Lewis !

Noelle Lewis

Whitney Gilchrist

ENC 2135-08

9 April 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 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-V) as the

presence of two or more personalities or an experience of a distinct alternative personality akin

possession of an individual (qtd. in Jacobson 308). 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 appreciating the life we have while

helping them recover in the process. What are the myths surrounding dissociative identity

disorder (DID) to make people have disbelief for it and how do patients live with such a

disorder? How do treatments affect the process of recovery?

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 are diagnosed in the
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USA (Ringrose 4). It is first important to note how these individuals develop this uncommon

disorder.

Researcher Jesse Fox conducted a narratology alongside a patient named Sophia who

was diagnosed with DID at a very young age. He gathered personal accounts of her experiences

in her life and put them in chronological order. Since she was 2 years old, Sophia was sexually,

physically, and mentally abused by family members (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] (332). Not every child goes through the tortures of being

sexually, physically, and mentally abused, however, those who are abused have a predisposition

of many future issues. Depression, anxiety, borderline personality disorder, and many more

mental disorders can come about from this trauma. The bigger 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

(Jacobson 308).

The symptoms of this disorder then become almost unmanagable. Like described in the

DSM-V, voices take over the mind, time periods start disappearing, and major mood swings

occur. Many are described as staring into space, unresponsive and almost catatonic (Spring 81).

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 (333). These voices can say
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hurtful things and cause confusion all together. Next, forgetting becomes a prominent symptom.

Periods of time are taken away from the individual without them ever keeping track of it.

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

frustrating. I was diagnosed with everything, Sophia expressed. This is a major problem when

it comes to this disorder (334). Many people are commonly diagnosed with paranoid

schizophrenia or borderline personality disorder (BPD) (Ellerman 72). This can make the

patients feel inferior and become even more frustrated. In fact, some therapists argue that DID is

just a stronger form of BPD rather than its own separate disorder (Markwick 490). Although

patients do typically have other conditions such as post-traumatic stress disorder, substance

abuse, eating disorders, and suicidality, DID is usually found way later on despite being the main

problem (Brand 302, 2013).

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 she was about to actually communicate with her other alters without

dissociating from herself in the real life (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 (337). Making the patients feel normal, even if he or she does not, helps stress that is

put on the patient.

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

Sophias case, the easiest way was to give each alter a task to gain control over the manifestation

of her alters (337). This is a very long and tedious process for the therapist due to the fact that

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. 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. Psychotherapy is a highly debated form of treatment for those with DID.

Psychotherapy is a different treatment method that focuses on the emotional side of treatment

rather than a medical standpoint. A study done by Bethany L. Brand (2014) weighed the good

and the bad of psychotherapy and found that psychotherapy helped reduce symptoms of DID,

decreased rates of hospitalization, and reduced costs of treatment. False claims are constantly

being made based on personal anecdotes of DID patients who had a negative experience with an

untrained therapist. These claims lead many to think that psychotherapy causes more harm than

good. However, memory recovery of the patients past puts him or her more at ease with the

present day. Those with DID felt more at ease when they could safely open up about their trauma

and their alters with their therapist (Brand 172, 2014).

Factors that make it hard for patients is mainly misdiagnosis and misunderstanding of the

disorder. In Sophias case, she was desperate to find someone who understood her and what she

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

searched for the right person to help her (332). Dissociative identity disorder only accounts for a
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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 who had DID to find out which methods of counseling did and did not work and

what treatment they considered helpful and not useful at all. In order to gain the data, the

researchers used an open ended question interview to gain insight. The main effective approach

to counseling that therapists should consider is the pacing of the session (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 (311).

Another important technique according to the study is support groups. Some critics may

argue that this could harm the patient even more. Many counselors claimed 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). Empathy

is a natural human response which makes us feel better about what we are going through. This is

also what the patients looked for in an effective therapist. Not surprisingly, like Sophias 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 freedom only made situations worse (315). No one wants their freedom taken away, so

patients in an office should be able to feel safe. Many participants agreed that some counselors
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acted as if they were going to take away their personal autonomy by recommending that they be

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

to (315). A participant in this studied discussed how she refused to go back to her counselor

because someone [would knock] on her door and [start] to come in and she didn't even lock the

door (315). This lack of privacy ultimately makes the patient feel uncomfortable.

But how can someone not believe that dissociation is a real concept of the mind? To start,

many disbelievers think that DID is over diagnosed and brought upon by therapists too easily.

While, the argument is that over zealous therapists put thoughts of DID symptoms into the

patients head creating a fad, this is incorrect (McAllister 26). It is the therapists job to listen and

then provide input based on what they hear. Multiple bodies of research also prove that DID is

not a fad and is actually growing as a knowledgeable disorder. The disorder was officially

recognized in the 1980 edition of the DSM-III and a high number of publications about DID

have been produced from the year 2000-2014 (Brand 259, 2016).

Another misconception that is established is the fact that DID is the same as BPD. Before

the DSM-V, there had been a substandard definition to distinguish the two terms. However, there

are many techniques that can differentiate them. Individuals with BPD can generally recall their

actions across different emotions unlike those with DID who discernible amnesia while they are

dissociating (Brand 263, 2016). Another way to diminish this misconception is through the

Rorschach inkblot test. Persons with DID had more traumatic intrusions of the inkblot shown

compared to BDP patients who showed self-interest and logical thinking when shown the same

inkblot (Brand 263, 2016). By recognizing the difference between these can be crucial to the

patient when treatment is necessary.

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Claims, such as dissociative identity disorder is over-diagnosed and borderline

personality disorder are on the same level, are proven to be false by many personal accounts of

patients and research. Understanding the efficacious and inefficacious treatments to DID expand

the uncommon knowledge of the disorder and help more therapists comprehend how patients

want to be regarded. The many symptoms and experience of the sorts of people with DID give

others a perspective on how he or she lives and contributes to the growing knowledge of the

disorder.
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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. 301308. American Psychological

Association, 10.1037/a0027654

Brand, Bethany L., Richard J. Loewenstein, & David Spiegel. 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, dx.doi.org/10.1521/psyc.2014.77.2.169

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,

2016, pp. 257270, 10.1097/HRP.0000000000000100

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,

Inc.

Fox, Jesse, Hope Bell, Lamerial Jacobson, and Gulnora Hundley. 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.

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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 Shuichi Suetani. Meet Dr Jekyll: a case of a psychiatrist with

dissociative identity disorder. Australasian Psychiatry, Vol 22, Issue 5, 2014, pp.

489-491. The Royal Australian and New Zealand College of Psychiatrists,

10.1177/1039856214547424

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

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

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

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

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

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