DISSOCIATIVE IDENTITY DISORDER 1Dissociative Identity DisorderAbby EdeleLindenwood University
DISSOCIATIVE IDENTITY DISORDER 2AbstractThis paper is a brief overview of Dissociative Identity Disorder, or DID. It explores what the disorder is,why it is no longer referred to as Multiple Personality Disorder (MPD), the symptoms of the disorder, therole of the ―alters‖ or other individuals present within the host, diagnosis of the disorder, and treatment ofthe disorder. It also explores some of the basic reasons why some professionals do not ―believe‖ in thisdisorder that is becoming more and more prevalent and researched.
DISSOCIATIVE IDENTITY DISORDER 3Dissociative Identity DisorderWhat is Dissociative Identity Disorder?Dissociative Identity Disorder is, according to an article on Psychology Today, ―a severecondition in which two or more distinct identities, or personality states, are present in—and alternatelytake control of—an individual.‖ Individuals who have this disorder also have bouts of extremeforgetfulness and memory loss (Psychology Today). There are many degrees of severity of the disorder.Many people might actually experience disassociation without realizing it. In an article onPsychCentral.com, there are many ―dissociative experiences common to most people, such asdaydreaming, highway hypnosis, or ‗getting lost‘ in a book or movie, all of which involve ‗losing touch‘with conscious awareness of ones immediate surroundings.‖ However, these are mild. On the other endof the spectrum is chronic disassociation which may not allow people to function normally(PsychCentral.com) DID usually manifests itself due to some traumatic experience in the individual‘spast.According to the author who writes under the pseudonym ―Quiet Storm‖ whose work is published inthe textbook by Sattler (1998), ―MPD [Multiple Personality Disorder] is not a disease. It is not a sickness.It is a highly developed coping mechanism that allows the young mind to compartmentalize, or dissociate,repeated and traumatic abuse‖ (p. 41). The author adds that for her, ―being able to create Alterpersonalities to cope with the abuse is the only thing that allowed us to survive our childhood alive. MPDwas never a disease – it was a gift, the gift of life we gave to ourselves‖ (p. 41).“Dissociative Identity Disorder” vs. “Multiple Personality Disorder”Dissociative Identity Disorder (DID) is often referred to as ―Multiple Personality Disorder.‖However, ―Multiple Personality Disorder‖ is no longer the official name of the disorder. It was changedin 1994 when the disorder became more common and was more widely studied (Psychology Today).Mostoften, people diagnosed with DID do not feel like they are overcome by different personalities. The―personalities‖ that possess them are more like alternate people or different parts of a person. Accordingto an article on PsychCentral.com (2010), ―A person diagnosed with DID feels as if she has within hertwo or more entities, or personality states, each with its own independent way of relating, perceiving,
DISSOCIATIVE IDENTITY DISORDER 4thinking, and remembering about herself and her life.‖ PsychCentral.com also advises that although theseidentities or ―alternate states‖ are all very different, they are all ―manifestations of a single person.‖According to an article on Psychology Today, DID is not made up of different personalities, but instead it―is characterized by a fragmentation, or splintering, of identity rather than by a proliferation, or growth, ofseparate identities.‖ According to Psychology Today, ―the various identities may deny knowledge of oneanother, be critical of one another or appear to be in open conflict.‖ It makes a little more sense fordifferent fractions of an individual, or different identities, to be in conflict with one another rather thanjust personalities.SymptomsThe most prominent symptom is what gives the disorder its name: having other identities. Theremust be at least two identities or ―alters‖ that periodically take over a person and his or her behavior andactions. Psychology Today states that ―half of the reported cases include individuals with 10 or fewer‖identities. Another major symptom of DID is memory loss. Those suffering from DID have an ―Inabilityto recall important personal information that is too extensive to be explained by ordinary forgetfulness‖(PsychCentral.com). The ―alters‖ of a person suffering from DID may appear when the individual isstressed or in an uncomfortable situation.Certain alters may appear when particular stressors appear(Psychology Today). Other symptoms include depression, guilt, and anxiety. There may be behavioralproblems in childhood, and as a student the individual may be unable to focus. Self-destructive oraggressive behavior may appear along with audio or visual hallucinations (Psychology Today). BecauseDID is usually brought about by severe trauma, people may experience ―post-traumatic symptoms(nightmares, flashbacks, and startle responses) or Post-Traumatic Stress Disorder‖ (Psychology Today).The AltersThe ―alters‖ are the different ―personalities‖ or identities of the person who experiences DID. Aperson can have over a hundred alters, but generally a person has ten or fewer (Psychology Today). All ofthe individual‘s alters have distinct personalities and identities, and ―Each may exhibit its own distincthistory, self-image, behaviors, and, physical characteristics, as well as possess a separate name‖
