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Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse,somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5
James A. Chu
Dissociative identity disorder is conceptualized as a childhood onset, posttraumatic developmental disorder in which the child is unable to consolidate a unified sense of self. Detachment from emotional and physical pain during trauma can result in alterations in memory encoding and storage. In turn, this leads to fragmentation and compartmentalization of memory and impairments in retrieving memory.2,4,19 Exposure to early, usually repeated trauma results in the creation of discrete behavioral states that can persist and, over later development, become elaborated, ultimately developing into the alternate identities of dissociative identity disorder.
Bethany L. Brand
Prior to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of Dissociative Identity Disorder had been referred to as Multiple Personality Disorder. The renaming of this diagnosis has caused quite a bit of confusion among professionals and those who live with DID. Because dissociation describes the process by which DID begins to develop, rather than the actual outcome of this process (the formation of various personalities), this new term may be a bit un
Karen Marshall
Shortly after I began work with Teresa, I acquired another MPD client, a supposedly schizophrenic young man I will call Tony. He called in to the clinic on a day I was on telephone duty, saying he was having flashbacks of "ritual abuse.” I did not yet know what that was. Tony became my client. He could be quite entertaining. I have a vivid memory of him as a three-year-old, "Tiny Tony,” standing on his head on my office couch, and running down the hall to try unsuccessfully to make it to the bathroom. He had in his head the entire rock band of Guns’n’Roses, and I got to know Axl, the band leader, quite well. I remember the time Tony was in hospital and I went to visit him; Axl popped out and said, "Remember, we’re schizophrenic in here!
Alison Miller
Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters.Good DID therapy involves promoting co-consciousness. With co-consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal.Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-coordinated or living in harmony. If they were all in harmony, there would be no “disease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.
David Yeung
Did I imagine the castle, the dungeon, the ritual orgies and violations? Did Lucy, Billy, Samuel, Eliza, Shirley and Kato make it all up? I went back to the industrial estate and found the castle. It was an old factory that had burned to the ground, but the charred ruins of the basement remained. I closed my eyes and could see the black candles, the dancing shadows, the inverted pentagram, the people chanting through hooded robes. I could see myself among other children being abused in ways that defy imagination. I have no doubt now that the cult of devil worshippers was nothing more than a ring of paedophiles, the satanic paraphernalia a cover for their true lusts: the innocent bodies of young children.
Alice Jamieson
In this chapter I restrict myself to exploring the nature of the amnesia which is reported between personality states in most people who are diagnosed with DID. Note that this is not an explicit diagnostic criterion, although such amnesia features strongly in the public view of DID, particularly in the form of the fugue-like conditions depicted in films of the condition, such as The Three Faces of Eve (1957). Typically, when one personality state, or ‘alter’, takes over from another, they have no idea what happened just before. They report having lost time, and often will have no idea where they are or how they got there. However, this is not a universal feature of DID. It happens that with certain individuals with DID, one personality state can retrieve what happened when another was in control. In other cases we have what is described as ‘co-consciousness’ where one personality state can apparently monitor what is happening when another personality state is in control and, in certain circumstances, can take over the conversation.
John Morton
Some alters are what Dr Ross describes in Multiple Personality Disorder as 'fragments'. which are 'relatively limited psychic states that express only one feeling, hold one memory, or carry out a limited task in the person's life. A fragment might be a frightened child who holds the memory of one particular abuse incident.' In complex multiples, Dr Ross continues, the 'personalities are relatively full-bodied, complete states capable of a range of emotions and behaviours.' The alters will have 'executive control some substantial amount of time over the person's life'. He stresses, and I repeat his emphasis, 'Complex MPD with over 15 alter personalities and complicated amnesia barriers are associated with 100 percent frequency of childhood physical, sexual and emotional abuse.' Did I imagine the castle, the dungeon, the ritual orgies and violations? Did Lucy, Billy, Samuel, Eliza, Shirley and Kato make it all up? I went back to the industrial estate and found the castle. It was an old factory that had burned to the ground, but the charred ruins of the basement remained. I closed my eyes and could see the black candles, the dancing shadows, the inverted pentagram, the people chanting through hooded robes. I could see myself among other children being abused in ways that defy imagination. I have no doubt now that the cult of devil worshippers was nothing more than a ring of paedophiles, the satanic paraphernalia a cover for their true lusts: the innocent bodies of young children.
Alice Jamieson
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