whattdoesdissociationfeellike

[whattdoesdissociationfeellike]

Living With Dissociative Identity Disorder

What Does DID mean?

DID stands for Dissociative Identity Disorder and is the new name for Multiple Personality Disorder. All this means is that there is more than one person in your body, often these other people were split from you in order to help you cope with traumas you went through as a child (these traumas need not necessarily be abuse), although this is not always the case. There is no known cause of DID and there are studies that suggest that some people with DID have never been abused, either as a child or adult.

How Do I Know If I Have DID?

Many people are aware they have DID before they are officially diagnosed. You may see, hear or even just have a sense that you have people inside. The signs of DID are difficult to define as they vary so widely from person to person. Some people lose time and are told of conversations they have had and things they have done that they have no memory of, other people are co-conscious and never lose time, they are always aware of what has happened even when they are inside.

Unfortunately the media has presented a "popular" version of DID that normally has no resemblance to what it's like to actually live with and therefore do not judge yourself on what you have seen or read in the media.

What Do You All Need?

Probably the most important thing to consider is what you all need, not just you but those inside too. They will have needs and desires that differ to yours but are just as important. If communication is poor there are ways to work on this. Have a file on a computer that you can type to each other on, have a notepad that you carry around so that you can write notes to each other. If you have a specific question that you want or need the answer then write this on a sheet of paper, leave it in an obvious place and check back later for an answer.

If communication is bad then be sure to keep a diary of any important things that has happened each day and any meetings or appointments to be sure that nothing gets forgotten.

Don't You Have to Integrate to Live a Normal Life?

Actually no, and I would never even consider integration with a client until everyone was working together and living a 'normal' life. After this if you, as my client, wanted to integrate that is something we could look at together. Some people, especially if the DID is brought on through trauma or abuse, never feel complete until they have integrated. If this is true for you then we can and will work towards integration once you are all functioning cooperatively as a group.

On the other hand, I have worked with several people who feel strongly that integration isn't right for them. One person I have worked with said "I'd hate to find myself abandoned alone in this body and mind, after all these years." Similarly, someone else has said "We've been on meds before that inhibited our ability to communicate, and that was really hard for us. Everything seemed turned upside down and backwards. It was also very uncomfortable. As far as integration goes, I think it would feel the same, like a huge part of our life was missing and we don't want that."

DID can be very disabling for some people and I am not trying to deny that. The important point when trying to cope with this is not to focus on integration but instead to improve communication and to learn how to work together. Only after this should integration be even considered. You may find that integration isn't an option you wish to consider. When I talked to people with DID about writing this article one thing stood out to me. DID need not be a disorder or even a negative experience. I was given statements that pointed out the positive elements such as "it's hard to feel lonely when you're never truly alone." and "we find it harder to be in denial because there's always someone who points out what we don't want to look at."

[whattdoesdissociationfeellike]

Dissociative Identity Disorder - What's the Modern Hype?

"Because, we're the same person," the famous line that twisted the whole plot of the 1999 hit blockbuster "Fight Club" awed many people including myself. For some reason, the thought of having two completely different identities still amazes me today. Dissociative Identity Disorder "is a severe condition in which two or more distinct identities, or personality states, are present in -- and alternately take control of -- an individual" (Stephens, 2005).

Although in the case of "Fight Club" the narrator's disorder was a more severe case, in which both his identities had their own separate lives, the nature of Dissociative Identity Disorder (DID) for many cases shows only a few distinct characteristics, because the identities are not fully independent. That is the reason the name of the disorder was changed from "multiple personality disorder" to DID (Barlow & Durand, 2005).

Now before we get into the fun waking conscious and legal issues in DID, let's look at some statistics and causes of this disorder. Although Hollywood films portray the disorder for the subject to have two distinct personalities, the actual number reported by clinicians is closer to 15 with a female to male ratio of 9:1, these findings are based on accumulated case studies (Barlow & Durand, 2005). A large portion of patients diagnosed with DID are also diagnosed with other psychological disorders, to make this more clear, a sample of over 100 patients were found to have an average of seven additional disorders on top of the DID (Barlow & Durand, 2005).

