Unified sense of self
A Unified Sense of Self
People with dissociative identity disorder do not have a unified sense of self, instead they have a sense of having multiple identities. A unified sense of self can only be achieved by a complete integration, merger and loss of separateness of all identities; this type of full integration has been called fusion or final fusion.[1]:133 There is a dissociated sense of identity.
How can the different identities form part of a single personality?
This is a very difficult topic for people with dissociative identity disorder, especially when amnesia may prevent some identities being aware that others exist. Using the term "parts" to refer to dissociative identities, Howell (2011):55 states "all of the parts participate in one overall personality systemAll alters that make up the personality in an individual with Dissociative Identity Disorder., as well as sharing one body. The different identities are highly interrelated parts of a system that comprises the total person". The ISST-D treatment guidelines for dissociative identity disorder (DID) explain how each identity experiences itself separately: "each identity seems to have its “own” first-person perspective and sense of its “own” self, as well as a perspective of other parts as being “not self.” The identity that is in control usually speaks in the first person and may disown other parts or be completely unaware of them."[1]:132 Some identities may insist they do not inhabit the same body as others, which can lead to serious safety problems including self-harm and suicide attempts.[1]:140Integrated Functioning as the Goal of Treatment
Although the DID patient has the subjective experience of having separate identities, it is important for clinicians to keep in mind that the patient is not a collection of separate people sharing the same body. The DID patient should be seen as a whole adult person, with the identities sharing responsibility for daily life. Clinicians working with DID patients 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." [1]:132
At times two or more identities may be aware of each other, or one identity may be consciously aware of the actions or thoughts of another, which is known as co-consciousness[1]:140 and leads to improved functioning due to reduced day-to-day amnesia. Alter identities can also learn to "ask inside",[1]:140 this internal communication improves functioning as a whole.
It is also important for those with dissociative identity disorder to be responsible for their behavior of their different identities (even those which they have amnesia for). The term "integrated functioning" refers to identities working together for the benefit of all, it does not refer to a unification (fusion) of identities since many with DID will not wish to integrate into a single identity (or may be unable to do so).[1]:133References
- ^ a b c d e f g International Society for the Study of Trauma and Dissociation. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation, volume 12, issue 2, 28 February 2011, page 115–187. (doi:10.1080/152947)
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