Identifying causes is a major problem with diagnosing DID and this is one of many reasons why the inclusion and categorization of MPD/DID is an ongoing issue in the DSM-V. One reason is that there is no general consensus as to what causes the disorder. There are debates but no scientific proof. There are no longitudinal studies. There are no epidemiological studies. There is no in-depth research on case studies. Diagnosis is dependent upon:
- Memory – a poor methodology at best
- Comparison of symptoms between case studies.
- Suspicion exists as to whether doctors themselves create alters through hypnotherapy and other methods (Iatrogenesis or brought forth by the healer).
- New discovery that DID development is possible after childhood
- prevalence rates across cultures and populations
- DID in children may partly result from a strong imagination used in coping skills. In adults however, DID may present as PTSD (post-traumatic stress disorder).
- Trauma – sexual and physical abuse appear to occur frequently in these individuals The accuracy of these reports are disputed by professionals, witnesses and families.
- Other causes – early loss, serious medical illness or other traumatic event
- Lack of comfort by at least one parent or guardian during ongoing abuse. Individuals who have a chance to process the abuse and turn to a “safe” adult after
abusive episodes seldom develop DID. Those who do not have this option frequently develop DID. However this too is called into question. How does the therapist know whether a traumatized individual would have potentially
developed DID when this disorder doesn’t occur?
- Possible genetic connection. However, the gene theory hasn’t and cannot be proven. It is possible that forms of dissociation, such as dissociative fugue or amnesia, may be present in immediate or extended family members although this isn’t always the case.
Dr. Susan Taylor, a psychiatrist and expert in MPD (is there such a thing as an expert?) offers the explanation
that the higher self recognizes when a situation occurs that shouldn’t. That self acknowledges that “this is not right. I really shouldn’t do it. Just this once.” (She is referring to the splitting into another alter). Over time, the splitting becomes a kind of “belief system” and therefore ingrained. When that happens “we don’t remember the wisdom of the body and the wisdom of nature that told us, hey, don’t go down that road.” Inevitably, this leads to a “full-blown disease state.” Frankly this is one of the most comprehensive, if incomplete, explanations of the causes of multiplicity that I’ve ever heard.