There is some support for "the notion that persons with DID consciously redefine their perceptions of the environment when this environment starts to become unpleasant and intrusive. In this process the individual seems to change point-of-view on demand and is able to alter his or her experience in the situation by rerouting the perception of the stimuli observed" (Dale, 2008)
While there may not be a single best approach to treating people with DID, there are established treatments that have been proven effective. Many patients with DID may exhibit symptoms that might require hospitalization, including: "severe acting-out, overt psychosis, or situations involving a danger to self or others" (Elmore, 2000)
Dissociative identity disorder (DID), or as it has previously been known and is still referred to in popular culture, multiple personality disorder (MPD), may be one of the most misunderstood and controversial of all psychiatric diagnoses. DID is characterized by the presence of two or more personality states or identities in a single person (Gentile et al
In fact, in the early 1990, some researchers concluded that DID and borderline personality disorder were essentially the same, suggesting that DID was merely a subtype of the broader borderline personality disorder diagnosis. This led them to conclude that, because DID was not distinguishable and diagnosable by set standards, it was not a stand-alone diagnosis (Gillig, 2009)
used a concealed information task to assess recognition of autobiographic details in an identity of a patient with DID, which was supposed to be an amnesic identity. What they discovered was the patients did subjectively report amnesia for autobiographical details that were present in the task, there was a transfer of information between the identities (Huntjens et al
However, the reality is that life is threatening and a process that begins as an adaptive way to dissociate during childhood trauma, particularly childhood sexual abuse, can transform into a problem that keeps the person from being fully integrated. As a result, people with DID may report four main psychiatric symptoms: depersonalization, derealization, amnesia, and identity confusion (Johnson, 2012)
, 2013). Unfortunately, comorbidities can contribute to patient instability in patients with DID, making them more treatment-resistant (Lakshmanan et al
" When asked to write the sentence again, she wrote the same sentence in the same direction as fluidly as she had done before. She later reported that she was normally right handed (Le et al
, 2012). The fantasy view of DID suggests that DID is a syndrome that "consists of rule-governed and goal-directed experiences and displays of multiple role enactments that have been created, legitimized, and maintained by social reinforcement" (Lilienfeld et al
The reason is it important to understand that the diagnosis is controversial is that any healthcare provider who is presented with a patient that exhibits the symptoms of DID must consider DID as a possible diagnosis, even if the patient has an extensive history of psychiatric care because there is such a high probability of misdiagnosis. Moreover, it is critical to recognize that the reticence to recognize DID as a disorder appears to be unfounded; in patients with DID, researchers have noted "important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states" which could not be simulated by either high or low fantasy prone controls without DID (Reinders et al
Moreover, those who believe that DID is related to fantasy may even go so far as suggesting that it is not actually a disorder. While the etiology of DID is not fully understood, it is believed that "severe and chronic dissociative symptoms tend to develop in the context of severe and chronic childhood traumatization, which includes profound attachment disruptions" (Schlumpf et al
, 2013). This fact is backed up by studies that have found that psychiatric patients with DD are almost three times as likely to report childhood abuse than psychiatric patients without DD (Yu et al
The secondary personalities are often childlike, disparate from the primary personality, or may be a different gender and age from the person with the disorder (Ross, 2006). The prevalence of DID is hotly debated with one extreme believing it is very rare and the other believing it is enormously underdiagnosed (Gleaves, May, & Carden, 2001)
Prior to 1800 persons afflicted with DID were likely considered to be possessed (APA, 2000). The American psychiatrist Benjamin Rush provided a clinical description of DID (Kluft
Prior to 1800 persons afflicted with DID were likely considered to be possessed (APA, 2000). The American psychiatrist Benjamin Rush provided a clinical description of DID (Kluft
, dementia). The primary personality (the one that is the original personality) is often not aware of the existence of the other personalities (Ross, 2006)
In psychiatry, according to standard American textbooks in clinical psychology, Dissociative Identity Disorder is a psychological condition characterized by the use of dissociation as a primary defense mechanism. A chronic reliance on dissociation as a means of defending against stressors in the environment causes the individual to experience their psyche/identity as disconnected or split into distinct parts (Grohol, 2005)
Autobiographical memory deficits are also experimentally evident in DID. Although no experimental studies have addressed the issue of source amnesia or pseudomemories, there is some evidence that pseudomemories are an infrequent and real phenomenon in DID patients (Dorahi, 2001)
DID personalities therefore tend to live completely different lives, including cognitively. The book "Sybil" was published in 1973 by the professional author Flora Schreiber, in collaboration with the psychiatrist Cornelia Wilbur, which described a patient who was alleged to have DID (Lynn and Deming 289)
In contrast to Sybil, Chris Sizemore, or "Eve," represents a validated case of DID. The disturbing events that triggered the first dissociative episode are known to the patient and diagnosis depended first on the presence of amnesia (Sizemore and Huber)