The cause of DID seems to be universal, in 97% of the cases, significant trauma was previously experienced. The patient was extremely and unspeakably abused as a child, usually sexually or physically, with 68% reporting incest (Barlow & Durand, 2005). From experiencing such trauma, there is a "wide-range agreement that DID is rooted in a natural tendency to escape or 'dissociate' from the unremitting negative affect associated with severe abuse" (Barlow & Durand, 2005).

Steering away from the physical and sexual abuse relating to DID, the disorder in itself is extremely interesting and perplexing. Hollywood films only add to its compelling nature by over dramatizing the identities, creating a "what if" phenomenon in all its viewers, "what if I had another identity". In my experience, everyone wants to be someone better, everyone has flaws that they wish magically disappear, this thought of DID, having a smarter, "smoother", and overall better identity is what drives people to be so fascinated with this disorder. We live our lives day by day, as our waking conscious builds our model of the world. Although many of us will never get to experience the real clinical DID, Robert Ornstein believes that "We all experience mind split."

He gives a very real example of how many of us just feel "out of it" and suddenly snaps back to reality, with absolutely no recollection of time (Ornstein, 1991). "Reading a sentence, we are consciously aware of meaning but we are not usually conscious of the spelling of words, hence the difficulty of proofreading (did you notice that consciously was misspelled earlier in this sentence?). And we are not conscious of grammar unless wrong it being" (Ornstein, 1991). So with Ornstein's example, we can somewhat create a simulation of what a person with DID may feel like. One big factor in DID is memory loss or amnesia prior to the "switch", just like we are conscious of the meaning of a sentence, but not particularly the spelling, a patient with DID, or "multiple selves" although may be aware of the other selves, but not the specific situation (Ornstein, 1991) thus resulting in a memory lapse.

Eric Eich, et al., did a research study in 1997 on nine patients with DID. What they were looking for was the relevance of interpersonal amnesia among the patients to see if memories of certain events experienced by one identity, could be recalled later by that same identity, but not the alters. The results further strengthened the reasoning for memory lapses in patients with DID, as the patients in the study after a test of free recall, did very poorly, where only one word out of 180 presented to a patients "p1" identity was properly recalled by their "p2" identity. In addition, none of the 180 words were recalled when they were initially given to the "p2" and asked for recall by the "p1". (Eich et al., 1997). Although their study did not employ all the possible ways of measuring interpersonal amnesia, their results are fairly consistent with other scientific findings on the subject, although one interesting finding in the study was that the "leakage" of information that occurs from one identity to the other "depends on the extent to which encoding and retrieval processes are susceptible to personality-specific factors" (Eich et al., 1997).

"Our normal waking consciousness builds us a model of the world, based on sense and body information, expectations, fantasy and crazy hopes, and other cognitive processes. If any of these factors is radically altered, an altered state of consciousness may result" (Ornstein, 1991). If we look at that quote and break down its meaning, it is clear then as to why so many victims of severe physical or sexual abuse may "dissociate" and form alter identities. If their "real" world is drastically destroyed, then they must form these "alters" to cope with their shattered world, in essence they create a stronger identity able to cope with the traumatic events of which the previous could not.

DID at times, takes attention away from the subjects being the victim, a good example of this is when DID patients turn to criminal activities. When later presented in court, the subject has no recollection of his crimes (Noonan 2000). Now the question in focus is whether the subject is responsible for his actions (particularly in the case of homicide), or if he can be released to a mental institution for reasons of insanity (Noonan, 2000). Assuming the subject is not faking DID, judicial approaches to determining responsibility can be very challenging as the court would have to decide first if the subject actually meets the diagnostic criteria for Dissociative Identity Disorder set forth in the DSM-IV. After determining if DID is present, then an assessment of the subjects host personality would have to be taken (most likely by a professional i.e. forensic psychiatrist) to determine if the host was aware of the alter personalities actions, and whether or not the host assisted in the criminal activity (Noonan, 2000).

