DISSOCIATIVE IDENTITY DISORDER

AN INFORMATIVE LOOK AT DISSOCIATIVE IDENTITY DISORDER

JACQUELINE LINTHORNE
6475388
KENZIE FOSTER
6582852
MELISSA GALVEZ
7271695
PSYCH1010
MAGGIE PRZEDNOWEK
DECEMBER 13TH, 2015

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Abstract
The purpose of this paper was to provide information on Dissociative Identity
Disorder (DID). This was accomplished by researching symptoms, causes, treatments,
how DID is depicted in the media and daily life, why an understanding of this disorder is
important, and the implications of being diagnosed. It was found that there is
considerable stigma associated with DID. This lead to the conclusion that while
therapies exist to combat the symptoms of DID, there is no true cure for this disorder.

DISSOCIATIVE IDENTITY DISORDER

Introduction
Our ultimate goals for this paper are to: practice and apply our researching skills,
learn how to properly format a paper using APA, practice functioning as a group and
work on our communication and time management skills. We hope that we can discuss
and combine our knowledge and ideas in order to create a cohesive paper. The disorder
we chose to research is Dissociative Identity Disorder (formally known as Multiple
Personality Disorder). We chose this disorder because we found it interesting and
wanted to learn more information about it, such as: the causes, diagnostics and
treatments. It is easy to joke about those who we might assume have multiple
personalities. But Dissociative Identity Disorder (DID) is a complex and serious
dissociative disorder. The media sometimes portrays it as something funny or less
serious. Those who are suffering from DID have experienced trauma that has forced
them to escape by creating another persona. The purpose of this paper is to research
and understand what causes people to form multiple personas, as well as to research
ways those who are suffering from DID are treated. We will discuss how DID and mental
illness affects people in their day-to-day lives, how it is important to have an
understanding and an appreciation of mental illness in a helping profession, how mental
illness specifically DID is portrayed in the media, and finally the implications of
receiving a formal diagnosis.

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Methodology
To insure our project on Dissociative Identity Disorder (DID) went smoothly, our
group took many steps. First off, we picked a topic that was interesting to all of us.
Secondly, we split up all the work for our proposal. Finally, we stuck with the portion we
worked on for the proposal and continued to finish it off in a report. By sticking to the
parts we had already worked on for the proposal, it allowed us the ability to expand on
what we already knew so we werent learning a topic all over again (e.g., treatments, or
discussion questions).. Overall, researching information about DID was one of the
largest aspects of this group research assignment. In order to gain credible information
for our paper we used multiple sources. These sources consisted of: google scholar
articles, credible websites, Conestoga Colleges online Library Resource Centre (LRC)
and books from the LRC located at Conestoga College, Doon Campus. To ensure these
sources were all credible we looked into the details of the websites we used to make
sure they were government approved, for instance; .org vs. .com. Once finding
credible resources the overall research process became fairly easy.
There is a large amount of research and information on mental disorders which
made finding information on DID more accessible. In addition, while conducting
research for our assignment, key words or phrases that turned up the best results were:
Dissociative Identity Disorder, treatments, causes, diagnoses, symptoms, medications,
definition, prevalence, dissociative disorders, mental illness and DID.. However, while
looking into media representations, these key words did not serve much of a purpose.
The research process for the media representation of DID was challenging and required

DISSOCIATIVE IDENTITY DISORDER

more in-depth research then other parts. We had to find a form of media that
represented our exact topic and had to make sure it had the type of information we were
looking for. This was a time consuming aspect of our assignment. We found that
conducting research in books was difficult because we had to make sure that the
information that books contained was up-to-date (e.g., DSM-5 opposed to DSM-4). In
conclusion, all the information we gathered was credible and very beneficial while
writing our final report.
Literature Review
Definition
Dissociative identity disorder (DID) is a very complex dissociative disorder that
contains all of the major dissociative symptoms (Engdahl, 2013, p. 23). It is usually
developed in early childhood as a response to trauma. An individual creates alternate
personas, which will exist along with his/her original persona (Engdahl, 2013, p. 34).
The individual uses the alternate personas as an escape mechanism, as they are
unaffected by the trauma that the individual has experienced (Engdahl, 2013, p. 35).
Symptoms/Diagnostic Criteria
The American Psychiatric Association (APA): Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition (DSM-5) (2013) states that an individual must meet the
following criteria before the diagnosis of DID: disruption of identity characterized by two
or more personality states, recurrent gaps in memory, symptoms that cause significant
distress or impairment in daily functioning, disturbances that are not accepted as a
social normality, and the symptoms are not caused by the physiological effects of a
substance (drugs or alcohol) (p. 292). The personality state controls the persons

