Multiple Personality Disorder Multiple Personality Disorder, renamed dissociative identity disorder, is the suggestion that one body may serve as a home to multiple individuals, each with their own distinct personality. (Grolier encyclopedia) This suggestion is accepted by psychiatrists world wide and is recognized as a serious mental illness.
However, all of the personalities that are present in an individual are normal. They act as any other normal personality, because the multiple personalities have their own memories which dictate the personality of the individual or alter personality.(Dr. McQueen) There can be over one hundred personalities in a body, some not even human. (There have been many documented cases of people having animal or even inanimate object personalities) But, how can psychiatrist remove all of them or allow them to coincide in peace? There are many different treatments for dissociative identity disorder, but if they will work all depends on the case and treatment method.
The symptoms of dissociative identity disorder are fairly easy to recognize, as well.The least puzzling thing about dissociative identity disorder is what causes it. There are many different theories on why people create or have multiple personalities but few are scientifically accepted. The most accepted and proved reason is severe and prolonged abuse.
The host feels that they are responsible for the abuse but not for their own behavior and they feel that they deserve the punishment but cant comprehend why the abuse is taking place. To deal with these conflicting thoughts the abused person creates multiple personalities so they can hold these mutually exclusive belief systems concurrently without conflict.(Ross and Gahan 231-239) Also severely abused persons will create multiple personalities to help them deal with the inescapable situation that they are in. Severely abused people are not the only ones who are at risk for having dissociative identity disorder, substance abusers, children (under nine) who have suffered a life-threatening trauma, or people with a theoretical gene that causes dissociative identity disorder to occur.(Sidran Foundation brochure) Those severely and/or prolongly abused, or survivors of austere sexual abuse are at the greatest risk for having dissociative identity disorder and often have many symptoms of it.
There is another dark side to the multiple personalities caused by severe or prolonged abuse. About sixty percent of all people who created multiple personalities due to abuse, often have an abusive personality. Because the abusive personality will surface in times of great stress the once abused victim can become an abuser him/herself. Continuing a horrible cycle of abuse and severe mental scarring.(Sidran Foundation-brochure) The symptoms of dissociative identity disorder are often fairly easily to identify. The most obvious symptom, but hardest to recognize, is the presence of multiple personalities in one body. They are very hard to detect unless you know the person well because most of the alter personalities will react rationally to the situation they are presented with. (Chase 187-194) Imaginary friends, for an adult or teen, and voices heard in the head are some of the more recognizable symptoms of dissociative identity disorder.
Other symptoms of dissociative identity disorder are blank spells, frequently misplaced personal objects, and referring to oneself in the first person plural sense.Any of these last three can refer to a variety of different things, but imaginary friends,as an adult or teen, hearing voices, and having alter personalities to deal with different situations are almost definite signs that a person has dissociative identity disorder. (Braun 4-23) Dissociative identity disorder can be cured by a few psychiatric and clinical ways. To treat dissociative identity disorder effectively it must first be identified properly , by taking the symptoms and patient history into consideration. Then to continue with treatment, the diagnosis must be fully explained to each personality who is fearful or in disbelief of the diagnosis. This is the first step in the Initial treatment phase. (Putnam 1989)(Ross 1989) Next the psychiatrist must form a trusting relationship with the personalities (not all but majority needed) and conduct the therapy in a secure environment where the person will feel safe.
Since each personality can differ greatly, in age, sex, memory, each will prefer a different area in which they feel secure, making this a very difficult task.The psychiatrist must learn where each personality feels safe, and conduct the session at an area dictated by which personality is present. Due to the differences in age, gender, and memories, each personality will need to be treated in a particular way.
You wouldnt treat an adult female like you would an adolescent male, which is why each needs to be treated specially. (Putnam 1989) Therapists, after finding the safe areas, must devise a treatment contract and the ultimate goal of the treatment. Many feel that the goal of the therapy should be to incorporate all of the alters into one whole personality.(Putnam 1989; Kluft 1985 24) Still others feel that this could be quite problematic and even result in death, because one of the personalities might not be able to cope without the presence of a previous personality and kill itself and the host body.
