Dissociative Identity Disorder (Did) And Its Devastating Impacts Research Paper Example

Type of paper: Research Paper

Topic: Disorders, Psychology, Identity, Personality, Nursing, Trauma, Patient, Medicine

Pages: 8

Words: 2200

Published: 2020/10/09

Introduction 3

What is Dissociative Identity Disorder (DID)? 3
DSM-V classification system 4
The distinct personality states 4
Alternate personality/identity, dissociated personality/identity 4
Dissociated boundaries 4
Normal Personality States 5
Diagnostic criteria for dissociative identity disorder 5
Diagnostic Features 6
Causes and reasons for manifestations 7
Common Standard Treatment 8
Theological Concept 9
Conclusion 11

References 12

Dissociative Identity Disorder (DID) and its devastating impacts
Introduction
What is Dissociative Identity Disorder (DID)?
‘Dissociative Identity Disorder’ which we previously referred to as ‘Multiple Personality Disorder’, is a Dissociative Disorder in which, two or more personalities control the thoughts and actions of a single individual at different times. The different identities which we describe using the term ‘alters’ may exhibit differences in speech; the reactions to different circumstances and in their thought processes. ‘Dissociative Disorders’ on the other hand are mental conditions that affect an individual’s sense of reality. These disorders alter the way in which the individual perceives the world around them and their own identity.
People have different facets to their personalities; like assertive, angry or comforting, but in an individual who suffers from Dissociative Identity Disorder, every characteristic is taken over by a separate part of identity rather than being represented by one single personality. It is often difficult when treating a patient to put a number to the personalities or ‘alters’ that reside within because many of these alters do not even make themselves known. Where these diseases take root is a matter that most of the psychiatrists and experts agree on. According to Dr. David Spiegel, who is a psychiatrist at the Stanford University, DID is a childhood disorder which stems from trauma and physical and psychological abuse suffered by a child and isn’t diagnosed until adulthood. “It’s a natural response to overwhelming repeated trauma,” says Spiegel. The matter of existence of DID has been under immense scrutiny, and the problem is still not accepted as a medical difficulty by many. Some cultures even regard the manifestation of this state as ‘spirit possession’.
DSM-V classification system
The distinct personality states
There are, however, a few different classifications to the Dissociative Identity Disorder. Which means that all cases of DID do not present themselves in the same manner rather; there are quite a few forms in which DID could manifest itself. These are enumerated below.
Alternate personality/identity, dissociated personality/identity
When a child suffers a trauma that he/she finds difficult to handle on their own, they create one Emotional Part of their personality. This happens because the single emotional part to the person cannot handle the traumatic effects of a certain incident so they create this another part which could aid with the burden of that disturbance. This emotional part then matures and leaks into the normal part of the personality which creates yet another Emotional Part and so, multiple personalities keep on forming.
Dissociated boundaries
The other type is the Dissociative disorder which takes root during the childhood and takes a strong hold through various episodes of child abuse and lack of secure attachment which eventually accumulates in a child an unresolved trauma. In this type of disorder, there is one distinct state which is the apparent normal part of the personality, and there are two or more Emotional parts. Individuals in this state of a DID are perfectly capable as a normal individual and use the Apparent Normal Part of the personality as a front. This disorder mostly exists through a person’s childhood and does not become evident until a person is in an extremely stressful situation, like prisoner of war or a kidnap victim.
Normal Personality States
The other two form of personalities does not have more than one distinct state, but this type of DID, which is the most complex is what we see in movies and books,,. There are two or more distinct states to a person’s personality which are all apparently normal parts. According to Onno van, der Hart, and Ellert Nijenhuis’s strong beliefs, this disorder makes itself apparent first during infancy, and then during the next phase of childhood when the brain is undergoing massive changes. The children create Emotional Parts to handle memories that apparently normal personalities cringe away from and the brain works to prevent the apparent emotional parts from experiencing this trauma. In these cases, the normal parts of a person’s personality appear to be the entities that are in control, but the reality is far from it.
Diagnostic criteria for dissociative identity disorder
