The different types of dissociation
There are five types of dissociation:
This is when you can’t remember incidents or experiences that happened at a particular time, or when you can’t remember important personal information.
A feeling that your body is unreal, changing or dissolving. It also includes out-of-body experiences, such as seeing yourself as if watching a movie.
The world around you seems unreal. You may see objects changing in shape, size or colour, or you may feel that other people are robots.
Feeling uncertain about who you are. You may feel as if there is a struggle within to define yourself.
This is when there is a shift in your role or identity that changes your behaviour in ways that others could notice. For instance, you may be very different at work from when you are at home.
What are the different types of dissociative disorder?
Occasional, mild episodes of dissociation are part of ordinary, everyday life. Sometimes – at the time of a one-off trauma or during the prolonged ‘identity confusion’ of adolescence, for instance – more severe episodes are quite natural.
Dissociative disorders occur when you have continuing and repeated episodes of dissociation. These usually cause what many people describe as ‘internal chaos’, and may interfere with your work, school, social, or home life. However, you may be someone who appears to be functioning well, and this may hide the distress you are experiencing.
This is when you can’t remember significant personal information or particular periods of time, which can’t be explained by ordinary forgetfulness. You may also experience mild to moderate depersonalisation, derealisation and identity confusion.
I didn’t know I had other personalities at first because I wouldn’t remember them taking over – usually people closest to you are the first to know.
Depersonalisation disorder
You will have strong feelings of detachment from your own body or feel that your body is unreal. You may also experience mild to moderate derealisation and mild identity confusion.
You may travel to a new location during a temporary loss of identity. You may then assume a different identity and a new life. Usually this ‘fugue’ will last for a few days, but it can last longer. To people who don’t know you, your behaviour may appear normal.
When your memory of your identity returns, you may have a range of different feelings about what you did while in the fugue, such as depression, guilt, shame, fear and/or confusion. If you experience dissociative fugue, you are likely to have experienced severe amnesia, with moderate to severe identity confusion and often
identity alteration.
Dissociative identity disorder (DID)
This is the most complex dissociative disorder. It is also known as multiple personality disorder (MPD). This has led some to see it as a personality disorder, although it is not. The defining feature is severe change in identity.
I’d look in the mirror and it would be a different face. I was chaotic and unsettled.
If you experience DID, you may experience the shifts of identity as separate personalities. Each identity may be in control of your behaviour and thoughts at different times. Each has a distinctive pattern of thinking and relating to the world. If you also have very severe amnesia, it may mean that one identity may have no awareness of what happens when another identity is in control. The amnesia can be one-way or two-way. Identity confusion is usually moderate to severe. DID also includes severe depersonalisation and derealisation.
Dissociative disorder not otherwise specified (DDNOS)
Each of the five types of dissociative response (see What are the different types of dissociative disorder?) may occur, but the pattern of mix and severity does not fit any of the other dissociative disorders listed above.
If you have a dissociative disorder, you may experience other problems too, e.g.depression, mood swings, anxiety and panic attacks, suicidal thoughts and feelings, self-harm, headaches, hearing voices, sleep disorders, phobias, alcohol and drug abuse,eating disorders, obsessive-compulsive behaviour and various physical health problems.
These may be directly connected with the dissociative problem, or could mean that you also have a non-dissociative disorder. In DID, some problems may only emerge when a particular identity has control of your behaviour, thoughts and feelings.
What are the effects of a dissociative disorder?
Dissociation can affect your perception, thinking, feeling, behaviour, body and memory. If you experience a dissociative disorder you may have to cope with many challenges in life. The impact of dissociation varies from person to person and may change over time. How well a person appears to be coping is not a good way of telling how severely affected they are.
The effects of dissociative disorder may include:
finding yourself in a strange place without knowing how you got there
loss of feeling in parts of your body
distorted views of your body
forgetting important personal information
being unable to recognise your image in a mirror
a sense of detachment from your emotions
the impression of watching a movie of yourself
internal voices and dialogue
feeling detached from the world
feeling that a customary environment is unfamiliar
a sense that what is happening is unreal
forgetting a talent or learned skill
a sense that people you know are strangers
a perception of objects changing shape, colour or size
feeling you don’t know who you are
acting like different people, including child-like behaviour
being unsure of the boundaries between yourself and others
feeling like a stranger to yourself
being confused about your sexuality or gender
feeling like there are different people inside you
referring to yourself as ‘we’
being told by others that you have behaved out of character
finding items in your possession that you don’t remember buying or receiving
writing in different handwriting
having knowledge of a subject you don’t recall studying.