DISSOCIATIVE IDENTITY DISORDER

behaviour, and will often change due to a stressor or a trigger (Engdahl, 2013, p. 23).
Each persona has a separate name, temperaments, and vocabularies (Engdahl, 2013,
p. 23).
Prevalence
According to APA a small twelve month community study showed that the
prevalence across the male and female genders was 1.6% (males) and 1.4% (females),
the overall study had a prevalence of 1.5% (APA, 2013, p. 294).
Causes
Dissociative identity disorder seems to be caused by two things: childhood
trauma (Ross, 2006), and/or neglect (Draijer, 1999). Examples of childhood trauma may
include extreme cases of physical or sexual abuse, if not both. In a study of twelve
murderers also diagnosed with DID conducted by Lewis, Yeager, Swica, Pincus, and
Lewis (2014), it was found that all twelve participants in the study had experienced
severe forms of physical or sexual abuse in their early childhood years. In another study
conducted by Draijer and Langeland (1999), it was reported that the early separation
from parents was significantly more often reported by patients with DID (p. 380). This
finding supports the theory that neglect combined with trauma can contribute to the
development of dissociative identity disorder. Draijer and Langelands study also noted
higher levels of dissociation from patients whose mothers were heavy drinkers (p.382).
Finally, Draijer and Langelands study also suggests that one reason why physical and
sexual abuse are related to adult dissociation is because of the secretive nature of
these forms of abuse, combined with the denial associated with it, stating that the child

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lives in a fragmented reality, and social support is limited because the traumatization
occurs through exactly the persons on whom the child is dependant (p.383).
(Kenz)
Treatments
Finding closure in the trauma of a patients past can be terrifying, paralyzing, and
bring up conflicts within the patients mind. There can be a continuous struggle to find a
healthy balance between safety and containment, while being able to process the
traumatic experiences they have endured (MacIntosh, H., 2015). Research states that
regardless of the struggles DID patients will have to deal with throughout their
treatments, most patients have a significant desire to seek help (MacIntosh, H., 2015).
Psychotherapy, cognitive therapy, medications, self-help, and hypnosis are common
and effective methods that DID patients use in order to manage and defeat the
symptoms they display (Dissociative Identity Disorder Treatments, 2013).
Psychotherapy and cognitive therapy. These treatments are available to any
patients who have been diagnosed with DID. The treatments are intended to draw all
personas into one, thus creating one whole personality (Maisano, M., 2010). The
downside of psychotherapy and cognitive therapy is if one personality gets hurt then all
the personalities that patient possesses will also believe they are hurt (Maisano, M.,
2010). If these therapies are successful, the results will allow the patient the ability to fill
the gaps within their past while still being present in their surroundings (Maisano, M.,
2010).

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Hypnosis. This treatment helps the patient focus and concentrate on their

thoughts and the messages that are hidden from the conscious mind while in a relaxed
environment (Dissociative Identity Disorder Treatment, 2013). By doing so, the patients
are able to access certain persona while illuminating the destructive persona in the
process (Dissociative Identity Disorder Treatment, 2013). Hypnosis also helps reduce
the amount of flashbacks, hallucinations and passive influence the patient acquires in
their life (Dissociative Identity Disorder Treatment, 2013).
Self-help and support groups. Patients with DID have the ability to seek self-help to

maintain their disease. Support groups offer a controlled setting in which patients can
open up to people who are encountering similar symptoms (American Association for
Marriage and Family Therapy [AAMFT], 2015). Virtual online groups are also available
as a form of self-help that is popular amongst patients, due to the fact that this option is
available while in the privacy of your own home (AAMFT, 2015). In addition, patients
and their families can use family therapy to help further understand the patients
disorder, and to help recognize reoccurring symptoms (AAMFT, 2015).
Creative therapy. Is also extremely effective in the sense that it helps relax the

mind and helps the patients get in touch with their feelings while expressing their
emotions in a healthy way. Different types of creative therapy are: art, crafts, music and
dancing (AAMFT, 2015). It is possible that patients will not notice any drastic changes in
their symptoms if they participate in this therapy while taking medication.
Patients do not usually start off taking medications because there is not any
specific medication made to treat Dissociative Identity Disorder, and most patients are
not in a stable enough condition to be in charge of their own medications (Maisano, M.,

