DISSOCIATIVE IDENTITY DISORDER

JAYANT KISHNANI

“Dissociative Identity Disorder (DID), also known as Multiple Personality Disorder is a

severe condition in which two or more distinct identities, or personality states, are
present and alternately take control of an individual.”

ACKNOWLEDGEMENTS
I would like to thank my Psychology teacher, Mrs. Garima Sandhu, who
has been instrumental in the success of this project and has helped in
the very selection of this topic. All of her suggestions and advices
proved to be extremely helpful and insightful.
I would also like to thank my parents and my friends who provided me
with immensely helpful tips and guidance, without which my project
would have been incomplete.

Palomi Jain
XII-C

TABLE OF CONTENTS

1. Acknowledgements
2. Introduction to DID
3. Causes
 4. Symptoms
5. DID in Children
6. Treatments and Therapy
7. Famous Cases of DID
8. Bibliography

DISSOCIATIVE IDENTITY DISORDER

DID is a disorder characterised by identity fragmentation rather than a
proliferation of separate personalities. The disturbance is not due to the direct
psychological effects of a substance or of a general medical condition. DID
was called multiple personality disorder until 1994, when the name was
changed to reflect a better understanding of the condition—namely, that it is
characterized by a fragmentation, or splintering, of identity rather than by a
proliferation, or growth, of separate identities.  As this once rarely reported
disorder has become more common,
the diagnosis has become controversial. It is a rare dissociative disorder in
which two or more personalities with
DID reflects a failure to integrate various distinct memories and behaviour
patterns apparently exist in one
aspects of identity, memory, and
individual.
consciousness into a single
multidimensional self. Usually, a primary
identity carries the individual's given name and is passive, dependent, guilty,
and depressed. When in control, each personality state, or alter, may be
experienced as if it has a distinct history, self-image and identity. The alters'
characteristics—including name, reported age and gender, vocabulary,
general knowledge, and predominant mood—contrast with those of the
primary identity. Certain circumstances or stressors can cause a particular
alter to emerge. The various identities may deny knowledge of one another,
be critical of one another or appear to be in open conflict.

Possession-form identities often manifest as behaviors that appear as if a

spirit or other supernatural being has taken control of the person. Many
possession states around the world are a normal part of a cultural or spiritual
practice; these possession states become a disorder when they are
unwanted, cause distress or impairment, and are not accepted as part of a
cultural or religious practice. 

Causes
Why some people develop DID is not entirely understood, but they frequently
report having experienced severe physical and sexual abuse, particularly
during childhood. Among those with the DID in the U.S., Canada, and Europe,
approximately 90 percent report experiencing childhood abuse. 

The disorder may first manifest at any age. Individuals with DID may have
post-traumatic symptoms (nightmares, flashbacks, and startle responses) or
post-traumatic stress disorder. Several studies suggest that DID is more
common among close biological relatives of persons who also have the
disorder than in the general population. As this once rarely reported disorder
has grown more common, the diagnosis has become controversial. Some
believe that because DID patients are highly suggestible, their symptoms are
at least partly iatrogenic—that is, prompted by their therapists' probing. Brain
imaging studies, however, have corroborated identity transitions.

Symptoms

The following criteria must be met for an individual to be diagnosed with

dissociative identity disorder:
• The individual experiences two or more distinct identities or personality
states (each with its own enduring pattern of perceiving, relating to, and
 thinking about the environment and self). Some cultures describe this as
an experience of possession.
• The disruption in identity involves a change in sense of self, sense of
agency, and changes in behavior, consciousness, memory, perception,
cognition, and motor function.
• Frequent gaps are found in memories of personal history, including
people, places, and events, for both the distant and recent past. These
recurrent gaps are not consistent with ordinary forgetting.
• These symptoms cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning. 

Particular identities may emerge in specific circumstances. Transitions from

one identity to another are often triggered by psychosocial stress. In the
possession-form cases of dissociative identity disorder, alternate identities
are visibly obvious to people around the individual. In non-possession-form
cases, most individuals do not overtly display their change in identity for long
periods of time. 

People with DID may describe feeling that they have suddenly become
depersonalized observers of their own speech and actions. They might
report hearing voices (a child's voice, the voice of a spiritual power), and in
some cases, these voices accompany multiple streams of thought that the
individual has no control over. The individual might also experience sudden
impulses or strong emotions that they don't feel control or a sense of
ownership over. People may also report that their bodies suddenly feel
different (like a small child, huge and muscular), or that they experience a
sudden shift in attitudes or personal preferences before shifting back. 