DSM-5 has provided us with criteria to help us diagnose Dissociative Identity Disorder. It requires the presence of two or more personalities which could be identified by separate and unique entities with separate thought processes, perceptions, and relation styles. These personalities should also exhibit control over the individual, and the patient should also be experiencing gaps in memory. The symptoms also encompass extreme stress and dysfunctions in relationships and work and study routines. Drugs and other substances of medication as well as of abuse are also ruled out as possible suspects when diagnosing DIDs. The patient also experiences feelings of detachment from oneself and is vividly aware of the occurrence not being a part of reality. These symptoms do not become evident as part of other mental disorders like schizophrenia or a panic disorder which makes it that much easier to be detected. The patient is also seen to be unable to recall to recall details of everyday activities as well as the incident that is responsible for the trauma.
Diagnostic Features
When performing the diagnosis of DIDs, doctor first rule out physical conditions that exhibit the same symptoms as DID. These conditions include head injuries, brain injuries, side effects of medications and drug abuse or extreme stress and sleeplessness. It is also important to consider if the patient is suffering from lack of attention and for the same reason, is faking the symptoms and conditions.
After making sure that the patient has no physical complaint, the doctor proceeds to rule out psychotic disturbances including schizophrenia. If the doctors still suspect DID, a screening test known as the Dissociative Experiences Scale (DES) is carried out and on achieving a high score on this test, the patient is further evaluated through different interviews including Dissociative Disorders Interview Schedule (DDIS) and Structured Clinical Interview for Dissociative Disorders (SCID-D).
Causes and reasons for manifestations
According to Skinner (1953), we all possess the tendency to exhibit multiple personalities, which are brought on by a number of different situations that we in ourselves to be in. For instance, our behavior at a party is very different from how we react when we are in a church. These can be described as different aspects of our personality. In the case of Dissociative Identity Disorders, the differences in these personalities could be so profound that they do not remain a part of a single trait. Dissociative Disorders have commonly been attributed to the history to extremely high levels of stress which disrupts the regular functioning of a personality and also hinders the mental state of a person. In some cases, it is reasonably simple to pinpoint the reason or the origin of a trauma which commonly links back to psychologically-harsh events like sexual assault, physical assault or the death of a family member. . Incest and child abuse are two other events that later on mature into dissociative disorders of this classification. In some cases, however, there may even be a complete absence of a distinct traumatic event .
One form in which dissociative disorders may come to the surface is sleep disorders like sleepwalking and night terrors. These manifestations surface when the traumatic memories, feelings and experiences escape within the person’s sleep and try to take control of the mental defense mechanism. These sleep disorders are not however conclusive evidence to the existence of these personality disorders. The ramifications of DID also come forth in several other forms of suicidal tendencies, sexual dysfunction, Post-Traumatic Stress Disorder, eating disorders and severe headaches. There are also a few psychological impacts that come with the territory. People going through personality disorders are unable to keep their relationships and personal lives intact due to their ever-changing moods and behaviors. These people maintain isolations and avoid gathering and social functions, suffer immense decline in performance at work and school.
Common Standard Treatment
The treatment for Dissociative Identity Disorders lasts for a prolonged period of times and usually involves one-to-one psychotherapy. The frequency of these therapy sessions and their time duration relies greatly on the condition of the patient and the impact of this issue on the daily life of that patient. During these sessions, the psychiatrists focus on their relationships with their friends, spouse, family members and other people in their lives. These experts motivate and teach the victims of these psychological ordeals to coexist with the condition and to figure out ways to prevent the manifestations of alternative personalities. Other treatment methods make use of several different methods including cognitive-behavior therapy (CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR) and sensor motor psychotherapy. The treatment is usually carried out in three distinct stages; establishing safety and achieving symptom reduction, working through and integrating traumatic memories, and Integration and rehabilitation.
Experts also make use of drugs to minimize the effect of the disorders in the lives of a person, and in certain extreme cases, also to stop the sufferer from inflicting harm on him. They use anti-depressants including citalopram, venlafaxine, phenelzine, fluoxetine, and sertraline which quite effectively reduce depression and stress in the subjects. Some conditions of DID also call for anti-psychotic medication which effectively work as mood stabilizers. Patients who display anxiety are also prescribed anti-anxiety meds to cope with the stress of the trauma as well as in their lives.
