Introduced to many on social media via influencers such as @we.are.olympe, or in a fictionalized form in the movie Split (2016), Dissociative Identity Disorder (DID) can be both fascinating and frightening. But for those who live with several “alters” in one body, it is mainly a psychic protection mechanism that follows extreme traumas such as repeated sexual violence during childhood. Classified by the WHO, it affects nearly 1% of the population to varying degrees. However, even within the scientific community, DID is still not widely recognized.

“One time, one of my alters suggested to my boyfriend that we shouldn’t live together anymore. He came over later and told me he thought it might be a good idea. We argued because I had no idea what he was talking about, and I thought he didn’t want to live with me anymore.” Chloe*, a 24-year-old from Bordeaux who is studying art in London, was diagnosed with DID six months ago. “Before that, we had a hard time understanding each other. Now that he knows that maybe it’s not me who is saying such intense things to him, we can talk about it, and I can do some introspection to try to find out why my alter said that to him,” explains the young woman, who has been in a relationship for six years and has identified five of her personalities.

Dissociative Identity Disorder, or DID for short, is characterized by the presence of two or more distinct personality states that are conscious at different times. Each has its own name, history, personality traits, and tastes. “For as long as I can remember, I’ve had pretty intense mental health issues. But starting when I was 15, I began to notice memory loss, moments of anxiety, intense depression, and times when I felt like someone else was taking over my body. I felt sort of possessed,” says Chloe. 

“DID is a hidden epidemic, because the person concerned is generally unaware of the existence of their alters or feels too ashamed to talk about them.”

In recent months, testimonials have gone viral and TV shows featuring people with DID have proliferated. They illustrate the growing openness around discussing mental health issues on social media. Celebrities have also played a role in this phenomenon, from Kanye West speaking freely about his bipolarity to Billie Eilish talking about her depression. In France, influencer Olympe, who says she has DID, borderline personality disorder, and post-traumatic stress disorder, is spearheading the movement. On her Instagram account @we.are.olympe, which has more than 100,000 followers, the 21-year-old model speaks in the first person plural about her daily life with at least thirteen “alters,” a term used to describe the dissociative personalities that coexist within a person with DID.

Olympe has helped to spread the DID community’s terminology, which is often derived from English. “Switch” indicates the passage from one personality state to another; “system” describes all the personalities; “core” is used for the primary alter state; “host” for the one that mainly controls the body; “cofronting” for when two or more alters are present at the same time; “protector” for an alter that protects the system, “child” for the part that remained a child, or “memory holder” for the part that holds onto trauma. 

Plume (her online handle) uses this insider vocabulary to tell her community about her disorder. “Switching is when you change fronts between alters. Today there were no switches, it was just Sophia and I [cofronting, editor’s note]. But in particularly stressful situations, there can be several in a single day and it can increase very quickly,” says the 20-year-old brunette who studies languages in Angers, cohabitates with 46 alters, and uses the Instagram account handle @plume_systeme. On her Instagram @partiellement.moi, Chloe, for her part, prefers not to show her face, instead expressing the pain that accompanies the disorder through drawings. 

A psychological disorder linked to severe trauma

The origin of DID has nothing to do with Instagram. “It is the most severe of the disorders with traumatic origins,” warns Olivier Piedfort-Marin, a psychotherapist who founded and serves as honorary president of the French-speaking Association of trauma and dissociation (AFTD). Dissociation is characteristic of complex, i.e., repeated and long-lasting, traumas, which typically take place in early childhood. The earlier the trauma is experienced, the more it can affect the psyche.

Plume was born in Colombia, and was later adopted. “My mother abandoned me when I was one year old. The file says she left me in an old house, and I was screaming at the top of my lungs,” the young woman explains. Growing up, Plume witnessed her half-brother’s depression and drug addiction. At the age of 10, she was sexually assaulted by a relative of her adoptive family. “Cases of DID where there was no sexual abuse are quite rare,” remarks the psychotherapist. Chloe, who grew up with a borderline mother, was sexually abused by one of her stepfathers from ages 5 to 8. “Some of my identities are not aware that it happened, while others remember everything, and some know that it happened, but have no memory of it,” she explains. “If we experience new traumas, new alters might emerge, because that’s the way our brains work.”

