DID is (mostly) a culture-bound disorder

It’s been nearly 2.5 years since I first started my DID self discovery journey, and in that time I’ve gained massive amounts of insight into how my early childhood experiences have shaped my way of experiencing the world. Before I gained this insight, however, came confusion. Specifically, I truly didn’t understand how this fantastical-sounding diagnosis of DID that had been given to me by multiple mental health professionals applied to me and my experiences. In the years that followed my diagnosis, I spent a significant amount of time playing with my understanding of what DID is, and perhaps more importantly, what DID is not. At this point in time, I am very comfortable stating that DID is, first and foremost, a culture-bound disorder.

A culture-bound disorder is one where cultural factors significantly influence how the disorder is conceptualized, understood, and presented. In the case of DID, the way it is interpreted in the present day is just one way of understanding a specific set of experiences, which is shaped by cultural narratives and is not based on any definitive reality. This doesn’t mean DID isn’t real—in fact, I believe DID is very real to those who experience it. However, I believe that there are major cultural influences that shape how DID presents and is understood, and that needs to be acknowledged.

What the label of DID is attempting to describe is a post-traumatic reaction that is very complex, but in general terms, involves one developing discrete compartmentalized internal states. Labeling these compartmentalized internal states as being “different identities”, which encourages one to assign these states as having individual characteristics such as names, ages, genders, and likes/dislikes, is entirely a product of the modern day cultural understanding of how to describe this set of experiences.

There is a huge cultural component to dissociative identity disorder—even though the underlying symptoms and experiences may be similar between those diagnosed with DID, how one chooses to interpret those experiences can vary significantly. And once one chooses a specific conceptualization to understand and describe their experiences, this can further influence how their symptoms present, creating a positive feedback loop¹. Right now, there is one dominant cultural understanding of what DID is which encourages people to have a very narrow view of their disorder. I believe this is actively harmful to those who live with “dissociative identity disorder”². The current conceptualization of DID should be entirely reworked to not introduce cultural bias into the diagnostic criteria—a more cohesive diagnosis called Complex Dissociative Disorder I/II has been proposed, which I very strongly agree with.

So while the underlying phenomenon that the label of DID is attempting to describe is something that many people experience, simply conceptualizing those experiences in the particular way that the diagnosis of DID does shapes how one experiences those symptoms. The pervasive “multiple people in the same body” narrative is entirely and unequivocally a product of our culture.