How Does DID/OSDD Develop?

How does someone develop DID or OSDD? The answer is in trauma. Because a traumatic incident is an experience that is extremely distressing, dissociation is a common response. It allows someone experiencing the trauma to change their consciousness in a way that allows them to distance or disconnect from the full impact of what is happening.5 Escaping trauma literally and bodily may be difficult or impossible for small children, so escaping it mentally, emotionally, and developmentally through dissociation is a particularly sophisticated coping mechanism. But what is dissociation?

Dissociation

Dissociation is a mental process that causes a lack of connection in a person’s thoughts, memory and sense of identity. Dissociation seems to fall on a continuum of severity. Mild dissociation would be like daydreaming, getting “lost” in a book, or when you are driving down a familiar stretch of road and realize that you do not remember the last several miles. 6

Dissociation can feel like:

  • Lapses of awareness
  • Feeling a disconnection to the brain, as if operating on autopilot
  • Being lost in a fog, feeling like the world is very ethereal
  • Feeling disconnected from the world around you
  • Feeling like there is an invisible shield that prevents you from interacting with others
  • In severe cases, feeling a distortion of time/losing time

The purpose of dissociation is to take memory of emotion that is directly associated with a trauma and to encapsulate, or separate, it from the conscious self. It is a way for the internal system to protect secrets and continually learn to adapt to the environment.5

Dissociation is an adaptive response of the brain to respond to trauma. However, there comes a point when dissociation becomes dysfunctional. Dysfunctional dissociation happens when:

  • An individual is not aware of or able to control their dissociative responses
  • These dissociative responses occur in inappropriate situations
  • The intensity and duration of the dissociation is disruptive to their life

Dissociation in DID/OSDD

A severe and more chronic form of dissociation is seen in DID/OSDD. When a person is overwhelmed, the experience may remain fragmented and separated into compartmentalized components. Different parts of the experience are separated and disconnected. In the face of extreme stress, susceptible individuals actually forget, dissociating cognitive knowledge of events from ordinary awareness (amnesia), or they can feel as though the events are occurring to someone else (depersonalization). In response to the most severe childhood traumatization, we see the dissociative ability to function as a series of different self-states or personalities as the person attempts to adapt as best possible to intolerable events and irreconcilable feelings. 20

The theory of Structural Dissociation works off of the assumption that no one is born with an integrated personality. Instead, infants operate based off of a loose collection of different ego states that handle their different needs- feeding, attachment to a caregiver, exploring the world around them. Over time, these ego states naturally integrate into one coherent and cohesive personality, usually by the ages of 6 to 9.

However, chronic childhood trauma disrupts this process. If children are exposed to severe chronic stress during critical developmental periods, they may fail to achieve the normal integration of cognition, memory, emotions, perceptions, abilities, and sense of self that supports optimal functioning. This kind of dissociation in response to childhood trauma is a failure of integration, rather than a process of fragmentation.20

When Does DID/OSDD Develop and Who Does it Develop in?

A modest scientific literature indicates that the vulnerability to dissociation is highest in early childhood and normally decreases with age20, which is consistent with the observation that a relatively high level of dissociative experiences is commonly observed in young children. Modern literature and research has repeatedly concluded that DID/OSDD is formed in childhood, most likely between the ages of 6 and 9.

The vast majority of persons who develop DID/OSDD have histories of severe and chronic childhood trauma, usually beginning in early childhood. Conversely, adults who are exposed to even pervasive and harsh trauma (e.g.,torture victims or concentration camp survivors) do not develop this disorder.20