What is Dissociative Identity Disorder?

Dissociative Identity Disorder (DID), previously known as Multiple-Personality Disorder (MPD), is also called dissociative personality disorder in some publications. According to DSM-IV-TR, it refers to a dramatic dissociative disorder in which two or more different identities or personality states are displayed, in which these different identities alternate with personality in some way Controls patient behavior.

There is also a lack of ability to recall important personal information in disjointed identification disorders, and this phenomenon cannot be explained by ordinary forgetting. And each identity seems to have a different personal history, self-image, and name, all representing a specific and sound emotional and thought process, and an independent and stable personality ^[1]

Diagnostic criteria

The diagnostic criteria for DID in the Diagnostic and Statistical Manual of Mental Disorder (DSM-1V) of the American Diagnostic and Statistical Manual of Mental Disorders (fourth edition) are as follows:

A. There are two or more different identities or personality states (each with its own relatively lasting perception, connection, and way of thinking about the environment and itself).

B. There are at least two identities or personality states that repeatedly control a patient's behavior.

C. Can't recall important personal information, the degree cannot be explained by ordinary forgetfulness.

D. These disorders are not due to the direct physiological effects of the substance (such as temporary loss of consciousness or chaotic behavior during alcohol intoxication) or general medical conditions (such as complex partial attacks).

diagnosis

Diagnosis requires a comprehensive physical and mental examination, including special examinations of dissociative phenomena. Sometimes psychiatrists can use extended talk time, hypnosis, drug-induced hypnosis, or let patients record different visitors, etc. Personality changes during the examination. Specially developed questionnaires can also help identify dissociative disorders.

Psychiatrists may also try to contact and eliminate other personalities by asking the patient to talk to one part of the consciousness, and the behavior involved in this part of consciousness is exactly what the patient has forgotten or experienced in a depersonalized or unrealistic manner Passed.

treatment

Symptoms of dissociative identity disorder may change or alleviate, but the disease itself does not alleviate spontaneously. Medications may help alleviate some symptoms but do not work on the nature of the disease. All successful treatments use dissociative identity disorder The special psychotherapy of the patient can promote the integration of the patient's personality. Some patients are unwilling or refuse to integrate the personality. For them, the goal of treatment should be to promote the coordination and cooperation between the patient's various personality to reduce symptoms. Difficult and painful, the interaction between various personalities exposes the crisis faced by the patient, and the patient is suffering from traumatic memory. One or more hospitalizations can help the patient through difficult times or through their painful memories Hypnosis can be used to understand various personality traits, facilitate communication between them, and make them coordinate and smooth. Hypnosis is also used to discover traumatic experiences and reduce their negative effects. Sometimes eye movement loss sensation and recovery test (EMDR) is An effective method, he reminds patients of traumatic experiences and replaces negative thinking about self with positive thinking.

If you want to achieve the integration of the patient's personality, promote harmony and unity, restore normal function, and completely eliminate the symptoms, the treatment goals generally require at least twice a week for 3 to 6 years of psychological treatment. Personality integration is the most ideal treatment. result.

There are three main stages of psychotherapy. The first stage is to strengthen the sense of security and stability, to make the patient strong enough to face traumatic experience and personality problems. The discovery of the personality system is to plan further treatment in the future. The second stage is to help the patient Recalling the painful experience will express the painful experience of loss and trauma. When the patient's dissociative symptoms are removed, the treatment enters the final stage. At this time, the patient's self, interpersonal relationships and social functions are connected, integrated and repaired. Some integrations can be achieved spontaneously, but most require recombination and construction of the personality, or must be facilitated by imagination and hypnosis. After the integration is completed, the patient must also treat the rest. The integrated treatment is necessary, although the number of treatments is not limited. Reduction, but not complete cessation. Patients see psychiatrists as people who can help them solve their psychological problems, just as they regularly seek the help of a physician ^[2] .

Prognosis

There are three types of prognostic outcomes. The first is those with mainly separated symptoms and traumatic characteristics, and they usually return to normal after special treatment. The second is those with other severe mental symptoms. Such as personality disorders, affective disorders, eating disorders, and substance abuse. They generally recover slowly, treatment may be ineffective, or slow and risky; the third is those not only accompanied by other severe mental symptoms, but may still be and The abusers they alleged live together, and the treatment of such patients is often time-consuming and poorly effective. For them, the purpose of treatment is mainly to reduce symptoms rather than personality integration. Sometimes, treatment can make a patient with a poor prognosis move towards recovery. Step forward.