Laurence Carluer, a neurologist at the University of Caen Hospital Center and researcher at the National Institute of Health and Medical Research (INSERM), specifies in an article for Le Figaro that, “Since they are dependent on their caretakers and unable to flee, toddlers have only defense mechanism if they are mistreated and/or sexually abused by relatives; they learn not to feel the sensations experienced in their bodies through disassociation. But frequent recourse to this defense mechanism has an effect on the connections that are established between the reptilian brain, which is in charge of vital functions, the limbic brain, which controls emotions, and the neocortex, which governs the abstract functions that are mobilized for self-awareness and understanding the world.”

Plume: “I had an extremely difficult time holding down a steady job. I made very rash decisions. When I was 19, I was working in a day-care center and one of my alters, who doesn’t like authority, insulted my boss”

This type of journey involves a great deal of pain and self-harm. Depression, self-harm, and substance use are very common among people with DID. “Lena, one of my alters, carries my trauma, and experiences it almost on repeat. When she’s around, I stay under the blanket,” says Chloe. At 17, she tried to escape it by taking Codoliprane – an opioid that was once available in pharmacies – cannabis, and alcohol. The Londoner also remembers the time when she wanted to go back to France to see her family, against the advice of one of her alters. “She took control and swallowed a lot of drugs to prevent me from flying. I saw my body in motion, but I couldn’t do anything.” The art student considers that her DID should be recognized as a disability, especially in the workplace. “I had an extremely difficult time holding down a steady job. I made very rash decisions. When I was 19, I was working in a day-care center and one of my alters, who doesn’t like authority, insulted my boss,” says Plume, who took her high school exams as an external candidate. Plume also switched to distance learning. “In high school, there were several times when the alter at the front had no idea what to do in front of an in-class assignment.” 

Officially recognized by the American Psychiatric Association since 2000 and by the WHO, the dissociative disorder affects at least 1% of the population, according to the projections of Dr. Olivier Piedfort-Marin, who published a paper on the subject last year. This would represent 670,000 French people, almost as many as for schizophrenia. “Dissociative disorder includes DID, partial DID, and other less common disorders such as depersonalization disorder and derealization disorder.” Partial DIDs are much milder and therefore even more rarely diagnosed. They manifest as internal dialogue, such as a voice that insults the person with the disorder, at times of intense stress. Although no epidemiological study can attest it, women are more likely to be concerned, according to the psychologist. “What we also know is that women are more likely to undergo sexual aggressions as children than men,” he notes.

Sigmund Freud and pop culture have fueled misunderstandings of the disorder

If information is lacking, it is because the disorder is downplayed and misunderstood, especially in France. This delay has its roots in the history of psychology. At the end of the nineteenth century, Pierre Janet was an authority in the discipline. The French psychologist was interested in the after-effects of trauma and dissociation. Sigmund Freud’s early work engaged the same subjects, but the Austrian turned to the notion of fantasy, more in line with Zurich researcher Eugen Bleuler, who coined the term “schizophrenia.” The success of psychoanalysis, which was very prevalent in France, overshadowed Pierre Janet’s theories. “This sounded the death knell for the understanding of many psychological disorders with traumatic origins,” says Frenchman Olivier Piedfort-Marin, who practices in Switzerland. Dissociative identity disorder is indeed a very different illness from schizophrenia. Each of the dissociative parts of the person suffering from DID is in a reality of its own, linked to its own history, whereas the patient suffering from schizophrenia experiences psychotic episodes that make them lose contact with all sense of reality. For example, in schizophrenics, auditory hallucinations do not come from within, as in a dialogue between different alters, but from outside, as if the voice were someone else’s.