Many times in these cases, a defendant in court, on trial for serious charges (e.g. murder) may fake DID to get off on a plea of insanity. With this in mind, there have been many ways to determine whether or not the defendant is malingering, one method often used is having each alter take the Minnesota Multiphasic Personality Inventory (MMPI) (again usually administered by a professional). The MMPI is such a unique test in that it does a really accurate job in measuring ones personality, so if the subject indeed does have DID, the MMPI tests taken by the alter identities should vary considerably. (Noonan, 2000). Other ways of determining if one is faking DID is often by structured interviews with psychologists. In one case, a psychologist had every reason to believe his subject (a serial rapist and murderer) met the criteria for DID, until he did one last test; the subject claimed to have two identities, but when the psychologist mentioned that the usual case for DID is three identities, the subject quickly created a third, unexpectedly. On this basis, the subject was found guilty and sentenced to life.

Finally after going through the fun times of altered identities and trying to evade murder, it is time to put a stop to this train of DID. Treatment of DID however is very complex in it nature, mainly because you are trying to just down possibly hundreds of different identities. The best treatment for DID is definitely long-term psychotherapy, where a therapist must gather as much information on the subjects past and use mapping techniques to bring each identity together (Kluft 1999). Getting the subject's history is particularly important, as the therapist must take extreme caution not to jump right into healing the past trauma without prior background knowledge (Kluft 1999).

In treatment, the therapist wants to get to the threshold of moving toward a resolution, thus integrating the alters, essentially bringing them together, working out the differences. Once the integration step is accomplished, it is downhill from there, now the therapist must focus on coping skills for the patient after his new found resolution among his identities. These are skills dealing with relationships and life decisions. Once the subject gets a feel for these coping skills, the therapist will want to solidify these skills, making sure the subject has mastered them and is able to use them as if they were automatic. Routine follow-ups are necessary obviously to make sure the subject continues to use the learned skills and does not relapse to the alter identities (Kluft 1999). Although this is a very effective method of treatment for DID, it is important to know every case if different and this method will not work on everyone with the disorder.

"DID reflects a failure to integrate various aspects of identity, memory and consciousness in a single multidimensional self" (Stephens 2005). To the many of us without DID, we may never know exactly how that feels, but if we want to get close, we should listen to Robert Ornstein, and just proofread a paper.

[whattdoesdissociationfeellike]

How To Identify Severe Dissociative Disorders After Trauma

Tom was stunned. The last he remembered he was at home enjoying a cold Sunday winter morning with his family. And now... well, he found himself at a biker's bar. Instead of his fashionable trousers and shirt, he was wearing leather chaps and jacket. To his shock, he was holding a cigarette in one hand and a beer in the other. He hated both.

A woman, whom he didn't recognize, called to him, addressing him as John. She wanted to know if he wanted to join everyone for a ride on the bikes to the mountains. Tom did not know how to answer. John, whoever he was, certainly was not him! Tom had no interests in bikes nor had he ever rode one; he liked driving his BMW if he wanted to go into the mountains with wine, not beer, in the trunk. Something was terribly wrong and he was terrified.

Tom's experience is not uncommon for those who experience severe dissociative disorders- those experiences, which are not induced by use of drugs, that severely disrupt our memory, identity, perceptions and our ability to function in our daily lives.

DISSOCIATION: FROM MILD TO SEVERE

what does dissociation feel like, having time go in slow motion, or a sense of floating outside of your body- is a very natural process can happen after trauma; it's one way that our bodies help us to cope with overwhelming threats. In mild cases, the symptoms are transient; after the threat passes, we return to feeling and acting like ourselves. Some people, however, live their lives in a dissociated state long after the threatening events, which are usually related to prolonged and severe childhood abuse, have passed. By knowing what to look for to help identify severe dissociation, you can better choose the care you need to recover from severe trauma.

