Remission from Dissociative Identity Disorder?
Reader Deanna asked if anyone has ever experienced remission from Dissociative Identity Disorder. If we’re defining remission as a period of diminished, unobtrusive dissociative symptoms – “normal” dissociation, in other words – then I’d wager there are people who have experienced exactly that. But they have worked hard to achieve that degree of integration and awareness. It didn’t happen spontaneously, which is what I suspect most of us with Dissociative Identity Disorder mean when we bring up this idea of remission. And I also suspect it isn’t really integration we’re talking about, but the apparent disappearance of other personality states. I’m guessing plenty of people experience this latter scenario too; but remission it is not.
Increased Dissociation is not Remission
I’ve heard people with Dissociative Identity Disorder talk about personality states dying or disappearing enough to believe it’s something most of us with DID have experienced at one time or another, myself included. But I don’t believe anyone has actually gone anywhere. In fact, I’d say that’s impossible. Because when we talk about personality states we aren’t talking about superfluous identities, additional personalities that can be disposed of once they’re no longer needed. We’re talking about dissociated aspects of self, disowned parts of who we are. True remission from Dissociative Identity Disorder, therefore, doesn’t involve putting greater distance between the self and its various aspects. And when we say things like, “My system disappeared,” we are saying, essentially, “There is now even more distance between me and these other parts of who I am.” That's an increase in dissociation, not a remission from it.
Integration Leads to Remission
Remission from Dissociative Identity Disorder occurs when we have, over time, diminished the distance between our various personality states and integrated them into one multifaceted identity. Though I’ve not experienced it, I can’t imagine that complete integration feels anything like the sense that all or parts of your system have simply disappeared. After all, what’s happened is the opposite: rather than parts of the identity disappearing, they become accessible to each other, woven into the overall sense of self.
In the context of dissociative disorders, integration can be understood as the organization of all the different aspects of personality (including our sense of self) into a unified whole that functions in a cohesive manner.
- Coping with Trauma-Related Dissociation
Boon, Steele, van der Hart
Achieving Remission from Dissociative Identity Disorder
If having Dissociative Identity Disorder meant having extra personalities to help out until the "real" person becomes strong and flexible enough to navigate life on their own (a common misconception), achieving remission would involve getting rid of those extra personalities. But that’s not what DID is. No part of who we are is disposable. And the belief that there are aspects of self that should go away is part of the pathology of DID. Achieving remission means challenging that belief by choosing to move closer to dissociated personality states. Remission is the opposite, in other words, of your system disappearing – it is your system moving together and becoming one.
Gray, H. (2011, August 25). Remission from Dissociative Identity Disorder?, HealthyPlace. Retrieved on 2022, October 7 from https://www.healthyplace.com/blogs/dissociativeliving/2011/08/remission-from-dissociative-identity-disorder
Author: Holly Gray
I'm so glad I ran into this post. I haven't had full D.I.D. - rather I have been diagnosed with DDNO years ago. I had symptoms for most of my life and then they just.... stopped. I started to think I made the symptoms up. I started to think it all went away. Whatever. I may hear a snippet of a voice now and again, but that was about it. Suddenly, after about 8 years of nothing everything changed. I have no idea what triggered it. I can't say it is entirely bad, because I am suddenly feeling certain things I haven't felt in years. Some difficult, but some good. Some of it is not so great. I feel the co-consciousnes of the different parts with their different affects talking through me. Just today a kid burst into a conversation I was trying to have about baking cookies. I felt like clapping a hand over my mouth mid sentence, I was so surprised. I have been trying to figure out why there was nothing and now there is everything. But like I said, even though I am suddenly feeling crazy I am also generally feeling more even if it is not all "me" and even if I feel like I am not always entirely driving. I'm a little freaked out, but I think I can learn to hang with this. I just hope it doesn't disrupt anything good I have got going. Things have been pretty steady.
Hi Holly I have been integrated for aproximately 3 years with no breaks. It took me 25yrs of off and on treatment. Trying to find help going into remission and breaking apart over and over. Then 6 yrs ago I found the right therapist and I was ready to do whatever I had to do to be able to opeate as one to live my life as a whole person. This took 5yrs over very hard work. Once Interated I had a new journey and a whoe new set of problems. How to access the other parts of me, how to live in this new world because believe me the world from insanity to sanity is definately different. I thought when I got well all would be wonderful and although it really is better and to me worth it, it is just the beginning of more hard work, learning coping skills I no longer had any. Finding out who Nancy is and what I am capable of but mostly being able to be consistant having love in my life giving love back and never having to look over my shoulder wondering what I did and do not remember.Today I am stong I am mentally healthier than I have ever been and have reunited with my family and people trust me. Most of all I can trust myself. Nancy
@Stephanie ... "clue-by-four." I've never heard that before! Awesome. :) You said: "I’ve just recently started having “system activity” again after a “remission” of a few months. But… it wasn’t a remission. It was getting even more dissociated from them." I just want to add that that's super normal, the ebb and flow. I'm sure you've heard others with DID say it too, things like "whoa, I think my system disappeared!" or something like that. I kind of think that ebb and flow is necessary, to keep us from getting overwhelmed.