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2010). Some of the medications that doctors prescribe to help with the patients
symptoms include: medications for thought disorder, medications for acute dyscontrol.
medications for sleeping problems, medications for self-injury, as well as, antidepressants (Maisano, M., 2010).
Discussion Outline
Negative Impacts of DID on Daily Life
Dissociative Identity Disorder is complex, and according to Barlow and Chu
(2014), many who have it are not aware of the presence of their other identities before
they are diagnosed. We think that because of this, DID could have negative impacts on
many of the relationships and the formation of new relationships in an individuals life.
We think it would be hard to form new relationships when their identity is constantly
changing, as these individuals essentially become entirely different people altogether.
For this same reason, we maintain that it would be difficult to remain successful in
school, work, etc. If one identity does not work at a job that the main identity actually is
employed at, they wouldould miss work and be completely unaware that they have
missed this important task.
If an individual with DID iswas receiving psychotherapy for their diagnosis,
personal distress may arise when they are urged to integrate their different identities
and memories, this is also called secondary traumatisation (Slack, 2014). We think this
would be difficult for someone with DID because they have compartmentalized their
memories and experiences and often are not aware of traumatic memories from their

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childhood. If someones identities are all very different, this can be disconcerting to
family, friends, and colleagues who do not understand the nature of this disorder.
Someone diagnosed with DID may push those close to them away when or if
they attempt to make them aware of their multiple personaslities. As well, in extreme
cases, people may have identities that aremay be violent or sociopathic in nature.
These personalities may cause the person to do terrible things that they later have no
recollection of.
Understanding Mental Illness in Helping Professions
Having an appreciation of mental illness is important to our career paths because
we need to be able to understand our clients and their mental states. Understanding
mental illness will give us a better insight on what to look out for when we are
concerned about our clients mental health (e.g., if we are concerned they might selfharm). We also need to be able to look out for signs that they may be struggling with a
mental illness that we are not aware of. It is important that we do not diagnose the
situation, but assess and provide the help where it is needed (e.g., referring our client to
a psychiatrist if needed).
Social workers. Those who are in this helping profession are expected to

understand and engage with the wider social world of their clients (Barker, 2011, p. 70).
It is important for them to have an understanding and appreciation of psychology,
because they need to understand their clients mental state (Barker, 2011, p. 89). Social
workers usually meet clients in their most vulnerable states (Barker, 2011, p. 90), having
an understanding of mental illness and mental health will allow them to assess the

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situation. After assessing the situation social workers will then be ready to provide the
help that the client needs in order to regain their dignity and self-determination (Barker,
2011, p. 90). Social workers are also expected to take a psychological approach in their
practice, and believe that their clients have a potential for positive change and growth
(Barker, 2011, p. 90).
Psychotherapy and counselling. These two professions are ways of helping

people deal with problems in their lives (Barker, 2011, p. 107). The problems that
psychotherapists and counsellors might help their clients with can include: problems
with family, friends or partners, as well as dealing with abstract ideas such as: luck,
misfortune and death (Barker, 2011, p. 107). Therapy is normally not more than two
people, or in some cases, a group session (Barker, 2011, p. 109). Some therapists
and/or counsellors spend a lot of time listening, clarifying, interpreting and questioning,
while some other therapists might believe in educating their clients about their illness
as a part of their therapy (Barker, 2011, p. 109). When therapists are approached by a
client to help them with a specific disorder (e.g., DID), the therapist is obligated to
address their experiences (i.e., how they relate to their impulses), as a whole, lived
experience (Barker, 2011, p.109). It is important for therapists to have an understanding
of psychology, specifically mental illnesses, so they can understand their clients
experiences when they are seeking help in dealing with a disorder.
Stigma in The Media
Those with DID tend to hide or rationalise symptoms and often avoid disclosing
intrusive thoughts, impulses, and inner voices, due to the fear of being called crazy
(Slack, C., 2014). Media representations of DID typically portray dual adult personalities

