Dissociative Disorders and DID

I specialize in the treatment of Dissociative identity Disorder and other dissociative disorders. Dissociative disorders are sometimes referred to as “Complex” or “Chronic” Posttraumatic Stress Disorder. Dissociative Disorders result from traumas such as childhood physical or sexual abuse. Some of the symptoms of dissociation are “zoning out,” forgetfulness, rage outbursts, panic attacks, nightmares, intrusive memories, and intrusive thoughts. People who suffer from dissociative disorders are often diagnosed with depression or other mood disorders. Sometimes people with dissociative disorders are diagnosed with psychotic disorders, such as Schizoaffective Disorder.

Dissociative Identity Disorder (formerly known as Multiple Personality) is a type of dissociative disorder. People with DID can sometimes act if they are two or more different people. They might experience memory lapses or hear “voices.”

There is effective treatment for DID and the other dissociative disorders. Psychotherapy can take a long time, but people with dissociative disorders CAN eventually lead happier and productive lives.

Symptoms of Dissociative Disorders

While a full diagnosis can only be made by an experienced mental health professional, below are some questions you can ask yourself. If you answer “yes” to one or more of these, you may have a dissociative disorder.

1. Do you often find yourself zoning out in the middle of a
   conversation, having forgotten what was said?
2. Did you spend a lot of time in fantasy as a child, so much
   so that teachers or parents criticized you for being in another
   world a good bit of the time?
3. Do you daydream about pleasant things so much that it
   jeopardizes your job or compromises your relationships.
4. Do you feel like a child sometimes, just pretending to be an adult?
5. Do friends or your spouse suggest that you seem quite changeable, different from day to day?
6. Do you have a sense that part of you is missing or had to be
   jettisoned along the way?
7. Do you notice things about your sex life that you think are weird,
   like hating to be touched in ways that most people seem to enjoy?
8. Do you have large chunks of your childhood that are devoid
   of memories?
9. Are you more indecisive than most of the people you know?
10. Do you experience frequent nightmares and insomnia?
11. Do you sometimes feel disconnected from your body?
12. Do you find evidence that you have done things which you don’t remember doing?
13. Do you have intrusive memories that cause intense anxiety or panic?
14. Does it sometimes feel as if you are looking at the world through
    a fog, so that people and things seem far away or unreal?
15. Are you sometimes able to ignore physical pain?

Trauma

Dissociative disorders are usually caused by traumas in childhood. During childhood the brain is still developing and is therefore more susceptible to negative emotional and physical events. There are many types of childhood traumas. Physical and sexual abuse are the most obvious. Other traumas may include medical procedures, serious illness, neglect, and emotional abuse.

Daily Living versus Trauma Living

People with dissociative disoders live in two separate realities. They work, parent their children, make plans, eat, and do other functions of daily living. Meanwhile, portions of their brains are locked down in past traumas, which repeatedly re-play themselves. Some of the symptoms of dissociation--“zoning out”, feeling detached from self and others, amnesia—occur in order to keep trauma living and daily living separated. Other symptoms, such as intrusive memories, nightmares, insomnia, and panic, occur when trauma living intrudes upon daily living.

“Parts”

Often people with dissociative disorders have different “parts.” This is especially true of Dissociative Identity Disorder. “Parts” have also been referred to as “alters,” “modes,” or “personalities.” Some of these parts help out with daily living. For example, one part might be responsible for working at a job and another for caring for children. Some parts are stuck in past traumas. These “trauma parts” might seem to be like children, angry adolescents, or internalized perpetrators. For people with DID, parts often appear to be quite separate and may even have different names. For persons with less severe dissociative disoders, parts may be less well defined.

Parts have different ways of perceiving the world and different behavioral patterns or habits. For example, one part may believe that “people are always out to get me,” while another part perceives that others are generally helpful. A person with a dissociativedisorder, then, could act distrustful one day and trusting the next depending on which parts are more active.

Sometimes a part “takes over” the entire functioning of the person, and the person has amnesia for the events which occurred during this time. More often, parts exhibit a “passive influence.” That is, they subtly influence the person’s perceptions, emotional responses, and behaviors. The person may think later, “I don’t know why I acted that way. What was I thinking?”

The Process of Psychotherapy

The basic healing work for people with dissociative disorders is trauma resolution. However, it is NOT advisable to begin psychotherapy by talking about past traumas. Beginning psychotherapy with “memory work” can suddenly and drastically increase panic, rage, and suicidal thoughts. Instead, it is important to work with all of the parts to achieve the following goals:

• Daily living parts work together to meet needs such as consistent employment, friendships, rest, and adequate nutrition.
• Trauma parts recognize that the traumas are no longer occurring and are able to be comforted.
• All parts work together to avoid self-destructive behaviors such as substance abuse, self-injury, and suicide attempts.
• All parts agree that memories can be shared with the self and with the therapist.

When these goals are achieved, it is safer to proceed with trauma resolution.

Coping Skills

The Coping Skills Groups I lead can be helpful for people with Dissociative Disorders. Some of the skills taught help participants to decrease the symptoms of dissociation, especially “zoning out” and intrusive memories. Other skills help with regulating mood states, so that parts don’t try to “take over” or cause self-destructive behaviors.

Click here to find out more about my Coping Skills Groups.

Psychiatric Care

Most people with dissociative disorders benefit from psychiatric medications. It is not necessary to suffer with symptoms of mood disoders, suicidal thoughts, or panic attacks. While medications do not resolve the dissociative disorder, they can reduce symptoms enough so that clients can effectively participate in therapy. Only psychiatrists or other medical doctors can prescribe psychiatric medications.

For more information on Dissociative Disorders, visit the International
Society for the Study of Dissociation and Trauma.

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