Dissociative identity disorder (DID), formerly known as multiple personality disorder, is characterised by the development two or more distinct sub-personalities, which are called alters. These alters frequently take control of both the person’s consciousness and behaviour. Each of the alters generally exhibits behaviour patterns, memories and social relationships unique to the individual alter.
Dissociative identity disorder is estimated to affect between 1 in 500 and 1 in 5000 people. DID is four times more common in woman.
Characteristics of Dissociative Identity Disorder
In a lot of cases of DID, the primary personality of the person with the disorder is religious with very strong moral values. The sub-personalities, however, are usually radically different.
The sub-personalities may:
- Behave aggressively;
- Lack sexual inhibitions;
- Have a different gender;
- Have a different sexual orientation;
- Have a different religion;
- Differ in hand dominance;
- Differ in intelligence level; and
- Be a different age than the primary personality.
Often, the primary personality is unaware of the sub-personalities, and therefore may think that they are losing time, and have events in their lives that they cannot explain. However, the sub-personalities are more likely to be aware of each other, and may even interact with each other.
The Causes of Dissociative Identity Disorder
Currently, no single cause of DID has been identified, but experts do believe that the disorder has its roots in trauma or extreme stress, particularly experienced before the age of 15. Research has identified a strong link between dissociative identity disorder and a history of severe childhood abuse.
Some psychiatrists have suggested that DID is a survival mechanism for people who have experienced severe trauma and abuse. The theory is that a child who is exposed to an overwhelming level of trauma may evolve different personalities so as to dissociate themselves from the traumatic situation.
As well as emotional, physical or sexual abuse, other factors that may contribute to dissociative identity disorder include:
- A genetic predisposition
- A lack of nurturing experiences to help recover from abuse
- Very low self-esteem
Signs and Symptoms of Dissociative Identity Disorder
Some of the signs and symptoms of dissociative identity disorder include:
- A lack of recall that goes beyond ordinary forgetfulness
- Hallucinations of an auditory or visual nature
- Flashbacks or nightmares
- Recurrent depression
- Having difficulty forming intimate relationships
- Sleep disorders
- Eating disorders
- Substance abuse
- Guilt or shame
- Self-harming
A person with dissociative identity disorder may experience amnesia and they may have distortions in their perception of time. Additionally, people close to someone with dissociative identity disorder may notice pronounced changes in the person’s facial expressions, voice and behaviour that indicate the presence of a sub-personality or alter.
Treatment of Dissociative Identity Disorder
The treatment of dissociative identity disorder takes a long time. Usually therapy will last for five or more years. The primary goal of treatment with therapy is to integrate all the personalities and subsequently prevent the personality from splitting again. A therapist will try to decrease the degree of dissociation and to increase cooperation and co-consciousness among the sub-personalities, eventually merging them into one personality.
Therapists have to be careful when treating someone with DID that their interventions aren’t counterproductive. In some cases, therapy sessions have resulted in people with dissociative identity disorder creating additional sub-personalities.
Drugs such as benzodiazepines and SSRI antidepressants may be used to treat dissociative identity disorder, in addition to therapy.
An Overview of Dissociative Identity Disorder
Dissociative identity disorder is a very complex disorder which is distressing for both the people experiencing it and their friends and families. Because it stems from traumatic or extremely stressful events, it is rather difficult to treat and it may take years of therapy before a person with DID has been integrated, and even then, there is a continued risk of the personality splitting again.
Sources:
Evans, D and Allen, H (2009) Mental Health Nursing Made Incredibly Easy, London, Lippincott Williams and Wilkins.
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