Dissociative Identity Disorder (Multiple Personality)

[David Baxter PhD]

Dissociative Identity Disorder (NAMI)
(formerly Multiple Personality Disorder)

Dissociative Identity Disorder (DID), previously referred to as multiple personality disorder (MPD), is a dissociative disorder involving a disturbance of identity in which two or more separate and distinct personality states (or identities) control the individual's behavior at different times. When under the control of one identity, the person is usually unable to remember some of the events that occurred while other personalities were in control. The different identities, referred to as alters, may exhibit differences in speech, mannerisms, attitudes, thoughts, and gender orientation. The alters may even differ in "physical" properties such as allergies, right-or-left handedness, or the need for eyeglass prescriptions. These differences between alters are often quite striking.

The person with DID may have as few as two alters, or as many as 100. The average number is about 10. Often alters are stable over time, continuing to play specific roles in the person's life for years. Some alters may harbor aggressive tendencies, directed toward individuals in the person's environment, or toward other alters within the person.

At the time that a person with DID first seeks professional help, he or she is usually not aware of the condition. A very common complaint in people with DID is episodes of amnesia, or time loss. These individuals may be unable to remember events in all or part of a proceeding time period. They may repeatedly encounter unfamiliar people who claim to know them, find themselves somewhere without knowing how they got there, or find items that they don't remember purchasing among their possessions.

Often people with DID are depressed or even suicidal, and self-mutilation is common in this group. Approximately one-third of patients complain of auditory or visual hallucinations. It is common for these patients to complain that they hear voices within their head.

Treatment for DID consists primarily of psychotherapy with hypnosis. The therapist seeks to make contact with as many alters as possible and to understand their roles and functions in the patient's life. In particular, the therapist seeks to form an effective relationship with any personalities that are responsible for violent or self-destructive behavior, and to curb this behavior. The therapist seeks to establish communication among the personality states and to find ones that have memories of traumatic events in the patient's past. The goal of the therapist is to enable the patient to achieve breakdown of the patient's separate identities and their unification into a single identity.

Retrieving and dealing with memories of trauma is important for the person with DID, because this disorder is believed to be caused by physical or sexual abuse in childhood. Young children have a pronounced ability to dissociate, and it is believed that those who are abused may learn to use dissociation as a defense. In effect, the child slips into a state of mind in which it seems that the abuse is not really occurring to him or her, but to somebody else. In time, such a child may begin to split off alter identities. Research has shown that the average age for the initial development of alters is 5.9 years.

Children with DID have a great variety of symptoms, including depressive tendencies, anxiety, conduct problems, episodes of amnesia, difficulty paying attention in school, and hallucinations. Often these children are misdiagnosed as having schizophrenia. By the time the child reaches adolescence, it is less difficult for a mental health professional to recognize the symptoms and make a diagnosis of DID.

 

[Allegro]

The goal of the therapist is to enable the patient to achieve breakdown of the patient's separate identities and their unification into a single identity.

David, I know this has been the prevailing opinion for successful treatment of DID, but I must say that I vehemently disaggree. Way back when Dr. L. and I first discovered the presence of others within my body, we both thought that "Integration" was the only treatment option. Try to make life better by pulling each and every person's different personality structure into one amalgamation.

But after a few months, we discovered that each person considered themself a whole and complete individual and were quite appalled at the notion of "disappearing" inside of "me." Each person had a specific role and performed a necessary function. Some of those functions were outdated and unnecessary, but that did not make that person unnecessary. Actually, they were introduced to new functions and found a new role for their lives.

I have to also say that the notion of integration became extremely unsavory when the discovery was made that "I", the person who had married, had children, become a writer and artist, was actually someone who was made when the body was around age four or five, and that the person who made her and all of the others was actually someone who spent the majority of her life hiding inside away from the world she had "run away" from to begin with. It was shocking, I'll tell you. It took Dr. L. a long time to convince me that I was not just a figment of someone's imagination, that I was, in fact, a very real person. That everyone inside was each a very real person.

I can't say whether choosing not to integrate was a better treatment option because I have never met anyone who has be successfully integrated. Dr. L. says that he has met people who were integrated, but they were no better than they were prior to therapeutic intervention. Maybe sharing a body with seventeen people is an unusual way to live, but I have learned to love each and every one of those people, and not just for the sacrafices they made in order to keep the body alive, but for how wonderfully unique and beautiful each of them are.

Were I to give any advice to someone who had just learned they had DID, my best advice I think I could give would be to become their own parent, learn as much as possible about each personality, especially learn to respect what each of them did for the whole, and to learn how to love and admire each one individually. At some point in the past, a very small and helpless person decided to survive. That took a tremendous amount of bravery and wisdom. That deserves respect.

 

[comfortzone]

Allegro,

I believe that there is still an integration that takes place but not in the sense of one personality. The personalities are all important and have their purpose. But the person needs to have the personalities working in unison for resolution. There is no destruction or getting rid of a personality in the process of integration but rather a "group" effort of sharing the responibilities of life. The therapist needs to work with each personality to obtain a unified individual (whose individual personalities work as one individual).

 

[Allegro]

Well said, Dr. Dobson. Yes, working together, finding common goals, letting no one be left behind, giving each person a job that is satisfying and healthy,...all of this is absolutely critical to growth and healing.

Something that you might find interesting: Dr. L. and I rarely discuss anything from memories unless someone inside wishes to discuss it. We spend most of our time on what is happening today. It has always been this way.

One thing we have never done: we have never gone fishing for memories. Neither Dr. L. nor any of us had any desire to go hunting for the terrifying memories. If one popped up, we tackled it then. Otherwise, we concentrated on being happy, and ways to increase happiness.