A brief explanation of Identity Alteration (DID OSDD)

Added: 2026-05-15

[00:00:08]Hi, my name is Dr. Mike Lloyd and I'm a consultant clinical psychologist and I'm going to be looking in this video about what is identity alteration. Now this is one of the five pillars, the last of the five pillars of dissociation and it's often the one that causes the most amount of difficulty and distress in people's lives. And this is because it's the most severe of all of the different types of dissociation that people can encounter. When we think of identity alteration, we're thinking of conditions on the lines of other specified dissociative disorder, dissociative identity disorder and partial dissociative identity disorder. And the essence of identity alteration is that the degree of trauma nearly always experienced in early childhood has led to a situation where the brain has compartmentalized the sense of self into different identities, each with its own role and process and design in order to withhold and sustain the type of trauma that is being experienced. And this often takes place in childhood because the developing child brain is generally incapable of being able to understand and comprehend and therefore with and hold and contain the essence of the trauma that is being experienced which can take place over period of many months and many years and is formed in the basis of what we call complex trauma. And the way that the brain does this is by compartmentalizing the trauma into different sections so that each section is held in a separate location within the sense of self. So the integrated sense of self does not happen, the development of the sense of self does not happen in a whole way, it happens in a broad kind of categorical way where all of these parts are separated out. And when we think of the word parts, it will cause you to be called others or alters, each part then starts beginning to build its own sense of self in order to manage the individual design of holding the trauma that it's supposed to do. So, for example, some parts or alters are responsible for holding traumatic memory. Some parts are are designed to hold the everyday functionality of life, to be able to manage, to be able to cope, to be able to do things. So, everyday activities of living could be broken down and separated between um several or many different alters. The nature of the trauma, the nature of the attachment process is also broken down and separated between one or many different types of alters. And what can happen, not always, but what can happen is that these compartments start forming their own identity and somehow can be associated with age, they can be associated with temperament, uh with a visual image, and can even be named, but not necessarily. It's not a necessary component that there are names or visual depictions. Sometimes they can be purely kind of broad, general emotional states of being. And the difference between the two two different types, the OSDD and the DID, is largely whether those compartmentalized alters, the others on the inside, remain on the inside or whether they have the potential to step forward into everyday life and take control of the body and manage and organize the functionality of everyday life through the external mechanisms.

[00:03:26]So, OSDD tends to be an internal kind of a visual, auditory type emotional experience, and DID is all of those, but also a behavioral experience on the outside. And when we look at identity alteration, the key factors we're thinking of are whether or not the individual that we're talking to at the point of assessment feels as if there are separate and different parts of themselves functioning in a way that is not necessarily in keeping with their own sense of being. So, often the the parts behave or react or or describe things or talk about things in ways that the person that we're talking to does not feel belongs to them. So, this is different from just say having different parts of the self like one part of me might might want a blue car, one part of me might want a red car, one part of me might want to go outside, one part of me might want to stay inside. It's not like that. These are very separate parts of the individual sense of self that have not been integrated into the whole. So, when we ask the questions about this, we're looking at whether or not they have recognized that there are aspects to themselves that they don't recognize, that behave or function or think or talk in ways that do not belong to them, and also whether or not people on the outside have recognized these things and seen these things. Because in the case of severe identity alteration, this is a behavioral mechanism that takes place in the outside world and therefore is generally seen or understood by others that that person might associate with.

[00:04:57]So, we're also looking at factors where the person's life is going in directions that they can't begin to understand or comprehend as being their own choice.

[00:05:05]Things are happening around them or because of them that they can't explain or recognize or may not want to happen.

[00:05:12]They might find things in their possession, they might behave in ways, say things, or know people, or have learned skills or been to places that they cannot account for in any reasonable cognitive way. So, we discount things like psychosis and schizophrenia when we're doing these assessments because we're looking at a logical ordered set of cognitive functions and the behaviors that are taking place make sense in a logical way once they're formulated and understood.

[00:05:41]So, once we've discounted all of the things that could cause something like identity alteration such as substances or some sort of other uh brain difficulties that might be going on in the organic phase, then we're left with identity alteration. So, this as I said is the most severe type of dissociative experience that person can have. It can be extremely distressing. It can be extremely disorientating and disabling and generally causes chaos and difficulty in an individual's life. We also know that the person that we're speaking to at the front may not be the might not be the main person. It could be that the collection of parts have organized themselves or chosen one part to be at the front and that could be a changing pattern of behaving and being that we have to take account of. So, I hope that that's been helpful in giving a sense of what identity alteration is as one of the five key points of the dissociative spectrum. Thanks ever so much for watching.