How to Live with Someone with Dissociative Identity Disorder

Dissociative Identity Disorder (DID) is a condition in which a person has two or more identities, each demonstrating different behaviors, moods, and emotions. While this condition used to be known as "multiple personality disorder," it isn't the same thing and the diagnostic criteria are different. DID isn't rare, and it isn't like "multiple personalities" you might've seen on TV or in movies. Movie and TV depictions are greatly exaggerated and real DID isn't as sensational.^{[1]XResearch source} Living with someone with DID can be challenging at first, but Plurals (people with DID) can and do have loving, supportive relationships.

Part 1

Part 1 of 3:

Creating a Safe Environment for Your Partner

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1
Learn about DID and its symptoms. Talk to your partner as well as professionals to get a better understanding of DID. People with DID often refer to themselves as a System, and may or may not be aware of all of their different alters. Their alters may or may not be aware of each other. With therapy, your partner might discover other alters. Here are some things you can ask to better understand what DID is like for them:^{[2]XResearch source}
- How many alters do you have?
- Can I meet all of your alters?
- Are all of your alters supportive?
- What roles do your alters play in your System?
- What does it feel like to switch?
- What can I do to help you?
2
Stay composed when another alter is in the front. When an alter is in control of the body, it's said to be "fronting." The alter that takes care of daily life is the one you might be most familiar with or consider your partner.^{[3]XResearch source} The others might be new and strange to you—they could be different genders, different ages, or have vastly different interests and ways of communicating. It can take some time to learn to love and accept all of your partner's alters.
- Ask your partner if they are willing or able to tell you when a different alter is fronting, but be willing to accept "no" as an answer. Remember that alters are often formed to cope with trauma and are extremely vulnerable.
- Some might front more willingly than others and your partner might have more sway with some alters than with others.
- Try to learn and understand the role each alter plays and when they're most likely to front. For example, your partner might have a protector or caretaker alter who fronts when they're frightened or feel threatened.
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3
Be patient. Your partner is dealing with an extremely challenging situation. To be diagnosed with DID, the person must be distressed by the disorder and the effects it has on their daily life. While you might find yourself at times frustrated or hurt by something they've done, remember that your partner (the alter you most identify as "them") isn't necessarily in control and might not know what's happening.^{[4]XResearch source}
- If it gets too overwhelming and you are losing patience, try to excuse yourself from the conversation and take a break.
- Although it can be difficult to shorten a dissociative episode, one form of treatment is to intervene immediately following a traumatic event. So, if you can help the person overcome their trauma that might reduce symptoms of DID and speed up the process. That said, this generally needs to be done under the supervision of a qualified mental health professional.^{[5]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
Along with having patience, you must also have empathy. Your partner is experiencing a very scary situation. They will need as much love and support as you can possibly give them. Say kind things to them, listen to them when they want to talk about their situation, and show them that you care.
5
Discuss boundaries and consent with your partner's alters. Different alters might have different physical and emotional needs. They also might relate to you in different ways. Talk with your partner to better understand their alters and the issues you might face—but also keep in mind that these issues might change over time if new alters surface.^{[6]XResearch source}
- Alters might be children. If you have a sexual relationship with your partner, it's important not to engage in sexual activities while a child alter is fronting. If a child alter comes forward during sexual activities, stop immediately. You don't want to risk re-traumatizing the child.
- Alters can also be non-human. Because being a human is so complex and frightening for small children, they might develop animal alters as well. Animal alters will have far different needs than human alters, and you'll need to take care of them as well.
- Child alters frequently have a poor sense of boundaries and might need more "rules" than adult alters do. Be clear on what your partner wants help with and when.
6
Avoid conflict and other stressful situations. Stress is the most common trigger of a switch or transition to a different alter fronting.^{[7]XResearch source} Conflict may be inevitable in any long-term relationship, but learn productive conflict-resolution skills that help decrease the stress and anxiety that can accompany an argument. If your partner does something that angers you, take some time alone to breathe and clear your mind.
- Get help if you have problems with anger management or difficulty controlling your emotions. If you lash out at your partner, your words or actions might be seen as a threat to the System.
- If you disagree with something that your partner said or is doing, use the “Yes, but…” technique. When they assert something that you do not agree with, say “yes, but…” so that you avoid directly conflicting with them.

Part 2

Part 2 of 3:

