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Home >> Health >> Conditions >> Dissociative Identity Disorder
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Dissociative Identity Disorder

Research article kindly donated by Dr Khan
 
“Because…we’re the same person”, the famous line that twisted the whole plot of the 1999 hit blockbuster “Fight Club” awed many people including myself. For some reason, the thought of having two completely different identities still amazes me today. Dissociative Identity Disorder is a severe condition in which two or more distinct identities, or personality states, are present in -- and alternately take control of -- an individual. Although in the case of “Fight Club” the narrator’s disorder was a more severe case, in which both his identities had their own separate lives, the nature of Dissociative Identity Disorder (DID) for many cases shows only a few distinct characteristics, because the identities are not fully independent. That is the reason the name of the disorder was changed from “multiple personality disorder” to DID.

Now before we get into the fun waking conscious and legal issues in DID, let’s look at some statistics and causes of this disorder. Although Hollywood films portray the disorder for the subject to have two distinct personalities, the actual number reported by clinicians is closer to 15 with a female to male ratio of 9:1, these findings are based on accumulated case studies (Barlow & Durand, 2005). A large portion of patients diagnosed with DID are also diagnosed with other psychological disorders, to make this more clear, a sample of over 100 patients were found to have an average of seven additional disorders on top of the DID (Barlow & Durand, 2005). The cause of DID seems to be universal, in 97% of the cases, significant trauma was previously experienced. The patient was extremely and unspeakably abused as a child, usually sexually or physically, with 68% reporting incest. From experiencing such trauma, there is a wide-range agreement that DID is rooted in a natural tendency to escape or ‘dissociate’ from the unremitting negative affect associated with severe abuse.
 
Eric Eich did a research study in 1997 on nine patients with DID. What they were looking for was the relevance of interpersonal amnesia among the patients to see if memories of certain events experienced by one identity, could be recalled later by that same identity, but not the alters. The results further strengthened the reasoning for memory lapses in patients with DID, as the patients in the study after a test of free recall, did very poorly, where only one word out of 180 presented to a patients “p1” identity was properly recalled by their “p2” identity. In addition, none of the 180 words were recalled when they were initially given to the “p2” and asked for recall by the “p1”. 
 
Although their study did not employ all the possible ways of measuring interpersonal amnesia, their results are fairly consistent with other scientific findings on the subject, although one interesting finding in the study was that the “leakage” of information that occurs from one identity to the other depends on the extent to which encoding and retrieval processes are susceptible to personality-specific factors.
 
“Our normal waking consciousness builds us a model of the world, based on sense and body information, expectations, fantasy and crazy hopes, and other cognitive processes. If any of these factors is radically altered, an altered state of consciousness may result” (Ornstein, 1991). If we look at that quote and break down its meaning, it is clear then as to why so many victims of severe physical or sexual abuse may “dissociate” and form alter identities. If their “real” world is drastically destroyed, then they must form these “alters” to cope with their shattered world, in essence they create a stronger identity able to cope with the traumatic events of which the previous could not.
 
Treatment of DID however is very complex in it nature, mainly because you are trying to just down possibly hundreds of different identities. The best treatment for DID is definitely long-term psychotherapy, where a therapist must gather as much information on the subjects past and use mapping techniques to bring each identity together. Getting the subject’s history is particularly important, as the therapist must take extreme caution not to jump right into healing the past trauma without prior background knowledge. In treatment, the therapist wants to get to the threshold of moving toward a resolution, thus integrating the alters, essentially brining them together, working out the differences. Once the integration step is accomplished, it is downhill from there, now the therapist must focus on coping skills for the patient after his newfound resolution among his identities.
 
These are skills dealing with relationships and life decisions. Once the subject gets a feel for these coping skills, the therapist will want to solidify these skills, making sure the subject has mastered them and is able to use them as if they were automatic. Routine follow-ups are necessary obviously to make sure the subject continues to use the learned skills and does not relapse to the alter identities. Although this is a very effective method of treatment for DID, it is important to know every case if different and this method will not work on everyone with the disorder.

Published 15th Feb 2010

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