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According to the Diagnostic Statistics Manual version IV (DSMIV) which is the main book of reference, used by professionals in identifying Psychiatric disorders, Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) is
* The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
* At least two of these identities or personality states recurrently take control of the person's behaviour.
* Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
But what does that mean in everyday terms? Basically DID/MPD is an innovative and highly individualist survival technique. It is the creative attempt of highly traumatized children to protect themselves from what's happening to them. (Example "This isn't happening to me.") When these children dissociate from the trauma, they become different personalities within one body. Only young children, around the age of eight and under have the flexibility and vulnerability to adapt to trauma by means of creating personalities. Each child is different; the abuse that causes one child to dissociate to the point of different personalities won’t be the same for another child.
No, MPD and DID are the same thing. There was a problem that resulted from the publishing of the DSMIII R (Diagnostic Statistics Manual 3 Revised), which the ISSD (International Society for the Study of Dissociation) solved by having MPD renamed to DID because of the confusion that resulted from the word personality being used in the former name. DID/MPD has always been under the category Dissociative Disorders and was never found in the Personality Disorders section. The use of the word personality was confusing to not only professionals of mental health, but clients and laypersons as well.
DID is caused by trauma during childhood. There is a dissociative spectrum running from everyday dissociation (example daydreaming) all the way to the other end, which is, DID/MPD. It can occur when a child is traumatized by physical, sexual, emotional, and/or mental abuse. It can also occur by not having their basic needs met; i.e. food, shelter, and/or love. It can also be caused by extensive and/or invasive medical procedures such as transplants, being born premature, on a ventilator, separation from mom and dad. Any combination of this can start the child moving down the dissociative spectrum. The longer the trauma or combinations of traumas exist the further down the spectrum the child can move. Children are different meaning that for one child one instance of trauma is enough to move them all the way to DID while for another child the same trauma only moves them a little way. For other children it takes multiple traumas to move them down the spectrum. But the movement down the spectrum no matter how slow or fast the first instance of trauma must take place before the child is 8-9 years old.
In psychological terms dissociation means "that a person mentally distances themselves from traumatic situations or emotional distress." By using dissociation, a child can mentally remove him/herself from a dangerous, frightening and physically painful experience.
A child of say 5 years old does not have the knowledge or the ability to deal with a physical or sexual attack. Most likely by somebody s/he loves and trusts. The child cannot understand why this person whom s/he loves is hurting him/her in this manner. Most children during sexual abuse feel pain and pleasure. They have no way to comprehend that kind of pain or at times pleasure. So the child goes somewhere safe and happy inside their mind by dissociation. The mind creates an alternate personality (Alter) to come and deal with the abuse.
The more abuse the child experiences the more alters s/he may have. Each alter with its own "relatively enduring pattern of perceiving, relating to, and thinking about the environment and self." Dissociation to the point of forming Dissociative Identity Disorder is a sane and healthy response to an insane and unhealthy situation.
Dr Colin Ross founder of The Ross Institute for the treatment of Dissociative Disorders said, "Multiple Personality Disorder [This quote was given prior to the name change from MPD to DID] is a normal thing to have if you have suffered severe childhood abuse."
DID/MPD was once thought of as a strictly rare disorder, but as more and more reports of severe early childhood abuse come in the easier it is to understand that it is not rare at all. In fact it is estimated that about every 3 in 5 (60%) of children who are severely abused have some degree of dissociation. Whether they move to DID depend on the child. All children are different so the abuse or stressors it takes to cause one child to go multiple would not necessarily cause another child to go multiple.
The range of impairment across different persons with DID/MPD is best analogized to that of alcoholism. Impairment due to alcoholism
* Ranges from skid row bums to high functioning senators, doctors, and corporate executives.
* Alcoholics from one period of time to another can function through binges, different patterns of drinking, life stressors, etc.
It is much the same with DID/MPD. There are some multiples who are chronic state mental patients, others who undergo recurrent hospitalization due to self-destructive behaviour, and many more who raise children, hold jobs, in many areas such as lawyers, physicians, or psychotherapists.
Being DID/MPD helps a child survive traumatic abuse by allowing the memories to be stored away until such a time as the child is able to deal with the memories. Multiples inside family/alters, for the most part, are their good friends. They have come to rescue the child, endured pain, and they have hidden lots of feelings when it wasn't safe for the child to have those feelings, for fear of further abuse or pain.
All humans have different aspects of their personality, but MPD/DID is not that because;
* people with DID/MPD have Post Traumatic Stress disorder.
