Methods Of Treatment The Dissociative Identity Disorder

The complex disorder when a single individual has two or more personalities within themselves is known as dissociative identity disorder (DID). Victims of this disorder have alternate personalities that are also called subpersonalities, this means that a single individual has two or more personalities within themselves. Alternate personalities are never the same, as they can vary from different genders and the way they act and dress, they also may enjoy different activities and have different hobbies, morals, and their handwriting can even be different (Murray, 1994). The switch between one identity to the next may be random and unexpected, affecting family and friend relationships. With the amount of cases increasing in DID since 1970, a lot of new information was released about the disorder since then.

It was found that each personality may be a fully integrated and complex unit with memories, behavior patterns, and social relationships that determine the nature of the individual’s action when that personality is dominant. Since alternative have their own memory, they respond to stimuli differently from other alternatives (Apter, 2008). In an investigation done on a woman who had ten personalities, three of those 10 personalities learned off of the others (Murray, 1994). In another investigation, two researchers named Thigpen and Cleckley studied the differences in allergic reactions in the different alternatives. They used galvanometers and kymographs to identify the physiological changes in the different alternatives. Thigpen and Cleckley showed the major differences in subpersonalities in their research and also proved that they can vary in which hand they write with, prescriptions for glasses and can have different allergies (Murray, 1994). The important findings of these investigations showed how unique each alter is from one another, they are their own person.

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Alters have been seen as a type of defense mechanism in DID subjects, as it helps them cope with their reality. People with DID may have experienced trauma in their childhood years, usually sexual abuse. Murray included a report made by Ross in 1991, which concluded that 90% of people diagnosed with DID had experienced physical and/or sexual abuse in their childhood (1994). Having different identities can be a way to allow the person to escape their reality. A significant amount of people who are abuse sexually or physically develop alternate personalities as a type of defense mechanism to protect themselves (Murray, 1994). Although the statistics may show a positive correlation between childhood trauma and the development of DID, this does not mean that every child that experiences abuse will be diagnosed with DID because this also depends on the child’s memory. There are no studies that show the direct correlation between childhood abuse and the development of DID or is there enough evidence that shows that children who were physically or sexually abused have a higher chance of developing DID than children who did not experience abuse (Murray, 1994). DID develops if the child is going through trauma when his or her personality is in the process of forming. This may lead to the child having imaginary friends, which is common among young kids and does not guarantee that they will have DID, but it can be a start. Erxleben and Cates talk about the Four Factor Theory that is a theorized address to how DID develops (Erxleben and Cates, 1991). First, the traumatized child has the ability to disconnect from their reality (Erxleben and Cates, 1991). Second, the traumatic experience or experiences overwhelm the child’s ability to respond to stress using internal resources that they already have (Erxleben and Cates, 1991). Third, the child displays dissociative splitting of the self into different identities (Erxleben and Cates, 1991). Personality formation continues quickly, although within the identities that have been made to protect them (Erxleben and Cates, 1991). Fourth, if the traumatic experience continues, overwhelming internal resources, the dissociative splitting action continues to grow, creating the potential for each part to develop into a discrete personality (Erxleben and Cates, 1991). Although, there are fewer reports on DID among younger children, this stage of their life when DID begins to form with a couple alternative personalities, but as they grow up that number increases.

Treatment for DID patients is only beneficial or active if they accept the therapy, rather than rejecting it. DID symptoms are usually hidden; therefore, keeping it secret is an important aspect to be considered while diagnosing and treating the DID subjects (Murray, 1994). Helping DID patients can come in many different forms of therapy. Therapists have used behavior therapy, psychodynamic therapy, hypnotherapy, and sodium amobarbital to help patients with DID (Murray, 1994). Although, these approaches may be a slow process, they are effective if the patient decides to follow through with them. Difficulties trying to get patients to cooperate do occur as many of the patients have trust issues due to past experiences and are afraid of their own disorder. Also, the understanding that having multiple personalities is a way for the patient to cope with their past experiences is important. A therapist’s failure to this understanding can lead the patient to more problems, such as self-destructive behavior, addiction, and/or eating disorders. In order to get the patient to cooperate, the therapist may assign instructions to the patients’ friends and family to slowly get the patient to open up. Hypnotherapy may be useful with alters that are more difficult. Hypnosis is useful towards those who usually reject help because it can allow the therapist to see “secret” identities, the only downfall is if not used correctly this can only make matters worse if not used correctly (Murray, 1994). Again, understanding plays a big role in therapy, as the patients also needs to be able to start to understand themselves throughout the process as well. If the patient is unable to understand and realize, it is not helpful because then the patient will not talk to the therapist about their symptoms or loss of memories (Murray, 1994). Hypnosis is only useful in therapy when it allows the patients understand and use the past and present for self-growth and understanding (Murray, 1994). However, more complications may occur if a less dominant alter is not ready to completely vanish from existence, this is a form of death to them. The alternative may help the host see the alters as a sort of community. When the host becomes accepting of their alter personalities, this may lead to the patient not wanting integration of their different identities because they no longer feel the need for it (Erxleben and Cates, 1991). A sense of community replaces earlier feelings of chaos and discontrol, further fostering communication and positive relationships (Erxleben and Cates, 1991). In the end, the process of treatments may be slow and require patience, the end goal is to help the MPD patients retrieve lost memory, be able to recognize their disorder, and eventually combine their subpersonalities into one.

The number of DID cases have increased in the past years, but there still is not enough cases to conclude the most effective treatment. Cases of DID in children is fairly low as may be less noticeable, leading to the formation of multiple alternate personalities for when they are older. Although the correlation between physical and/ or sexual abuse in one’s childhood and the development of DID is positive, it is not a guarantee that this is the official cause of DID. More research is required to say a patient diagnosed with DID is completely dependent on their childhood history of physical or sexual abuse (Murray, 1994). Official treatment of the disorder remains unknown, but not completely. There are methods out there that do seem effective, such as hypnosis. The role of hypnosis in treatment seems secure, but researchers must be cautious in drawing conclusions because they may alter the subjects’ memory (Murray, 1994).

References

1. Apter, A. (1991). The Problem of Who: Multiple personality, personal identity and the double brain. doi: 10.1080/09515089108573028
2. Erxleben, J. and Cates, J. (1991). Systemic Treatment of Multiple Personality: Response to a Chronic Disorder. American Journal of Psychotherapy, Vol. 45 (Issue 2), pp.269-278.
3. Murray, John B. (n.d). Demensions of multiple personality disorder. Journal of Genetic Psychology. Jun94, Vol. 155 (Issue 2), p233. 14p. doi:10.1080/00221325.1994.9914774