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It is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior, accompanied by the inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. The main causes of this disease are dissociation, traumatic experiences, especially severe childhood abuse. The patient creates another personality that did not suffer from abuse as a way to suppress the traumatic memories. Possible treatments for DID can include practices such as hypnosis, but the most common form of treatment is psychotherapy. Two treatments that seem to be most effective for DID are Draw-A-Person (DAP) test and Dissociative Disorders Psychotherapy Program.
The narrator attends support groups in an attempt to subdue his emotional state and relieve his insomniac state. When he meets Marla, his life seems to become a little more bearable. However, when he associates himself with Tyler, he is dragged into an underground fight club and soap-making scheme. Together the two men spiral out of control and engage in competitive rivalry for love and power. When the narrator is exposed to the hidden agenda of Tyler's fight club, he also founds out that they are actually one person. Since the narrator has insomnia and can't sleep, whenever he thinks he is (or at random parts of the day), Tyler's persona takes over.
In ‘Fight Club’, the narrator creates an alternative identity in the character of Tyler Durden. The main symptoms present in the movie are anxiety, insomnia, memory lapses, auditory hallucinations, and the inability to recall events. The narrator treats himself through consumerism, but it does not help. He uses his other identity as a defense mechanism to cope with his anxiety and feeling of entrapment. Tyler represents his urge to break free from the system. Nevertheless, some aspects of the disease are not very realistic: the use of violence to portray the disorder and the absence of any mention of the narrator’s past background (if he had childhood trauma, etc.).
The diagnosis of DID is difficult to identify and accurately distinguish, however, there are several ways to help diagnose the illness, according to Dr. Gary Peterson. First, inconsistency of the patient’s conscious mind could be the reflecting symptoms of fluctuating attentiveness, such as trance states or blackouts. Second, the forgetfulness of the patient’s autobiography paired with the inconsistencies in accessing the information, could mean an indication of a disruption in the processing of memory during early childhood development. Third, self-regulation difficulties may be reflected in the form of mood swings and behavior fluctuations. Fourth, a disorganization of the development of a consistent self may be reflected in the belief in the alternate self or imaginary acquaintances. And fifth, the subjective experience of dissociation from the physical body, as well as, the perception, may indicate derealization and depersonalization in the patient's psyche. These assessments demonstrate detachment of primary personality and a subsequent rise in sub-personality.
Smaller hippocampal volume has been reported in several stress-related psychiatric disorders. Some researchers examined hippocampal and amygdala volumes in patients with DID, a disorder that has been associated with a history of severe childhood trauma. Hippocampal volume was 19.2% smaller and amygdala volume was 31.6% smaller in the patients with DID, compared to the healthy subjects. In both animal and human studies, early stress has been shown to be associated with changes in the structure of the hippocampus, which plays a critical role in learning, memory, and stress regulation.
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