We agree with you, Zelda! Thank you for saying that.

Here's our thoughts on this:

There are continued controversies surrounding dissociative disorders, some of which have been deemed "rare," "culture-bound," "somatoform," and/or "ficticious." Others have previously categorized DID as a personality disorder (when Axis II disorders were still being used, and the DID was formerly MPD); but research had found that it's (a) an Axis I disorder (when there were such axes), and (b) it's dissociation-based, not personality-based. Furthermore, DID is NOT a "worse form of any personality disorder, including borderline personality disorder." While there may be some with comorbidity with borderline personality disorder, many people with DID do not have that disorder.

That said, many people with DID do meet the requirements for PTSD as well as the newfound controversial CPTSD (complex post-traumatic stress disorder). Again, CPTSD might be along the continuum of dissociative disorders, but it remains unclear whether or not there's a continuum there or merely an overlap between two disorders (i.e., comorbidity). Further, CPTSD is also thought to not be a personality disorder either, and many people with borderline personality disorder are thought to have been misdiagnosed with that disorder when, in reality, they have CPTSD instead.

Personality disorders are also highly controversial disorders, insofar that research continues to use such to describe adolescents and younger, even though ethically, practitioners should not diagnose personality disorders until a person has reached the age of 18 and has an extensive history that goes beyond being simply situational (as opposed to dispositional). Personality disorders are thought to be more dispositional, whereas trauma-based and anxiety-based disorders are thought to be more situational.

It would therefore be that, since a few personality disorders have been removed from the DSM (I think "passive-aggressive personality disorder" was removed), it would follow that, perhaps, borderline personality should also be removed as well. If dissociation and trauma have affected a person's emotion regulation, then borderline would be best thought of as a post-traumatic emotion dysregulation disorder. If the person with an emotion dysregulation disorder frequently has conduct issues, then there might be comorbidity with conduct disorder or antisocial personality disorder, as opposed to those features being lumped into one category of borderline personality disorder. The other personality disorders might have a lot to do with childhood neglect (the environment) coupled with a predisposition in the brain (biological/neurological features) to exact an actual personality disorder, but some people actually have personality disorders without any form of childhood abuse or neglect (i.e., childhood interpersonal trauma). When persons don't recall how they react to others in the instances of high stress, high trauma triggers, etc., then it is thought that dissociation might be another symptom either common to that particular disorder or comorbid with that disorder, since dissociation is thought to be trauma-related (including medical traumas that cause amnesia). Thus, dissociation should really be considered a form of trauma-related disorders and not just one out there on its own. (There's still, to this day, little emphasis on medical traumas, including repercussions from physical abuse, sexual abuse, medical malpractice, iatrogenic effects of medical mistakes or medical treatments given with true warnings, medical experimentation, ICU-related traumas, birth-related traumas, and even pandemic-related traumas. Some dissociation could stem from such medical traumas as well, even those that have occurred in childhood.)

The False Memory Syndrome Foundation is comprised of parents who were accused of child maltreatment coupled with lawyers affirming that parental rights are more important than children's rights. However, history has shown that children have consistently been abused and mistreated by certain parents with certain historical traumas and/or individual dispositions, and that it took animal rights (because animals had more rights than children at some point) to affirm children's rights in a court of law. Such animal rights that afforded children's rights gave birth to (a) the child welfare system and (b) the juvenile justice (therapeutic jurisprudence) system, whereby parental powers (parens patriae) and rehabilitation paradigms were more appropriate for youth and dysfunctional families than police powers (letter of the law) and related parental rights. Prior to this time, parents could ask the courts to have their children put to death. The False Memory Syndrome Foundation sought to fight against trauma-related disorders - in particular, dissociative disorders - in order to bring back parental rights and allow defendants once again to have more rights than victims (in this case, child victims). Dissociative disorders were made to be "false" - in much the same manner as disinformation is spreading about "false news" or "false this" or "false that." Things that are, in fact, NOT FALSE are being seen as "false" because of continued disinformation from those who, by and large, lack empathy and are abusers, spreaders of harm, and/or instigators of harm - who simply want to maintain power and control no matter how harmful their actions are to do so.

So, over time, dissociative disorders have continued to be questioned by society and those attempting to learn about it. In many of the same ways that our own educational system has been censored, so, too, has the education and therefore research funding for dissociative disorders also been censured.

Just read over all the controversial discussions about dissociative disorders, and then see which political leanings there are between those who are for and against the diagnosis and treatment for such disorders. You will find at least a correlation there. You will also find a correlation between those who uphold parental rights versus those who are proponents for children's rights. You see that today, in terms of medical neglect traumas being inflicted on children right before our very eyes, but no one seems to care about the kids, about the elderly, about the disabled, and about those with invisible disabilities (such as cancer, mental disorders, and immunocompromising disorders). All are controversial because of politics, and what's included in politics are defendant's rights to - basically - not get caught and then punished for their crimes against humans, society, etc., including children.

So, there's a lot behind why the DID diagnosis is controversial, and why people think it is "rare." It's actually more common than you think.

There are many people who are misdiagnosed with schizophrenia, schizoaffective, schizotypal, bipolar, fictive, somatoform, and personality disorders because they were actually DID with CPTSD instead. When the voices and images are on the inside (as opposed to the outside), it's most likely (not always) DID or at least a form of dissociation. Conversely, when the voices and images are on the outside (as opposed to the inside), it's most likely some sort of psychosis, delusion, or schizophrenia. I say most likely because it could be that there is comorbidity involved with dissociative disorders, or it could be that schizophrenia or other psychotic-based disorders have similarities to dissociation when voices and images are seen on both the inside and the outside or just on the inside as well. But history has shown us that DID is largely under-diagnosed, and that it could be more prevalent than what is stated today.

For these reasons, finding treatment for DID is really challenging. Also, getting a proper diagnosis is also challenging.