Introduction
Daydreaming? Getting lost for a moment when doing a certain task? Being absorbed in one’s thoughts and forgetting the rest of the world for a moment? These are most common examples of what we call mild dissociation and it is just a normal experience for any person at some certain point. However dissociation that causes disruption in one’s life, this would be a time the dissociation is considered to be a disorder. Dissociative Identity Disorder (DID) is a disorder that is defined as the existence of more than one personality in a certain person or formerly called as Multiple Personality Disorder. DID is also considered by the American Psychiatric Association as one of the 4 main kinds of dissociative disorders (Kaplan, 1998). Persons having this disorder may have more than one personality from 2 to be the least and can be up to a hundred personalities (Dissociative Identity Disorder, 2000). Persons may be unaware that they already have the disorder but some seek help because of the symptoms that this disorder presents. Patients commonly complain of amnesia episodes that these individuals may not recall some events that took place. They may meet people who claim to know them but are unfamiliar to them, being in a place but could not remember how they reached that certain place or have things at home that they couldn’t even remember purchasing. These are just some of the signs and symptoms of the disorder but there are other existing manifestations that differentiate this disorder from other psychological disorders. During 1970’s there are only few cases of Dissociative Identity Disorder were reported but nowadays over 6,000 cases are reported every year (Madison, 2007). It was reported that among the general population there is an occurrence of.01% to 1% cases of Dissociative Identity Disorder. On the brighter side, this disorder, however complicated it may seem, has existing treatments. There are many ways that psychiatrists and psychologists deal with this disorder. As this disorder may be caused by a variety of reasons and every patient differs, the treatment and the approach may not be the same for each patient. Knowing more about Dissociative Identity Disorder may help in better understanding what the disorder really is.
Causes
The cause of Dissociative Identity Disorder (DID) is not fully understood but the reports usually show that it has a connection to some childhood trauma a person experienced. Persons with DID may also have the diagnosis of Post-Traumatic Stress Disorder (Stephens, 2008). Some research also indicated that a combination environmental and biological factors can cause DID. Almost 98-99% of person’s with DID have history of disturbances that are very traumatic and recurring that occurs before the age of 9 which is considered to be a sensitive developmental stage of a child (Dissociative Identity Disorder). Sexual and physical abuses among young children are the most common believed caused by DID this is because of their pronounced dissociation ability and that an abused child may learn dissociation as a form of defense (Dissociative Identity Disorder, 2000). Physiologically, this can be explained by the following: if a person is experiences very stressful events, a release of neurohormones is facilitated; these neurohormones are endogenous and stress-responsive and they are the following: cortisol, vasopressin, oxytocin, epinephrine and norepinephrine, and endogenous opiods. The release of the said neurohormones induces the release of glucose which in turn would activate the immune system that would enable the person to deal with stress. However, if the stress is chronic, such as a repetition of an abuse, be it sexual or physical, it may decrease the effectiveness of the said system. In a hypothesis, if this system is bombarded with chronic stress, a malfunction occurs at the negative feedback loop. Instead of the negative feedback working, the system would then start working in a positive feedback mode causing desensitization of the system causing a person to have an intense reaction to stress even with a small stimulus that can trigger it. This situation can cause exacerbation of the process of dissociation. In children, in order for them to cope with this extreme stress, they psychologically separate themselves to those experiences which are traumatic. The more frequent the abuse, the more the method becomes ingrained that may lead to impaired functioning (Kaplan, 1998).
Signs and Symptoms
A person with DID is showing the following signs and symptoms. Other than having more than one personality, a person with DID may also the have inability to remember personal information with distinct variations in memory that fluctuates as the person’s personality fluctuates as well. Each personality the person has would also have their own age, race or sex and may also have their own way of acting. The switching of the personalities a person may have may take just seconds up to weeks. Other than the multiple personality the person with DID may also have depression, self-destructive or aggressive behavior may be present, self mutilation is common, dependence, guilt, extreme mood swings, night terrors, insomnia or sleep walking, anxiety attacks, suicidal tendencies, passivity, substance abuse, compulsions accompanied by rituals, hallucinations (auditory being a common report) and eating disorders. The person with DID may also experience “amnesia, time loss, experiences which are said to be “out-of-the-body”, trances and headaches” (Dissociative Identity Disorder).
