Dissociative Disorders Therapy

What is Dissociative Identity Disorder (DID)?

There are three types of dissociative disorders: dissociative identity disorder, dissociative amnesia, and depersonalization / derealization disorder.

Dissociative Identity Disorder (DID) (formerly known as multiple personality disorder or split personality disorder) is a complex psychological disorder that is likely caused by many variables, including severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional abuse).

People with DID escape from the stress of their day to day life by losing their identity. Most of us have experienced mild dissociation, like daydreaming or being immersed in a project. However, DID is a severe form of dissociation, a mental process that produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of their identity. This ranges from temporary amnesia to complex alternate identities.

In most cases, the person struggling with DID is not aware that they have the disorder. They may recognize that they have some symptoms, however, the symptoms are typically similar to that of depression on the onset. Being that DID 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, friends and family members will be the first to notice the problem. The memory loss for a person with DID may or may not be permanent depending on the stress levels involved and the severity of the disorder.

Dissociative fugue is when the person with DID totally gets away from their true identity. During the fugue, they may wonder, travel, start new relationships, and sometimes even start a whole new life that revolves around this new identity. This personality can last for a few minutes to months. Upon waking, the individual may not realize that they have even been gone, though they will most likely not remember what has happened.

Symptoms of Dissociative Identity Disorder

With DID, there’s also an inability to recall key personal information that can’t be explained as forgetfulness. With DID, there are also highly distinct memory variations, that change with the person’s split personality. The alter personalities or different identities have their own age, sex, or race. Every personality has their own postures, gestures, and distinct way of talking. As each personality reveals itself and controls the individuals’ behavior and thoughts, it’s called “switching.” Switching can take seconds to minutes to days.

Individuals with DID may experience a number of other psychiatric problems, including symptoms of:

• Depression
• Mood swings
• Suicidal tendencies
• Sleep disorders (insomnia, night terrors, and sleepwalking)
• Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or “triggers”)
• Alcohol and drug abuse
• Compulsions and rituals
• Psychotic-like symptoms (including auditory and visual hallucinations)
• Eating disorders

Other symptoms of DID may include headache, amnesia, time loss, trances, and “out of body experiences.” People with DID may find themselves doing things they wouldn’t normally do, such as speeding, reckless driving, or stealing money from their friends, but they feel like they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice.

Methods Used in Therapy for Dissociative Identity Disorder

The three primary methods of treatment for individuals with dissociative disorders are psychotherapy, hypnosis, and medication.

Psychotherapy itself includes a number of possible courses, though it is always a long process to recovery. The most common psychotherapies to treat DID are creative art therapy and cognitive therapy.

• Creative art therapy, the analysis focuses on what is being expressed as well as the cultivation of self-awareness and coping mechanisms.
• Cognitive therapy, focuses on the identification of unhealthy and negative behaviors and then replacing them with positive ones.

In both cases, the therapist will work on understanding the underlying causes of DID, as well as, help them develop better coping mechanisms.

Hypnosis and medication are usually used in addition to therapy. Through hypnosis, the patient is taught to relax and try to bring back their memories. The medication used is not specifically for DID since no such medication exists. However, the medication typically prescribed is antidepressants or anti-anxiety medications to help make it less likely that a dissociative episode will be triggered due to stress.

Reasons for Hiring a Therapist / Psychologist

While medication and hypnosis can help to control some of the symptoms, to this day there is no true cure for DID. Dissociative disorders are difficult to treat because they can easily worsen under stress or with changed circumstances.

According to the Mayo Clinic, individuals struggling with any form of dissociative identity need to choose a therapist to assist them in developing new methods of coping so that they can lead healthy lives.

What to Look for in a Therapist / Psychologist

Ideally, you will want a therapist who has experience in handling individuals with DID. A therapist whose general practice is in psychotherapy, abnormal behavioral psychology, and/or cognitive therapy that specializes in treating DID.

Your connection with the therapist is essential. Find someone that you can learn to trust and who does not trigger your episodes. DID typically requires a lot of therapy due to the severity of the disorder. Search TherapyTribe for a Psychologists that specialize in dissociative identity disorder in your area.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC: Author.
• Joseph Goldberg, MD (2018, May 11). Dissociative Identity Disorder (Multiple Personality Disorder). Retrieved April 5, 2019, from https://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder#1
• National Alliance on Mental Illness. Dissociative disorders. http://www.nami.org/Learn-More/Mental-Health-Conditions/Dissociative-Disorders. Accessed Oct. 11, 2016.
• Mayo Clinic. (2017, November 17). Dissociative disorders. Retrieved April 5, 2019, from https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/symptoms-causes/syc-20355215
• Saxena M, Tote S, Sapkale B. Multiple Personality Disorder or Dissociative Identity Disorder: Etiology, Diagnosis, and Management. Cureus. 2023 Nov 19;15(11):e49057. doi: 10.7759/cureus.49057. PMID: 38116333; PMCID: PMC10730093.