Sometimes with DID experience dissociative fugues, where they discover

they have traveled but have no recollection of the experience. People vary in
their awareness of their amnesias, and it is common for people with DID to
minimize their amnestic symptoms, even when the lapses in memory are
obvious and distressing to others. 

More than 70 percent of people with DID have attempted suicide, and self-
injurious behavior is common among this population. Treatment is crucial to
improving quality of life and preventing suicide attempts.

DID in Children

DID can also be seen in children since the disorder usually starts early due to
severe neglect, abuse or trauma that occurred in childhood.

Psychiatrist Frank Putnam, National Institute of Mental Health, supports this

view of the disorder’s etiology. Young children faced with severe sexual or
physical abuse or neglect, have no effective way of fighting or avoiding the
offender. To escape the painful reality, the only tool available during the
abusive incident is that of dissociation. Separating mind from physical
experience provides a sense of protection. In addition, dissociation interferes
with the process of memory encoding, so that sometimes there is little or no
memory of the traumatic event.

Although dissociation may help children cope with maltreatment in the short
run, it can become problematic. Some traumatized children use dissociation
to cope with stress in a wide variety of settings, including the classroom,
playground, and at home. Frequent dissociation of memories, emotions, and
thoughts interferes with normal functioning and results in socialization
problems.
Accurately diagnosing children with DID can be a challenge. And often,
children are misdiagnosed with more common mental illnesses such
as depression and attention deficit hyperactivity disorder, leading to incorrect
treatment.

Jeffrey Haugaard, a professor of human development at Cornell University

outlines some symptoms in children with DID. Common signs are frequent
trance-like states (“spacing out” or daydreaming), as well as the child
reporting that people often become angry or upset with them for unknown
reasons. Or, the child shows dramatic changes in preferences, such as food,
games, or clothes, as well as changes in language, accent, or even voice or
handwriting style. The child may experience recurrent periods of amnesia or
missing blocks of time, such as having no memory of the previous day, which
may include denying behaviours that others have personally witnessed the
child do. These could be negative behaviors, but may also include behaviours
that the child would appear to have little motivation to deny. Additional
common signs in children with DID are having an imaginary friend well into
school-age, as well as unprovoked rages and violent behaviour that may
seem to come out of nowhere.

Lise McLewin, a psychologist practicing in Victoria, British Columbia suggests

a few differences between the imaginary play of typically developing children
and those with DID. Children with DID are much more likely to develop
imaginary friends at a younger age (two or three years old), and often have
more of them. These friends seem very real to the child with a great deal of
reality confusion and persistent impersonation. The imaginary friend does not
always “act” in the best interest of the child. And, the child may be truly
unable to remember misbehaviours, blaming it on the imaginary friend.

Typically developing children better appreciate the difference between real

and pretend, and that their imaginary friends are not real. They also tend to
discontinue this kind of play by the age of ten.
Individuals with DID are treated mostly with psychotherapy. Nonverbal forms
of psychotherapy such as hypnosis, art, and play therapy are also common
because they help the patient express the trauma when it is too difficult to
express verbally. Children with DID are easier to treat than adults and have
higher recovery rates, so it is important to bring to the attention of healthcare
professionals and parents the signs of this disorder so that it can be treated
early on.

Treatments and Therapy

The primary treatment for DID is long-term psychotherapy with the goal of
deconstructing the different personalities and uniting them into one. Other
treatments include cognitive and creative therapies. Although there are no
medications that specifically treat this disorder, antidepressants, anti-anxiety
drugs or tranquilizers may be prescribed to help control the mental health
symptoms associated with it. With proper treatment, many people who are
impaired by DID experience improvement in their ability to function in
their occupational and personal lives. 

In treating individuals with DID, therapists usually try to help clients improve
their relationships with others and to experience feelings they have not felt
comfortable being in touch with or openly expressing in the past. This may be
done using individual, family, and/or group psychotherapy. It is carefully
paced in order to prevent the person with DID from becoming overwhelmed
by anxiety, risking a figurative repetition of their traumatic past being inflicted
by those very strong emotions. Dialectical behavior therapy is a form of
cognitive behavior therapy that emphasizes mindfulness and works on
helping the DID sufferer soothe him- or herself by decreasing negative
responses to stressors.
Mental health professionals also often guide clients in finding a way to have
each aspect of them coexist, and work together, as well as developing crisis-
prevention techniques and finding ways of coping with memory lapses that
occur during times of dissociation. The goal of achieving a more peaceful
coexistence of the person's multiple personalities is quite different than the
reintegration of all those aspects into just one identity state. While
reintegration used to be the goal of psychotherapy, it has frequently been
found to leave individuals with DID feeling as if the goal of the practitioner is
to get rid of, or "kill," parts of them.

