The Many Faces of Dissociative Identity Disorder

Abstract This research paper aims to explore the mental disease known as Dissociative Identity Disorder (DID), previously known as multiple personality disorder. I explore the meaning, symptoms, and effects of DID. My research describes those diagnosed with DID and the probable reasons of why they have the disorder. This study also explains the many different treatments and the effects those treatments might have on a person that has the disorder. I include a research study done on someone diagnosed with DID, the method used to help treat her, and the results of her treatment. Lastly, I state my opinion on DID and the methods I believe with help people prevent, treat, and cope with Dissociative Identity Disorder.

The Many Faces of Dissociative Identity Disorder

Dissociative Identity Disorder (DID), previously known as Multiple Personality Disorder, is a mental condition where a person possesses two or more different personalities which may alternate within the individual’s conscious awareness. A person living with DID many have as little as two personalities, referred to as alters, or as many as 100, though the average is about ten. Alters may exhibit differences in speech, behaviors, attitudes, thoughts, and gender orientation. They may even have physical differences, such as allergies, right-or-left handedness, or the need for eyeglass prescriptions. At least two of these personalities assert themselves repeatedly to control the affected person's behavior and consciousness, causing long lapses in memory (Pais, 2013). When alters switch or take over individuals may not be able to remember events in all or part of a proceeding time period. They may also repeatedly encounter unfamiliar people who claim to know them, find themselves somewhere without knowing how they got there, or find items that they don't remember purchasing in their possession. Although when in alter states individuals have memory lapses the individuals continue to survive in their environment (Kennett, 2002). For example, they may continue to know where the grocery store is, how to use the microwave, how to count, or how to write. Only bits of information directly or indirectly associated with the alter’s memory are lost, the rest is stored.
The definite cause of DID is unknown, but one main cause of the disorder is believed to be severe and prolonged trauma experienced during childhood, including emotional, physical, or sexual abuse. Symptoms of DID can include: an inability to remember large parts of childhood, sudden return of memories, as in a flashback and/or flashback to traumatic events, episodes of feeling disconnected or detached from one's body and thoughts, hallucinations, changing levels of functioning, from highly effective to nearly disabled, depression, anxiety, alcohol and/or drug abuse, headaches, and eating disorders. DID is a serious mental illness that occurs across all ethnic groups and all income levels, but has been proven to affect women nine times more than men. Research has shown that the average age for the initial development of alters is 5.9 years old. Statistics show that DID occurs in 0.01 to 1 percent of the general population (Mayo, 2014).
First, doctors diagnose dissociative disorders based on a review of symptoms and personal history. The doctor may perform tests to rule out physical conditions that can cause symptoms like amnesia and a sense of unreality. If the doctor rules out physical causes, they will probably refer you to a mental health specialist to determine your diagnosis. To be diagnosed with DID, you have to meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. The DSM is the standard classification of mental disorders used by mental health professionals in the United States. For a diagnosis of DID the DSM includes the following criteria: You display, or others observe, two or more distinct identities or personalities, you have recurrent gaps in memory for everyday events, skills, important personal information and traumatic events that are too extensive to be explained by ordinary forgetfulness, your symptoms are not a part of broadly accepted cultural or religious practice, your symptoms are not due to alcohol or other drugs, or a medical condition. In children, symptoms are not due to imaginary playmates or other fantasy play, and your symptoms cause you significant stress or problems in your relationships, work or other important areas of your life (DSM, 2014). The goals of treatment for DID are to relieve symptoms, to ensure the safety of the individual, and to "reconnect" the different identities into one well-functioning identity. Another main purpose of treatment to help the person safely express and process painful memories, develop new coping and life skills, restore functioning, and improve relationships. The best treatment approach depends on the individual and the severity of their symptoms. The simplest and most common form of treatment for DID is psychotherapy, also known as talk therapy or counseling. The therapist will work with the patient to uncover the cause of the disorder and to help the patient find new coping skills. In time, the therapist may help the patient talk more about the trauma they experienced, but generally only when they have the coping skills and relationship with their therapist to safely have those conversations. Psychotherapy treatment may include the following stages: uncovering and "mapping" the alters or parts; treating the traumatic memories and "fusing" the alters; and consolidating the newly integrated personality. Other forms of therapy treatment for DID are group therapy and family therapy. Family therapy helps those is the patients family understand their loved ones disorder and how to support, cope, and help take the proper steps when faced with problems brought on by the disorder. Although family therapy can have a lot of benefits, in some cases it may produce significant