- Mental Health
Dissociative Identity Disorder, Multiple Personality Disorder, DDNOS, DID, MPD
What is Dissociative Identity Disorder? (D.I.D)
Dissociative Identity Disorder is also known as Multiple Personality Disorder. It is a mental disorder whereby a person has at least two distinct identities or dissociated personality states which alternately control a person's actions and behavior. During these periods, the individual commonly suffers from memory impairment which is not explained by ordinary forgetfulness. Often people with DID cannot remember their "switch" periods as their dissociated personality "takes over".
What Causes Dissociative Identity Disorder?
The cause of Dissociative Identity Disorder is not known, however, the symptoms are not seen to be caused by alcohol or drug abuse, seizures, imaginative play or other medical conditions.
Many diagnosed cases of Dissociative Disorders, including DID, have been seen to have experienced trauma and other forms of severe stress which have caused the individuals memory to dissociate. Alternatively, some medical professionals believe that DID is due to techniques employed by some therapists such as hypnosis and other unorthodox therapies - this theory is due to the recorded increase in dissociative disorder cases during the period where hypnosis and other alternative therapies were widely used and recommended.
How is Dissociative Identity Disorder Diagnosed?
Dissociative Identity Disorder is often difficult to diagnose due to the presence of one or more mental disorders along with DID. Mental health practitioners have to be wary of individuals deliberately producing or exaggerating symptoms, especially if help-seeking behaviour is evident or there is potential financial gain.
Due to the fact that there is no clear consensus on the diagnosis of Dissociative Identity Disorder, or any specific tests, the disease is one of the most controversial mental disorders in the medical community. Research has been undertaken on treatment effectiveness, however, each individual case is different and requires different treatment methods.
Mental health practitioners will conduct a mental health interview that gathers information on the presence of the signs and symptoms commonly seen in DID patients (outlined below). One way which Dissociation is commonly measured is by the Dissociative Experiences Scale. This scale looks at those symptoms seen to be present in the mental health interview and then looks at whether the person has the following diagnostic criteria:
- Two or more distinct personalities or identity states (each with its own individual way of thinking, perceiving, relating and acting to themselves and the world around them)
- At least two of the identities repeatedly take control of the persons behaviour
- Memory lapses and complete inability to recall important information, which cannot be explained by ordinary forgetfulness
- No presence of direct physiological effects such as substance abuse, general medical conditions, seizures, medication or imaginative play.
What are the Symptoms of Dissociative Identity Disorder?
There is no official definition of "dissociation", however, common symptoms seen in DID patients include:
- multiple personalities
- lapses in memory or attention
- fugue states
- pathological dissociative disorders
Dissociative Identity Disorder Treatment
Treatment is generally dependent on the individual case, however, there are many common components in treatment for Dissociative Identity Disorder such as:
Specifically improving the individuals relationship with others and working on experiencing feelings and emotions that they have not felt comfortable with or expressed in the past. Therapists need to be careful to not overwhelm the patient, causing further trauma and risking repetition of their traumatic past.
Mental health professionals will often guide their DID patients in allowing the different aspects of themselves to coexist and cooperate, developing crisis prevention techniques and finding ways in which the individual can cope with the memory lapses seen during dissociation.
Reintegration is the opposite of coexistence and looks at reintegrating the different aspects of the individuals personality into one identity state.This treatment method is controversial and patients often reject treatment, feeling that the medical professionals are trying to "kill" parts of their personality.
Whilst viewed by some medical professionals as a potential cause of Dissociative Disorders, hypnosis is sometimes used to help inform the individual with DID about their symptoms and different personality states in an effort to increase the control they have over those states as they change from one to another. It is believed that enhancing the communication between personalities will increase this control, however, this is yet to be proven or researched.
EMDR or Eye Movement Desensitization and Reprocessing, is a treatment method which is becoming more common in the treatment of people with Dissociative Identity Disorder. This treatment involves integrating traumatic experiences with the patient's own resources and has seen to benefit healing and information processing.
Medications are often prescribed to address the coexisting mental health conditions that DID sufferers tend to have. By reducing the level of depression, severe anxiety, anger and OCD behaviours, DID patients can potentially gain further control over their dissociation. The treatment of DID is controversial as the effects can cause the dissociative states to get worse or have the sufferer feel that they are being controlled or parts of them are being "killed", therefore further traumatizing them.
Dissociative Identity Disorder symptoms seem to vary over time and, in general, the prognosis for patients is poor.
Dissociative Identity Disorder in the Media
Dissociative Identity Disorder has been the star of many documentaries, books and biographies, as well as the inspiration behind many movies and TV series.
Some very cases of Dissociative Identity Disorder have been seen in:
A novel and two films which were a fictional version of the life story of psychiatric patient and commercial artist, Shirley Ardell Mason (known in both the book and films as Sybil Dorsett) who was said to have Dissociative Identity Disorder as a result of severe sexual abuse.
- Three Faces of Eve
An American film made from a case study of Corbett H. Thigpen and Hervey M. Cleckley on Chris Costner Sizemore, known as Eve White - a woman who suffered from DID. Eve had three distinct "alter" personalities.
- Kim Noble
Kim Noble's Dissociative Identity Disorder was made incredibly public with her interview on the Oprah Show in 2010. Kim has 20 main personalities and many fragments and, from the age of 14, spent 20 years in and out of hospital before being diagnosed with DID. Kim Noble (as her "alter" Patricia) has written her own autobiography, All of Me - Kim Noble which details different experiences of each of her "alters" and explains how she copes with day to day life.