Psychology
Dissociative Identity Disorder
Dissociative Identity Disorder (DID) is a complex psychological condition characterized by the presence of two or more distinct personality states or identities within an individual. These identities may have unique behaviors, memories, and mannerisms. Individuals with DID often experience gaps in memory and may struggle with a sense of identity and self. Treatment typically involves psychotherapy to integrate the different identities into a cohesive whole.
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12 Key excerpts on "Dissociative Identity Disorder"
- Michael B. First, Allan Tasman(Authors)
- 2013(Publication Date)
- Wiley(Publisher)
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behav- ior during alcohol intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Rev. Copyright 2000 American Psychiatric Association. Dissociative Identity Disorder (DID) is the most popular, widely discussed and recognized of the disso- ciative disorders. By definition, the disorder involves the “presence of two or more distinct identities or personal- ity states each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environ- ment and self.” These identities or personality states recurrently take control of the person’s behavior. Often amnesia is present: “Inability to recall important per- sonal information that is too extensive to be explained by ordinary forgetfulness.” DID can better be understood as a failure of integration of various aspects of identity and personality structure. This allows for different relation- ship styles (dependent versus assertive/aggressive) and mood states (depressed versus hostile) to be segregated with different identities and personal memories, which leaves patients mystified by events that occurred in another “state,” or by responses of others to them for behavior that occurred in a different “state.” As in most dissociative disorders, this degree of abnormal fragmentation of personality is often the sequelae of traumatic events in childhood. The devel- opment of dissociated experiences may be perceived by the patient as protective, allowing him or her to tolerate and partially evade the experience of chronic abuse.
eBook - PDFClinical Assessment Workbook
Balancing Strengths and Differential Diagnosis
- Elizabeth Pomeroy(Author)
- 2014(Publication Date)
- Cengage Learning EMEA(Publisher)
232 Disorders As a psychiatric term, dissociation refers to instances in which the normally integrated aspects of psychological and cognitive functioning (e.g., conscious-ness, memory, identity, perception, and motor control) are disrupted. More concretely, some aspects of an individual’s thoughts, feelings, or behaviors are not under his or her conscious awareness and/or control. It should be noted that dissociative symptoms often precede trauma and may occur in a number of other DSM-5 (APA, 2013) diagnoses, particularly in Acute or Posttraumatic Stress Disorders (ASD/PTSD). In the first and most complicated diagnosis in this section, Dissociative Identity Disorder (DID), there is a “disruption of identity characterized by two or more distinct personality states which may be described in some cultures as an experience of possession” (APA, 2013, p.292). This disturbance in identity manifests as changes in one’s sense of self, characteristic attributes, cognitive constructs, awareness, expected behaviors, and memories. In addition to the di-rect observation of alternate identities, the criterion now allows for self-report. There is an inability to recall personal information (ordinary and/or traumatic events) beyond normal forgetfulness while the client is in at least one of the distinct identities. The identity disturbance is not due to substance use or a general medical condition, and symptoms must cause clinically significant dis-tress and/or psychosocial impairment. Additionally, the disturbance in identity is not understood as a culturally accepted behavior or a religious practice, nor attributable to imaginary play in children (APA, 2013). Individuals impaired from this disorder are often ignorant of, perplexed and/ or embarrassed by their symptoms, often minimizing, concealing, and underreport-ing them.
