Why Do Diagnostic Manuals Call DID A Dissociative Disorder When People Claim That Its A Trauma Disorder?

Why do diagnostic manuals call DID a dissociative disorder when people claim that it’s a trauma disorder? This was a question I saw floating around and I thought it was interesting so I did some research.

From the DSM-5 (pg.291):

“The dissociative disorders are frequently found in the aftermath of trauma, and many of the symptoms, including embarrassment and confusion about the symptoms or desire to hide them, are influenced by the proximity to trauma. In DSM-5, the dissociative disorders are placed next to, but not part of, the trauma-and-stressor-related disorders, reflecting the close relationship between these diagnostic classes. Both acute stress disorder and posttraumatic stress disorder contain dissociative symptoms, such as amnesia, flashbacks, numbing, and depersonalization/derealization.”

According to the DSM-5 itself, dissociative disorders are listed next to trauma-and-stressor-related disorders because of the close relationship between them. Why not mix them together, though? Here’s what I think:

From the DSM-5 (pg.265):

“Trauma-and-stressor-related disorders include disorders in which exposure to a traumatic or stressful event is listed explicitly as a diagnostic criterion.”

In order to diagnose trauma-and-stressor-related disorders, a traumatic event has to be explicitly specified. On the other hand, the DSM-5 clarifies that dissociative disorders often involve forgetting trauma. It would gatekeep so many people from treatment if trauma had to be recalled in order to be diagnosed with disorders involving amnesia and dissociation…

Does the DSM-5 think that DID can develop without trauma? Well, here’s what some of the researchers who worked on revising the dissociative disorders section in the DSM-5 say (source):

“DID is currently understood as a complex posttraumatic developmental disorder that usually begins before the age of 5–6. It is hypothesized that, after that developmental window, the consolidation of a more unified sense of subjective self and other developmental cognitive changes have occurred. This leads to different kinds of identity disturbances than that of the DID alternate identities in response to overwhelming and/or traumatic circumstances, although other complex dissociative symptoms may continue to develop.”

Now, what about the ICD? I don’t know much about it because it’s not used in my area, but the older version of the ICD actually listed DID under a “neurotic, stress-related and somatoform disorders” section and described them as coming from events that are “highly stressful, traumatic, and/or that involve intolerable, insoluble problems” (source). However, its placement of dissociative disorders was critiqued academically because it described them “as primarily acute disorders that usually remit within a few weeks or months” rather than long-term disorders (source). In the updated version, the ICD-11 opted to create its own dissociative disorder section next to the trauma-related section, most likely to reflect the DSM.

- Sunflower

We’ve always had an issue with people establishing emotions about some of our fictives before even knowing them just based on their source so

Yeah. Well enough said

quick liddol psa on interacting with fictives

treat fictives like people please i am begging you

do not tell them that you simp for them or that you dislike them simply based on their source 

do not ask them questions about their source unless they say it’s okay (especially about their relationships with other characters) 

ask before discussing their source with them

don’t push your headcanons onto them, or insist that what they experienced was’t real because it didn’t happen in canon

i know it’s exciting that your comfort character is kind of real. i know you want to tell us how much you like/hate us. but please just use basic manners. it is not that hard. 

[for those who don’t know- fictives are alters that are based on fictional characters. this doesn’t mean that they act like the canon character.] 

Still not out to a lot of them

[Text: This system is nervous about telling their friends.]

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al pacino as sonny wortzik | DOG DAY AFTERNOON (1975)