The disturbance is not due to the direct physiological effects of a substance, alcohol intoxication or a general medical condition. "In children, the symptoms are not attributable to imaginary playmates or another fantasy play” (American Psychiatric Association, 2000).
A condition like DID can seem strange and unbelievable to some skeptics. There are even some psychologists that do not believe in such a disorder. DID is the most extreme case of dissociation.
A crucial aspect of this disorder is its relationship to trauma. Many individuals diagnosed with DID have had a traumatic event occur to them in the past. According to The Dissociative Identity Disorder Sourcebook written by Deborah Haddock, DID in trauma clients can be described as “being lost in a fog” or at times others may describe it as though the world around them seems eerie and dark. Individuals with DID may also report feeling disconnected from the body as if they were living in an “auto-pilot” state of mind. They also feel disconnected from families and friends around them, like if something was preventing them from interacting with everyone around them. Disconnections like these can become so enveloping that the individual begins to distort and in some cases even lose time. In the event that they lose time they state not being able to remember anything that occurred during the dissociative