* People with DID/MPD may have amnesia in regards to many daily activates.
* Those that do not have amnesia feel like they are trapped and being high jacked into something. They see their body doing an activity, but cannot stop it.
* An aspects cannot hide trauma or memories of abuse.
* An aspect cannot be abused individually.
* An aspect does not have its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
* an aspect does not have different IQ levels, educational likes, musical talents, political preferences, food preferences, eye glasses prescriptions, eye colours, allergies, etc
* different aspects cannot change how the brain accesses information.
* alters can and do all the above on a daily basis.
No, in fact it is the ability to dissociate which kept the child and then later the adult, sane. When someone is forced to endure trauma, dissociation is the normal thing to have happen.
No, DID/MPD develops long before a person ever sees a therapist. For most people with DID/MPD it has developed long before the age of eight. It is generally diagnosed around the age of 30 so the person on an average has had 25 years of being DID/MPD before they even see a therapist that can diagnosis them.
Yes, it is not uncommon for alters to have different, eye site, eye colour, sense of smell, foods they like and don’t like, amount they eat, amount of energy they have, hand that is dominate, educational knowledge. When body scans are done of a multiples body it shows physical differences when they switch as well as different pathways for accessing information in the brain.
No. DID/MPD is neither a chemical imbalance nor a psychotic disorder, because of that drugs for depression rarely work unless there is coexisting conditions. Anti psychotics never work because DID/MPD is not a psychotic disorder. People with DID/MPD can often times find relief with anti-anxieties such as Vistaril because those drugs effectiveness is not based on a chemical imbalance.
Cooperation and Integration are both finishing choices of healing. Each family/system has to make the choice together as to how they want to live. Spontaneous Integration is where the mind integrates one or more alters without warning or plans.
Therapists may tell you that in order to truly heal you must integrate. That is not true. I have known some people living in cooperation that were much healthier than those who had integrated and visa versa. How a family/systems decides to finish their healing is a choice to be made as they see fit. It will be there life when they are done not their therapists and how they want to live needs to be decided by the ones who will be living it.
Cooperation is a state of living in peace with everyone inside. Things are laid out and discussed with everyone. Choices are made with everyone being involved. All DID/MPDs need to reach this point in order to heal. But many decide to live out the rest of their lives this way.
Spontaneous Integration is where the mind integrates one or more alters itself. Many believe this to be the way to go over planed integrations. Based on the fact that the mind was smart enough to come apart to survive it will also know when it is safe to come back together. Families/systems that choose to go this way live in cooperation and does all the healing work. When each alter is totally done with their healing they spontaneously integrate. Many people ask, “Well how do I know when someone is done healing?” Spontaneous integration takes out the guess work of planed integration because it won’t happen until the alters are truly done.
Planned Integration is done towards the end of therapy. Where two alters will decide they don’t want to be separate anymore. They will blend together generally by walking into one another and meshing. This can be done as many times as is wanted by the family/system. Some only do this a few times and then the rest live in cooperation, while others will integrate down to one person. However planned integration is very hard to do. It takes very specific healing steps that have to be finished first. All abuse issues need to be taken care of and a level of stability has to be maintained for the persons left. Healthy coping skills have to be established and used daily or else the integration will come apart at the first sign of stress. A person with DID/MPD has established coping skills, which they have been living with for years; it takes a lot of work and commitment to establish a new way of life.
No, if integration is successful the person that is left is a blend of all alters.
Very simply stated it is a gift because being a multiple helped the child to stay alive. It allowed them to protect themselves and remain sane in the face of severe and often time’s long lasting abuse. It allowed them to endure the bad times and to keep their heart and soul safe from their abusers. I am very grateful for the others here with me. We have been able to survive unspeakable and unthinkable abuse together and come out on the other end strong and with a will to live.
Without DID/MPD myself and many of my multiple friends would, I truly believe, be dead right now. To me DID/MPD is like the dashing hero that pushes a child out of the way from a speeding car. Even though that action causes them to be hit by the car. They do it willingly. Just as society would rightly hold that hero in the highest regard, I hold my inside family members/alters and family/system which saved my life, in the same manor.
However, as much as DID/ MPD is a gift; it can still on some days be a difficult thing to live with. Just like in a "real community" there are "people" in my family/system that are good, a few that act inappropriately, some that understand what is going on, some that don't, and some that do but refuse to believe it! Often times these other personalities will "switch", and come out, taking control of the body and its activities. Sometimes things that were supposed to get done one day don't. But we continue to learn and to grow together. Working hard each day to make sure that things improve and that the old unhealthy ways of life do not continue. Each day is new and we are able to start over and learn.