eBook - PDFDealing with Anxiety and Related Disorders
Understanding, Coping, and Prevention
- Rudy Nydegger(Author)
- 2011(Publication Date)
- Praeger(Publisher)
Treatments for this type of disorder depend on the culture but may involve rubbing the body with special potions, attempting to change the person’s social circumstances, as well as physical restraint. It is also common to invoke certain ceremonies to appease the invading spirits and to drive them out or encourage them to abandon the possession. Dissociative Identity Disorder Dissociative Identity Disorder involves the presence of two or more dis- tinct personalities that represent very different ways of relating to other peo- ple and of perceiving the world around them. Historically, this fascinating and controversial disorder has been called Multiple Personality Disorder or Split Personality. The disorder is not related to Schizophrenia, although it is frequently confused with this condition in the media and is the subject of several books, movies, plays, and television shows. Historically, the term schizophrenia did not mean to infer that there is a split in a patient’s personal- Dissociative Disorders 177 ity or that multiple personalities or ego states develop. Rather, it explains that there is a split between cognition and affect, which means that a patient’s thinking and emotions do not seem to fit together. Although the entertainment media sometimes portray a character with an alternate personality being responsible for illegal or immoral acts (for ex- ample, Mr. Hyde), this is rarely the case. 33 The alternative personalities may be male or female, and each usually has a distinctly different way of talking, perceiving, and presenting him- or herself. DID can be found in children, although it is very rare; it usually emerges in teens and young adults. DID is rarely seen in people over the age of 40 and is found more frequently in women than in men.
eBook - PDF- Wood, Jeffrey C.(Authors)
- 2007(Publication Date)
- New Harbinger Publications(Publisher)
Often, these techniques can help recover lost memories and resolve conflicts that might have led to the memories’ original departure. Dissociative Identity Disorder What is it? Dissociative Identity Disorder is a problem characterized by severe splits in a person’s sense of self. 1 Formerly, Dissociative Identity Disorder was called “multiple personality disorder.” If you suffer from Dissociative Identity Disorder, you experience two or more distinct alternative personalities in your body that emerge at certain times. In reported cases, the number of personalities has ranged from two to over a hundred, but most people report ten or fewer. 1 Often, the appearance of these alternative personalities is triggered by stressful situations. 1 These alternative personalities are far different than the normal shifts in behavior a person makes to adapt to new situations in life. Usually, these alternative personalities have their own unique names, behaviors, memories, and traits. In addi- tion, the individual alternative personalities are often unaware of each other 32 and they’re also unaware of information learned by other personalities. 33, 34 It is often the case that the alternative personalities display behaviors that are far different than the original personality. For instance, perhaps one of the alternative personalities likes to go to parties and dance, while the original personality is more of a shy homebody. Even more puzzling, the alternative personalities sometimes insist that they are a different age, gender, race, or sexual orientation than the original personality. 35 If you’re suffering from Dissociative Identity Disorder, perhaps some of your friends have commented on your strange behavior. Maybe they’ve told you that you weren’t acting “like yourself,” or perhaps they told you stories about yourself that you think are impossible; stories you can’t remember, but which your friends can prove.
eBook - PDF- Alderman, Tracy(Authors)
- 1(Publication Date)
- New Harbinger Publications(Publisher)
C H A P T E R 1 What Is DID? As you read this first chapter, you will gain a better understanding of what Dissociative Identity Disorder (DID) actually is, as well as many of its symptoms. You will be able to complete activities which will help you determine if you have DID and understand how this might affect your life. You will also learn some basic information about DID and how it develops. By the end of this chapter you should have a better sense of the role DID plays in your life and the lives of others. Understanding DID Prior to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of Dissociative Identity Dis- order had been referred to as Multiple Personality Disorder. The renaming of this diagnosis has caused quite a bit of confusion among professionals and those who live with DID. Because dissociation describes the process by which DID begins to develop, rather than the actual outcome of this process (the formation of various personali- ties), this new term may be a bit unclear. We know that the diagnosis is DID and that DID is what people say we have. We’d just like to point out that words sometimes do not describe what we live with. For people like us, DID is just a step on the way to where we live—a place with many of us inside! We just want people who have little ones and bigger ones living inside to know that the title Dissociative Identity Disorder sounds like something other than how we see ourselves—we think it is about us having different personalities. Regardless of the term, it is clear that, in general, the different person- alities develop as a reaction to severe trauma. When the person disso- ciates, they leave their body to get away from the pain or trauma. When this defense is not strong enough to protect the person, differ- ent personalities emerge to handle the experience.
