Inner worlds in dissociative identity disorder: An interpretative phenomenological analysis of spatial, relational and agentic organisation

Abstract

OBJECTIVES: This study examined how adults diagnosed with Dissociative Identity Disorder (DID) experience and make sense of "inner worlds": recurrent, internally experienced spatial settings associated with dissociative parts, events and relationships. DESIGN: A qualitative study was conducted using Interpretative Phenomenological Analysis (IPA). METHODS: Five adults who reported pre-existing DID diagnoses made by adult psychiatry specialists participated in in-depth semi-structured interviews. Interviews examined the sensory, embodied, spatial, temporal, relational and agentic qualities of inner-world experience. Transcripts were analysed idiographically before patterns of convergence and divergence were examined across cases. RESULTS: Four superordinate themes were generated: (1) inner worlds as lived, multisensory and embodied environments; (2) architectures of containment and passage; (3) awareness without authorship, distributed agency and internal governance; and (4) the internal community, comprising roles, relations and forms of selfhood. Across themes, places, boundaries and relationships regulated containment, access, communication and possibilities for action. Participants could be aware of internal events without experiencing themselves as able to initiate, stop or alter them. CONCLUSIONS: Inner worlds were experienced as embodied, spatially and relationally organised environments rather than as uniformly voluntary constructions. The separation of awareness from authorship identifies the distribution of perceived agency within one whole person as an important phenomenological dimension. Clinically, these experiences warrant collaborative and non-leading exploration; their comparative and diagnostic significance requires direct investigation rather than inference from vividness or reduced control alone.