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Causes and Treatments of Dissociative Identity Disorder By Antonella Cattaneo & Carlos Zegarra What is did? Dissociative Identity Disorder was previously known as Multiple Personality Disorder, Dissociative Identity Disorder (DID) is a condition in which a person has more than one distinct identity or personality state. At least two of these personalities repeatedly assert themselves to control the affected person's behavior. Each personality state has a distinct name, past, identity, and self-image. causes The severe dissociation that characterizes patients with DID is currently understood to result from a set of causes: • an innate ability to dissociate easily • repeated episodes of severe physical or sexual abuse in childhood • lack of a supportive or comforting person to counteract abusive relative(s) • influence of other relatives with dissociative symptoms or disorders Signs and symptoms • lapses in memory (dissociation), particularly of significant life events, like birthdays, weddings, or birth of a child; • experiencing blackouts in time, resulting in finding oneself in places but not recalling how one traveled there; • being frequently accused of lying when they do not believe they are lying (for example, being told of things they did but do not recall, unrelated to the influence of any drug or medical condition); • finding items in one's possession but not recalling how those things were acquired; • encountering people with whom one is unfamiliar but who seem to know them sometimes as someone else; • being called names that are completely unlike their own name or nickname Continued… • finding items they have clearly written but are in handwriting other than their own; • hearing voices inside their head that are not their own; • not recognizing themselves in the mirror; • feeling unreal (derealization); • feeling like they are watching themselves move through life rather than living their own life; • feeling like more than one person. How is Did Diagnosed? There is no specific definitive test that can accurately assess that a person has dissociative identity disorder. So, practitioners conduct a mental health interview that gathers information, looking for the presence of the signs and symptoms that we talked about. They look for: • The presence of two or more distinct identities or personality states (each with its own relatively persistent pattern of perceiving, relating to, and thinking about him or herself and the world) • At least two of the identities or personality states repeatedly take control of the person's behavior. • Inability to recall important personal information that is too severe to be explained by ordinary forgetfulness • The illness is not the result of the direct physiological effects of a substance (for example, blackouts or other abnormal behavior during alcohol or other drug intoxication) or a general medical condition (for example, seizures). In children, the symptoms are not caused by imaginary playmates or other fantasy play. Treatments • Psychotherapy • Medications • Hypnosis Psychotherapy • Psychotherapy for DID patients typically has several stages: an initial phase for uncovering and "mapping" the patient's alters; a phase of treating the traumatic memories and "fusing" the alters; and a phase of consolidating the patient's newly integrated personality. Medications • Some doctors will prescribe tranquilizers or antidepressants for DID patients because their alter personalities may have anxiety or mood disorders. However, other therapists who treat DID patients prefer to keep medications to a minimum because these patients can easily become psychologically dependent on drugs. Also, many DID patients have at least one alter who abuses drugs or alcohol, substances which are dangerous in combination with most tranquilizers. Hypnosis • While not always necessary, hypnosis is a standard method of treatment for DID patients. Hypnosis may help patients recover repressed ideas and memories. Further, hypnosis can also be used to control problematic behaviors that many DID patients exhibit, such as self-mutilation, or eating disorders like bulima nervosa. In the later stages of treatment, the therapist may use hypnosis to "fuse" the alters as part of the patient's personality integration process. Video clip • http://www.oprah.com/oprahshow/Art-Therapy-andDissociative-Identity-Disorder-Video