In conclusion, I’d just like to say that DID/MPD is a normal response to an insane situation. A person with DID/MPD is not crazy or psychotic. It allowed them to protect themselves and remain sane in the face of severe and often time’s long lasting abuse. It allowed them to endure the bad times and to keep their heart and soul safe from their abusers. As family and friends of people with DID/MPD I urge you to be supportive and non-judgmental. I know it can be hard to believe, accept and process, but the person with DID/MPD will heal and grow with or without you. I know that from the statements of myself and others we would much rather do it with the support of family and friends then without it.
PTSD is an anxiety disorder that some people get after seeing or living through a dangerous event.
When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.
TSD can cause many symptoms. These symptoms can be grouped into three categories:
1. Re-experiencing symptoms:
Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweatingBad dreamsFrightening thoughts.Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.
2. Avoidance symptoms
Staying away from places, events, or objects that are reminders of the experienceFeeling emotionally numbFeeling strong guilt, depression, or worryLosing interest in activities that were enjoyable in the pastHaving trouble remembering the dangerous event.Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
3. Hyperarousal symptoms:
Being easily startledFeeling tense or “on edge”Having difficulty sleeping, and/or having angry outbursts.Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.
The psychiatric definition is "an event ouside normal human experience." But what exactly is outside normal human experience? According to David Baldwin, trauma involves exposure to a life threatening event. This is trauma in its purest sense. There are however, other forms of trauma. When you look at PTSD, some receive the diagnosis after an event or events which would not constitute life threatening. When there is betrayal from someone you love or depend on for survival, there is a trauma reaction. Examples of this include the sexual abuse of children or surviving combat in a war. Experience of this kind of trauma may increase the likelihood of psychogenic amnesia as compared to fear-based reactions.
ComplexPosttraumatic Stress Disorder has been proposed by Judith Herman in her book Traumaand Recovery, c1992. She suggests that individuals who have been subjectedto months or years of prolonged trauma experience different effects thanindividuals after a one-time trauma or a couple of traumatic experiences. Thediagnostic criteria she recommends is listed below:
1. Ahistory of subjection to totalitarian control over a prolonged period (monthsto years). Examples include hostages, prisoners of war, concentration-campsurvivors, and survivors of some religious cults. Examples also include thosesubjected to totalitarian systems in sexual and domestic life, includingsurvivors of domestic battering, childhood physical or sexual abuse, andorganized sexual exploitation
2. Alterations in Affect Regulation, Including:
-Chronic Suicidal Preoccupation
-Self-Injury Explosive or Extremely Inhibited Anger (May Alternate) -Compulsive or Extremely Inhibited Sexuality (May Alternate)
3. Alterations in Self-Perception, Including:
-Amnesia or Hypernesia for Traumatic Events
-Transient Dissociative Episodes
-Reliving Experiences, either in the form of Intrusive Posttraumatic Stress Disorder symptoms or in the form of ruminative preoccupation
4. Alterations in Perception of Perpetrator, Including:
-Sense of Helplessness or Paralysis of Initiative
-Shame, Guilt, or Self-Blame
-Sense of Defilement or Stigma
-Sense of Complete Difference from Others (may include a sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)
5. Alterations in Relations with Others, Including:
-Isolation and Withdrawal Disruption in Intimate Relationships
-Repeated Search for Rescuer (may alternate with isolation and withdrawal)
-Persistent Distrust Repeated Failures of Self-Protection
6. Alterations in Systems of Meaning:
-Loss of Sustaining Faith
-Sense of Hopelessness and Despair
Elements common to many treatment modalities for PTSD include education, exposure, exploration of feelings and beliefs, and coping skills training. Additionally, the most common treatment modalities include cognitive-behavioral treatment, pharmacotherapy, EMDR, group treatment, and psychodynamic treatment.
Eye movement desensitization and reprocessing (EMDR) is a relatively new procedure. It involves using systematic eye movements to help someone with PTSD process the thoughts and feelings surrounding a traumatic event. If you wish to try this procedure, be sure that your therapist is trained in it.
Only about 15% of people with PTSD have flashbacks. Flashbacks are one of several ways in which a memory of a traumatic event can intrude upon a person's life. Unwelcome feelings, thoughts and images can be just as intrusive.