File Name: understanding and treating dissociative identity disorder .zip
- Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder
- Psychodynamic Psychotherapy of Dissociative Identity Disorder
- What Are Dissociative Disorders?
Dissociative disorders as described by ICD 10 include a range of disorders and combine what are conversion disorders assumed under somatoform disorders in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the cluster of dissociative disorders. The mutual idea shared by these disorders is a partial or complete loss of usual integration between memories, cognizance of identity, and immediate sensations and voluntary control of body movements. Conversion occurs when there are clinical symptoms representing alteration of functioning of motor or sensory systems and which do not follow a pattern of a known neurological or medical disease. Dissociation is a mechanism that allows the mind to compartmentalize certain memories or thoughts from normal consciousness. These split-off mental contents are available and may return to consciousness either by an event or spontaneously.
Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder
This is a normal process that everyone has experienced. During a traumatic experience such as an accident, disaster or crime victimization, dissociation can help a person tolerate what might otherwise be too difficult to bear. In situations like these, a person may dissociate the memory of the place, circumstances or feelings about of the overwhelming event, mentally escaping from the fear, pain and horror.
This may make it difficult to later remember the details of the experience, as reported by many disaster and accident survivors. Dissociative identity disorder was previously referred to as multiple personality disorder. In addition, the disturbance must not be a normal part of a broadly accepted cultural or religious practice.
As noted in the DSM-5 1 , in many cultures around the world, experiences of being possessed are a normal part of spiritual practice and are not dissociative disorders. The attitude and personal preferences for example, about food, activities, clothes of a person with dissociative identity disorder may suddenly shift and then shift back.
The identities happen involuntarily and are unwanted and cause distress. People with dissociative identity disorder may feel that they have suddenly become observers of their own speech and actions, or their bodies may feel different e.
It is important to keep in mind that although these alternate states may feel or appear to be very different, they are all manifestations of a single, whole person. For people with dissociative identity disorder, the extent of problems functioning can vary widely, from minimal to significant problems. People often try to minimize the impact of their symptoms. People who have experienced physical and sexual abuse in childhood are at increased risk of dissociative identity disorder.
The vast majority of people who develop dissociative disorders have experienced repetitive, overwhelming trauma in childhood. Among people with dissociative identity disorder in the United States, Canada and Europe, about 90 percent had been the victims of childhood abuse and neglect. Suicide attempts and other self-injurious behavior are common among people with dissociative identity disorder. More than 70 percent of outpatients with dissociative identity disorder have attempted suicide.
With appropriate treatment, many people are successful in addressing the major symptoms of dissociative identity disorder and improving their ability to function and live a productive, fulfilling life. Treatment typically involves psychotherapy. Therapy can help people gain control over the dissociative process and symptoms.
The goal of therapy is to help integrate the different elements of identity. Therapy may be intense and difficult as it involves remembering and coping with past traumatic experiences. Cognitive behavioral therapy and dialectical behavioral therapy are two commonly used types of therapy.
Hypnosis has also been found to be helpful in treatment of dissociative identity disorder. There are no medications to directly treat the symptoms of dissociative identity disorder. However, medication may be helpful in treating related conditions or symptoms, such as the use of antidepressants to treat symptoms of depression. During these altered experiences the person is aware of reality and that their experience is unusual. The experience is very distressful, even though the person may appear to be unreactive or lacking emotion.
Symptoms may begin in early childhood; the average age a person experiences the disorder is Dissociative amnesia involves not being able to recall information about oneself not normal forgetting. This amnesia is usually related to a traumatic or stressful event and may be:. Dissociative amnesia is associated with having experiences of childhood trauma, and particularly with experiences of emotional abuse and emotional neglect.
People may not be aware of their memory loss or may have only limited awareness. And people may minimize the importance of memory loss about a particular event or time. Both acute stress disorder and posttraumatic stress disorder PTSD may involve dissociative symptoms, such as amnesia and depersonalization or derealization.
View More. I agree. The distinct identities are accompanied by changes in behavior, memory and thinking. The signs and symptoms may be observed by others or reported by the individual. The symptoms cause significant distress or problems in social, occupational or other areas of functioning. Risk Factors and Suicide Risk People who have experienced physical and sexual abuse in childhood are at increased risk of dissociative identity disorder. People may feel as if they are outside their bodies and watching events happening to them.
People may feel as if things and people in the world around them are not real. Dissociative Amnesia Dissociative amnesia involves not being able to recall information about oneself not normal forgetting.
This amnesia is usually related to a traumatic or stressful event and may be: localized — unable to remember an event or period of time most common type selective — unable to remember a specific aspect of an event or some events within a period of time generalized — complete loss of identity and life history rare Dissociative amnesia is associated with having experiences of childhood trauma, and particularly with experiences of emotional abuse and emotional neglect.
Patient Stories: Dissociative Disorders Read patient stories about dissociative disorders and learn how to share your story.
Psychodynamic Psychotherapy of Dissociative Identity Disorder
Karen M. Am J Occup Ther ;47 10 — Adult persons with multiple personality disorder have survived a traumatic past. After diagnosis and the initiation of psychotherapy, they frequently face a long and arduous treatment process. During this time, intense emotions and memories are retrieved that can disrupt functional life skills in an already disjointed life. The stresses of life combine with therapeutic issues to perpetuate the dissociation that interrupts functional performance. The original traumas occurred when the child was functioning primarily at a sensorimotor level.
Diagnosis usually involves assessment of symptoms and ruling out any medical condition that could cause the symptoms. Testing and diagnosis often involves a referral to a mental health professional to determine your diagnosis. Dissociative disorders treatment may vary based on the type of disorder you have, but generally include psychotherapy and medication. Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional.
treatment of dissociative identity disorder (DID) and those forms of disso- entific knowledge and clinical experience specific to the diagnosis and treat- ment of.
What Are Dissociative Disorders?
Language: English Spanish French. Controversy about dissociation and the dissociative disorders DD has existed since the beginning of modern psychiatry and psychology. Almost no research or clinical data support this view. DD are common in general and clinical populations and represent a major underserved population with a substantial risk for suicidal and self-destructive behavior. Since first systematically described in the early 19 th century, dissociative disorders and dissociation have been entangled not only in professional debates, but in controversies within the social, political, and cultural Zeitgeist.
Handbook of Dissociation pp Cite as. The tools of psychodynamic therapy serve the purpose of bringing disparate elements of the psyche together. These tools originate from a model of the psyche that highlights the symptomatic properties of unresolved and unconscious conflicts, and the tools help to bring these conflicts to awareness so that the patient may confront them.