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Lewis !


Noelle Lewis

Whitney Gilchrist

ENC 2135-08

27 February 2017

Dissociative Identity Disorder: Myths and Survival

Imagine you are sitting in your room, you space out, and suddenly you are in your

kitchen not remembering how you got there. Then, voices start surrounding you, but you cannot

see any people. The voices crowd your head with words and phrases and nonsense. Suddenly,

you zone out and wake up feeling tired and depressed. This is the almost the everyday life of

someone with dissociative identity disorder. Dissociative identity disorder is characterized,

according to the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) as “(a) There

must be evidence of two or more distinct and enduring personality states, defined as a unique

way of perceiving, relating, and thinking about the environment and the self. (b) At least two of

the personality states described must repeatedly control the individuals behavior. (c) the personal

experiencing the alter personality cannot recall information for significant periods of time that

are not better explained by memory loss. (d) The first three criteria are not better explained by

the consumption of a psychoactive chemical or by general medical condition” (Fox 324). Many

people have misconceptions about the disorder that must be disproven for the sake of the

patients. It is important to understand how these patients live by going into personal accounts and

appreciate the life we have while helping them recover in the process. What are the myths

surrounding dissociative identity disorder (DID) and how do patients live with such a disorder?

How do treatments affect the process of recovery?
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The very descriptive criteria above gives insight about how intense dissociative identity

disorder really is. The disorder is not very common among the population, a mere 1% of the

general and 1% to 20% of the inpatient and outpatient psychiatric patients (Fox 324). It is first

important to note how these individuals develop this uncommon disorder.

Since she was 2 years old, Sophia was sexually, physically, and mentally abused by

family members (Fox 332). Dissociative symptoms soon appeared as a defense mechanism.

Denial could have occurred as a first step, and then for Sophia, dissociation took over to protect

her. When Sophia turned to therapy, she described to her therapist that, she did not experience

her memories “as [her] own experiences… but they happened in different parts of [her]” (Fox

332). Not every child goes through the tortures of being sexually, physically, and mentally

abused, however, those who do, have a predisposition of many future issues. Depression, anxiety,

borderline personality disorder, and many more mental disorders can come about from this

trauma. The more big disorder that comes about from the most abused children is dissociation

from the world around them. Statistically, 71% of those diagnosed have experienced childhood

physical abuse and 74% childhood sexual abuse (Fox 326).

The symptoms of this disorder then become outrageous. Like described in the DSM IV,

voices take over the mind, time periods start disappearing, and major mood swings occur. For

many, the first symptom is hearing voices in your own head. For Sophia, these voices started in

kindergarten, but she had no idea where they were coming from (Fox 333). Next, forgetting

becomes a prominent symptom. Periods of time are taken away from the individual without them

ever keeping track of it. But how can someone not believe that dissociation is a real concept of

the mind?
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Sophia described her experience of trying to find out what was wrong with her as very

frustrating. “I was diagnosed with everything,” a prominent problem when it comes to this

disorder (Fox 334).

Once dissociative identity disorder is recognized by the individual and the therapist,

awareness of each personality can be distinguished. The patient with the disorder can be

described as the “host” seeing as their body seems to be taken over by multiple “people”. There

is also another “alter” that can be labeled as the “protector” or the one that thinks they are

helping the host with the childhood trauma that occurred. Sophia, unlike many people, was “co-

conscious” meaning that he was about to actually communicate with her other alters without

dissociating from herself in the real life (Fox 333). It is important for the therapist to identify and

talk to each alter to see what he or she knows. In order to be successful in recovery, according to

Sophia, three actions must be taken: stabilization, trauma processing, and promoting daily life

functions (Fox 337).

