Clinic for Dissociative studies


About DID

Dissociative Identity Disorder

The international psychiatric criteria in the DSM IV specify that DID 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 identity 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 and not due to the direct effects of a substance (e.g. blackouts or chaotic behaviour during alcohol intoxication) or a general medical condition (e.g. complex partial seizures).

Professor Peter Fonagy and others have shown that the most common aetiology for DID is a disorganised attachment followed by abuse at the hands of a care-giver (McQueen, D; Kennedy, R; Itzin, C; Sinason, V; Maxted, F, 2009).

Whilst some people with DID have ‘alters’ that can communicate with each other, others can experience partial or total amnesia between personality states.  Particular events may trigger flashbacks or bring other personalities to the fore.  The results can have a devastating impact on an individual’s ability to maintain relationships and jobs and even to carry out everyday tasks.


All those faces

International research has shown that long-term specialist therapy is the most effective treatment option, and that as with work with extreme post-traumatic stress, short-term interventions are unlikely to have a lasting effect if used in isolation.  For some patients, particularly those coming to treatment early, the prognosis can be good.  For others, particularly if they are still being exposed to trauma and abuse, treatment needs to be approached in a similar way to that for long-term conditions, with the aim of minimising further psychological damage, improving quailty of life and reducing risk.

Major research from the Albert Einstein College of Medicine (Foote, Smolin, Neft and Lipschitz, 2008) has shown that adults with dissociative disorders are at high risk of suicide or self-harm, as well as sectioning and other unplanned psychiatric admissions.  As a result of its clinical and theoretical understanding of this subject the risk of suicide or involuntary psychiatric admissions of clinic patients has been substantially reduced.

5 responses »

  1. In all my time working in psychiatric enviornments I have yet to run into a DID case, yet DID is one of the main reasons I’ve gotten into psychology. I have read countless case studies on DID and still find it fascinating and I have also seen some extreme cases of schizophrenia that no textbook could do justice.

    • I think it exists, but that the understanding of it, might be somewhat disrupted by how movies etc portray it. When one thinks about it, a lot of people are able to “get into” the character and emotion of others, its actually an empathy skill. I recommend the book “the stranger in the mirror”, as it describes three cases of DID, and it also explains the symptoms in a very readable way, 🙂

  2. I wonder if people don’t see it partially because they are looking for the wrong signs. I’ve read thru ISSTD’s guidelines, and my wife had almost NONE of the typical signs associated with the disorder. I even did a little article on the “atypical signs” because only in retrospect can I see the clues of her disorder.

    • An interesting question. I have also read that the NP (normal part of the personality) can be highly intelligent and function well in society, and like many knows, we only see a little part of the truth in our clinics. Even very disturbed patient can pull themselves together immensely right before they talk to the doctor. We often see what we look for; If we are a drug specialist, we will look for drug abuse and so on 🙂 Thanks for this insightful comment!

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