(Ross 1989) Therapy contracts should focus on the type and duration of the treatment, dangerous behavior, and therapeutic boundaries(Putnam 1989) and the punishment if the contract is violated. Dangerous behavior is one of the most important issues that can be addressed, because often in cases of dissociative identity disorder internal homicides occur or are attempted.But to kill another personality, the personality must kill the host and in turn, it too will be eliminated, so measures preventing this must be contracted for the patients safety. Punishment is another tedious task in the treatment of dissociative identity disorder,because the therapist must establish appropriate punishments for each personality. (Braun 16-23 part2) The final component in the first stage of treatment is mapping the bodies internal system.
This includes outlining the personality system. The outline should contain who the alter personalities are, their characteristics and how they interact with one another. (Putnam 1989) Also the map should contain the name, sex, age, time of appearance, function, degree of amnesia, position in system, internal alliance, and any other relevant traits of each personality.(Ross 1989).Mapping is a progressive project throughout therapy and layers of alters may appear.
The best method to gain a complete map is to ask the alters what they know about the other personalities in the body, as well as information on itself. The final step in the Initial phase is the facilitating of internal communication and cooperation. To do this, the therapist must be a neutral party between the alters. Another technique to establish internal communication is the creation of an internal bulletin board where the alters can communicate with one another by posting messages.(Putnam 1989) Finally all of these methods build toward internal conversation, which should be a positive subject, that will enable the therapist to move onto the Middle Work Phase.
Hypnotic suggestions to break down the barriers peacefully between alters is also advocated by some therapists as a gradual way to establish internal communications without the use of the bulletin board.(Ross 1989) The next phase begins by the host recovering their traumatic and severing the emotions that cause internal conflict or pain to the host. This is essential for the healing process to occur. To desensitizes the memory and hopefully remove a personality, the memory must be communicated to the host and he must mentally relive it and learn to cope with it if he wants to become one body with one mind. (Putnam 1989) Putnam suggests many different techniques to help recover these memories.The first is by a process called talking through. Talking through is a processes of speaking to the system (host and personalities) as a whole under hypnosis, and having specific alters communicate their traumatic memories to the host so that they may be dealt with. Next, still under hypnosis, the host must be lead back to when the memory occurred so that it may relive the traumatic memory and deal with it properly, eliminating the created personality that dealt with that emotion.
There are other ways to go about the middle phase without the use of hypnosis. A suggested method of doing this is using metaphorical imagery.This involves the creation of a safe haven for the child or fearful alters. Finally, the therapist could use dreams to enter into the traumatic memories, and try to work them out after obtaining dream recalled information about that particular trauma.(Ross 1989) The Final or Resolution Phase of therapy deals with the possible outcomes of the Initial and Middle Phases. The first outcome is that the treatment was a failure.
Reasons that this could occur is because the person is unwilling to recover traumatic memories or they are afraid that they will lose important relationships (either with the other alters or with the therapist.) The second possible outcome is that the integration of the personalities into one was successful and now there is only one personalities. The Final outcome is that the person responds by not sharing traumatic memories much as in the first possible outcome, but through the interpersonal changes of being with someone trusted for an extended period of time, the personalities fuse together or die and the person is left with only one personality. However, this outcome is not as long lasting a the second outcome.(Putnam 1989) The final step of the Final Stage is to aid the person in readjustment into their personal life.The person must learn how to interact with others and handle situations with only one personality. The best way to allow the person to re-adjust into a social environment is by group therapy with the persons spouse, children, or significant other(s). (Coons and Bradley 515-521) Coincidentally, there is always a chance of relapse in cases where successful integration has occurred.
In a little less than one third of the cases, relapse into dissociative identity disorder occurs. The most common cause for relapse into dissociative identity disorder is that the person cannot handle their present life, so they revert to the use of alters to deal with the new stress and trauma of their life.The other reason that many relapse occur is that the person relives a previous traumatic event. Such as they are reconfronted with an abuser or location of the abuse. (Spiegal 554-562) There alternatives to investigate if a person relapses into dissociative identity disorder. If there is a relapse into dissociative identity disorder the therapist can attempt to refuse the personalities, but there is little chance of success with that approach.
The therapist must recognize the existence of the multiple personalities and devise a way to allow them to coincide peacefully in the host.Often, he will need to devise a set of rules or a plan to allow the person and the personalities to live in peace. (Kluft 20 24) I learned a great deal doing this report. One of the things I learned is that although these people are mentally ill, they arent sick. They are products of their (abusive) environment and made these personalities to deal with the stress and trauma of their life.
In conclusion, there is always a good chance a person with.