recovering from addictions, learning coping and life skills, and learning to have health relationships and support network in your life. Recovery may be lifelong.

But yes, I have seen in myself and others that you can move from a place of chaos, abreactions and flashback, PTSD and frequent triggers to a healthy place. You can reach a point where you actually have a hard time retrieving some of the same memories that used to jump into your mind whenever they wanted. It's wonderful when you are able to control your memories instead of them controlling you.

Some people are afraid of losing memories. Don't be. When you move out of the "stuck in trauma overdrive" into a place where memories are stored naturally, then you do lose some of the details. But you don't lose the gist. You don't forget that you were hurt. You just forget the intense details that act as triggers such as specific smells or fabrics. And normal, healthy people do not have access to as many detailed memories as traumatic abuse survivors. Part of that is functional - the brain removes memories that are no longer needed to make room for new learning and new memories. Wouldn't you rather have that room for some newer, better, happier memories? Another part of it is consolidation - memories that are of similar events may be merged into more generic memories. For example, remembering abuse that occurred repeatedly but now no longer able to remember them each individually.

So Dissociative Identity Disorder will stay around as long as it is needed, or it can be improved and possibly ended through the hard work of recovery. Some people claim their alters just "went away" but all the times I've seen that they have actually suppressed their memories and alters and run the risk of it all coming apart again. They aren't done with recovery, they are in denial.

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