eBook - PDF- Thomas F. Oltmanns, Michele T. Martin(Authors)
- 2018(Publication Date)
- Wiley(Publisher)
These estimates occasionally reach preposterous numbers, with some clinicians claiming to see patients who have hundreds of per- sonalities. The dissociative disorders committee for DSM‐IV (APA, 1994) felt strongly that a dif- ferent approach should be encouraged. The chairperson of that committee explained that “there is a widespread misunderstanding of the essential psychopathology in this dissociative disorder, which is failure of integration of various aspects of identity, memory, and consciousness. The problem is not having more than one personality; it is having less than one personality” (Hacking, 1995, p. 18). For this reason, the name was changed, and it has been called Dissociative Identity Disorder since the publication of DSM‐IV. DID is a rare phenomenon. Prior to 1980, fewer than two or three hundred cases had been reported in the professional literature (Pope, Barry, Bodkin, & Hudson, 2006). This number is incredibly small compared to the millions of patients who suffer from disorders such as schizo- phrenia and depression at any point in time. Some investigators have suggested that DID appears more frequently than previously assumed (e.g., Ross, 1997; Sar, 2006), but these claims have 108 Dissociative Identity Disorder been disputed (e.g., Kihlstrom, 2005; Lynn, Fassler, Knox, & Lilienfeld, 2006). The prevalence of DID in the general population is almost certainly much less than 1 percent. DID has attracted considerable attention, partly because a few dramatic cases have received widespread publicity through popular books and films. These include The Three Faces of Eve (Thigpen & Cleckley, 1957) and Sybil (Schreiber, 1973). Sybil was one of the most famous cases in psychiatry during the 20th century; interest surrounding the book and the film fueled an enor- mous increase in interest in this fascinating phenomenon throughout the 1970s and 1980s. The authenticity of the Sybil case has been seriously questioned, however.
eBook - ePubSelecting Effective Treatments
A Comprehensive, Systematic Guide to Treating Mental Disorders
- Lourie W. Reichenberg, Linda Seligman(Authors)
- 2016(Publication Date)
- Wiley(Publisher)
Different causes have been proposed to explain the development of dissociative disorders. Since most people with this type of disorder have a history of childhood trauma or abuse, one theory posits a trauma-linked cause. Dissociative disorders are closely related to hysteria, and in many instances can be iatrogenic and exacerbated by suggestion, hypnosis, and social forces.Because the thalamus in the brain shuts down, traumatic memories are not recalled as a story, with beginning, middle, and end. Rather, the body stores isolated sensory impressions in images, sounds, and physical sensations that are mixed with intense emotions such as fear, terror, or helplessness (van der Kolk, 2014).Now we turn to a description of each of the dissociative disorders.Dissociative Identity Disorder (DID)
The DSM-5 criteria for DID requires the presence of two or more distinct personality states (termed possession in some cultures) that is observed or self-reported and that results in disruption or discontinuity in the sense of self, and is accompanied by changes in affect, behavior, cognition, perception, consciousness, memory, or sensory-motor functioning. The disruption in identity results in gaps in the recall of everyday events, personal information, and/or traumatic events that are inconsistent with ordinary forgetting. These gaps in memory cause distress in interpersonal relationships and at work. The symptoms are not the result of cultural or religious practices, or the result of substance use or another medical condition.The presence of two symptom clusters can be helpful in identifying DID:- Recurrent dissociative amnesias that manifest as gaps in personal life events (e.g., marriage, giving birth), lapses in dependable memory (e.g., how to drive, how to use a computer), and discovery in everyday life of unexplained items the person has no memory of acquiring (e.g., shopping bags, clothing). According to DSM-5
