More accepted than before, this disease was known for splitting ot splintering personalities. This disease was previously known as Multiple Personality Disorder(MPD). However the name was changed in 1994 to Dissociative Identity Disorder(DID). Reasoning behind that is, so the disease can appropriately broaden the spectrum for individuals who might fall under this diagnosis. Before 1994 it was thought that MPD meant the individual diagnosed with this disorder was taking on or developing another personality. When actually the person is being “protected by” the other personality against the abuse or trauma that took place at an earlier part in their life(Psychology Today, Dissociative Identity Disorder).
Dissociative identity disorder can occur at any age, but the trauma usually begins at a young age, and can overwhelm the child depending on the severity. A traumatic event at a young age like sexual abuse, emotional neglect, or physical abuse can cause damage psychologically and harm the body in unimaginable ways. “Instead of memory, bodily sensation, emotions, and thoughts all being associated with an experience, these aspects lose their association and seem to separate” (Pitrowski, 2003, p.1013). When a child undergoes a traumatic experience and “represses the threatening emotions that accompany this experience he or she is releasing control and the emotions are pushed to unconsciousness” (Pitrowski, 2003) as stated by a renowned psychiatrist, Sigmund Freud. If consciousness is lost this can lead to many different things which can include: an out of body experience, loss of memory, surroundings, and even identity. Women and men both can undergo some traumatic experience as a child. However women are more likely to be the ones who are officially diagnosed with the disease than men would be. Men are less likely to seek out professional help to understand what is going on within their mind. If they did seek out professional help then they would have to address and undergo an extensive treatment plan. Facing previous hurt and previous damaged memories that the individual has more than likely suppressed for many years. For men who do not seek professional help they are the ones who are more likely to turn to a violent behavior versus the state of mind where your body does its best to protect from bad memories (NAMI, Dissociative Disorders).
Being properly diagnosed with a disorder is crucial on how an individual will then cope with the rest of their life. Adjusting to a life after being diagnosed can be more difficult for one than the other but being diagnosed by a professional all have similar techniques. A patient wouldn’t have a blood test, they would visit a psychiatrist undergo a series of questions where the psychiatrist would analyze the symptoms discussed. They would then have to decipher between what could be D.I.D and another mental illness. What would help them do that is what’s called Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). For being correctly diagnosed with this disease, the patient must have meet the following. Would have to have at least two or more identities that would take place of their own personality. Which then the personality would alter the individuals actions. Absolutely cannot recall important events in their life, that one should not forget. With no explanation to backup their forgetfulness(Medicine Net, Dissociative Identity Disorder). Some symptoms don’t surface till later in the child’s life, these symptoms could also surface in adulthood.
An individual with dissociative identity disorder has most likely had more than two occasions of unpleasant experiences that were dissociated at a young age into alternate personalities. These personalities are a coping mechanism that usually are detectable in the adult years. Symptoms can include memory loss, where certain periods of time, people and places could be gone from their memory bank. Lack of attachment of one’s own feelings or emotions. A Lot of the time an individual will also feel very detached from their own identity. Also ones who struggle with this disease will more than likely not be able to deal with day to day stresses of life, and cannot cope with any kind of anxiety. According to Erikson’s stages of psychosocial development, this disorder highly impacts the Identity vs, Role confusion stage. In this stage, a person from age 12-18 is trying to develop a sense of self. When multiple personalities develop to protect the patient, it is very apparent how hard finding a sense of self can be. This will lead to more problems in the next stage of Erikson’s theory, which is intimacy vs. isolation. This stage deals with ages 20 to early 40’s and deals with finding a life with another person. Erikson believed that individuals with a poor sense of self had a harder time finding and keeping relationships. Marital problems could be very prevalent among those with DID based on an almost non-existent sense of self. There are also times when some identities do not even view themselves as married, which can lead to even more problems. The following is an example of a case that relates and will put this disease into perspective
Dissociative Identity Disorder(DID) has normally been considered a rare diagnosis. Only 72 cases had been reported between 1816 and 1944. The number may seem low, but that could contribute to the fact that DID is a very underdiagnosed condition. Also, according to Richard P. Kluft, a clinical psychiatrist, observed that only 6% make their DID symptoms obvious. Today DID seems to be more common than one may think, because DID is estimated to have a prevalence rate of 1%-3% of the population.
