The two dissociative symptoms that, once described clearly, are the easiest for people to relate to and understand are also the ones that have earned Dissociative Identity Disorder its undeserved reputation as a bizarre aberration. Identity alteration (experiencing the self as multiple) and dissociative amnesia (gaps in memory) are the two manifestations of dissociation that are mythologized the most. But it’s not because they’re too foreign for most people to grasp. On the contrary, in their mildest forms they’re downright normal.

One of the things that makes Dissociative Identity Disorder so difficult to recognize is that, contrary to popular belief, DID symptoms are not the stuff of science fiction. They are, in fact, severe amplifications of normal human experiences. I can think of nothing more normal, nothing more intrinsically human than identity confusion. Of the five primary manifestations of dissociation, I believe identity confusion is easily the most common. But it's also the one few people will acknowledge in any meaningful way. People are pretty dedicated to the idea that we should know who we are without question, and we fervently admire those who appear most convincingly to do exactly that. But despite appearances, no one gets to live a human life without struggling with their sense of self.

On Friday I went to the pharmacy to pick up some medication. It was a long wait, and I wasn’t feeling well. Around me I heard people talking, phones ringing, and the various noises of the grocery store that houses the pharmacy. The sounds seemed to come from a distance, and I felt profoundly disconnected from everyone and everything around me, as if I was an observer in a dream that wasn’t mine. It wasn’t a particularly comfortable experience but it certainly wasn’t an unusual one. I have Dissociative Identity Disorder, and I've lived with chronic, severe dissociation nearly all my life. The episode I described illustrates the combined forces of depersonalization and derealization, two forms of dissociation that often appear together. And despite the fact that I have DID and my dissociative experiences, taken as a whole, are decidedly abnormal, dissociation itself is something just about everyone experiences from time to time.

Depersonalization is a way of experiencing the self. It's a form of dissociation that manifests in a variety of ways that all boil down to a sense of detachment or separateness from one's self. And though depersonalization is a chronic part of living with Dissociative Identity Disorder, it isn't something only those of us with DID experience. For most people, episodes of depersonalization are transient, infrequent, and typically occur during periods of high stress.

Clarifying the distinction between relatively normal dissociation and relatively abnormal dissociation is important for a number of reasons, including: 1) understanding what Dissociative Identity Disorder is becomes easier when you can clearly identify what it is not, 2) describing symptoms like dissociative amnesia to others is less of a challenge when you start from a place they can relate to, and 3) those of us with DID could do with regular reminders that we aren’t aberrant life forms and, in fact, a good portion of our dissociative experiences aren’t as far-fetched to other people as we may believe.

Decreasing dissociation in dissociative identity disorder (DID) relies on actively increasing awareness of the world around us. Dissociation is the process by which we separate ourselves from our experiences, memories, bodies, and very selves. When we're dissociating, we're disengaged from some or all of our own reality. It's not inherently a bad thing; I truly believe dissociation serves a valuable purpose, and not just in traumatic circumstances. But there's no doubt that the chronic, severe dissociation intrinsic to dissociative identity disorder is problematic, disruptive, even at times actively destructive. By increasing awareness, by being more fully present in our bodies and minds, we can mitigate the damaging effects of dissociation.

If you've ever seen a television crime show featuring a suspect with Dissociative Identity Disorder, you've seen a theatrical depiction of identity alteration, the fifth of the five main dissociative symptoms. A bewildered man suspected of murder is brought in for questioning. Eventually his manner, style of speech, and affect change dramatically and he says something like, "Sam didn't kill her. I did. I'm Joe." That switch in personality states is identity alteration at it's most extreme.

I used to make lists of things I liked and didn't like. If I wanted to marry and have children, that went on the list. If I enjoyed musical theater, that too went on the list. Inevitably a day would come when I couldn't imagine wanting to marry or liking musicals. I was perplexed as to why they were on the list in the first place. So I'd start a new one. I was trying hard to figure out who I was. As soon as I had a decent handle on the nature of my identity, it would slip through my fingers once again. I kept these lists in an effort to pin down my sense of self in a concrete and lasting way. What I didn't know is that I have Dissociative Identity Disorder. Identity confusion is a normal, if monumentally frustrating, part of DID.

We've covered depersonalization and derealization, two of the five core dissociative symptoms. As someone with dissociative identity disorder, both of those forms of dissociation affect me regularly. But the remaining three impact my life most profoundly. Dissociative amnesia, as I'll explain, is a deeply frustrating and disruptive part of living with DID.

I remember a certain meeting with a girlfriend in a coffee shop. I arrived before her and sat working on a crossword puzzle while I waited. It wasn't long before she was standing next to me saying, "Hi!" I looked at her, and even though I knew my purpose in the coffee shop that day - to meet her - it took me a moment to understand who she was. It was a jarring moment in her Dissociative Identity Disorder education. "You didn't recognize me," she said. She was right. I didn't immediately recognize her, even though by then we'd spent hundreds of hours together. But it wasn't amnesia, the form of dissociation one might suspect, that prevented me from recognizing her. It was a different dissociative symptom: derealization.