Myth: People with DID are dangerous

The story people are taught

DID appears often in horror, thrillers, and crime stories. The plot is usually the same: one identity seems harmless while another is waiting to hurt someone. Repeat that story often enough and the diagnosis itself starts to sound like a warning.¹

Dylan Crumpler's short film Petals of a Rose goes another way. It follows a day in the life of a woman with DID, focusing on daily life and relationships instead of making an identity state the villain. Crumpler created the film in response to negative portrayals of DID, and it has been screened for communities of people with dissociative disorders and clinicians who treat them.²

What did the study actually count?

Before their 2017 study, much of the writing about dissociative disorders and violence came from older case reviews. Some asked clinicians whether patients had “violent” or “homicidal” identity states. Those reports did not always separate threats aimed at another state from violence toward another person. If an internal threat were acted on, the result would be self-harm or suicide, not homicide.¹

Webermann and Brand looked at something more concrete: criminal-justice involvement during the previous six months among 173 people with dissociative disorders who were already in treatment. Their questionnaire included more than criminal behavior. Police contact and court involvement could also mean reporting an offence, appearing as a witness, dealing with a domestic-violence order, or being brought to a hospital by police.¹

Three percent reported being charged with an offence, 0.6% reported incarceration, and nobody reported a conviction or probation during that period. Dissociative, post-traumatic stress, and emotion-regulation symptoms did not reliably predict recent criminal behavior in the sample.¹

There are limits here. Everyone in the study was receiving treatment, and the researchers relied on participants' answers rather than checking criminal records. The six-month figures only describe this treatment group.¹

Someone with DID can hurt another person, just as anyone can. A threat or violent act deserves a direct response. If a person has never made a threat or hurt anybody, the diagnosis is no reason to assume they will.¹

Some of the danger points inward

An identity state threatening another can sound like one person threatening someone else, even though every state shares one body. In practice, the danger may be self-directed.¹

Calati and colleagues examined that wider safety problem in a meta-analysis of 19 studies. Psychiatric patients with dissociative disorders were more likely than psychiatric patients without them to report previous suicide attempts and non-suicidal self-injury.³

Calati's review grouped DID with other dissociative disorders, so it cannot provide a DID-specific rate. An internal threat involving suicide or self-harm still calls for immediate help, whatever diagnosis eventually fits.³

Stigma follows people into treatment

Nester and colleagues surveyed adults recruited online who reported dissociative symptoms or a dissociative-disorder diagnosis. Nearly 46% feared a poor response from a provider, often because they expected disbelief. About 36% had difficulty finding somebody trained in trauma or dissociation, and 32% reported stigma as a barrier to getting care.⁴

Someone who expects disbelief or alarm from a clinician may decide it is safer not to disclose what is happening, or not to ask for help at all.⁴

Footnotes4

Footnotes

1. Webermann, A. R., & Brand, B. L. (2017). Mental illness and violent behavior: The role of dissociation. Borderline Personality Disorder and Emotion Dysregulation, 4, 2. Background, results, and discussion. Media stereotypes, older reports that blurred internal and external violence, and recent criminal-justice involvement in the study sample. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

2. Crumpler, D. (2022). Petals of a Rose [Short film and project website]. Film description and community screenings. A short film created in response to negative portrayals of DID, following a day in the life of a woman with DID. ↩

3. Calati, R., Bensassi, I., & Courtet, P. (2017). The link between dissociation and both suicide attempts and non-suicidal self-injury: Meta-analyses. Psychiatry Research, 251, 103-114. Abstract. Meta-analysis of 19 studies comparing suicide attempts and non-suicidal self-injury in psychiatric patients with and without dissociative disorders. ↩ ↩²

4. Nester, M. S., Hawkins, S. L., & Brand, B. L. (2022). Barriers to accessing and continuing mental health treatment among individuals with dissociative symptoms. European Journal of Psychotraumatology, 13(1), 2031594. Results and discussion. Survey findings on anticipated negative treatment experiences, difficulty locating trained clinicians, stigma, and other barriers to care. ↩ ↩²