There are many techniques to treat a patient with dissociative identity disorder. In

Sophia’s case, the easiest way for me was to give each alter a task to gain control over the

manifestation of her alters (Fox 337). This is a very long and tedious process for the therapist

seeing as they have to understand and know each identity before talking with them as one. In a

study done by Lamerial Jacobson, this also proved to be an effective treatment for many. The

patients explained this by saying that if each alter has their own power, they decrease their power

overall in the host by reporting to the host (Jacobson 313). However, there are also other

methods recognized by patients that also help with the recovery process.
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Factors that make it hard for patients is mainly misdiagnosis and misunderstanding of the

disorder. In Sophia’s case, she was desperate to find someone who understood her and whats she

was going through. Sophia specifically mentioned feeling a sense of hopelessness as she

searched for the right person to help her (Fox 332). Dissociative identity disorder only accounts

for a small amount of people, so many therapists do not put the time and effort into studying it

the way they should. In order to solve this, Lamerial Jacobson conducted a study with thirteen

participants, just like Sophia, to find out which methods of counseling did and did not work and

what treatment they considered helpful and not useful at all. The main effective approach to

counseling that therapists should consider is the pacing of the session (Jacobson 331). Although

sometimes hard for the therapist, making the time to see the patient on weekly basis is essential

to recovery. One participant in this study even admitted that he “wished [he] could afford to go

more often… one-hour sessions, minimum of two hours… four days a week. That would be

perfect” (Jacobson 311). Another important technique according to the study is support groups.

Some unknowledgeable people may argue that this could harm the patient. Counselors said that

sending patients to support groups could cause them to be re-traumatized by hearing other group

members tell stories of their own abuse (Jacobson 311). However, the participants disagreed

saying that the universal understanding of the survivors provided healing and comfort (Jacobson

331). This is also what the patients looked for in an effective therapist. Not surprisingly, like

Sophia’s case, participants in this study also agreed that identifying and assigning alter roles was

an effective treatment.

Going into ineffective techniques, the same study by Jacobson, showed that patients felt a

lack of safety only made situations worse (Jacobson 315). Many participants agreed that some
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counselors acted as if they were going to take away their personal autonomy by recommending

they be hospitalized without due process or being told they could not leave a session when they

wanted to (Jacobson 315).
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Works Cited

Brand, Bethany L., et al. “A Longitudinal Naturalistic Study of Patients With Dissociative

Disorders Treated by Community Clinicians.” Psychological Trauma: Theory, Research,

Practice, and Policy, Vol. 5, No. 4, 2013, pp. 301–308. American Psychological

Association, 10.1037/a0027654

Brand, Bethany L., Loewenstein, Richard J., & Spiegel, David. “Dispelling Myths About

Dissociative Identity Disorder Treatment: An Empirically Based Approach.” Psychiatry

Interpersonal and Biological Processes, Vol. 77, No. 2, 2014, pp. 169-184. Taylor &

Francis Online,

Brand, Bethany L., et al. “Separating Fact from Fiction: An Empirical Examination of Six Myths

About Dissociative Identity Disorder.” Harvard Review of Psychiatry, Vol. 24, No. 4, pp.

257–270, 10.1097/HRP.0000000000000100

Fox, Jesse, Bell, Hope, Jacobson, Lamerial, and Hundley, Gulnora. “Recovering Identity: A

Qualitative Investigation of a Survivor of Dissociative Identity Disorder.” Journal of

Mental Health Counseling, Vol. 35, No. 4, 2013, pp. 324-341.

Jacobson, Lamerial, et al. “Survivors with Dissociative Identity Disorder: Perspectives on the

Counseling Process.” Journal of Mental Health Counseling, Vol. 37, No. 4, 2015, pp.

308-322, 10.17777/mehc.37.4.03

Markwick, Elizabeth and Suetani, Shuichi “Meet Dr Jekyll: a case of a psychiatrist with

dissociative identity disorder.” Australasian Psychiatry, Vol 22, Issue 5, 2014, pp.
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489-491. The Royal Australian and New Zealand College of Psychiatrists,


McAllister, M. M. “Dissociative identity disorder: a literature review.” Journal of psychiatric

and mental health nursing, Vol. 7, No. 1, 1999, pp. 25-33.

Spring, Rob. “Back to normal? Surviving life with dissociation.” Living With the Reality of

Dissociative Identity Disorder, Ch. 9, pp. 81-91. EBSCO Publishing

Ellerman, Carl P. “The Phenomenological Treatment of Dissociative Identity Disorder.” Journal

of Contemporary Psychotherapy, Vol. 28, No. 1, 1998, pp. 69-78. Human Sciences Press,


Ringrose, Jo L. “Understanding and Treating Dissociative Identity Disorder (or Multiple

Personality Disorder). Karnac Books, 2012. ProQuest ebrary.