Theological Concept
People who suffer through DID go through changes and struggles with their souls and emotions. Due to so many personalities existing in the head of a single person, the soul of the DID patient remains divided and because of the fugue states that these people live through, they are always faced with confusions, fear and frustration since their body is not in their own control anymore. The memories of the trauma in the subconscious mind of the person or in the conscious one evoke the feelings of shame, difficulty coping and induces the person to keep all personal information to oneself. The fearful memories that surface during the course of the disease erect a wall between the sufferer and the world where he/she endures in isolation and is faced with confusion, fear, and desperation. This is the main reason why patients take long times to open up to their therapists too.
Eventually, the person copes with his/her situation in many different ways. He/she does not forgive easily, does not let go of the hurt that he/she experienced during the trauma and also afterward. The therapy fails to achieve any results for a few months and in a few instances, also for years, and the patient tries desperately to take control of his/her life.
Even after all of the discussions and scrutiny on the disorder, it may still be hard to picture what patients are suffering from DID looks like. These reservations, however, are taken care of by the books printed and the movies made on the subject. After going through this material, we are able to understand and interpret in a better position the effects of the tribulation and how it could impact our lives. For this reason, let’s recount through two of very famous case studies which have passed through our attention more than once.
In 1957, our media came out with a motion picture titled ‘three faces of Eve’ which centered a woman named ‘Eve’. ‘Eve’ had harbored 22 personalities during her encounter with the disorder but of these 22 personalities, only three could exist at a single time. For a new personality to emerge in Eve, an old one had to die. Then in 1973 came a story of a woman named ‘Sybil’ published by Flora Rheta Schreiber, who had the liberty of working very closely with Sybil and her psychiatrist Dr. Cornelia B. Wilbur for about a decade. Throughout this period, a sum total of 16 personalities emerged from her. The interesting fact is that both these stories were based on real life case studies.
The doctors attributed the splitting of Eve’s personality to a series of traumatic events that she suffered through during her stay in the south at the time of the depression. In the midst of several soul racking events, Eve developed her first personality after she witnessed her mother slash her arm. She never described childhood abuse as a problem so the doctors attributed her condition to the anguish that was experienced by people around her. Sybil on the other hand had extreme abuse to blame for her condition. Sybil’s real name was later on discovered to be Shirley Mason, and she was an art student with sixteen different personalities that possessed different talents. The shocking incident, however, is that a number of these 16 personalities were also male.
Conclusion
Many may find it hard to believe, but a colossal number of people suffer from Dissociative Identity Disorders and these accounts for 10% of the total states population. . Despite the generous number of people who study and deal with patients on a regular basis, we still have the lot to understand about this anomaly before we could comprehend it properly and in great depth. Even when discussing the possible reasons for these disorders, we cannot list down all the possible causes and the different ways in which it could become evident. So it is important that we continue this research and tell our youngsters about the importance of coping with traumas and events that could come back and haunt them during the later part of their lives.
References
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David Spiegel, M. R. (2011). DISSOCIATIVE DISORDERS IN DSM-5. Depression and Anxiety, 824-852.
DissocativeIdentityDisorder.com. (n.d.). Structural dissociation of the personality. Retrieved from Dissociative Identity Disorder: http://www.dissociative-identity-disorder.net/wiki/Structural_dissociation
Encyclopedia of Mental Disorders. (n.d.). Dissociative identity disorder. Retrieved from http://www.minddisorders.com/Del-Fi/Dissociative-identity-disorder.html
Hartman, D. C. (2001). Is there a dissociative process in sleepwalking and night terrors? Retrieved from Pubmed: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1741968/?tool=pmcentrez
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Katherine Ramsland, R. K. (n.d.). Multiple Personalities: Crime and Defense. Retrieved from Crime Library: http://www.crimelibrary.com/criminal_mind/psychology/multiples/3.html
Kihlstorm, J. F. (2005). Dissociative Disorders. Annual Review of Clinical Psychology, p. 227.
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