Dissociative Identity Disorder
Dissociative Identity Disorder
Denise Eberhart
February 27, 2012
Intro to Community Mental Health
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Dissociative Identity Disorder
Abstract
The topic for this report is Dissociative Identity Disorder (DID). At one time, this disorder was
also known as Multiple Personality Disorder (MPD). This writer may refer using both
abbreviations as much of the controversy is about whether the classification holds much
difference in the ability to diagnose. Symptoms of this disorder will be explored. Treatment
approaches available will be addressed.
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Dissociative Identity Disorder
In this paper it is the writer’s intent to discuss Dissociative Identity Disorder (DID) and
Multiple Personality Disorder (MPD) as near the same. This writer became very interested in
Multiple Personality Disorder (MPD) years ago. Almost everyone has heard of MPD thanks to
Hollywood. The “Eve” and “Sybil” productions showed the world what the “disorder” looked
like and sensationalized an image of those who suffer from this disorder. However, those with
real psychosis and identity disorder are quite different as they struggle to maintain any shred of
normalcy or mundane life. From the movies and books one might assume that these lives will
end tragically but, is that really so? The answer lies in modern psychology. There has been and
continues to be much debate and perhaps some inaccuracies to diagnosis’ however, there is
sufficient evidence to support the theory that disassociation of identities really does exist for
some.
Let’s begin with the known symptoms, measurement techniques and the DVM-IV. Most
have experienced mild dissociation which is like daydreaming or getting lost in the moment
while working on a project. However, Dissociative Identity Disorder (DID) is a severe form of
dissociation; it is a mental process which produces a lack of connection in a person’s thoughts,
memories, feelings, actions or sense of identity. DID is thought to stem from experience(s) of
trauma. Then the person uses this disassociation as a coping mechanism. There is belief that
whatever traumatic experience occurred may have happened around age 7 or younger (Pica,
1999). This could be disputed as some believe the age range of 18 months to 18 years
determines the severity of the dissociative behavior patterns (Duddukuri, 2011). DID is
characterized by the presence of two or more distinct or split identities or personality states that
continually have power over the person’s behavior. There are several main ways in which the
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Dissociative Identity Disorder
psychological processes of Dissociative Identity Disorder change the way a person experiences
living. This would include the following

Depersonalization: This is a sense of being detached. Most closely described as “out of
body” feeling.

Derealization. This is the feeling that the world is not real or looking foggy or far away.

Amnesia. This is the failure to recall significant personal information too extensive to be
blamed on ordinary forgetfulness.

Identity confusion or identity alteration. Both of these involve a sense of confusion about
who a person is. An example might be when a person sometimes feels a thrill while
engaged in an activity (such as reckless driving, DUI, alcohol or drug abuse) which at
other times would be revolting. In addition to these apparent alterations, the person may
experience distortions in time, place, and situations.
While the causes of DID are still vague, research indicates that a combination of
environmental and biological factors work together. As many as 98-99% of individuals who
develop DID have recognized personal histories of recurring, overpowering, and often lifethreatening disturbances at a sensitive developmental stage of childhood. Evidence further
suggests insistent neglect or emotional abuse, even when there has been no overt physical or
sexual abuse can create this personality disturbance. Findings show that in families where
parents are frightening and unpredictable, the children may become dissociative (WebMd, 2012).
In the Diagnostic Statistical Manual third addition, this disorder was called Multiple
Personality Disorder. However, as discussed later in this paper, skepticism and some differences
in individuals changed the classification for DSM-IV (Dunn, 1992). In the manual the criteria to
diagnose is :
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Dissociative Identity Disorder
1. Two or more distinct identities of personality states are present each with its own
relatively enduring pattern of perceiving, relating to, and thinking about the
environment and self.
2. At least two of these identities or personality states recurrently take control of the
person’s behavior.
3. The person has an inability to recall important personal information that is too
extensive to be explained by ordinary forgetfulness.
4. The disturbance is not due to the direct physiological effects of a substance (such
as blackouts or chaotic behavior during alcohol intoxication) or a general medical
condition (such as complex partial seizures).
It is also known that most patients are women who have been diagnosed with other
disorders before being diagnosed with DID (Dunn, 1992). There are particalar personality traits
also linked to those who may be more likely to suffer from DID. These include fantasy
proneness, hypnotic susceptibility, absorption of information, depression, mood swings, sleep
disorders, suicidal tendencies, eating disorders , compulsions, abuse of drugs and alcohol,
anxiety and phobias. Many of these tendencies research also implies are more prone to women.
Some will overlap symptoms while others may seek medical attention for years with these other
ailments before a correct diagnosis is found. Not to be misunderstood, men are certainly
susceptible to DID as well, this writer found the information about women very interesting.
This brings us to treatment and also to controversy. DID treatment is done mostly
through psychoanalysis which helps to reveal the dissociative behavior of the patient and digs
deeper into the subconscious by dwelling on past, painful experiences. Catharsis (emotional
cleansing) is a tool used by the psychoanalyst to help the patient vent out his repressed feelings
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Dissociative Identity Disorder
and anger. The biggest challenge in the treatment is the identification of the disorder in the first
place. Borderline personality disorder can also be confused with DID due to the inadequacy of
the therapist. Sometimes the therapist can also instill the idea of dissociative personality into the
patient and encourage him to feign memories or alter personalities (Nathan, 2011). This is
perhaps the case of Shirley A. Mason (Sybil) as her psychiatrist used much intravenous drugs to
“bring out” personalities and recordings now show she often was suggestive in her sessions.
Miss Mason was at least addicted to the drugs and perhaps was shaped into the disorder.
Because of this skepticism many clinicians are reluctant to make this diagnosis. In addition to
borderline disorder, schizophrenia is often confused with DID. The differences may be subtle
but they are there. For example, with schizophrenia the patient speaks of “voices” from outside
his self. In DID the patients speak of their own voices or other personalities within themselves.
With the correct diagnosis, and a skilled psychoanalyst, there is hope for successful treatment.
In summary, the Dissociative Identity Disorder (DID) was discussed including the
definition and criteria for this diagnosis. Symptoms and tendencies were identified as well as
controversial opinions about the legitimacy of multiple personalities and dissociative behaviors.
DID can be mild and we all perhaps have experienced some sort of dissociation as a coping
mechanism. The classification was changed from Multiple Personality Disorder when it was
decided that Dissociation did not have to include multiple personalities as had been originally
thought. Some may dissociate emotionally, some physically and some using alter personalities.
All can be treated by knowledgeable, competent psychoanalysts.
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Dissociative Identity Disorder
References
(n.d.). Retrieved February 27, 2012, from WebMd: http://webmd.com/mental-health/dissociativeidentity-disorder
(2007). Retrieved February 27, 2012, from http://www.dissociation.com
Duddukuri, P. (2011, September 30). Multiple Personality Disorders. Retrieved February 25, 2012, from
http://www.buzzle.com
Dunn, G. (1992). Multiple Personality Disorder: A New Challenge for psychology. Professional
Psychology: Research and practice, , 23,18-23.
Nathan, D. (2011). Sybil Exposed. New York: Free Press.
Pica, M. (1999). The evolution of alter personality states in dissociative identity disorder. Psychotherapy:
Theory, Research, Practice, Training , 36,404-415.
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