Dissociative Identity Disorder

Atiya Mishra
 - Multiple personality disorder/
Split personality
What is Dissociative - Severe mental health condition
having 2 or more separate
Identity Disorder? -
personalities
Form of dissociation
- Produces lack of connection with
thoughts, memories, feelings,
actions and sense of identity
Symptoms
- 2 or more distinct identities
- “Core” is the usual personality. “Alter” are other personalities
- Identities can be of different genders, ethnicities, interests, ways of
interacting, mannerisms
- Inability to recall personal information that cannot be explained as
mere forgetfulness
- Dissociation- coping mechanism
Psychological Symptoms
● Anxiety
● Depression
● Memory loss/ Amnesia
● Disorientation
● Delusions/ Hallucinations
● Disconnections
● Identity confusion
● Internal voices
● Flashbacks (PTSD)
Behavioural Symptoms
● Impulsivity
● Self destructive
● Self harm
● Drug or alcohol abuse
● Changes in speech and behaviour
● Lying (unaware)
● Disordered eating
● Depersonalization (out of body)
Causes
● Physical, emotional or sexual abuse
● Loss of a loved one
● Prolonged illness
● Childhood abuse and neglect
● Experiences of child trafficking and prostitution
● Experiences of war or terrorism
● Dysfunctional family life
● Brain injury
Therapeutic Interventions

Psychotherapy
● talk therapy with a mental health professional is the first line of treatment
● Body movement therapy - release trauma thats held in the body
● Mindfulness and self awareness
● Coping methods to tolerate difficult emotions
● Trigger management
● Relationship support
● Cognitive Behavioural Therapy (CBT)
Medications
● No medication to directly treat DID
● Antidepressants
● Anti anxiety medication
● Antipssychotic medication to manage symptoms
Hospital Visits
● If self harm is severe
● Doctors can rule out underlying brain injury
● Group therapy settings
● Discuss medications
Self Help Strategies
● Balanced nutrition
● Daily movement - to boost mood, release tension
● Enough sleep for rest
● Meditation practice - studies show improved symptoms
 A four year old female child , Leigh,
was brought to therapy in December,
presenting with nightmares, complaints
of ear aches during sleep and clinging
behaviour. Leigh was first introduced
Case Study to the therapist by her stepmother,
behind whom she was hiding and
peeking and said “ No, my name is
Melissa”.
In her first few sessions Leigh was
responsive to the therapist and
answered questions easily. She asked
the therapist to read her a story and
would stay close to her.
In the first session her history was
taken from the father. When Leigh was
2 years old she had witnessed her
mother packing her bags and leaving
the house. After the legal divorce,
permanent custody was given to the
father. But after a few years the mother
wanted visitation rights which the
father agreed upon.
After a few visitations with her
biological mother, they noticed Leigh
having nightmares. In following
sessions the therapist asked about the
use of the name Melissa, the parents
reported that she had started calling
herself Melissa around 3 weeks ago
after meeting her biological mother.
In the following sessions Leigh asked
the therapist to call her Melissa. She
had visited her mother that weekend
and when questioned about the visit
she refused to respond (even to the
most simple questions). Although she
would talk about other people who
lived with her mother - her boyfriend
and 9 year old son, whom she was fond
of.

When her mother found out about
Leigh going to therapy she refused to
send her back home for a few weeks.
After which when Leigh returned and
went to therapy she would hide behind
her father and said she hated the
therapist. She told them that the
“WALL” had said the therapist is bad.
When questioned about the wall, Leigh
refused to answer. She would strike out
at the therapist repeatedly when
questioned about anything.
After around 3 months of going for therapy
Leigh started to develop a pattern of taking
pillows and building a wall in the corner of
the room. She would hide behind the
pillows and then jump out. After about a
week of this pillow ritual Leigh would
jump out and say “I want to pull your pants
down”. The therapist would say “ It is not
right for anyone to pull my pants down, and
it is not right for anyone to pull your pants
down, i wonder if someone is pulling your
pants down?”. For which Leigh replied
“Yes, my babysitter pulls my pants down”.
And therapist said “what happens next?”.
Leigh said “He goes to the bathroom”.
Therapist said “Who is he?”. Leigh just
turned around and played in the sand box.

The therapist asked the mother to come
in and found out that the 9 year old son
would often play with Leigh in a
locked room and refused to let adults
in.
Leigh had been going to therapy for a
long time and sometimes she would
come in angry and aggressive, or
passive and withdrawn, or happy and
playful.
One day Leigh was so angry that she pulled
the shoe off of her therapist and hurled it at
her, cutting the therapist. When her father
was brought in later, Leigh sat on his lap and
asked the therapist to read to her. As the
session was ending she looked at the
therapist and asked her how she got cut. The
therapist asked her if she knew who had
done this and Leigh said “yes”. The therapist
then asked her if it was her, and Leigh said
“NO”. Then the therapist asked “Who was
it?” And Leigh replied “She’s in the car”.
Conclusion

● Leigh was angry and aggressive

● Her alter personality, Melissa, was passive and withdrawn. She was
known to hide behind her father, be clingy and wanted to constantly be
close to her therapist.
● The pillow personality, a name which we dont have yet, is a personality
developed due to sexual abuse by the 9 year old son. She would hide
behind pillows, and jump out aggressively asking people to pull her
pants down.
Thank you!