eBook - PDF- Timothy Brown, David Barlow(Authors)
- 2016(Publication Date)
- Cengage Learning EMEA(Publisher)
In DSM-5 , DID is included in a category referred to as the dissociative disorders, which are characterized by alterations in perceptions or a sense of detachment from one ’ s own self, from one ’ s world, or from memory processes. The most extreme form of dissociative disorder is DID, reflecting the fact that dissociation can be so extensive that whole new identities are formed. The two other major types of DSM-5 dissociative disorders are dissociative amnesia (extensive inability to recall important personal information, usually traumatic or stressful in nature) Dissociative Identity Disorder 111 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 and depersonalization/derealization disorder (persistent or recurrent feelings of unreality or detachment from one ’ s mind, self, body, or surroundings). In preceding editions of the DSM , dissociative fugue was included as a distinct dissociative disor-der diagnostic category; dissociative fugue is characterized by sudden, unexpected travel away from home or work, accompanied by an inability to recall one ’ s past and confusion about personal identity or the assumption of a new identity. In DSM-5 , dissociative fugue is no longer a separate diagnostic entity but is instead considered to be an accompanying feature of DID and dissociative amnesia. The nature and treatment of DID (referred to as “ multiple personality disor-der ” in earlier versions of the DSM ) are discussed in more detail in the next sec-tions of the case. Posttraumatic stress disorder, major depression, and borderline personality disorder are discussed in Cases 4, 9, and 15, respectively. However, note that Wendy ’ s borderline personality disorder was assigned with the qualifier “ provisional diagnosis. ” This qualifier is used when the features of the disorder are present but there is uncertainty about whether the formal criteria for the dis-order are met.
- Stephen F. Davis, William Buskist, Stephen F. Davis, William F. Buskist(Authors)
- 2007(Publication Date)
- SAGE Publications, Inc(Publisher)
271 81 D ISSOCIATIVE D ISORDERS C OOPER B. H OLMES Emporia State University I n this chapter, the focus is on a group of disorders that generates more controversy than any other diagnostic category, especially two of them: Dissociative Identity Disorder , more commonly known as multiple personal-ity disorder, and dissociative amnesia. Throughout this chapter I use the designations mental health field and mental health professionals rather than psychology and psychologists to reflect the wide diversity of professions involved in the controversy over these diagnoses, for example, psychiatry, social work, counseling, and, of course, psychology. The controversy is principally over the dramatic increase in the frequency of dissociative diag-noses since the 1970s, although some professionals also seriously question the legitimacy of these diagnoses. For example, some research indicates only about one fourth of psychiatrists believe multiple personalities are strongly supported by data. Thigpen and Cleckly (1984)—authors of The Three Faces of Eve (1957)—reported that of many thousands of cases referred to them they found only one genuine multiple personality. Even if one accepts the diag-noses, does the reported increase reflect a genuine rise in the rate of the disorders or is it a result of misdiagnosis? We examine both sides of this controversy subsequently in a separate section. The concept of dissociative disorders rests in the word itself. To dissociate is the opposite of associate; therefore, to dissociate is to separate. In this case, the separation refers to a separation within the person’s psychological makeup. A person with this disorder has separated some part of his or her psychological experience(s) from other aspects of psychological functioning. The amount of separated material may vary from relatively restricted to all encompassing.