Keeping Your Partner on Track

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1
Support your partner with their treatment. Whether it is medication for other disorders that often co-occur with DID, such as depression or anxiety, or making sure that your partner goes to their appointments with their therapist, be there to help out. Talk to them about their goals with therapy and how their sessions are going.
- While some people with DID might have the ultimate goal of integrating their alters into one cohesive personality, a lot of them don't—and if your partner doesn't, you have to be okay with that.^{[8]XResearch source}
- Many people with DID seek a healthy multiplicity, in which all of their alters co-exist peacefully and manage their life and their body together.^{[9]XResearch source}
2
Encourage your partner to develop healthy coping skills. Ultimately, your partner is responsible for their own self-care. You might say that the System is responsible for the System. They can learn different techniques by working with their therapist and talking to other people with DID. Here are some things they can try:^{[10]XTrustworthy SourceMindU.K.-based mental health charity focused on providing advice and resources to anyone facing mental health problems.Go to source}
- Journaling can help them get to know their alters. This is especially helpful for Systems whose parts don't have conscious connections.
- Grounding techniques, such as focusing on specific sensations or sniffing a strong aroma, can help them stay in the present and avoid intrusive thoughts or flashbacks.
- Physical exercise, a healthy diet, and plenty of sleep help them maintain their body and give them enough energy to cope with difficult thoughts or feelings when they come up.
- Talking to other people with DID can help them learn other coping strategies and ways to help manage their alters.
3
Help your partner manage their time. While some people with DID can manage their own time and schedule activities for themselves, others won't be able to manage their time as well due to memory loss and different alters pulling their goal-directed behaviors in different directions. If your partner has a hard time keeping track of what they're supposed to be doing, help them along by reminding them of the activities they have planned.
- You might try creating a chart that you keep in a specific place they can easily see it. On the chart, write down important things they should be doing, as well as suggestions for other fun things to do.
4
Keep track of your partner’s possessions if they ask you to. When your partner switches, memories from their other alters do not necessarily carry over. This can make it very hard to keep track of important items, such as their wallet or cell phone. Create an inventory of your partner's important items and place notes or stickies on or inside the items with your name and phone number on them. That way, anyone who finds your partner’s item can call you to return it.^{[11]XResearch sourceRingrose,J.L(2012) Understanding and treating dissociative identity disorder (or multiple personality disorder).London : Karnac Books , Inc}
- It is also important that you have copies of all of your partner’s important documents, such as their Social Security card, health insurance card, passport, or ID card.
5
Monitor for self-harming tendencies. People with DID have almost always experienced abuse during childhood. Self-harming behaviors, such as suicidal thoughts, violence, substance abuse and risk-taking, are common in people who have DID. These behaviors tend to occur in those who have suffered abuse because they are used in an attempt to end their feelings of shame, horror, and fear spurred on by past abuse.
- If you notice that your partner has started developing self-harming behaviors, call their therapist immediately. If their life is in danger, call an ambulance.

Part 3

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Taking Care of Yourself

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Take time to do things you love. It is of the utmost importance that you take time to care for yourself, since taking care of someone with DID can be very stressful. You should take steps to maintain a healthy diet; it is also important to allow yourself some rest and relaxation time. ^{[12]XResearch sourceInternational Society for the Study of Trauma and Dissociation (2011): Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, Journal of Trauma & Dissociation,12(2), 115-187. DOI 10.1080/15299732.2011.537247}
- Sometimes, you will need to put your needs first in order to keep up the mental and physical strength required to support your partner.
2
Take breaks when you need to. Schedule alone time where you do not need to worry about anyone else’s time management. Stay connected with your friends and make sure that you go out and have fun every week. Taking a break can help you to regain your strength so that you can continue to be patient and empathetic to your partner’s situation.
- Join a yoga class to help you center yourself and restore inner peace. Yoga and meditation can be two great ways to help yourself relax and let go of any tensions and worries that you have.
3
Attend family therapy. There are family therapy sessions specifically for the family members of people with DID. It is very important that you attend sessions so that you can learn about other ways to help your partner and yourself.^{[13]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- There are also support groups you can join where you can meet other people who are also living with someone who has DID. You can talk to your therapist about support group options or run an internet search to find one near you.

Expert Q&A

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Question
What's the best way to interact with someone who has DID?
Noel Hunter, Psy.D
Clinical Psychologist
Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.
Noel Hunter, Psy.D
Clinical Psychologist
Expert Answer
My advice in a situation like that is the same as it would be with anybody, which is the best we can ever do is to be with another person in the place that they are at. If somebody is experiencing drastic shifts in personality state, or moods, you're not going to change that no matter how much you tell them to stop doing it. You can always share your observations, but you're not going to change it, and you're not going to stop it. So it's a matter of, how do you sit with it and be supportive, while also maintaining your own boundaries, and not feeling like you need to get caught up in whatever is going on for another person. And oftentimes, the best way to be supportive for somebody is to ask them individually, how they need to be supported.
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Question
What are the signs or symptoms that someone has DID?
Noel Hunter, Psy.D
Clinical Psychologist
Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.
Noel Hunter, Psy.D
Clinical Psychologist
Expert Answer
According to the DSM, it would be having experiences where the person either subjectively feels like or is told by others that they're a completely different person and having amnesia between these identity states. It really does boil down to that experience. It can be either subjective or objective of feeling like you're more than one person or having possession type experiences as if some entity or other person is possessing your body.
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Tips

Develop your own personal way of calming yourself down—count to ten, repeat a phrase, or practice breathing exercises.
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Both people with DID and their partners can find support and resources through the Plurals Association, a nonprofit organization, and their Plural Warmline project, available at https://thepluralwarmline.org/.
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Warnings

If your partner becomes violent (towards themselves or others) or you're worried they might, call their therapist or an ambulance. Don't call the police—they aren't trained to deal with people who have DID and can put your partner in danger.
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