Dissociative Identity Disorder

Joshua T. Toyer
Spring Arbor University
PSY100_FA20_E4 Introduction to Psychology
Audra Stinson
October 21st, 2020
 Dissociative Identity Disorder is described as "a mental process which produces a lack of

connection in a person's thoughts, memories, feelings, actions, or sense of identity. Dissociative

identity disorder is thought to stem from a combination of factors that may include trauma

experienced by the person with the disorder. The dissociative aspect is thought to be a coping

mechanism -- the person literally shuts off or dissociates himself from a situation or experience

that's too violent, traumatic, or painful to assimilate with his conscious self" (Bhandari, 2020, p

1). What this means in layman's terms is that sometimes, events occur that are too painful for one

person to process alone. Trauma of this nature is mainly linked to sustained emotional, physical,

and sexual abuse in their childhood, which causes a person to try and dissociate from their

situation. This typically takes the form of a personality that is removed from the current

traumatic situation; for instance, a person who is perceived to be "weak" creates a "strong"

persona in order to cope with the situation. It should also be noted that the "personalities" act

relatively independently of the other, with the personality that answers to the given name

typically not being aware of the other personality's existence. The patient also exhibits symptoms

of memory loss, having an inability to recall key personal information (such as the abuse

received in their childhoods), and the personalities recalling the same event differently. The

personalities may exhibit their own behaviors, speech patterns, gestures, and even age, sex, and

race. The process of one personality expressing itself over the other is known as "switching," and

can take place over a variety of times, from nearly instantaneous, to a period of a few months.

The typical treatment (which I will discuss at length later) involves reconciling the personalities

in order to unify them into one.

Dissociative Identity Disorder unfortunately does not affect a patient's family all that

much. Due to Dissociative Identity Disorder's origins of heavy, sustained abuse, it is unlikely
that the patient's family cared about what they were doing. At best, the family was ignorant of

the patient's situation and the abuse came from another source, but at worst, the family must be

removed from the patient's life immediately. For a patient's spouse or children, the disorder may

cause the patient to act more aggressively towards them, putting them at risk for abuse as well. In

addition, patients with Dissociative Identity Disorder are more at risk of inflicting self-harm or

committing suicide. A 25 year old soldier named Sandra was diagnosed with the disorder after

she was found with a deep cut in her thigh, caused by another facet of her personality called

"Mary." (Speigel, 2020)

The causes of Dissociative Personality Disorder are varied. To begin with, the

psychological factor of deep trauma caused by abuse is at play. Abuse victims are typically at

risk for many psychological diseases, so it is no coincidence that most patients with this disorder

have some kind of abuse related trauma in their past. For biological influences, a problem with

the individual's memory processes caused by the transition to adulthood may be an explanation

for how an individual's memory is compromised during this disorder (Kluft, 1996). As for socio

cultural influences, the obvious answer is that a lack of a supportive, affectionate family may

make someone more at risk, especially if their family is abusive in nature. This lack of support

may also explain dissociative individuals' increased risk for self-harm and suicide.

Specific pharmacological treatments for this disease are harder to come by than most other

psychological disorders. Due to Dissociative Identity Disorder's unconventional and unique

manifestation of multiple personalities, there exists no mass produced drugs to truly suppress the

disorder. However, focusing on other underlying trauma in the patient's life is normally

instrumental to the success of treatment (Bhandari, 2020, p 4) Due to this factor, it is

advantageous to use antidepressants in order to reduce the patient's risk for suicide or self harm,
as the antidepressants will reduce the levels of serotonin in the brain. The drugs operate by

prohibiting excess serotonin from being reabsorbed, thereby causing less serotonin to be in the

synapses. This will in turn cause the dissociative patient to be slightly less depressed; however,

the problem of the multiple personalities remains.

The best way to treat Dissociative Identity Disorder is through a humanistic method. The

best way is typical Psychotherapy, which talks the patient through their thoughts and actions to

achieve self improvement. In the case of an individual suffering from Dissociative Identity

Disorder, this takes the form of talking through their past, recognizing trauma, and convincing

the personalities to reconcile. The first step is to talk about the patient's past, learning about their

childhood, their situation, and the exact kind of abuse that the patient suffered. This may also

include talking to another personality contained within the patient, as the "active" personality

may have removed all memory of the trauma from their own memory. Once the trauma is

identified, the patient must then find a way to resolve the trauma in their own life. This may take

the form of confrontations, or just acknowledging the fact that they have been traumatized. Once

the patient is ready to deal with their situation, the created personalities will typically vanish,

leaving the initial personality in control. Another issue to consider while treating a patient with

Dissociative Identity Disorder is that they typically express symptoms of anxiety, depression, or

both. Therefore, it may be of use to treat dissociative individuals as if they were suffering from

one or both of those conditions.

The long term prognosis for one who has this disorder is not dissimilar from those with

depression or anxiety. If one of the constructed personalities is dangerous (to the patient or

others), then measures may be taken to protect others from the dissociative individual, but a

typical case may be resolved by simply talking it out. However, it should be noted that this
method is most effective on adult patients. In the case of children or adolescents diagnosed with

this disorder, "In contrast to a rather favourable initial treatment outcome long-term course of

juvenile dissociative disorder proves to be more serious with respect to psychiatric morbidity in

adulthood. Treatment strategies have to consider that in a significant portion of young patients

initial recovery may not be stable over time... the development of somatization, anxiety and

depressive symptoms should also be taken into account" (Jans, 2008). What this essentially

means is that while children or adolescents diagnosed with Dissociative Identity Disorder can be

treated, their recovery may not be as stable as an adult's recovery would be. This also may cause

patients to be at a higher risk for other mental disorders later in life. However, with a proper

support network, there is no guarantee that patients will manifest these psychological disorders

later in life. With the right precautions, these individuals will be able to lead relatively normal

lives.
References

Bhandari, S. (Ed.). (2020). Dissociative Identity Disorder. Retrieved October 21, 2020, from

https://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-

disorder?scrlybrkr=bac42cb3#4

Jans, T., Schneck-Seif, S., Weigand, T., Schneider, W., Ellgring, H., Wewetzer, C., &

Warnke, A. (2008, July 23). Long-term outcome and prognosis of dissociative disorder with

onset in childhood or adolescence. Retrieved October 21, 2020, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517058/

Kluft, R. (1996, January 01). Dissociative Identity Disorder. Retrieved October 21, 2020, from

https://link.springer.com/chapter/10.1007/978-1-4899-0310-5_16

Speigel, D. (2020). Patient Story: Dissociative Disorders. Retrieved October 21, 2020, from

https://www.psychiatry.org/patients-families/dissociative-disorders/patient-story