DISSOCIATIVE IDENTITY DISORDER 5(Psychology Today).J.L. Ringrose (2011) uses the ―analogy of the body representing a house and thealters representing the rooms. Some may have the door open, where there is communication, and somemay have the door firmly closed, where there is no communication oronly muttering can be heard. Thiscan be extended to include how some alters can reach each other, through interconnecting doors, whilstothers cannot‖ (p. 298). Different alters appear at different times, usually due to stressors the individual isexperiencing. Different alters may show up to take control of different situations depending on which onemight handle the present situation the best. Psychology Today says that ―Alternative identities areexperienced as taking control in sequence, one at the expense of the other, and may deny knowledge ofone another, be critical of one another or appear to be in open conflict.‖ Alters can remember differentthings that the individual may have forgotten or blocked. Pieces of information the individual cannotremember may be stored in the memory of a different alter. According to an article on Psychology Today,―passive identities tend to have more limited memories whereas hostile, controlling or protectiveidentities have more complete memories.‖ Quiet Storm from Sattler‘s textbook explains that ―Many ofour Alter personalities were born of abuse. Some came because they were needed, others came to protect‖(p. 41). A person can develop alters with each new trauma, or they can develop to protect, defend,comfort, or heal the host after the trauma has already occurred.DiagnosisDID is rather rare, but as more research is being done on the disorder it is becoming more easilydiagnosed. As Spring (2011) explains in an article, ―DID is a well-researched, valid and cross-cultural diagnosis which despite widespread opinion is not rare: research indicates that it affects betweenone and three per cent of the general population.‖DID is oftentimes confused or misdiagnosed asschizophrenia or other psychotic disorders, and sufferers of the disorder often spend many years intherapy before they are properly diagnosed (Spring). According to Psychology Today, ―the average timethat elapses from the first symptom to diagnosis is six to seven years.‖ It is sometimes hard to diagnosechildren because of their vivid imaginations. PsychCentral.com states that ―In children, the symptoms arenot attributable to imaginary playmates or other fantasy play.‖ Despite all the references and research
DISSOCIATIVE IDENTITY DISORDER 6available on the disorder, ―perhaps the majority of people with DID will fail to receive acorrect diagnosis as some mental health professionals, despite the extensive literature, refuse to believethat it exists‘‖ (Spring.)TreatmentPsychotherapy is the treatment of choice for most professionals who have clients experiencingDID (PsychCentral.com).The goal of this long-term psychotherapy isto deconstruct ―the differentpersonalities and [unite] them into one‖ (Psychology Today). Quiet Storm shares that her ―therapist tellsus that when we have remembered everything and worked through the pain associated with thesememories, we will no longer need Alter personalities to protect us, and then and only then we can beginthe process of integration into a single, cohesive personality‖ (p. 43). In her journal published in 2011,J.L. Ringrose describes psychotherapy with a DID patient as resembling ― family therapy where all thefamily need to be heard and considered‖ because ―the host and each alter may have different beliefs,feelings and actions to the same event. Where the host and one or more alters believe it is safe to talkabout ‗x‘, other alters may disagree‖ (p. 297). Medication is usually not recommended for people whosuffer from DID. If medication is used, it must be monitored extremely closely (PsychCentral.com).Someacceptable medications that may help with DID include ―antidepressants, anti-anxiety drugs ortranquilizers [that] may be prescribed to help control the mental health symptoms associated with [DID]‖(Psychology Today). In recent years, many people who experience DID have formed or joined self-helpgroups. According to PsychCentral.com, ―There is no overt reason why a support group for this disorderwould not be beneficial to individuals.‖ Hypnosis is another option for treatment of the disorder. In hisjournal article published in 2012, R. P.Kluft explains that ―Hypnosis was used in the first successfultreatment of DID/DDNOS and has been associated with most successful treatments to date‖ (p. 146).DisputeThere are many people who do not believe that DID is an actual disorder. They believe that theindividual is simply role-playing or looking for attention.In a study by A. Reinders (2012) and others, theauthors state that ―despite its inclusion in the Diagnostic Manual for Mental Disorders, the genuineness
DISSOCIATIVE IDENTITY DISORDER 7ofdissociative identity disorder (DID) continues to be disputed‖ (p. 1). Those who do not view thedisorder, or ―The non-trauma-related position, also referred to as the sociocognitive model of DID, holdsthat DID is a simulation caused by high suggestibility and/or fantasy proneness, suggestive psychotherapyand other suggestive sociocultural influences (e.g., the media and/or the church)‖ (p.1). Those who holdthis position simply believe that the individual simply adopts different ways of speaking and acting, andhe or she claims memory loss all due to his or her proneness to high fantasy suggestions or actions.
DISSOCIATIVE IDENTITY DISORDER 8ReferencesKluft, R. P. (2012). Hypnosis in the treatment of Dissociative Identity Disorder and Allied States: anoverview and case study. South African Journal Of Psychology, 4(2), 146-155.PsychCentral.com. 26 August 2010. What is Disassociation?. Retrieved fromhttp://psychcentral.com/library/dissociation_intro.htmPsychology Today. Dissociative Identity Disorder (Multiple Personality Disorder). Retrieved fromhttp://www.psychologytoday.com/conditions/dissociative-identity-disorder-multiple-personality-disorderReinders, A., Willemsen, A. M., Vos, H.J., Boer, J., & Nijenhuis, E.S. (2012). Fact or Factitious? APsychobiological Study of Authentic and Simulated Dissociative Identity States. Plos ONE, 7(6),1-17). Doi:10.1371/journal.pone.0039279Ringrose, J.L. (2011). Meeting the needs of clients with dissociative identity disorder: considerations forpsychotherapy. British Journal of Guidance & Counseling, 39(4), 293-305).Doi:10.1080/03069885.2011.564606Sattler, D. N., Shabatay, V., Kramer, G. P. (1998). Abnormal Psychology in Context: Voices andPerspectives. Boston, MA: Houghton Mifflin Company.Spring, C. (2011). A guide to … working with dissociative identity disorder. Healthcare Counselling &Psychotherapy Journal, 11(4), 44-46.