Sexual Abuse & Dissociative Identity Disorder

In Young Children

When young children cannot handle something bad that has happened to them, such as sexual abuse, they sometimes develop a coping strategy of dissociating from the experience. They may actually forget the event even took place or if the child is being abused repeatedly, they may "zone out" during the abuse, remembering nothing of what happened.

All of us dissociate from time to time. Think of times you have been so preoccupied that you drove a car a couple of miles without realizing what you had done. Or, someone comes into the room and has to call your name several times before you realize they are there. Dissociation can be done in the form of fantasizing or daydreaming. In severe forms of dissociation, a child may actually experience a 'split' in his or her personality or repression.

One teenage girl I worked with who had been sexually abused repeatedly from a variety of sources, learned to tune out anytime something bad happened to her. She went about life thinking it was quite grand and there were no problems, while another side of her surfaced to raise havoc in the real world. She had no recollection of any of these experiences and could not honestly think of one bad thing in her life, even though a brother broke her arm in rage. She swore that he was good to her, would never hurt her, and was very fond of her.

Some children develop more than one alternative personality, such as in the world famous case of Sybil. Each personality has a part of the child's personality. One personality might be very aggressive, while another one might maintain the innocent age prior to when the abuse took place. In the case of the teenage girl, her one alter ego simply took the blunt of anything offense for her so that she did not have to face these issues.

This girl used two very distinct handwritings, called herself by a different name, and looked, acted, and dressed differently, depending upon which personality was being exposed.

Therapy for a child who has developed multiple personalities is very complex and long term. It is difficult for the child to give up a defense mechanism they needed to protect themselves. Because these children tend to be very non-trusting of the world and those in it, developing rapport in the early stages of therapy may take weeks or months, even years.

A child who has experienced sexual abuse should not be pressured into remembering and facing up to the event, but rather, should be gently led to recognition of what happened. The child must be helped to see how present behavior is linked to past behavior. New coping skills must be put into place before old ones can be eliminated. Too often, children who have been sexually abused are misdiagnosed with ADHD, Bipolar Disorder, Oppositional Defiance Disorder or some other childhood disorder.