@Poser I'm sorry, I meant to respond sooner. I wish you didn't feel so afraid because I think it's really okay ... it's just a process. We move closer, we back away, we move a little closer, and back away. As long as, overall, we're becoming more aware that's all that matters.
@Deanna You know, this one has me stumped. I'm not sure why a nerve block would have that effect. You might be right though, maybe the two things are connected. We just may not understand why yet.
@kerri I had the same reaction as you when I realized what integration really is. "This sounds much more appealing. A true goal that we can all work towards without fear. Cohesion, cooperation and clarity. Sounds wonderful!" Hear, hear!
Hi Holly, well WOW I just love this post!! You really clarified things for me regarding this topic.
In the past my inner family have been terrified of "integration" which has been defined as an absence of dissociation and therefore to them an absence of themselves and DEATH. But your definition helps all of us believe in functionality without the loss of anyone. This sounds much more appealing. A true goal that we can all work towards without fear. Cohesion, cooperation and clarity. Sounds wonderful!
"Were you in therapy at the time? Is it possible you’d done enough work within your system that you did achieve a kind of temporary integration?"
No I was not in therapy and had not been for well over 5 years. As I said in my original post, at the time, I attributed this "change" to a nerve block I had at the base of my skull. I left the procedure feeling like "some brain cells had been fried" but otherwise, OK. It was soon after I noticed the change in how I processed my feelings. I mentioned it to my pain dr. and he totally blew me off. 2 years ago I started back in therapy and eventually told her of this experience. She was very curious and did some research but nothing like this seems to be documented anywhere.
If my remission was not from the nerve block, then what happened? At the time I was so positive that the two events were connected.
Reading Deanna and Stephanie's posts has me a bit shaken. Add the wisdom of Holly, stir well and I think I am now completely afraid. I have noticed over the past few months that the others (parts) are less and less available. I felt a bit less scrambled and "more functionality" as Deanna says. It did think the miracle was a bit sudden but I attributed it all to medication and great therapy. I'm cured!!!! Now I think maybe not. Guess it's not a good time to give up therapy, huh?
I've been in a remission of sorts with my DID and I feel like you just hit me over the head with the largest clue-by-four in the world.
"And when we say things like, “My system disappeared,” we are saying, essentially, “There is now even more distance between me and these other parts of who I am.” That’s an increase in dissociation, not a remission from it."
All I thought after reading that was, "Holy shit." But you're so right. I've just recently started having "system activity" again after a "remission" of a few months. But... it wasn't a remission. It was getting even more dissociated from them.
I dunno. I need to process that. Thank god for therapy.
P.S. LOVE the pictures/graphics of Dissociation and Integration!
Thanks so much for posing this question. It is helping me clarify what I experienced and the language that it more helpful to the greater community.
“And when we say things like, “My system disappeared,” we are saying, essentially, “There is now even more distance between me and these other parts of who I am.” That’s an increase in dissociation, not a remission from it.” Let me chose another word: My system quieted. And whatever that experience is called, “remission,” “integration,” I would return to it in a heartbeat! I don’t believe it was an increase in dissociation because my functionality was high. There was a sense of relief; a step closer to health; a simplicity in my thoughts. Even though I was not actively moving toward integration in therapy at that point in time, I realize I could have reached a different sort of integration that I had not experienced in a very long time. And if THAT was remission/integration, then I have a long road right now to get back to what THAT remission felt like.
I think the big mistake I made 5 years ago was assuming that once I had experienced integration/remission, I was “cured” and all done!! Goal achieved! Holly when you used the term re-fragmentation, I realized I had not allowed for that possibility to exist and it was an incredibly difficult process admitting that to myself and allowing the “fragments” back into my life. To everyone who is at a place of wholeness/integration/remission, good for you!! We must also hold in our hearts the possibility that wholeness can shift very quickly by triggers we don’t expect. If we can allow for that possibility and be open to it and aware of it, then the return to wholeness/peace/calm/integration/remission/healing may be an easier road. I am no longer holding that experience as a benchmark for solid mental health (although it would be lovely!) That was then. This is now. It is also difficult to look back 5 years, and attribute what I might have been experiencing then to what I know now after two years of intense, excellent therapy.
This is so interesting:
"I don’t believe it was an increase in dissociation because my functionality was high. There was a sense of relief; a step closer to health; a simplicity in my thoughts. Even though I was not actively moving toward integration in therapy at that point in time, I realize I could have reached a different sort of integration that I had not experienced in a very long time."
Were you in therapy at the time? Is it possible you'd done enough work within your system that you did achieve a kind of temporary integration?
I can appreciate how difficult it must have been to re-fragment after such an experience. I think your advice is great ... allow for the possibility of re-fragmentation and be aware of it. You have insight many of us don't because you've been on both sides of this diagnosis. I hope to hear more!
Our definitions and wordings are different :) It's always those things that throw me off!
Every definition of integration I've read or been told says the parts will no longer be there, you will be ONE person. I hate integration for that reason. I interpret your definition as melding. I call it melding or meshing... that we're all just getting to know each other so well it's like we're the same... like friends who are so close they can finish each others' sentences. I can finish the sentences of the others cuz i can feel their feelings and hear their thoughts, but they are theirs and not mine. I have my own.