negative and traumatic memories of other family members which can hinder clinical progress. Group therapy can also be beneficial to those diagnosed with DID by giving them others to relate to. Another form of treatment include medication. Although there are no medications that specifically treat DID since it is not an organic disorder or a chemical imbalance, the doctor may prescribe antidepressants, anti-anxiety medications or antipsychotic medications to help control the mental health symptoms associated with dissociative disorders. Clinical hypnosis is the final method of treatment. Clinical hypnosis is a treatment technique that uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness or awareness, allowing a trained psychologist to explore thoughts, feelings and memories they might have hidden from their conscious minds. Despite controversy about therapists implanting false memories by suggestion, clinical hypnosis can be helpful when used in conjunction with psychotherapy and conducted safely by a trained therapist. Hypnosis can help clients access repressed memories, control problematic behaviors, such as self-mutilation and eating disorders, and help fuse the alters during the integration process.
There is no way to prevent DID, but early intervention and psychotherapy for experiences of abuse/trauma in both children and adults can help prevent the formation of dissociative symptoms and dissociative disorders.
One study done by Richard Kluft in 2012 observed the behavior, treatment, and results of a woman diagnosed with DID named Gwen. Gwen is a successful lawyer who survived over 20 years of well-documented incest and exploitation in prostitution and pornography. After overcoming her previous traumas Gwen was raped and suffered a blunt head injury while at law school. Then traumatic nightmares, probably flashbacks of horrible mistreatment, began to surface. After graduation she worked with her secret lover, a former mentor who became a nationally prominent politician. He began to fear their affair would be discovered, and fired her abruptly. Soon after all her efforts to find and hold employment failed because she seemed to lack all legal knowledge. As her memory problems were explored, Dissociative Identity Disorder was diagnosed. The personalities that attended law school had withdrawn from participation in life when Gwen was rejected by her lover and they could not be accessed. Dr. Kluft began clinical hypnosis on Gwen. As Gwen achieved some degree of self-competence, he communicated with alters by encapsulating traumatic experiences and with those experiences based on her abusers. Some traumatized parts chose not to surface between sessions and during work not related to their bad experiences. He reached them by repetitively demonstrating the ties between Gwen’s experiences and the alters that tried to see the events as separate, and by demonstrating that every time they inflicted hurt or humiliation he would focus treatment on them. Gradually Gwen became less scared and more accepting of her traumatic experiences, confident that she would survive processing them and become stronger as a result. The more trauma they processed, the stronger Gwen grew. She began to recover her legal knowledge and skills. Further, a great deal of generalization occurred amongst her alters. As they progressed, they frequently found that new areas of trauma were processed with much less time and effort than before. What had initially taken months was being managed in one or a few sessions, using hypnotic techniques. It took many years to deal with what Gwen had endured, to mitigate its consequences, and to help her develop a more powerful and healthy unified self, but her treatment brought about profound improvements and allowed her a satisfying quality of life. She helped prove that many people suffering from DID can benefit from individualized programs of hypnotherapeutic interventions (Kluft, 2012).
As we can see Dissociative Identity Disorder is a very serious disorder and life changing disorder. Although DID does not affect many people I believe that preventative measures should be taken to prevent this sometimes devastating disorder from occurring. After being involved in traumatizing events I believe that it should be protocol or a requirement for the individual involved to seek professional psychological help to ensure that no mental problems form. I also believe that those surrounding individuals diagnosed with DID should be required to participate in group therapy with the individual to support them and help everyone in the family cope. Hopefully as time passes more research can be made and more solid treatments for DID can be discovered. Until then, in my opinion, a combination of hypnosis and therapy seem like the best course of treatment for Dissociative Personality Disorder.
References
Cleveland Clinic. (2012, March 29). Dissociative identity disorder (multiple personality disorder). Retrieved from http://my.clevelandclinic.org/neurological_institute/center-for-behavorial-health/disease-conditions/hic-dissociative-identity-disorder.aspx
Kennett, J., & Matthews, S. (2002). Identity, control and responsibility: the case of Dissociative Identity Disorder. Philosophical Psychology, 15(4), 509-526. doi:10.1080/0951508021000042???
Kluft, R. P. (2012). Hypnosis in the treatment of Dissociative Identity Disorder and Allied States: an overview and case study. South African Journal Of Psychology, 42(2), 146-155.
Mayo staff. (2014). Diseases and conditions: dissociative disorder. Retrieved from http://www.mayoclinic.org/diseases-conditions/dissociative-disorders/basics/definition/con-20031012
NAMI. (2014). Dissociative identity disorder. Retrieved from http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/By_Illness/Dissociative_Identity_Disorder.htm
Pais, S. (2013). Dissociative identity disorder. Retrieved from http://www.aamft.org/imis15/content/consumer_updates/Dissociative_identity_disorder.aspx