Dissociative Disorder

Psychology Degree Guide: Dissociative Identity Disorder

Dissociative disorders are conditions causing severe disruption of a person’s identity, memory, awareness, or perception. Dissociative Identity Disorder, formerly referred to as Multiple Personality Disorder, underwent a name change in 1994 to more accurately convey the condition. It is not so much a propagation of multiple personalities as a fragmentation of identity, each separate piece disassociated from one another. The meaning of the term personality was also sometimes confused by its use in other conditions such as Borderline Personality Disorder. DID relates to identity rather than personality. Diagnosis of DID is somewhat controversial, with some arguing that it is an effect of psychiatric therapy or a misdiagnosis, but brain imaging has confirmed that there is a real transition occurring in at least some patients.

Definition, Diagnosis and Causes

Dissociative Identity Disorder is a condition in which two or more personalities exist within one person, and each takes control under different circumstances, or resulting from certain stressors. The different identities alternately appear because the patient cannot integrate all of their memory and consciousness into their main identity. All of the causes of DID are not yet well-understood, but there is one factor that stands out quite clearly. Those who suffer from this disorder are very commonly victims of severe physical and/or sexual abuse, especially as children. Adult victims of rape are also particularly susceptible. There is a higher rate of incidence among people who are closely biologically related than among the general public, so there are likely genetic factors, but the condition is not hereditary. When some people experience abuse, they react by creating a wall around their memories. When that reaction becomes severe it might result in a complete separation of more than just a block of memories, but with personality traits and other aspects of identity falling behind that wall as well.

To be diagnosed with DID, the symptoms must be distinct and acute, and it cannot be thr result of drugs or a medical condition. There is not currently a specific test for this condition, but typically a psychologist or psychiatrist will conduct an interview with the patient, looking for symptoms, asking about their childhood, etc. It is also important to make sure that the patient has recently had a complete physical to be sure that there are no physical conditions that may appear as symptoms of DID. The disorder does share many symptoms with several other disorders, so a detailed investigation is necessary to ensure that a patient is not misdiagnosed. Other disorders with similar features include Borderline Personality Disorder, Somatization, Psychogenic Amnesia, Conversion Disorder and Schizophrenia. The common overlaps are partly responsible for the debate regarding the actual existence of this disorder and misdiagnosis.

Symptoms

significant memory loss, often including important life events, like the birth of a child or a wedding occurring in both the distant and the recent past.
each identity may remember different events, but it is common for more passive identities to have a more limited memories, while aggressive identities will remember more
symptoms or co-occurrence of Post-Traumatic Stress Disorder.
two or more independent identities are present, often having a different name, age, history, self-image, behavior pattern, even physical characteristics.
identity transitions in which different personalities take control at different times or as a reaction to certain stressors and exhibit long-term, distinct sets of behavior.
the different identities can be unaware of each other or deny existence of each other, but they can also be critical or in open conflict with one another.
guilt, anxiety, depression and dependence, sometimes leading to self-destructive behaviors like cutting, also seen in Borderline Personality Disorder.
aggression, ‘problem behavior,’ and poor school performance are common in children with DID
hallucinations, visual and/or auditory.
development of a variety of phobias.
lack of self-recognition while looking in a mirror or feeling like someone else is living the patient’s life, or that they are somehow an observer.
patients commonly find things in their possession not knowing how they got them, or find notes in their own handwriting of which they have no recollection.
being called different names by different people, or failing to recognize friends and acquaintances.
blackouts resulting from a sudden identity transition in which the identity that takes over doesn’t know how they got to their current location.

Treating DID

There are no medications that treat the disorder itself, but anti-depressants, tranquilizers and anti-anxiety drugs are often used to treat some of the symptoms, like anger, depression, anxiety and issues with impulse-control. Caution is vital when using medication to treat symptoms of DID, since patients with the disorder can react very negatively and be further traumatized by the feeling of being controlled. Different methods, outlined below, can be used to treat the actual disorder. Some can be used in combination.

Long-term psychotherapy – The goal is to eventually break down the different personalities and unite them a little at a time. The pace is relatively slow so that the patient doesn’t become further traumatized by the stress off feeling that parts of themselves are being killed or taken away. Therapists also help people with DID to become more comfortable with certain emotions that have been problematic for them, and to improve their personal relationships that may have been suffering. The development of crisis-prevention and management techniques is also a usual goal to deal with blackouts and lapses in memory.
Hypnosis – This is sometimes used to create some kind of communication between the various identities within the patient, increasing the knowledge they have about themselves and their condition and enabling an increase in control over the transition between identities and over the identities themselves.
Electroconvulsive therapy – This procedure is done under anesthesia, so the patient does not feel pain. An electrical current is passed through the brain, causing a controlled seizure lasting between 60 and 90 seconds. The seizure creates a massive release of neurochemicals that fight depression. This treatment is typically resorted to only if anti-depressants are not working and the patient is in danger of committing suicide or hurting themselves or others, which is a risk with DID sufferers.

The overall prognosis for most people who have DID is fair, given the proper treatments, but if left untreated, these people will often become alcoholics or turn to other addictive substances. They may also attempt suicide or exhibit violent behavior toward others. At best, they will likely experience a lower quality of life in several respects, including difficulties in maintaining jobs and relationships.

PsychologyDegree.net

Psychology Degree Resources

Contact Us

Psychology Degree Guide: Dissociative Identity Disorder

Definition, Diagnosis and Causes

Symptoms

Treating DID

Further Reading