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Dissociative Identity Disorder Characteristics Formerly known as: Multiple Personality Disorder A disorder characterizes by two or more identities or personalities that alternatively take over the person’s behaviour. ♦ DID is closely correlated with severe trauma in childhood (approx. 98%), most typically extreme, repeated physical, sexual and/or emotional abuse. ♦ Dissociation is a mental process of disconnecting from one’s surroundings – this exists on a continuum of severity. ♦ DID is serious and chronic. ♦ There is a high level of suicide among people with DID ♦ DID is a COPING mechanism for children/people experiencing abuse and for survivors of abuse. ♦ Chronic dissociation may result in a series of separate entities or mental states which eventually take on identities of their own. ♦ Certain personalities are created to cope with different life experiences/responsibilities/roles and come in and out when the issue at hand changes or is modified (switching). Terms used to describe the ‘identities’; - alternate personalities, alters, parts, ego states, identities, states of consciousness. It is important to note that although these alternate states may appear different, they are all manifestations of the same person( often called the ‘system’). Contributing Factors Symptoms and Lived Experience of DID. ♦ 98% of individuals with DID experienced severe and repeated physical, mental and/or sexual as a child. ♦ Many have a secondary diagnosis of Post –Trauma Stress Disorder. ♦ A coping strategy used during abuse and continued through adulthood. Symptoms of DID: ♦ Abrupt change in tone of voice, focus, characteristics of personality. ♦ Fluctuating levels of function (effective to disabled) ♦ Experiencing time distortions. ♦ Time lapse ♦ Amnesia. ♦ Hallucinations (conversations between identities). ♦ May refer to themselves in plural (we) or 3rd person (s/he) ♦ Headaches ♦ Trances Individuals with DID may experience symptoms of: ♦ Depression, anxiety, phobias, panic attack, sexual dysfunction, eating disorders, PTSD. In a Crisis… The goal is to stabilize or ground the system. ♦ Ask for an adult part who can deal with situation to take control. ♦ If a child alter is out, remind the system that children need to be cared for inside by other parts. ♦ Orient and re-orient the person to time and place as needed. ♦ Validate feelings by reminding her of the trigger for the crisis (e.g. new memories etc.) ♦ Remind her that she’s safe and that the abuse is not happening now. ♦ Ask the system to internally care for the parts in crisis (to help the parts feel safe, to ask those parts to go to their safe places, to give them support, etc.) ♦ When the system is stabilizes or grounded, review with the system the strategies that were helpful and identify future uses for these strategies. ♦ Trust that the system can handle the situation and leave responsibility for this with the system. Support ♦ Be patient with each alter as they appear. ♦ Reintroduce topics as system switches, recognizing the possible lost memory that the former alter may have had. ♦ Validate feelings. ♦ Speak slowly and with an even tone. ♦ Highly responsive to individual psychotherapy. ♦ Involves reclaiming the dissociated traumatic experience. ♦ May involve working with separate entities and eventually treating all identities as one unit. ♦ Treatment is long-term and intensive. “The Dissociative Identity Disorder Sourcebook”, Deborah Bray Haddock. “ Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder”, Tracy Alderman, PhD Treatment Resources