Is Dissociative Identity Disorder Real? What 40 Years and 85,000 Sessions Have Taught Me

For decades, dissociative identity disorder (DID) has lived mostly in the realm of Hollywood thrillers — a plot device, a twist, a source of fear. Is it a real psychiatric diagnosis or sensationalized fiction? After 40 years of clinical practice and roughly 85,000 individual therapy sessions, I can tell you with certainty: it’s very real. And it’s one of the most misunderstood — and most treatable — conditions I’ve ever encountered.

How it begins

In the early 1990s, I began seeing patients who described strikingly similar childhood experiences: severe, repeated abuse, almost always sexual, occurring within highly organized and ritualistic settings. These patients came from different states, had never met one another, and yet their accounts shared details that were too specific and too consistent to be coincidence. 

Within a short time, I was working with dozens of such patients. What I learned shaped the rest of my career.

The clinical literature suggests that nearly all cases of DID stem from severe childhood trauma, predominantly sexual abuse. In my own experience the figure has been 100 percent.

Why the mind splits

Here’s what I’ve come to understand: children facing trauma that’s too overwhelming to process do something remarkable. They distribute it. A child can’t hold the full weight of horrific abuse and still function — still go to school, still play outside, still survive within the household where the abuse is occurring. So the mind compartmentalizes, assigning different pieces of the experience — the memories, the feelings, even specific functions — to separate parts of the self.

I often think of it like moving day. If you’ve ever relocated, you know that one person can’t carry a couch alone. So you call everyone you know to help. One person takes a box, another takes a lamp, someone else helps with tackling the couch. The load that would crush one person becomes manageable when distributed among several.

That is, in essence, what a child’s mind does when faced with the unbearable. The “alters” that form aren’t separate, otherworldly entities, but are fragments of the self, each carrying a portion of memory, emotion, or function the core person can’t yet bear.

When the bill comes due

But like a credit card, the bill eventually arrives — with interest. Often in their 30s or 40s, something triggers the surfacing of long-buried memories. They rise from the depths of the unconscious mind, and they arrive overwhelming and raw. Without competent help, this can be terrifying. With it, something extraordinary becomes possible.

What surprises most people, including many clinicians, is how orderly this process is. The therapist doesn’t need to go hunting for memories. They surface one at a time, almost like cups from a dispenser: pull one, and the next is ready to drop. Each memory, each alter, comes forward when the person is ready — not before.

The 5 steps to healing

Through decades of this work, I’ve come to understand healing as a five-step process: remembering the trauma (telling the story in full detail); feeling the feelings that were too dangerous to feel at the time; expressing the pain — often through rage and tears; releasing the memory and its emotional weight; and finally, reframing the experience in a way that empowers the person to move forward.

Each alter personality typically needs to walk through these steps for their particular piece of the story. A therapist might begin a session with a poised, articulate 55-year-old professional and, minutes later, find themselves face-to-face with a terrified seven-year-old boy who’s been waiting decades to tell his story. The key is simple but essential: believe the alters. Don’t go to war with them. Each one carries something important and each one deserves to be heard.

A curable condition

Unlike many serious mental health conditions, DID is not only treatable — it’s curable. As each alter completes their healing process, integration becomes possible. This isn’t loss; it’s reunification. It’s graduation. The person becomes whole — often for the first time since early childhood.

In my career, I’ve walked 17 patients across that finish line. I’m currently working with an 18th who is well on her way. And here’s perhaps the most remarkable part: years later, when I ask these former patients about their childhood trauma, many genuinely struggle to access the urgency they once felt. 

“We worked through that years ago,” one told me recently. “I’m just here because my husband’s MS has made him a real pain lately. But the childhood stuff? That’s done.”

That is what healing looks like.

Why this work matters

Working with DID patients has been among the most rewarding experiences of my career — more so, in many ways, than any other type of therapeutic work. The connection that forms is profound. The courage these individuals demonstrate, often carrying memories more horrific than most people experience in a lifetime, is humbling.

If there’s one message I hope readers take from this it’s that DID isn’t a curiosity or a plot twist. It’s a survival mechanism — ingenious, adaptive, and ultimately reversible. With patience, validation, and the right therapeutic approach, even the deepest wounds can heal completely.

Written By Dr. Christopher Cortman, PsyD

Dr. Christopher Cortman has facilitated over 80,000 hours of psychotherapy during his distinguished career spanning more than four decades. A Florida Licensed Psychologist since 1985, he maintains a thriving private practice while specializing in emotional trauma and anxiety disorders. He’s appeared nationwide on talk radio and television. The acclaimed author of four previous books, his new book, The Guided Imagery Cure: The Best Proven Methods for Quickly Resolving and Healing Trauma, describes a profoundly impactful tool for addressing trauma, grief, and more. Learn more at srqshrink.com.