So we're on the same wavelength just in different colors :D
Besides, I just had to say somethign to bug you anyway. ;P and say HI!!!! :D
I'd like a word with the people who are defining integration for you, then. Anyone who says "the parts will no longer be there" doesn't even understand Dissociative Identity Disorder, let alone the process of integrating and fusing. Integration does not involve getting rid of parts. And if an individual with DID achieves complete fusion, their parts are absolutely still there. In fact, they are *more* accessible, not less. Everyone has parts of self. People with DID have parts of self that are far more separate and operate independently. Integration is the process by which those parts move closer together and begin to operate as one. That's the opposite of parts no longer being there.
When I think of remission, I think of the aspects of DID that are no longer healthy since the abuse is no longer there. I don't necessarily equate remission into how dissociated or integrated we all are (especially since integration has such a negative connotation and we all refuse to do it), but as to how many of the frustrating issues and problems that were there in the beginning are still affecting our lives. We do have problems that come and go-- the losing time or a part overreacting and panicking over something that happened. If remission with cancer and other disorders is a lack of symptoms. Then wouldn't it be a lack of the negative aspects when it comes to DID?
I have had great times being DID, still switching but knowing what's going on. Laughing at the odd things that just make us quirky to others. Enjoying the various thought processes and experiences that the others have compared to my own. But the constant fears, anxieties, loss of time, the uncontrolled switching, feeling insane and crazy with the loss of control, all of that is nonexistent 95% of the time now. I still switch all the time. But to me that is ok. None of us have been killed off or died (unless they chose to do so in their own way-- that whole reincarnation thing appealed to some, die to come back as something better). But the aspects that caused the problems, the aspects that kept us unhealthy are basically gone. I view that as remission. They may come back from time to time depending upon what life throws at me. But the dissociation itself never goes away.
Considering that everyone on the planet dissociates from one degree to another, saying that dissociating more is a form of remission is confusing to me. We continue to dissociate, we continue to switch and enjoy the time though we work together and ask and cooperate and communicate in ways we never thought possible years ago. It's like we're one big happy family that always gets along and never fights, where before it was nothing but fighting. But we aren't becoming one. We all still have our own thoughts and opinions and we talk about it all.
It may be that our definitions of becoming one are different. I just know that for me, I feel in remission, but I'm not one. No negative aspects because of the DID but sill being DID. If that makes sense!
"If remission with cancer and other disorders is a lack of symptoms. Then wouldn’t it be a lack of the negative aspects when it comes to DID?"
Yes, precisely. That's what I said in the first paragraph, in fact.
"Considering that everyone on the planet dissociates from one degree to another, saying that dissociating more is a form of remission is confusing to me."
If one has Dissociative Identity Disorder, one is already far more severely dissociative than those who do not have a dissociative disorder or PTSD. Dissociating even more is therefore NOT a form of remission. Far from it.
Integration has a negative connotation because it's misunderstood. For one thing, it's not an event. It's a process ... "becoming one" is different than "being one." And if you have, over time, gained more and more insight into the nature of your system, learned to communicate more effectively, and worked together to such a degree that you are no longer experiencing any disabling aspects of DID then you *have* been integrating. That is precisely what integration is ... moving closer to these other aspects of who you are. For some, that eventually leads to fusion. But not for everyone. In fact, despite what the clinicians say, I'm not convinced total fusion is even a possibility for everyone. But integration is.
Dissociative Identity Disorder, like every other psychiatric condition, is called a disorder because it actively disrupts people's lives. It gets in the way, it causes problems, it creates distress. Some people aren't able to work. They may have difficulty maintaining relationships. Their symptoms are interrupting their lives in negative ways. So when someone tells me they have DID but everything is fine, I feel I'm missing something .... ;)
I rarely post replies, but I always find your blog so helpful! I think my brain works like yours (except much slower!)....I like to have clear logical explanations for everything. This post is great. The idea of alters dying or disappearing was confusing to me, knowing that they are actually just a very separated part of myself. It makes a lot of sense that the less dissociated you are in fact the more access you have to that knowledge about yourself.
I haven't been diagnosed very long, and just want to say that had it not been for blogs like yours and others such as mindparts, I think it would have been much harder to deal with. Thank you for your logical explanations, and thank you for being brave enough all the superstitions about DID which would have made it much harder to accept this diagnosis. If you ever get times where you feel like you're not succeeding in your blogging mission come back and read this:
This blog has helped me immensely so far in trying to understand my experience, and I will always appreciate having this forum for free debate about DID.
Thanks so much for taking the time to leave me this note. There are and will continue to be times when I think, "Man, what's the point?" And I will absolutely come back at those times and read your comment. Actually, I'll just put it on a post-it on my bulletin board. :)
I'm really glad Dissociative Living has been helpful. You say you haven't been diagnosed very long ... it's funny, when I think about what to write here the question I always come back to is what would I have wanted to read in those first couple of years after diagnosis? It was such a tremendously confusing time for me, and I don't think it has to be quite so chaotic.