A wide variety of dissociative disorders including DID occur in the psychiatric population and may be misdiagnosed or underdiagnosed for a variety of reasons. Some psychiatrists believe these disorders are extremely rare and some believe that they do not exist. More research is needed, but these disorders may be more common than previously thought.

Researchers’ understanding of [Dissociative Disorders] has been augmented by developments in investigative tools and strategies but also by a willingness of mainstream researchers to acknowledge the importance of traumatic dissociation in psychiatry and to investigate the possible effects and outcomes in patients who present for treatment.

Dissociation can be interpreted as an “emergency defense,” or a “shut off mechanism.”[6] According to Allen and Smith,[6] it is understood as an attempt by the individual to “prevent overwhelming flooding of consciousness at the time of trauma.” It is argued that the individual subconsciously cannot tolerate being present emotionally during the trauma but cannot control the situation, and therefore protects him- or herself from experiencing it in the moment via dissociation.

Once the individual has learned to dissociate in the context of trauma, he or she may subsequently transfer this response to other situations and it may be repeated thereafter arbitrarily in a wide variety of circumstances. The dissociation therefore “destabilizes adaptation and becomes pathological.”[6] It is important for the psychiatrist to accurately diagnose DDs and also to place the symptoms in perspective with regard to trauma history.

Psychotherapy is the cornerstone of a multidisciplinary treatment plan for dissociative disorders and other trauma-related disorders and must be incorporated into the interventional strategy; whether the mode of psychotherapy is supportive or psychodynamic in nature, or some combination of various approaches, the treatment must be based on the quality and acuity of the patient’s symptoms.