Supporting a Spouse With Dissociative Identity Disorder through Treatment and Beyond

Dissociative identity disorder, or DID, belongs to a class of mental illnesses known as dissociative disorders. These are very serious, highly disruptive conditions that cause a person to become detached from reality in some way. They impact memory, behaviors, perception of oneself and the rest of the world, identity, and emotions.

Someone with DID develops and lives with one or more alternative personalities—these are often referred to as alters—and identities in addition to the original, or core, personality. These individual identities may or may not be aware of the others, but when one is in control it can be very different from the others or from the person’s true personality. DID is more often diagnosed in women, but it is still very rare.

The diagnostic symptoms of DID include:

• Having two or more separate and distinct personalities and identities that cause changes in thoughts and behaviors and are obvious to other people
• Memory gap caused by switching between alters
• Significant distress or impairment that is caused by having these different identities

DID and other dissociative conditions are almost always caused by trauma. With DID, a common cause is abuse. If your spouse is struggling with DID, they may be using it to cope with the experience of past trauma and as a defense mechanism against difficult memories. But not consciously. By facing traumatic memories and experiences, your spouse can overcome this damaging condition.

As the partner of someone who dissociates and lives as more than one person, life can often feel out of control. You may try to help your husband or wife come back to their own personality or take steps you think will resolve this situation. But the first and most important thing you need to know about DID is that there is nothing you can do personally or at home to heal your spouse.

Once you understand how powerless you are over the condition, instead of giving into despair, realize that you must get your spouse into professional treatment. This is what you can do, along with continuing to support them going through the process. Because DID causes so much functional impairment and intense symptoms, it’s usually necessary for patients to stay in residential facilities for treatment.

The main type of treatment is psychotherapy focused on trauma. This can include trauma-focused cognitive behavioral therapy, dialectical behavior therapy (DBT), eye movement desensitization and reprocessing therapy (EMDR), and others.

Because trauma is the cause of the condition, it is essential to uncover these terrible experiences and face and process the memories in a safe and healing way. The best way to do this is in residential care. It may be hard to let your spouse go for a few months, but it is important for recovery from DID.

During residential treatment for DID, your spouse will be facing challenging, difficult memories. Therapy for this condition is the best care, but it isn’t easy. Your spouse will be asked to recall painful traumatic experiences, to talk about them, and to feel all the emotions they trigger.

For some patients, it may be best for loved ones to stay away for a period of time. To best support your spouse during treatment, stay in communication with the professionals in charge of their care. Find out what they need from you. If getting involved and attending some family or couples sessions is helpful or recommended, be available to do that.

It can be frustrating to be unable to something more active to help someone you love, but sometimes they need to heal without your presence. In the meantime, you can still support your spouse by learning more about DID and trauma. Many facilities offer family psychoeducation programs for loved ones. These educate family members about what the patient is experiencing and how best to support them when they return home.

Be patient as your spouse with dissociative identity disorder goes through what can be a lengthy treatment process. This is a complicated mental illness, and depending on the extent of the trauma and the severity of symptoms, it could take several months to heal and be ready to come home. With good treatment, it is possible for someone with DID to manage and minimize alternative identities and to live a normal life again. Here are some things to keep in mind to provide the best support for your loved one after residential care:

• Encourage ongoing therapy. Most mental illnesses are not simply cured. They are chronic diseases that can recur in times of stress. To help your spouse maintain good mental health, encourage them to stay in regular therapy.
• Be patient. Identities that came under control in therapy may resurface. Be patient and help your spouse use the strategies they learned in treatment to regain control.
• Don’t play games with the identities. There is no way you can reason your spouse out of an alternative identity. Doing so can make the situation worse. Instead, be honest at all times.
• Try to understand triggers. One thing your spouse will learn in therapy is what things tend to trigger changes in personality. Make sure you know what these triggers are and help your spouse be more aware and careful about recognizing them.
• Practice good mental hygiene together. Your spouse will have learned some healthy coping strategies in therapy. For instance, if stress triggers their shifts in personality, it’s helpful to have things like meditation or exercise to mitigate stress. Engage in these practices with your spouse to encourage them and help you both.
• Help with memory gaps. You know that your spouse may still have gaps in memory if personalities recur. If they seem confused at times, help them out by backing up and explaining anything they may have missed.