Hypnosis is sometimes used to help increase the information that the person
with DID has about their symptoms/identity states, thereby increasing the
control they have over those states when they change from one personality
state to another. That is said to occur by enhancing the communication that
each aspect of the person's identity has with the others. In this age of
insurance companies regulating the health care that most Americans receive,
having time-limited, multiple periods of psychotherapy rather than intensive
long-term care provides what may be another effective treatment option for
helping people who are living with DID.

Eye movement desensitization and reprocessing (EMDR), a type of treatment

that integrates traumatic memories with the patient's own resources, is being
increasingly used in the treatment of people with dissociative identity
disorder. It has been found to result in enhanced information processing and
healing.

Medications are often used to address the many other mental health
conditions that individuals with DID tend to have, like depression,
severe anxiety, anger, and impulse-control problems. However, particular
caution is appropriate when treating people with DID with medications
because any effects they may experience, good or bad, may cause the
sufferer of DID to feel like they are being controlled, and therefore traumatized
yet again. As DID is often associated with episodes of
severe depression, electroconvulsive therapy (ECT) can be a viable treatment
when the combination of psychotherapy and medication does not result in
adequate relief of symptoms.
 FAMOUS CASES OF DID

Truddi Chase

Truddi Chase claims that since she was two,

in 1937, her stepfather physically and
sexually assaulted her, while her mother
emotionally abused her for 12 years. As an
adult, Chase was under tremendous stress
while working as a real estate broker. She
went to a psychiatrist and discovered that
she had 92 different personalities that were
vastly different from each other.

The youngest was a girl about five or six years old named Lamb Chop.
Another was Ean, an Irish poet and philosopher 1,000 years old. None of the
personalities worked against one another and seem to be aware of one
another collectively. She didn’t want to integrate the personalities because
they all had been through so much together. She referred to her personalities
as “The Troops.”

Chase, along with her therapist, wrote the book When Rabbit Howls, and it
was published in 1987. It was adapted into a TV miniseries in 1990. Chase
also appeared on a very emotional segment of the Oprah Winfrey show in
1990. She died on March 10, 2010.
BiIlly Milligan

From October 14–26, 1977, three women

around Ohio S tate University were
kidnapped, taken to a secluded area, robbed,
and raped. One woman claimed the man
who raped her had a German accent, while
a n o t h e r o n e c l a i m e d t h a t ( d e s p i te
kidnapping and raping her) he was
actually kind of a nice guy. However, one man
committed the rapes: 22-year-old Billy
Milligan.

After his arrest, Milligan saw a psychiatrist, and he was diagnosed with DID.
Altogether, he had 24 different personalities. So when the kidnapping and
rapes happened, Milligan’s defense attorney said it wasn’t Billy Milligan who
was committing the crimes. Two different personalities were in control of his
body—Ragen, who was a Yugoslavian man, and Adalana, who was a lesbian.
The jury agreed, and he was the first American found not guilty due to DID. He
was confined to a mental hospital until 1988 and released after experts
thought that all the personalities had melded together.

In 1981, Daniel Keyes, the award-winning author of  Flowers for Algernon,
released a book about Milligan’s story called  The Minds of Billy Milligan. An
upcoming film based on his story,  The Crowded Room, will reportedly
star Leonardo DiCaprio.

Milligan died December 12, 2014 at the age of 59 from cancer.

The Trial Of Mark Peterson

On June 11, 1990, 29-year-old Mark Peterson

took an unidentified 26-year-old woman out
for coffee in Oshkosh, Wisconsin. They had
met two days prior in a park, and while they
were out, the woman says she started to show
Peterson some of her 21 personalities. After
they left the restaurant, Peterson suggested
that they should have sex in his car, and she
agreed.

However, a few days after the date, Peterson was arrested for sexual assault.
Apparently, two of the personalities  did not consent. One was 20 years old
and emerged during sex, while another personality, a six-year-old, watched
on.

Peterson was charged and convicted of second-degree sexual assault

because it is illegal to knowingly have sex with someone who is mentally ill
and cannot give consent. The verdict was overturned a month later, and
prosecutors didn’t want to put the woman through the stress of another trial.
Her personalities had increased to 46 between the incident in June and the
trial in November. Peterson was never retried for the crime.
 BIBLIOGRAPHY
https://www.psychologytoday.com/conditions/dissociative-identity-
disorder-multiple-personality-disorder

https://www.psychologytoday.com/blog/talking-about-trauma/201312/
understanding-dissociative-identity-disorder-in-children

http://listverse.com/2015/03/16/10-famous-cases-of-dissociative-identity-
disorder/