5 QUESTIONS TO ASK TO HELP YOU IDENTIFY SEVERE DISSOCIATION

1. Do you experience severe memory loss?

As in the example above, you cannot remember significant things about yourself. These can include: how you arrived at a strange place, your address or other important identifying information, skills you learned as a child or what season it is.

2. Does your physical body or emotions seem unfamiliar?

When this happens, you may feel invisible to others or as though you are viewing yourself as someone in a strange movie. Your mind can become cloudy so that you lose the ability to respond to danger appropriately.

3. Does your environment and all that is happening around you become unreal? What should be familiar appears very foreign. Even people who are close to you appear as strangers. Objects appear distorted and may change shape or color.

4. Do you feel as though you are split into several different people?

Rather than having beliefs, goals and ideals that are fairly consistent throughout your adult life, you have ongoing intense daily struggles as to who you are and what you think. At times, you may even wonder if you are male or female.

5. Have others commented about how your personality changes significantly?

Those close to you notice how you will act, think and feel a certain way then shift to another and very different way of looking and acting. You may use different names, change your penmanship dramatically, speak other languages or perform certain tasks even though you don't remember learning how to do them. John, in the story above, had very different tastes in dress and habits than the family man named Tom.

HOW ARE DISSOCIATIVE DISORDERS DIAGNOSED?

There are several forms of dissociative disorders with the most serious being Dissociative Identity Disorder, formerly known as Multiple Personality Disorder. Completing a special psychological test that is administered by a person trained in psychological testing usually provides a formal diagnosis. One such test is called the "Steinberg Clinical Interview for DSM-IV Dissociative Disorders" or SCID-D. A sample of this test is in an easy-to-read book entitled The Stranger in the Mirror: Dissociation: The Hidden Epidemic by Marlene Steinberg, MD and Maxine Schnall, © 2001 by Harper Collins Publishers. By completing this sample test, you will know if you should pursue formal testing and work with a therapist trained specifically in dissociative disorders.

BUT WAIT...

I'm afraid, if I talk to someone about these weird symptoms, I will start to think I am crazy, never mind what others will think!

Having things like severe memory loss and confusion about whether you are male or female combined with feeling like you are living in someone else's body can be alarming, to say the least. Working with a therapist, who is trained in identifying dissociative disorders, can actually be huge relief.

For example, by providing you with a correct diagnosis, you can avoid the ineffectual medical and therapy treatments that come with being mistakenly diagnosed with other conditions such as schizophrenia or bipolar. In addition, a trained therapist will help you see how being able to dissociate saved your life and kept you from actually going crazy!

I saw a therapist who said that there is no such thing as multiple personality disorder and that I was making it all up. Should I believe him?

Fortunately, more therapists are accepting the reality that severe abuse can lead to severe dissociative disorders and they are getting training in how to work with them. While some clients may try to fake the symptoms of dissociative disorders, psychological tests combined with clinical interviews are very good tools for identifying who actually has dissociative identity disorder, formerly known as multiple personality disorder. You can find a list of professionals who know about dissociation through the International Society for the Study of Trauma and Dissociation (isst-d.org).

I heard that someone with severe dissociative disorders really couldn't be healed. It's something you just have to live with. If that's the case, why should I even try to find a therapist?

For many years, this was the case; clinicians misdiagnosed individuals and they did not have specialized skills to address the needs of these clients. As we better understand the physiology of what happens in trauma through the work of such people as Dr. Peter Levine, PhD along with how trauma distorts our thinking and emotional development, therapy is much more effective in diminishing the body's need to dissociate. Length of treatment will depend on how often and to what degree you dissociate.