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with bizarre and violent behaviour characteristics. Violent behaviour is more of an

extreme symptom of DID, and is not necessarily the true nature of every persona. The
process of online representation toward disorders is cumulative, and with respect to
media it composes an online image which people in our society get influenced by
(Brunskill, D., 2014).
Dr. Phil represented DID when he had a patient come on to the show. This was a
realistic portrayal because the patient on the show had been diagnosed with the
disorder and was using Dr. Phil as a form of self-help. Within this episode Dr. Phil also
touches on answers to why she struggled with certain emotions, and reasons why she
acted out. Along with this, Dr. Phil also presented an opportunity for her to attend a
program which specialises in treating DID. This was a positive representation of DID in
the media, because, not only was the patient seeking help, Dr. Phil was approaching
her in a respectful manner just like he would anyone else.
Bates Motel is an accurate representation of Dissociative Identity Disorder,
although this show was approached in a way that would make the viewers think poorly
of the disorder, if not fear it. In the TV show, the main character presents symptoms of a
DID patient. Extreme symptoms of DID patients are aggression, self-harm and often
violence toward others. Although Bates Motel portrays aggression in an extreme
manner. The main character kill others and does so with an extensive amount of
violence with no recollection of it when he returns to his original persona. Patients who
suffer from DID can develop rage like this but often it is not as intense as Bates Motel
has the viewers believing it is.
Poor media representations can adversely effect a patient with DID as well as

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their families. When the media displays this disorder poorly, this leads viewers to
develop a prejudice against those with DID (Lehman, J., 2014). For example, if media
represents the disorder in a bad light, people will begin to not only fear the disorder, but
will also fear the people who have it. Studies showed that mothers with dissociative
identity disorder would not be left alone with their children if they have acted out in their
past because of their disorder (Lehman, J., 2014). This is due to poor media
representations.
Implications of Receiving a Formal Diagnosis
Dissociative Identity Disorder is used as a defensive mechanism to help cope
with trauma patients have encountered as a child (Slack, C., 2014). DID is often
misdiagnosed as borderline personality, psychotic or bipolar disorder (Slack, C., 2014).
Often an incorrect diagnosis can lead to suicide attempts, dysfunctional relationships,
constant change between therapists, and trying multiple medications with harmful side
effects. Patients who are misdiagnosed often begin to feel hopeless as the treatments
are not working. DID is one of the hardest disorders to diagnose, due to the extensive
amount of psychiatric disorders that share common symptoms of a dissociative
disorders (Maisano, M., 2010). Patients who have DID that has not been diagnosed will
often begin to feel separated from the people surrounding them, making everyday life a
challenge (Maisano, M., 2010). For example, when a patient switches from one
personality to another they may offend someone without any intention to. After returning
to their original persona they regret the broken relationships theyve created. Patients
with DID symptoms may try multiple medications in an attempt to solve the problem.
This can be an issue for a patient, owing to the fact that the medications could mix in a

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bad way and cause other complications (Maisano, M., 2010). The diagnosis of DID
requires medical and psychiatric evaluation which can include specific questions about
dissociation, prolonged interviews, and journals between visits. Once a patient has a
formal diagnosis they can begin to start to treat it. This will further lead to explanation
toward their actions in the past. Once a patient starts to experience symptoms abnormal
to their everyday life, they should seek help.

Conclusion
In writing this paper, we had three goals: to expand and apply our researching
skills, to learn how to properly adhere to APA when writing a paper, and to improve our
time management and communication skills. We highlighted the prevalence of
Dissociative Identity Disorder, then went on to discuss trauma and neglect as being the
two main causes of this disorder. Along with causes, treatments such as psychotherapy
and cognitive therapy, hypnosis, self-help and support groups, and creative therapy
were discussed. In our discussion outline, we touched on the negative impacts DID has
on daily life, the importance of understanding mental illness in helping professions,
stigma in the media, and the implications of receiving a formal diagnosis. We conclude
that Dissociative Identity Disorder is a very debilitating and is oftentimes a stressful
mental illness, characterized by the emergence of two or more distinct personas. These
personas can wreak havoc on an individuals personal life and mental health. While
there are treatments available to help manage and sometimes eliminate symptoms of
DID, there are no medications currently available to treat DID as a whole.

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As a group, we were able to meet the aforementioned goals, however we believe

that how we functioned as a group could have been improved in the areas of
communication and availability. Our paper was thoroughly researched by each
respective member. We utilized the virtual LRC as well as Conestogas LRC along with
Google Scholar.
In future group projects, we plan to ensure that we are more available to meet as
a group by changing our schedules around to accommodate time.

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