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“Identity Confusion in Patients With DID We can locate the identity confusion characteristic of DID in the middle-to-upper range of severity. Identity confusion is a significant factor in DID, when an environment created and sustained by one personality conflicts with the expectations of another personality who is not prepared to function in this alternate environment.”

“Interviewer: Have you ever felt as if there was a struggle going on inside of you as to who you really are? Patient: Yes, for years, and I still can't find out who the fuck am I, man. Excuse my language, doctor. I don't know who the fuck l am. Interviewer: What do you mean by that? Patient: Who is [A.B.]? Who the fuck am I? I don't know. I don't know who I am. I really don't know who I am. I look at the rest of my family and I say, "I ain't part of this family, man, this can't be. They're all different than me. They also look alike, but they look different to me." (SCID-D interview, unpublished transcript) As the preceding example indicates, the theme of puzzlement is characteristic of patients at all levels of educational achievement and verbal ability. The clinician should be alert to the presence of this theme in the self-descriptions of all patients endorsing dissociative symptoms, not just in those of patients who completed a college degree or who are accustomed to introspection and self-analysis.”

“People with DID often experience conflicting advice or opinions emanating from their alter personalities. Individual alter personalities may have coherent, consistent identities, but, taken as a group, the incompatible internal personalities generate an atmosphere of conflict as well as incoherence. As one patient described it, "Do you know how hard it is to get a hundred and four minds to come together to a single decision?”

“Another patient with DID described the visual images she had of the personalities inside her in the following way; Interviewer: What does she [the personality] look like? Patient: She wears jeans, she never wears a dress ... Interviewer: Does she look like Josie? Patient: Yes, they look identical except that their manners and their clothing and their hair.. .. Josie's hair is curly with ribbons and Julie has braids and could care less what she looks like. She's tomboy looking. Interviewer: Do they look like you? Patient: I think they look like me. Wthout the glasses. They don't wear glasses... Interviewer: Do you have an image of Diane? Patient: Blonde hair, she looks older. (SCID-D interview, unpublished transcript)”

“In some instances the patient will have a visual image of a contrasexual alter. For example, one female patient endorsed the presence of two male alters with the same name, one a boy of about age 10 wearing a baseball cap and the other a slightly older but still aggressive adolescent. Because a patient's use of visual images provides rich evidence for the degree of identity alteration, each of the SCID-D's follow-up sections incorporates questions about visual images to allow the patient to elaborate on this symptom.”

“Due to previous lack of systematic assessment of dissociative symptoms, many subjects experience the SCID-D as their first opportunity to describe their symptoms in their own words to a receptive listener.”