Dr Jozelle Miller
December 1, 2015
Guess who is coming to dinner?

Multiple personality disorder is thought to be an effect of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse. It is now referred to as Dissociative Identity Disorder.

What Is Dissociative Identity Disorder?

Dissociation speaks of the ability to disconnect or separate oneself from anything that causes some anxiety or incongruence within your sense of self. Most of us have experienced mild dissociation, which is like daydreaming, or getting lost in the moment while working on a project. {{more}}However, dissociative identity disorder is a severe form of disconnect, a mental process which produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. The dissociative aspect is considered to be a coping mechanism in dealing with the particular stressor — the person literally dissociates or mentally separates himself from a situation or experience that’s too violent, traumatic, or painful to assimilate with his conscious self; (it is reminiscent of a child creating a ‘happy place’ in light of being abused).

What Are the Symptoms of Dissociative Identity Disorder?

1. 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 behaviour.

2. There is an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness.

3. Highly distinct memory variations, which fluctuate with the person’s split personality.

4. 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.

5. As each personality reveals itself and controls the individuals’ behaviour and thoughts, it’s called “switching.” Switching can take seconds to minutes to days.

Other symptoms include:

6. Depression

7. Mood swings

8. Suicidal tendencies

9. Sleep disorders (insomnia, night terrors, and sleepwalking)

10. Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or “triggers”)

11. Alcohol and drug abuse

12. Psychotic-like symptoms (including auditory and visual hallucinations)

13. Eating disorders.

Who gets Multiple Personality Disorder?

While the causes of dissociative identity disorder are still vague, research indicates that it is likely a psychological response to interpersonal and environmental stresses, particularly during early childhood years, when emotional neglect or abuse may interfere with personality development.

Dissociation may also happen when there has been insistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse. Findings show that in families where parents are frightening and unpredictable, the children may become dissociative.

Recommended treatment plan for Multiple Personality Disorder:

While there’s no “cure” for dissociative identity disorder, long-term treatment can be helpful, if the patient stays committed. Effective treatment includes talk therapy or psychotherapy, hypnotherapy, and adjunctive therapies, such as art or movement therapy. There are no established medication treatments for dissociative identity disorder, making psychologically-based approaches the mainstay of therapy.

Because the symptoms of dissociative disorders often occur with other disorders, such as anxiety and depression, medicines to treat those co-occurring problems, if present, are sometimes used in addition to psychotherapy.

How to act towards someone with this disorder?

1. Understand the illness: be armed with the information needed to make informed decisions about the person; know what to expect and understand the severity of the disorder.

2. Avoiding casting judgments: People experiencing mental disorders often do not seek or comply with treatment because of stigma associated with being mentally ill. Acknowledge how difficult it must be to manage the reactions of others and avoid contributing to the shame and embarrassment a person with the disorder may already feel.

3. Asks questions, if you are familiar with the person. If the individual is a friend or family member, ask about his or her experiences to show you care. Strangers may feel very uncomfortable with questions about their mental health, so do not pry.

4. Provide needed emotional support: It is important to “Just be there”. Shame and stigma often lead people with mental disorders to feel very isolated. Help the person maintain a healthy relationship by actively engaging with him or her. You don’t need to discuss the illness. In fact, it may be better to spend time together not discussing the disorder. This may help him or her to feel “normal.”

5. Join a support group: Support groups are great ways to find others who share similar experiences. Try and attend a group meeting with your loved one.

6. Help the person avoid triggers: Trauma is common, and it causes dissociation is due to severe emotional stress. This means intense emotions may trigger “switching.” To help this person avoid switching, help them to recognize and manage stressful situations. If you see an encounter is becoming emotionally charged, defuse it by changing the topic or asking the person to join you in an unrelated activity.

7. Encourage treatment compliance: Treatment for multiple personality disorder typically includes regular counselling and lifestyle changes. People who experience depression and/or anxiety may also be treated with prescription medication. Treatment must be followed to be effective, so support the person’s efforts to comply.

Dr Miller is Health Psychologist at the Milton Cato Memorial Hospital.