Dissociation resembles wandering off in one’s thoughts or losing all sense of direction while working on an important project. Dissociative identity disorder is a serious type of dissociation, a psychological procedure which creates an absence of the association in one’s mind, emotions, memories, activities, or feelings of personality. Such a psychological issue is believed to come from the trauma that occurs in one’s childhood, however, the dissociative factor of the mental illness is believed to be a coping mechanism. The patient disassociates themselves from an experience that is aggressive and traumatic to integrate with one’s self. Those diagnosed with dissociative identity disorder tend to have difficulties dealing with stressful situations. Biopsychosocial causes are evident and correlate with the same causes in Christine Sizemore’s case. In terms of biological causes, scientists have confirmed that dissociative identity disorder is not hereditary and has no known biological causes, however, it does tend to run in families. The psychological causes of DID range from emotional stress to night terrors, which are mainly a result of the sociological causes of dissociative identity disorder. Sociological causes are factors that occurred in early childhood, such as emotional abuse, sexual abuse, neglect, or severe trauma. As a young child, Christine Sizemore witnessed horrific events including her mother being brutally harmed in a kitchen accident, the memorial service of a newborn child, a dead body being dragged out of an unmarked grave, and a man being sawed in half at a lumber company. The dissociation that she experienced at the age of two, was due to these occurrences.
According to the DSM-V, the primary symptoms of dissociative identity disorder are: the presence of two or more alter personalities, repetitive amnesia, which is periodic gaps in memory that are too severe to be classified as a lack of remembrance, recognition of voices in one’s head, and distress and dysfunction caused by the undiagnosed disorder. The secondary symptoms of dissociative identity disorder consist of such as depression, anxiety, stress, and suicidal thoughts, as well as impulsive and destructive behavior, and a sense of detachment from one’s ordinary self. While under psychiatric care, Christine stated that she had terrible headaches, irregular behavior and told doctors that she was hearing a voice in her head that insulted her about her husband. This example from one of Christine’s interviews displays attribute of both primary and secondary symptoms of dissociative identity disorder. Sizemore’s abnormal behavior is a secondary symptom while hearing voices in her head is a primary symptom, which means it is a greater indication of whether or not the patient has the disorder. Another example that exemplifies the symptoms of DID is when her psychiatric doctors, Corbett Thigpen, and Hervey Cleckley, characterized her continuous personality shifts as three different alter personalities, Eve Black, Eve White, and Jane. Eve Black contained more of the provocative attributes of Christine and was also the identity that had attempted to strangle her 2-year-old daughter. Eve White had the most influence over Christine and was the calmer and more authoritative version of Eve Black. There was also a third alter personality named Jane that had the ability to do many things that Eve White and Eve Black were not capable of. In addittion to these alter identities, there was The Purple Lady, who believed and caused Sizemore to act as if she were 58 years old, even to the extent of spraying her hair gray and the Strawberry Girl, which caused the patient to believe they were 21 years old, walk around barefoot, and constantly eat strawberries. This model exhibits the primary symptom of having at least two alter identities. From a conference with her psychiatrist, Sizemore declared that each time her personalities would change, a headache and abnormal facial movements would occur. It became so intense that Christine attempted suicide multiple times. These symptoms are all relevant to the diagnosis of dissociative identity disorder and were all present in the patient during the time being.
This example meets the 2 D’s, distressful and dysfunctional, necessary to be labeled as a disorder. A disorder is distressful when it causes one to worry or have anxiety and is dysfunctional or causes dsyfunction when the patient is unable to properly live or function. Christine Sizemore’s case meets the distressful standard because according to her autobiography, she suffered from bouts of stress to the point where she attempted suicide. This case also meets the dysfunctional measure for a disorder. The control the alter identities had over Mrs. Sizemore’s life and their ability to appear without warning inhibited her daily functions and even her ability to be a mother to her child. The actions of the personalities were unrelated to herself as a person, therefore it would not allow her to function on a daily basis. Based on the case meeting the requirement, the symptoms Christine Sizemore faced show reasoning for the diagnosis of dissociative identity disorder.
Treatment options for DID are abundant ranging from therapy sessions to psychotherapy and hypnosis, however, I would recommend a new treatment called Eye movement desensitization and reprocessing (EMDR). This has been increasingly used on patients with dissociative identity disorder, where the patient is asked to recall information regarding a traumatic event that occurred in the past and they analyze the patient’s rapid eye movement, which then weakens the effect that memory has on them. There are separate phases to the EMDR therapy, the first phase is where the patient gives information about the traumatic event, then the patient’s emotions and sensations are measured, afterward, the specialist begins to apply eye movements and corresponds them with current emotions, lastly, the patient is scanned for any abnormal activity and the evaluation is reassessed.The ordinary EMDR session will last around an hour to an hour and a half (60-90 min), and the number of sessions will depend on the amount of trauma that occurred. The success rate for this type of therapy is between 84 to 90 percent and continues to increase