A study conducted by The Colin A. Ross Institute for Psychological Trauma displays a patient by the name of “Kathy.” Kathy was 32 year old female seeking therapy who reported having an abusive childhood. Kathy’s abusive childhood is summarized by two alcoholic parents who were abusive towards each other and Kathy. After her parents decided to divorce, Kathy still failed to escape abuse because she was repeatedly raped by her mothers series of boyfriends. After years of abuse, at the age of 13, Kathy overdosed on Tylenol. Due to Kathy’s toxic home environment, shortly after she dropped out of school to prostitute on the streets for food and shelter. Kathy was eventually picked up by juvenile authorities, and spent the next four years in a juvenile penitentiary where she seemed to have cleaned up. At the age of 20 Kathy was married, working a steady job, and had a seemingly normal life. Soon after Kathy began having flashbacks and became extremely depressed. Due to her extreme depression, Kathy was hospitalized over the next 10 years, and was diagnosed with Schizoaffective disorder, bipolar mood disorder and borderline personality disorder. Before Kathy had been admitted into the Ross institute for treatment, her former therapist conducted an interview on Kathy which revealed she “heard mean voices” and “crying children.” Kathy’s former therapist also reported that he had the opportunity to speak to one of Kathy’s alternate personalities “Julie” upon request, who said she helps Kathy during her times of stress. This made it obviously clear that Kathy was battling DID and needed treatment. After Kathy had reported to be self-mutilating, self-abusing, and suicidal, her therapist referred her to the Ross treatment program. During Kathy’s treatment program, she was met with psychiatrist, master level therapist, direct care staff and case managers who designed a master treatment plan in her favor. In individual therapy sessions Kathy worked with her therapist on problem solving, coping skills, and identifying the personalities that were suicidal or self-injurious. Identifying the personalities that were suicidal or self-injurious was key factor because the therapist prompted other personalities to be present, express their feelings, and reframe them as a positive and helpful personality. In group therapy sessions, Kathy managed to openly discuss how her dissociative disorder has affected her life, which helped her learn about her disorders and feel less isolated. Ultimately throughout the course of therapy, Kathy gained an understanding of the protective role her dissociation has played in her life while also accepting it as apart of herself.
As of right now, there is no known cure for D.I.D. However, doctors and scientists believe that are proven methods to help an individual cope and treat this disorder. Studies have shown that more than 70% of people who have been diagnosed with this disorder have attempted suicide. Receiving the correct treatment with the right doctor is crucial for not only survival but for the patient to be able to live a normal life while coping with a disease not many people understand (Psychology Today, Dissociative Identity Disorder)
After undergoing a physical exam, psychological exam and a positive diagnosis is when an individual can begin treatment if the individual is recommended, admitted, or chooses to . Although therapy is a preferred method of treatment for an individual battling D.I.D, some individuals simply do not receive the treatment as intended, therefore a doctor might suggest medications such as antidepressants and anxiolytics. The issue that medication proposes is a temporary relief of mood and anxiety symptoms, but no relief for the dissociation. Treatments can include (EMOR) an eye movement desensitization and reprocessing or psychotherapies also known as talk therapy. Examples of psychotherapy methods are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). In the case study above, “Kathy” which was conducted by The Colin A. Ross Institute for Psychological Trauma. Patient Kathy had been exposed to psychotherapy, cognitive behavioral and dialectical behavioral therapy as a method of treatment.
For better understanding of what types of treatment patients can undergo, EMOR also known as Eye movement desensitization and reprocessing. For this type of treatment the doctor will attempt to alleviate and release the traumatic memories, which in return will relieve the distress that triggers the symptoms. They often complete this treatment with visual stimulation, which in turn triggers the memories and then the Therapist would been able to replace the bad memories with good ones.
Another known form of treatment is Dialectical behavioral therapy (DBT) this form of treatment would focus on teaching the patient how to cope with urges. Once the patient understands how to cope, they then would be able to regulate their emotions which will allow them to form relationships in a healthy manner. This therapy would help the patient center themselves, regulate their breathing and understand self-soothing rather than allowing themselves to give into the other personalities(NAMI, Dissociative Disorder).
The last known therapy is Cognitive Behavioral therapy (CBT) this therapy helps change the thinking of the patient from negative to positive. This is a therapy focused on teaching the patient how to cope with negative thoughts and how to cope with the actions that follow the negative thoughts(NAMI, Dissociative Disorder). If none of the treatment above works, then doctors and therapists might end up suggesting some medication such as antidepressants.
The overall outlook for an individual battling D.I.D. is not as distressing as one may believe. Although it is a long and overwhelming process for the individual to associate with the repressed trauma. Determining the appropriate diagnosis and treatment will allow the diagnosed to integrate the alternate personalities into one. This change occurs once the individual has identified the role the personalities play in the individual’s life and why they played that role. Then the individual can form their personalities into one functioning whole; as displayed with Kathy. In order to make sure an individual coping with DID will cope properly, it is imperative that the treatment process works. To make sure it eliminate any underlying issues such as depression or substance abuse and include reframing the individuals DID condition as positive.