eBook - ePubUnderstanding and Treating Dissociative Identity Disorder
A Relational Approach
- Elizabeth F. Howell(Author)
- 2011(Publication Date)
- Routledge(Publisher)
2001 ) noted: “Yet trauma-related disorders, including dissociative disorders, continue to be grossly underdiagnosed. This underrecognition can be best understood in light of the multiplicity of symptoms with which these patients present that may not be readily recognized as being related to their traumatic experiences” (p. 377).People with DID often do not know about their dissociative identities. Or, they may “sort of” know: They have an inkling, but they do not have the conceptual or emotional language yet to spell it out to themselves. Sometimes, if they do know, even sort of know, they may assume that everyone else is similar. Living in such a haze, people with DID often find it difficult even to think about, much less communicate about, their dissociative problems. Moreover, even when they know they have dissociative problems, they are often, for good reason, loath to reveal it: They fear being regarded as “crazy” and of being “put away.” They also fear they are crazy. As a result, the assessment must be conducted with great care and sensitivity.Diagnostic Constructs
Another contribution to the difficulties of accurate diagnosis has to do with our diagnostic constructs. There are two primary constructs: switching and intrusions/withdrawals of experience. However, both the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR
eBook - PDFBeware of the Other Side(s)
Multiple Personality Disorder and Dissociative Identity Disorder in American Fiction
- Heike Schwarz(Author)
- 2014(Publication Date)
- transcript Verlag(Publisher)
While even Morton Prince differentiated between acting, hypnotic states that are not em- 134 | B EWARE O F T HE O THER S IDE ( S ) bedded in a complex behavior of their own (Prince 1906: 4), Carter underlines her multiplicity model as also adaptable for role acting and the like: “In this state your behavior is an honest reflection of your inner self, and [...] therefore seems reasona-ble to describe it as the adoption of a different identity than an act” (Carter 2008: 15). These variations of multiple personality show a flexibility and construct of the syndrome. It can be embedded in heterogeneous contexts. It is in fact a “social con-struction”, as Acocella called it. Its liquidity perhaps explains its popularity especial-ly when connected to theories of postmodernism. In order to understand the wide-spread diagnosis and the successful adaptation of the multiple personality metaphor into popular culture, “the ‘social construction’ of mental illness– the fact that the forms mental illness takes (indeed, the very notion that there is such a thing as mental illness) are the product of shifting cultural assumptions – must be taken into the ac-count to explain the rise of MPD” (Acocella 1999: 28). The remains of multiple personality as Dissociative Identity Disorder is what Au-gust Piper and Harold Merskey called the “persistence of folly” (Piper and Merskey 2004). He pointed out that after the publication of “several critical articles and books, the concepts of dissociative amnesia and Dissociative Identity Disorder (DID) have suffered some significant wounds “so that by the end of the 1990s, the main dissocia-tive disorder organization, the International Society of Multiple Personality and Dis-sociation (ISSMP&D), had dissolved. The journal Dissociation published its last edi-tion in 1998” (Piper and Merskey 2004: 2).
eBook - PDFThe Disorders
Specialty Articles from the Encyclopedia of Mental Health
- Howard S. Friedman(Author)
- 2001(Publication Date)
- Academic Press(Publisher)
Some manifestations involve the use of different names, possession of knowl- edge or skills for which one cannot account, and the discovery of strange or unfamiliar personal items in one's possession. Identity alteration is often ac- companied by episodes of amnesia such that one has no recollection of the out-of-character behavior. It is quite developed in Dissociative Identity Disorder. Iden- tity alteration is an essential aspect of those forms of dissociative trance disorder in which another identity is enacted, and is the cardinal feature of Dissociative Identity Disorder. It is found in many cases of dissocia- tive fugue, and in many forms of dissociative disorder not otherwise specified that closely resemble dissocia- tive identity disorder. IV. DEPERSONALIZATIONDISORDER Although depersonalization is an extremely common experience and psychiatric symptom, it usually is en- countered in connection with other disorders, such as anxiety disorders in phobic patients with panic attacks and agoraphobia, depression, schizophrenia, borderline personality disorder, substance abuse (and withdrawal), seizure disorders (especially partial com- plex seizures), organic illness, and medication side ef- fects. Depersonalization is experienced transiently by many persons in connection with severe stress or dan- ger. Depersonalization Disorder itself is rarely diag- nosed, and has been little studied. Its diagnostic cri- teria are given in Table I. Depersonalization disorder is characterized by per- sistent or recurrent episodes of feeling of detachment Table I Diagnostic Criteria for Depersonalization Disorder A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream). B. During the depersonalization experience, reality testing re- mains intact.
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