Dissociative Identity Disorder: Etiology – Case File

How does Dissociative Identity Disorder (DID) begin in an individual? Although the etiology of DID remains complex, listed below are a few encounters in my previous practice. 

Her father had anger management issues and was divorced from her mother when she was 5 years old. He had legal custody over her, and they eventually migrated to Canada. When he was angry with her for the slightest infractions, he would use his leather belt on her. Some of these beatings were so severe, she would dissociate; viz., blank out her mind. In her twenties, she left Canada and arrived in Singapore. 

When she was five-year-old, one afternoon, she had repeatedly interrupted her mother who was on the phone. After hanging up, her mother brought her to the kitchen window and held her by her heel upside-down outside the window. They lived on the sixth floor. She dissociated and could not recall that incident.

At four years of age, she was alone with her mother, at home. She witnessed her mother foaming at her mouth, after drinking weed poison. Weeping non-stop, she tried desperately to wake her mother. For 6 hours, she sat by her mother’s lifeless body, until her father arrived home. Traumatized, that was her first dissociative experience. Subsequently, she was given away to her uncle, and was forced to work as a maid. Resentful of her, her aunt treated her poorly; torturing her by rubbing chilly into her eyes and forcing her face close to a grill, whenever she broke kitchenware or did not follow instructions closely. When she first arrived for counselling, she had no recollections of these memories.

Her parents oversaw a students’ hostel, and together with her siblings, she would be involved in fun-and-games with the students almost daily during their free time after classes. When she was six, one of the older boys raped her. She froze and cannot remember details of that incident. 

When their parents were at work, the children’s uncle, who was staying with them, would invite her, her brothers and cousins into his room to watch adult pornography. She was only ten years old, the youngest. The kids would act out the scenes among themselves after these viewings. She felt ill at ease and began dissociating during these sessions. 

​He was the oldest child in the family. Since a young age, he took the brunt of his father’s drunken anger tantrums. Occasionally, his mother, when she was at home, attempted to shield him from her husband. Whenever his father arrived home drunk, he would lock his younger siblings in their bedrooms. He said that when his father began to whip him with his belt, he would put himself into a trance state, and would feel nothing. The pain would come when he woke up after the abuses.

Once a child learns to dissociate, it is not uncommon that he normalizes his dissociative tendencies and repeats them whenever he faces future traumatic or highly stressful incidents. So, the first dissociative experience may not be his last. For some children, this is their coping strategy in the face of overwhelming trauma, until adulthood, when they begin to learn more safe ways of managing excessively stressful events. This will probably include resolving the many dissociative parts that had been created, be they co-conscious or otherwise.