|Posted on July 5, 2012 at 9:00 AM|
[Please note: Any case studies/people which may be mentioned in this blog are composites (unless otherwise indicated) of personal and professional experience over 25 years of people-helping in a number of different capacities and circumstances. Resemblance to any specific individual, living or dead, is purely coincidental and totally unintentional.]
Dissociative Identity Disorder (DID) is the proper term for what people generally call "multiple personalities." The myths and misunderstandings around this disorder confuse, and in some cases, create a sense of fear or stigma. This situation is not helped by Hollywood, which has produced such gems as The Three Faces of Eve and other such sensationalized fiction. Indeed, in the TV movie Sybil (Sally Field, 1976), the main character suffers such harrowing trauma throughout her childhood that she develops thirteen distinct personalities.
In its severest form, DID is a case of more than one "alter" in the same body. Each alter exists in the time period in which it was created, thus appearing to be a discrete personality. For example, someone with DID may have an alter who is the age at which the abuse began, i.e., 5 years old. Or one of the alters may be the 'executive' alter - aware of all the other alters and whose job it is to manage the internal process of self-protection. This disorder typically has its roots in severe childhood trauma and is a mechanism triggered by the psyche as a self-protective coping strategy. The client is often completely unaware of these protective alters, nor of the periods of time in which they are predominant. The dissociative state allows the child to endure harsh, traumatic, and/or painful experiences over which s/he has no control. (Good case study HERE) DID is usually a consequence of complex trauma experienced in childhood. The severity of the impact of the trauma is related to a number of factors including shock at onset, identity of victimizer, degree of pain/torture, loss of control, duration, and level of violence.
It is generally accepted that DID results from extreme and repeated trauma that occurs during important periods of development during childhood. The trauma often involves severe emotional, physical or sexual abuse, but also might be linked to a natural disaster or war. An important early loss, such as the loss of a parent, also might be a factor in the development of DID. In order to survive extreme stress, the person separates the thoughts, feelings and memories associated with traumatic experiences from their usual level of conscious awareness. (Cleveland Clinic) For 1 - 3% of adults, the created alters become the primary way of coping with life.
There are degrees of dissociation which do not include the formation of alters, and don't necessarily indicate the presence of the disorder. The mind is capable of cognitive tasks (one thing at a time) and associative tasks (multiple levels of thinking while performing a routine task). This is demonstrated by the difference between attempting something new, and doing something of long habit. When you decide to learn to golf, your mind is bent to the task of monitoring the process of learning. Your stance, your swing, your hips, follow through, etc. On the other hand, when you do the dishes, you can do the entire task and have your mind elsewhere the whole time; making 'To Do' lists, thinking about what to have for dinner, recalling the work day etc. You do not need your mind to do dishes. Or, have you ever turned into your driveway and you can't recall anything about the trip home? Or you've suddenly re-focused on your driving and you're not exactly sure where you are in the trip home? You have to find a familiar landmark to re-orient yourself. This is a form of dissociation.
Treatment of DID is similar to treating Borderline Personality Disorder (BPD). The paramount concern is to provide containment and safety. People with DID are a high-risk population, much more likely to experience:
Repeated victimization by others.
Treatment begins by focusing on crisis prevention, symptom management, and emotional regulation. Treatment is almost always provided by a team comprising a psychiatrist, a specially trained psychologist, a medical doctor, and the client. Eventually, when there is a trust relationship established between the client and the psychologist, therapy will begin to focus on the work of integrating the alters. This is a difficult and painful process for the client and requires the utmost care by the clinician, but DID is not a life sentence. Like any other chronic mental health disorder, with proper, effective treatment, life has the potential to be everything it could be.
For factual, helpful information about this disorder, check out these knowledgeable professionals. For help in Kuwait, you can call the Soor Center (2290-1677) or check us out online (www.soorcenter.com).