Diagnosing DID
Diagnosing a person with DID take time that may take up to seven years before an accurate diagnosis can be given. This is due to the similarities of the signs and symptoms have with the other psychiatric diagnoses. Anxiety, panic disorders or depression may also be diagnosed to people with DID. But in the “DSM-IV provided 4 criteria to be able to diagnose DID and these are the following: there is a presence of two or more distinct personality states that has its very own pattern of ones perception, relating to, and thinking about his or her environment and of self” (Dissociative Identity Disorder). Another is that the person’s behavior is controlled by at least two of these personalities recurrently. The third is that the person cannot recall important information about himself or herself that cannot be justified by just being forgetful and the fourth criterion is that the disturbance is not caused by direct physiological effects of substances such as alcohol or drugs and is not caused by a general medical condition (Dissociative Identity Disorder).
People who are prone to developing DID
Although what causes DID is not really well established, it has been believed that a combination of environmental and biological factors help explain the occurrence of DID. Almost 98-99% of those people with DID have history of abuse during their childhood years and that they have been experiencing these abuses not just once but recurrently (Dissociative Identity Disorder).
Treatment
However complicated the disorder may be there are treatments that are available for a person with DID. Treatment can be the use of hypnotherapy and nonverbal therapy. The commonly used method in treating a person with DID is hypnotherapy[y because it plays an important role in the memory retrieval. This is an effective tool in establishing communication between the other personalities and the therapist. In this process, the person’s pride may be a hindrance for convalescence. This therapy may be commonly used but this is accompanied with a danger that a person may believe in the fantasy world that he has while being hypnotized (Kaplan, 1998).
Another form of treatment is the nonverbal method which uses the therapy of art and play. In the art therapy, the most common technique is the House-Tree-Person technique. In this technique the person is made to draw a house, a tree, and a person in a white paper and this will be interpreted by the therapist. This would give the therapist an idea of how the person sees himself or herself and would give the therapist a baseline idea of what the person is and is used as a diagnostic technique (Art Therapy).
In play therapy, toys, games and paints are used to helps patients express how they feel, what they think, what they need and they wish. Rather than being questioned of what’s troubling them, they can express freely how they feel without the feeling of threat (What is Play Therapy). With these therapies the right side of the brain, which plays a role in creativity and imagination, is stimulated thus helping in bringing up the “sensorimotor and iconic” memories more readily (Kaplan, 1998).
Treatment is not limited to psychotherapy alone but is accompanied with pharmacological treatments. Although no specific drug can treat Dissociative Identity Disorder, antidepressants, drugs to treat anxiety or tranquilizers may be given to the patients to control the symptoms that accompany the disorder (Stephens, 2008).
Conclusion
Dissociative Identity Disorder is a psychological disorder that takes time to be diagnosed. The disorder is common to people who have been abused recurrently during their childhood years. Although the cause of the disease is not well established, it was believed to be caused by both biological and environmental factors. An extensive evaluation of what the person is going through is needed before it can be accurately diagnosed to be DID. The signs and symptoms of the disorder are very similar to other psychological diseases that makes it more difficult for DID to be diagnosed but with the criteria set in the DSM-IV, it helps differentiate DID from other psychological disorders. Treatment of the DID may also vary from each person but treatment may include psychotherapy, pharmacological treatment and other cognitive therapies. At this time where “cure” for DID is not yet available, it is only through long term treatment that succeeds with the committed cooperation from the patient. For as long as the patient is responsive to treatment, cooperative in whatever he has to go through during therapies and is willing to face the demons that he has been escaping, then there is a chance that a therapy is successful. A good therapist cannot help a patient who is not participative in his own therapy for it is the will of the patient that is needed for his or her convalescence.
Works Cited
Kaplan, Rachel (1998). Dissociative Identity Disorder. Web.
Madison, Kathleen (2007). Dissociative Identity Disorder (Multiple Identity Disorder). Web.
Stephens, Laura (2008). Dissociative Identity Disorder (Multiple Identity Disorder). Web.
Dissociative Identity Disorder (Multiple Identity Disorder).
Dissociative Identity Disorder (formerly Multiple Personality Disorder). (2000). Web.
Art Therapy. Web.
What is Play Therapy? Web.