Olivier Piedfort-Marin: “But in France, dissociation and dissociative disorders are almost never taught in psychology and medical school. As a result, very few colleagues believe in DID”

In the 1980s in the United States, and then in the 1990s in Europe – specifically, in the Netherlands – researchers updated Pierre Janet by proposing the theory of structural personality dissociation. “But in France, dissociation and dissociative disorders are almost never taught in psychology and medical school. As a result, very few colleagues believe in DID,” says the clinician.

In addition to this lack of historical legitimacy, there is the impact of pop culture films. The disorder has a spectacular aspect such that many directors have appropriated it, from Victor Fleming in Dr. Jekyll and Mr. Hyde (1941) to David Fincher in Fight Club (1999), Alfred Hitchcock in No Springtime for Marnie (1964), and Irene’s Fools (2000) featuring Jim Carrey.

Americans may especially remember the film Sybil (1976), adapted from a book of the same name, which tells the real-life story of a psychiatrist and her patient with 16 “personalities.” Seen by tens of millions of television viewers, the film brought the disorder to the forefront and led to an explosion in the number of cases diagnosed in the United States, which then only numbered in the thousands. But momentum for the recognition of DID waned in the 1990s, especially after successful lawsuits were waged against several psychiatrists. The courts found that they had used questionable methods to get people to talk about themselves and had allegedly manipulated their patients by implanting “false memories” to make their stories fit the disorder.

In 2017, Night Shyamalan’s blockbuster Split shined the spotlight on DID once more. The main character, Kevin, kidnaps three young girls, who take turns dealing with his 24 personalities, one of which has a bestial appearance and superhuman strength. In July 2020, the hashtag #GetSplitOffNetflix appeared on Twitter. Claiming that the film conveyed a negative image of the disorder, Internet users demanded its removal from the platform’s catalog. At first, Plume wasn’t upset when she saw Split. Rather, what bothered her was the impact the feature film had on the perception of the disorder. “It’s a fictional work with supernatural elements. You have to be realistic! We’re not killer beasts that climb walls. We’ve just been through things that make our brains seek out this way to survive,” claims the linguist-in-training.

A disorder forgotten by professionals and patients deprived of care

The final factor that explains the lack of awareness of DID is intrinsically linked to the disorder itself. American dissociation researcher Marlene Steinberg published The Stranger in the Mirror: The Hidden Epidemic, in 2000. In the book, she argued that DID is a hidden epidemic, because the person concerned is generally unaware of the existence of their alters or feels too ashamed to talk about them. In his office, Olivier Piedfort-Marin treated a woman who came to see him at the age of 42, following domestic violence that led some of her alters to become dangerous. “She had clearly had DID since her teenage years, but no one around her ever noticed anything, other than her voice becoming strange from time to time.” Throughout her therapy, his patient was able to continue her work as a teacher without hindrance, limiting hospitalizations to school vacations. “These are forces of nature,” the psychotherapist noted.

What is the consequence of this invisibility? Care is often inadequate for affected patients. Professionals who finish their studies without ever having heard of DID tend to diagnose it as schizophrenia, bipolar, or borderline disorder. “I was admitted to a psychiatric hospital this summer and because I have voices in my head that talk to each other, the psychiatrists thought it was psychosis and gave me treatment for schizophrenia. I also had treatments for bipolarity, because I have hyperactive and depressive personalities,” Chloe recalls. But neither antipsychotics nor mood stabilizers had any effect on her alters.

“Most people with DID do not even go through the health care system or do so only briefly for secondary symptoms such as depression, anxiety disorders, or difficulty sleeping,” says Dr. Piedfort-Marin. However, he assures us that treatments do exist: “If, as many people think, the origin of schizophrenia is largely biological, this is not the case for DID,” he explains. “It is possible to work on complex traumas through a long and difficult analysis. So there is hope.”

