I was sitting in a group therapy session once when the leader succinctly described the perception those of us with multiple personalities have of ourselves as groups of entirely separate people by writing the following on the white board: Me/Not Me. This is me. That is not me. For instance, I am a writer. But if another member of my system were assigned the task of writing this blog post, we would see how the Multiple Personality Disorder label came about. Some might have done a passable job. Others would have struggled mightily only to ultimately produce a choppy, thoroughly unimpressive piece of work. I am me. They are not me.

Yesterday I talked about the Dissociative Identity Disorder diagnosis and the vital role clinicians play in making that diagnosis. One of the reasons it's important to talk to a therapist if you think you may have DID is that dissociation by nature impedes awareness. Most people can't see the spot between their shoulder blades without a mirror. Similarly, most severely dissociative people aren't able to clearly recognize the symptoms of DID and the extent of their problem without the help of a skilled clinician. In fact, the diagnosis often comes as a shock. Today I'd like to share with you a typical diagnosis story - my own.

We were talking about dissociation when a man I once knew told me he'd been entirely unaware of a hospital stay until he got the bill. I didn't say it, but I immediately thought, 'he obviously has Dissociative Identity Disorder.' I now know how presumptuous that was. Though his experience was clearly indicative of something outside of everyday experience, it's taking a lot for granted to assume that something is DID. And looking back, it's absurd that I was so convinced. Not satisfied with a second opinion of my own diagnosis, I sought out four. One would think someone as hesitant to jump to conclusions as that would exercise a little more caution.

If you've ever seen a television crime show featuring a suspect with Dissociative Identity Disorder, you've seen a theatrical depiction of identity alteration, the fifth of the five main dissociative symptoms. A bewildered man suspected of murder is brought in for questioning. Eventually his manner, style of speech, and affect change dramatically and he says something like, "Sam didn't kill her. I did. I'm Joe." That switch in personality states is identity alteration at it's most extreme.

I used to make lists of things I liked and didn't like. If I wanted to marry and have children, that went on the list. If I enjoyed musical theater, that too went on the list. Inevitably a day would come when I couldn't imagine wanting to marry or liking musicals. I was perplexed as to why they were on the list in the first place. So I'd start a new one. I was trying hard to figure out who I was. As soon as I had a decent handle on the nature of my identity, it would slip through my fingers once again. I kept these lists in an effort to pin down my sense of self in a concrete and lasting way. What I didn't know is that I have Dissociative Identity Disorder. Identity confusion is a normal, if monumentally frustrating, part of DID.

We've covered depersonalization and derealization, two of the five core dissociative symptoms. As someone with dissociative identity disorder, both of those forms of dissociation affect me regularly. But the remaining three impact my life most profoundly. Dissociative amnesia, as I'll explain, is a deeply frustrating and disruptive part of living with DID.

I remember a certain meeting with a girlfriend in a coffee shop. I arrived before her and sat working on a crossword puzzle while I waited. It wasn't long before she was standing next to me saying, "Hi!" I looked at her, and even though I knew my purpose in the coffee shop that day - to meet her - it took me a moment to understand who she was. It was a jarring moment in her Dissociative Identity Disorder education. "You didn't recognize me," she said. She was right. I didn't immediately recognize her, even though by then we'd spent hundreds of hours together. But it wasn't amnesia, the form of dissociation one might suspect, that prevented me from recognizing her. It was a different dissociative symptom: derealization.

What's it like to live with depersonalization in dissociative identity disorder ? Articulating the answer is challenging for me. Partly because I don't know what it's like to live without DID; partly because describing it requires a base-line level of awareness that dissociation by nature impedes. And partly because the question is so large, sort of like asking what it's like to be female. Breaking dissociation down into the five primary ways it manifests makes illuminating the experience of living with dissociative identity disorder easier. Depersonalization - the feeling that you're separate from your body - is the first.

Among those with Dissociative Identity Disorder, there's some debate about whether it should be called a disorder at all. Some even view DID as evidence of mental health. When you consider that its development is regarded as an example of adaptive functioning by many of both those who live with it and those who treat it, it's easy to understand why some might dispute the mental illness label. Mental illness by definition implies maladaptive functioning - it interferes with and disrupts daily living. But Dissociative Identity Disorder is often described as life-saving. Which is it?

I Can't Tell You I Have DID. You Don't Understand. I no longer hide the fact that I have Dissociative Identity Disorder. The major players in my life know I have DID. When it comes up in conversation, when not mentioning my diagnosis would require lying or warping the truth, I tell people I have DID. It's a new way of living for me and it's teaching me a lot about myself and others. One of the most surprising things I've discovered is that just as there are assumptions about DID in the general public, there are assumptions about the general public in the multiple community. Those assumptions obscure the potential for acceptance and support, and create barriers to understanding dissociative disorders.