Usually the family that causes a toddler to be traumatized is so dysfunctional they promote the dissociation. They are so insensitive that they do not see anything wrong. They do not communicate with the child enough to really know the child's personality. So over years the dissociation is reinforced by the dysfunctional family. Late in life when the person is no longer around the dysfunctional family that caused him/her to be dissociative, the person starts to recognized the problems going on in his/her relationships and life in general. This happens many times before there is knowledge of the alters.

I realized that I had a dissociative disorder in 1989 to 1992. I had no knowledge of my alters except from my dysfunctional personal relationships. I still do not know my alters. I just know that they exist. I have a few memories of them. Most of us who get a dissociative diagnosis have loved ones who care enough about us to see that there is something wrong and get involved with the mental health treatment. For people like me who have no significant others that care, it is extremely hard to get help. When I applied for SSI through the Social Security Office, a staff member asked me about loved ones that could verify the mental illness. I told him that that was the problem! I had no one who cared.