Chloe: “Instead of submitting to these controlling voices, I tried to understand them and acknowledge their existence. I realized that telling them I love them all is also a way to love myself.”

Treatment takes decades to complete. The therapist must first develop a relationship of trust with a patient who was abused by relatives as a child and who has therefore always learned to be suspicious. The therapist must then learn to identify and know the different dissociative parts present and their relationship to each other. Once the patient has sufficiently understood and analyzed their system, the goal is to work on the traumas and to mourn a happy childhood that did not exist. “But the therapy is not linear, it goes back and forth. Sometimes, the patient is ready to talk about the traumas and then it destabilizes them, and we have to go back to the previous stage,” specifies the psychotherapist. 

While Chloe takes antidepressants every day and anxiolytics in the case of anxiety attacks, Plume hardly takes any medication. In addition to therapy, they each have their own methods for living with their disorder on the day to day. “When I lived in my tiny apartment in the Crous, we used to stick Post-it notes everywhere with silly things like ‘we are invited on such and such a day to such and such’s house,” says the latter. The former has a notebook in which she writes rules that everyone must follow. “No drugs or medication for recreational purposes, because one of them was having a little fun with Xanax. No sex without checking that everyone who is conscious is okay with it. No long-term decisions without communicating first.” After realizing she was being too directive, Chloe added a list of reasons why she was grateful for each of her alters. “Instead of submitting to these controlling voices, I tried to understand them and acknowledge their existence. I realized that telling them I love them all is also a way to love myself.”

DID goes viral: positive representations and toxic drifts

Social networks, where she found more positive representations of DID, helped her to turn towards self-acceptance. It was in 2012 that Jess, a 25-year-old British woman with blonde bangs gave an online account of life with DID for the first time, describing her stable job and supportive partner. Today, MultiplicityAndMe, her handle, has more than 200,000 subscribers on YouTube. In France, Olympe’s fame explodes during the first quarantine of 2020, followed by The Peculiar Club, and Zelliana. The latter, who is 23 years old, is in her first year of a master’s degree in neurobiology at the University of Grenoble to better understand her disorder. “I told myself that I had to educate people, so I started with little videos on TikTok,” says Zelliana, who has 10 alters. “It came from Gilliane, who always felt the need to talk about it, so it had to come out.” 

But this new bubble that allows those suffering from the same disorder to be in dialogue with each other also has negative effects. “There is a lot of romanticizing within the community. Some people tend to show it only in a good light, as if it’s fun to switch and have different people in their heads. It can quickly become toxic, even for us,” says Plume. “Despite the diagnosis, I haven’t dared to tell my friends about it yet. I don’t want to be judged or for them not to believe me. And since there is a lot of talk about it on social media, I’m afraid that people will think it’s a fad,” adds Chloe.

Dr. Olivier Piedfort-Marin is also concerned about the presence of “fake DID” online, especially when users claim to have been “self-diagnosed.” “These are people who are also suffering, but we can distinguish them because they do not meet the diagnostic criteria,” says the psychologist. “Their simulated switches come at an opportune time,” while people with “genuine” DID are actually more likely to hide their personality changes, as they have always done. “When male alters take the front, I have a slightly deeper voice and when they are child alters, it is slightly higher pitched. But it’s not very noticeable, because they know how to imitate my voice,” says Plume.

For the Switzerland-based specialist, cases of fake DID pose a real problem. “They don’t do our professional field any good. It’s already been under attack for a long time, especially because of the fact that some DIDers, it’s said, fake their disorders or want to please their therapist.” A study based on brain imaging and published in 2018 in the British Journal of Psychiatry, however, showed that reactions in the brain were not the same in people with DID and in actors simulating it.

Rather than questioning the authenticity of an illness linked to deeply buried traumas, wouldn’t our society be better off understanding it? “It’s always interesting to listen to people with mental disorders,” concludes Chloe, “we’ve reached such advanced stages that we have some great lessons to teach.” 

* First names have been changed.