Dissociative disorders simply refer to the process through which an individual escapes from reality involuntarily. It is mainly caused by the dissociation between thoughts, memory, and consciousness. There are three types of dissociative disorders; dissociative amnesia, depersonalization disorder and finally, dissociative identity disorder (Understanding Dissociative Disorders, 2013, p. 4 – 6). Dissociative amnesia is a disorder where an individual forgets information about themselves. Depersonalization, on the other hand, is characterized by an individual having emotional dissociation from their actions, sensations, thoughts and feelings (Understanding Dissociative Disorders, 2013, p. 4 – 6). The individual feels like they were watching themselves from a distance. Finally, dissociative identity disorder is where an individual alternating between multiple personalities. In this paper, we will look at dissociative identity disorders in detail highlighting its causes, symptoms and available treatments.
As mentioned earlier, dissociative identity disorder occurs when an individual alternates between multiple personalities. In the past, it was referred to as multiple personality disorder (Understanding Dissociative Disorders, 2013, p. 4 – 6). The real feeling is like there are numerous voices in the patient’s mind trying to take over them. These voices represent various personalities that exist in them. In some cases, these personalities have different characteristics, mannerism, and even names. Individuals with this disorder will normally have memory lapses of day to day experiences (Understanding Dissociative Disorders, 2013, p. 4 – 6).
According to DSM – 5, there are five criteria for identifying dissociative identity disorder. The first one is that the individual must have multiple personalities and all of them must differ in perception, memory, cognition, and behavior (Ashraf et al., 2016, p. 1). The personalities should also differ in how they see the environment and self. These signs can be reported by the individual experiencing them or people around them. The second criterion is that the patients must experience amnesia of personal information or day to day activities. The disorder must also affect the normal functioning of the individual in at least one major area of their lives (Ashraf et al., 2016, p. 1). This requirement is necessary when diagnosing other mental disorders mainly because of the fact that a disorder is only a disorder when it negatively affects the life of the patient in a considerable way. The other requirement is that the multiplicity must not be a part of cultural or religious practices (Ashraf et al., 2016, p. 1). The final criterion is that the memory lapses should be as a result of substance abuse or other medical condition such as seizures. Substances such as alcohol are known to cause memory lapses especially when the individual blacks out. Physicians should, therefore, be very careful when diagnosing to avoid confusing the two (Ashraf et al., 2016, p. 1).
As mentioned, there are two main causes of dissociative identity disorder. They are; trauma and dissociation. Dissociative identity disorder is not really a mental illness but a development condition. It mostly occurs in individuals who experienced some kind of trauma repetitively when they were growing up. Trauma can be defined as the repeated fear and memory of a past unfortunate event that occurred in the past. The individual gets constant memory flashes of the event as it if it were happening in the present. When the trauma becomes unbearable, the mind develops other personalities which deliberately leaves out the traumatic experience in their memory. This process is what is commonly referred to as dissociation. What starts as a defense and coping mechanism develops into a disorder when the individual matures.
The main symptoms of dissociative identity disorder are constant memory lapses and amnesia of who the person is. In full-blown dissociative identity disorder, the individual switches personalities without even realizing it (Dissociative Identity Disorder). Therefore, what an individual does when in a different state or personality is forgotten when the individual switches into their normal personality. The main reason for this lapses is that the different personalities do not share memory. Each personality has its own memory and perception of the self and environment. For example, a patient might go shopping while in one personality and forget they did it when they switch to another or their original personality. In some cases, patients have also complained of depression, excessive drinking, losing time, daydreaming, blacking out and finally time moving slowly especially when the patient is afraid (Dissociative Identity Disorder).
The only treatment available for dissociative identity disorder is psychotherapy (Dissociative Identity Disorder). Psychotherapy can be seen to comprise of three stages; establishing safety and symptom reduction, working through the traumatic experiences and finally, integration and rehabilitation. The first stage is to make sure that the patient feels secure and safe (Dissociative Identity Disorder). Therapists have to make sure that they build a strong relationship with the patient that is founded on trust. It is only when the patient feels that they can trust the therapist and also feel safe and secure that they can then begin to open up to them. Once this relationship is established, they then can move to the next step which is walking through the traumatic experience (Dissociative Identity Disorder). Here, the therapist asks the patient to walk them through their traumatic experience enabling them to face it rather than escape from it. Slowly, the therapist then helps the patient begin to view the experience from another perspective. Once the patient is comfortable with the experience and has even moved on from it, they then move to the last stage which is rehabilitation and integration (Dissociative Identity Disorder). In this stage, the therapist helps the patient integrate their different personalities into one personality.
In conclusion, dissociative identity disorder is a condition where an individual develops multiple personalities in order to deal with a past traumatic experience. The patient then switches between those personalities constantly. Some of the symptoms include memory lapses of day to day events and even personal information. The only treatment available is psychotherapy.
Dissociative Identity Disorder. Patient. Retrieved from http://m.patient.media/pdf/28709.pdf
Ashraf, A., Krishnan, R., Wudnen, E., Acharia, A. & Tohid, A. (2016). Dissociative Identity Disorder: A pathophysiological Phenomenon. .Journal of Cell Science and Therapy, Vol. 7(5), p. 1 – 3. Retrieved from https://www.omicsonline.org/open-access/dissociative-identity-disorder-a-pathophysiological-phenomenon-2157-7013-1000251.pdf
Understanding Dissociative Disorders (2013). Mental Health. Retrieved from https://www.mentalhealth.org.nz/assets/A-Z/Downloads/understanding-DD.pdf