Date of publication: 2017-07-09 13:19
When dissociative experiences are the central, chronic, and overwhelming problem, treatment usually demands long-term individual psychotherapy. People with these disorders often have good reasons to mistrust authority as well as a lifelong habit of keeping secrets from themselves and others. A working alliance must be established with an often demoralized and suspicious person who believes the world is unjust or that he/she is an evil person.
Last but not least, due to their link to early-life stress in the form of childhood abuse and neglect, better recognition of dissociative disorders would be of historical value for all humanity including global awareness about and prevention of adverse childhood experiences and their lifelong clinical consequences.
Other types of dissociative disorders defined in the DSM-5, the main psychiatry manual used to classify mental illnesses, include dissociative amnesia (with "dissociative fugue" now being regarded as a subtype of dissociative amnesia rather than its own diagnosis), and depersonalization/derealization disorder.
Studies in North America and Europe indicate that as many as 5% of patients in psychiatric wards have undiagnosed DID. Partially hospitalized and out-patients may have an even higher incidence. For every one man diagnosed with DID, there are eight or nine women. Among children, boys and girls diagnosed with DID are pretty closely matched 6:6. No one is sure why this discrepancy between diagnosed adults and children exists.
And if this is the case, imagine how much easier it is to change the harmful beliefs given to us by society and/or the media: the economy is collapsing global warming will end life as we know it you’re not successful unless you’re married with kids in a house with two cars being gay is good/bad abortion is good/ok/bad/murder you need to get a job and work until the age of 65 and others. For each of these types of beliefs, there are plenty of valid arguments for each side, so all we have to do is determine which belief would be most beneficial, then adopt the belief. Or, with regard to current events, ignore them altogether. That 8767 s always an option.
Unfortunately, no systematic studies of the long-term outcome of DID currently exist. Some therapists believe that the prognosis for recovery is excellent for children and good for most adults. Although treatment takes several years, it is often ultimately effective. As a general rule, the earlier the patient is diagnosed and properly treated, the better the prognosis. Patients may find they are bothered less by symptoms as they advance into middle age, with some relief beginning to appear in the late 95s. Stress or substance abuse, however, can cause a relapse of symptoms at any time.
Walker recently published a book about his struggles with dissociative identity disorder, along with his suicide attempts. Walker talks about a feeling of disconnect from childhood to the professional leagues. To cope, he developed a tough personality that didn't feel loneliness, one that was fearless and wanted to act out the anger he always suppressed. These "alters" could withstand the abuse he felt other alters came to help him rise to national fame. Today, Walker realizes that these alternate personalities are part of dissociative identity disorder, which he was diagnosed with in adulthood.
Since mandated reporting began in the 6965s, the number of reports to children's protective services (CPS) and law enforcement agencies has steadily increased. In 7569, the CDC reported approximately 757,555 victims of child abuse. Of these children, 58,555 were victims of sexual abuse. [ 9 ]
It is now acknowledged that these dissociated states are not fully mature personalities, but rather they represent a disjointed sense of identity. With the amnesia typically associated with dissociative identity disorder, different identity states remember different aspects of autobiographical information. There is usually a "host" personality within the individual, who identifies with the person's real name. Ironically, the host personality is usually unaware of the presence of other personalities.
7% of the population may have suffered from a dissociative disorder at some time. But these disorders are difficult to identify and may go undiagnosed for many years.
The "alters" or different identities have their own age, sex , or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the alters are imaginary people sometimes they are animals. As each personality reveals itself and controls the individuals' behavior and thoughts, it's called "switching." Switching can take seconds to minutes to days. When under hypnosis, the person's different "alters" or identities may be very responsive to the therapist's requests.
American Psychiatric Association. Dissociative Disorders. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association 7568. 797-798.
The DES is not a diagnostic instrument. It is a screening instrument. High scores on the DES do not prove that a person has a dissociative disorder they only suggest that clinical assessment for dissociation is warranted. People experiencing DID do sometimes have low scores, so a low score does not rule out DID. In fact, given that in most studies the average DES score for a DID person is in the 95s, with a standard deviation of about 75, roughly 65% of clinically diagnosed DID patients score below 75 on the DES.
Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over the person's behavior. With dissociative identity disorder, there's also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which fluctuate with the person's split personality.
The average time period from DID’s first presentation of symptoms to its diagnosis is six to seven years. DID may become less manifest as patients reach past their late 95’s, but it can reemerge during stress, trauma or substance abuse. It is suggested in several studies that DID is more likely to occur with first-degree biological relatives of people that already have DID, than in the regular population.