Dissociative Identity Disorder

 

Severe childhood trauma and abuse is often the underlying cause of dissociative identity disorder. In this sense, rather than taking the approach of blaming the client's suggestibility and use of imagination, Dalenberg and his colleagues have examined the role that trauma has in the development of the dissociative symptoms. Several studies have noted that it is a combination of the cognitive suggestion effects and some horrible traumas, be it in a sexual, emotional or physical sense. Traumatic stress can induce a person to take the view that their experiences are not real, leading to symptoms like insomnia and posttraumatic dissociation, or the experience of being separate from your body. The fantasy suggetion theory describes the way these symptoms are more common in those that have a potential psychological precondition to be more vulnerable because of the influence of the media and social isolation.

Experienced psychologists and psychiatric professionals use a comprehensive history for diagnosing dissociative identity disorder. Individuals with this disorder are often mistakenly diagnosed with other varieties of personality disorders (most commonly borderline personality disorder) because dissociation and even memory loss are very common symptoms. Completing diagnostic tests typically requires detailed history-taking and longitudinal assessments spanning long periods of time. History is often gathered from multiple sources as well. To eliminate autoimmune encephalitis, neurological tests are often warranted. The tests often include brain scans, lumbar puncture, and EEGs.

Dissociative disorders are traditionally defined as disruption of normal consciousness, memory, identity, and behavior. The positive symptoms are often identified as "new personalities, derealization", while the negative symptoms are mostly identified as autism/paralysis, and these types of symptoms are usually classified as "positive" and "negative". While the DAgnostic & Statistical Manual Edition provides more useful criteria that includes dissociative identity disorder as one of a broader range of dissociative disorders, at least two distinct personalities are also a group of criteria of the Diagnostic and Statistical Manual (DSM-5) for DID. Each of the personalities varies in terms of behavior, awareness, perception of the world, memory of experiences, and the meanings they had and what they felt about those experiences. People with DID have experiences of amnesia, obvious gaps in memory, and memories of ordinary events to strangely traumatic events.

Dissociative Identity Disorder (DID) is not an everyday occurrence. Approximately 1% of the population has this disorder. It is more prevalent in women than in men. 

 Depersonalization : One should note that most dissociative disorders are the result of trauma or traumatic events. The different states of dissociation and the signs of symptoms associated with them are actually side effects or "coping mechanisms" that take people's mind(s) away from the trauma. One example of these signs is depersonalization. Depersonalization is a sense of not being part of or is disconnected from one's body. Many people who experience it, identify it as an "out of body" experience. Other people describe it as a feeling whenever they become completely lost with their identity. They say that they are not their self.

Amnesia : Of the five types of dissociation, amnesia is likely the best known. Like DID, however, it has been distorted in contemporary culture. Movies routinely use amnesia in order to tell some "cute" story. But in real life, forgetfulness is anything but adorable. Someone with amnesia cannot recall personal information to the extent that it goes beyond forgetfulness. Typically, people who have dissociative amnesia have some type of experience that they block out. Usually, this is a trauma or a series of traumas.

Derealization : The next area of dissociation is derealization. Derealization is the sense that the world around someone is not real. This feeling has been described as if one was watching a movie. Others have described it as if there were a fog or mist separating them from the world around them. The separation creates a difficulty in relating to the world. 

Signs and symptoms : Depending on the type of dissociative disorder, symptoms may include: feeling disconnected from your feelings and sense of identity. feeling that everything and everybody around you is distorted and unreal. DID is characterized by the presence of two or more distinct or split identities or personality states that take control of your behavior on a recurrent basis. There is also amnesia of some personal information that is too extensive to be a mere forgetfulness. Furthermore, DID can have quite different memory versions that could change. The experience of DID varies by individual. some people's "alters" are NOT only their own age, sex, or race, but bring in totally unique body language, gestures and speech strokes. The alters are sometimes animals and sometimes fictional people.

When each "alter" or personality as they are called takes control of your thoughts and behaviour, that is to say "switching." It could take seconds, minutes, or even days. You may seek treatment and the therapist may also use hypnosis where your different "alters" could respond to suggestions from your therapist.

DID Treatment There are no official, evidence-based treatment guidelines for the treatment of DID. Many common treatments are based on anecdotal evidence, and are often controversial. One thing we do know about Dissociative Identity Disorder, is that there is no cure, although it is suggested that long-term treatment might be useful, if a patient is willing to commit. Some of the components of treatment that work would include: 

 Psychotherapy: Also called "talk therapy", is designed to help you manage the triggers associated with your DID. The intent is for you to integrate your separate personality states into one integrated personality capable of managing your triggers. Family often can be a part of this therapy too. CBT stands for cognitive behavioral therapy. This type of treatment is goal-directed, and structured. Cognitive behavior therapy (CBT) allows you to rewire your brain, to think and act more positively.

DBT is short for dialectical behavior therapy :  This technique is very effective for clients who will be experiencing some strong emotions. The goal around DBT therapy, is to find a good balance between the pros/cons of change, what you must confront, and where you and who you are now accepts or validates that aspect of you. The therapist will teach you control (regulate) your emotions. Hypnotherapy. Clinical hypnosis or hypnotherapy can help you regulate and control some of the unwanted behaviours related to DID, help you access some of your memories that have been repressed, and at times, to help facilitate a merging of the identities.

Conclusion : To summarize, Dissociative Identity Disorder (DID), previously referred to as Multiple Personality Disorder, is characterized by the existence of two or more distinct identities or personality states, and the presence of alters can control the person's function at times with identity confusion, distress, and amnesia. DID is a challenging and complex illness. People with DID can live fulfilling and integrated lives with appropriate treatment and support. Better outcomes require early identification and intervention, and a holistic approach utilizing the individualized needs and experiences of each person.