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Myriam Ibarra

Psychology

Mrs. Barresi

9 December 2019

Dissociative Identity Disorder

Dissociative identity disorder (DID), previously known as multiple personality disorder,

is a very rare disorder is which a “person's identity is fragmented into two or more distinct

personality states” that are often referred to as “alters” (Sane Australia Staff). The various

“alters” within the person may also vary in race, age, gender, sexual orientation, and could also

be “animals” (WebMD Staff).

This disorder falls under the category of somatoform disorder. Somatoform disorders are

a group of disorders in which the patient experiences “physical symptoms that are inconsistent

with or cannot be fully explained by any underlying general medical or neurological condition”

(Spratt). Other disorders that fall into this category are pain disorder, hypochondriasis,

somatization disorder, body dysmorphic disorder, and conversion disorder. All of the disorders

under this category cause “clinically significant distress or impairment in daily functioning”

(Spratt). The patients that fall under this general category also tend to require “integrated medical

and psychiatric treatment” approaches in order to try to “decrease the impairment[s]” that result

from their perspective disorder (Spratt).

Dissociative identity disorder is believed to be caused by a variety of factors such as

"severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional

abuse)" (WebMD Staff). This disorder is therefore caused by the environment in which the
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patient was raised as it has not been linked to or believed to have a biological cause and it's other

possible causes which are "childhood medical and surgical procedures, war, childhood

prostitution, and terrorism" are also environmental in nature (American Psychiatric Association).

DID is also thought to have been caused within a patient so that it could act as a" coping

mechanism" for them (WebMD Staff). By taking over, an alter helps the patient distance himself

or herself from a problem, question, or situation that may be or have been too stressful, painful,

or even traumatic to deal with or to remember (WebMD Staff). This is further proven by the fact

that DID tends to be triggered by stressful situations within the patient's life.

The evidence that is available to show why people suffer from this disorder is that "[a]s

many as 99%" of the people who develop this disorder "have recognized personal histories of

recurring, overpowering, and often life-threatening disturbances at a sensitive developmental

stage of childhood" (WebMD Staff). People rarely suffer from this disorder as it is very rare yet

it's prevalence in the United States of America is "1.5%"for the general population, "1.6% for

males, and 1.4% for females" therefore, males tend to be affected by dissociative identity

disorder more so than females (American Psychiatric Association). Additionally, while there is

no specific age at which the symptoms appear, although young men and women tend to be

affected by it more so than older adults, the symptoms can appear after a highly traumatic event

has occurred.

A symptom of dissociative identity disorder is identity confusion which is also known as

identity alteration. Patient's with this symptom may be unable to recall important personal

information to an extent that is not normal. They may not be able to tell you their "sexual
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orientation," "the things that interest them in life," or even goals (WebMD Staff). Due to this, the

person may be conflicted as there is confusion about who the person truly is.

Another symptom of dissociative identity disorder is amnesia. The patient may

experience amnesia when "an alter takes control over the person's behavior" (Cleveland Clinic

Staff). Amnesia is not uncommon among DID patients as the various alters have control of the

body and while the core personality may not be aware of the existence of his or her other

personalities, the alters have free reign to the body and may do or go wherever they may please.

This may also result in the patient waking up in random places or in them discovering that they

have new or moved possessions.

Another symptom of this disorder is that there is a suicide risk. More than "70%" of the

people with DID have attempted suicide, and self-injurious behavior" such as slitting one's skin

typically at the wrists or in the inner thighs (Rehan). This percentage may appear to be rather

high but it may be due to the fact that DID may cause the patient to feel that the "world is not

real" (derealization) (WebMD Staff). It may also be as high as it is due to the depression,

anxiety, or suicidal thoughts that dissociative identity disorder patients may have. Strangely

enough, despite the many symptoms that are associated with this disorder, dissociative identity is

rarely a successful insanity plea even though the patient may not have had control over his or her

condition and must still "preclude criminal responsibility" (Farrell).

Due to the various personalities and even different sexual preferences of the alters, the

host personality tends to have difficulty with romantic relationships as their other personality

may also be in a romantic relationship with another person. Relationships in general can also be

strained and affected by the patient's mental state as lapses in memory can make the person
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forget an interaction that an alter of themselves may have had with another and a violent

personality that they may possess may also strain their relationships with others as that

personality may lash out or harm a loved one or friend.

An example of this disorder is a 55-year-old Caucasian female whose "personality would

split" during "stressful situations" (Rehan). She had a variety of personalities including a "the

personality of a seven-year-old child, a personality that would behave as a teenager, and another

that acted as a male" as well as her core personality which is that of a normal 55-year-old

woman. Under the influence of her alter, she could become "violent," "suicidal," or "homicidal"

(Rehan). Under her teenage personality there were incidents of self-harm, increased "substance

abuse, alcohol use and [of] smoking weed" (Rehan). Also, as a male her "perception of male

body parts" and "choice of friends" also changed. Her treatment included "psychotherapy"

(Rehan).

Although dissociative identity disorder cases are "rarely seen in South and East Asian

countries, likely due to the higher prevalence of possession disorder" the following recent case of

a 20-year-old unnamed Korean male is another perfect example of the disorder (Kim). Originally

"shy and timid," he had returned from abroad as a "very confident," "passionate," and "outgoing"

person and also seemed to be "very forgetful" (Kim). At one point he was even found in an

"alley far from his house" by the police and he has no idea how he got there (Kim). That lapse in

memory is a clear sign of amnesia which is prevalent in those who suffer from this disorder.

Under one of his personalities, he experienced "violent behaviors" such as "[breaking] a

window" (Kim). Like most dissociative identity disorder patients, he too had "experienced
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repeated childhood physical abuse and neglect" and their "violent alters appeared only when

childhood traumatic event[s] [were] remembered or recalled through emotional triggers" (Kim).

Those with this disorder require outpatient treatment and not impatient treatment as they

do not tend to be harmful to others or themselves for the most part although if they have a violent

personality then they might be slightly dangerous to themself. They can receive support at a

clinic or through a therapist. They can cope with this disorder by going to therapy and receiving

medication. While there is no cure for dissociative identity disorder, there are a multitude of

management and treatment options. "Psychotherapy" also known as "talk therapy" is the main

treatment for this disorder because it encompasses "several forms of therapy" and it's purpose it

to try and help "the different personalities" ensure the safety of others and to get the personalities

to coexist with each other (Cleveland Clinic). It is administered through a one on one therapist

appointment. Dialect-behavior treatment (DBT) is another form of psychotherapy that may be

used and its purpose is to help people cope with their experience of trauma or abuse" (Cleveland

Clinic). It is administered through a one on one therapist appointment. Misdiagnosis is also

highly common for dissociative identity disorder as it's symptoms are very similar to the

symptoms of other mental health disorders such as "borderline personality disorder …

schizophrenia … borderline personality disorder" (The Recovery Village Staff).

In conclusion, dissociative identity disorder is a disorder within the somatoform disorder

category that has no cure yet can be treated through medication and therapy. It is also

characterized by at least two or more personalities in one body. And it's symptoms include

amnesia, derealization, depersonalization, age regression, and identity confusion.

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Works Cited

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