Podcast Summary
Understanding Dissociative Identity Disorder: A Complex Mental Health Condition: Dissociative Identity Disorder (DID) is a complex mental health condition characterized by disconnection or disintegration of psychologically integrated functions, often resulting from childhood trauma. Dr. Bethany Brand, a specialist in treating trauma related disorders including DID, emphasizes the importance of recognizing its realities and complexities.
Dissociative identity disorder (DID), also known as multiple personality disorder, is a complex and controversial mental health condition. It's defined as a dissociative disorder, which means it involves a disconnection or disintegration of psychologically integrated functions. While some dissociation is normal, such as forgetting parts of a car ride, more pathological dissociation can occur after experiencing serious trauma, especially childhood trauma. DID is more common than portrayed in fiction, but its causes and treatments are still debated among researchers. Dr. Bethany Brand, a clinical psychologist and professor of psychology at Towson University, specializes in the assessment and treatment of trauma related disorders including DID. She explained that people with DID may disconnect from their emotions and body, leading to a disconnection from reality. Dr. Brand is conducting a large prospective treatment outcome study on DID and maintains a private practice focused on assessing and treating patients with trauma disorders. Overall, it's important to remember that DID is a real condition with complex causes and treatments, and it's not as simple or dramatic as its portrayal in fiction.
Understanding Dissociative Identity Disorder as a coping mechanism for childhood trauma: DID is a complex trauma response, allowing individuals to disconnect from painful experiences, leading to the development of multiple self-states and potential amnesia.
Dissociative Identity Disorder (DID), a developmentally based trauma disorder, is an adaptive coping mechanism for individuals who have experienced repetitive, physically or emotionally painful traumas during their early childhood. This coping mechanism allows the child to disconnect from their body, emotions, or memory to alleviate the pain in the moment. However, over time, these disconnections lead to the development of different dissociative self-states, which can result in amnesia for certain behaviors and a disorder associated with significant suffering. Unfortunately, media portrayals of DID have often been stereotypical and stigmatizing, leading to negative impacts on individuals living with the disorder. In reality, the shifts between different self-states are not as dramatic or sudden as often portrayed in media. Instead, they may be subtle and less noticeable to observers. It is crucial to recognize the complexities of DID and the need for accurate and compassionate representation in media.
Misunderstood Disorder: Dissociative Identity Disorder: DID is a complex disorder with symptoms including amnesia, dissociative states, depression, PTSD, substance abuse, eating disorders, sleep problems, and memory lapses. It's often misdiagnosed due to lack of understanding and training among mental health professionals.
Dissociative Identity Disorder (DID) is often misdiagnosed due to common misconceptions and media portrayals. DID is not the same as schizophrenia or bipolar disorder, and it's characterized by amnesia and dissociative states. Patients with DID may experience severe depression, PTSD, substance abuse, eating disorders, and sleep problems. They often hide their memory lapses due to embarrassment. Assessing patients for dissociative disorders requires specialized training, which is unfortunately not widely available. There are validated self-report questionnaires and interviews for assessing dissociation, but most mental health professionals lack the necessary training. My current project, a book for the American Psychological Association, is the first to focus solely on assessing dissociation, highlighting the need for more research and education in this area.
Stages of DID Treatment: Stabilization, Trauma Processing, and Living a Full Life: Effective DID treatment includes managing symptoms, reducing shame, gradually processing traumas, and focusing on personal growth and relationships
Effective treatment for Dissociative Identity Disorder (DID) involves a multi-stage approach focusing on stabilization, trauma processing, and living a full life. During the stabilization stage, therapists help clients manage symptoms such as depression, self-harm, sleep problems, and dissociative episodes. They also work to reduce shame and self-hatred. In the trauma processing stage, clients gradually work through their traumas with careful pacing to avoid flooding and retraumatization. Lastly, in the living a full life stage, clients focus on building healthy relationships, establishing or advancing their careers, and overall personal growth. Throughout this process, therapists must be trained in treating traumatized and dissociative clients to ensure effective and safe treatment.
Understanding the Complexities of Dissociative Identity Disorder: Researchers are exploring new ways to diagnose and treat DID through brain imaging studies and developing tests to distinguish genuine patients from those who may be faking symptoms.
Individuals diagnosed with Dissociative Identity Disorder (DID) often receive a combination of antidepressants, antianxiety medications, and antipsychotics in their treatment. However, there is no medication specifically designed to treat dissociation. Researchers are working to develop tests to distinguish genuine DID patients from those who may be faking symptoms. Brain imaging studies are also being conducted to understand the neurological differences in individuals with DID. It's important for clinicians to stay informed about the latest research and use evidence-based measures to make accurate diagnoses. Newport Healthcare, a mental health organization, provides comprehensive treatment for young people struggling with mental health concerns, including dissociative disorders.
Brain Patterns in Dissociative PTSD: Research reveals distinct brain network patterns in Dissociative PTSD, characterized by less connectivity and brain flow, compared to classic PTSD. Controversial diagnosis due to societal reluctance to confront trauma.
Researchers, including Ruth Lanius and her team in Ontario and the Netherlands, have identified distinct brain network patterns in individuals with Dissociative PTSD (DID) compared to those with classic PTSD. People with DID can experience both hyper-aroused and shutdown states, while those with classic PTSD primarily exhibit emotional arousal. Brain scans show less connectivity and brain flow in areas of the brain in individuals with DID, and these patterns cannot be imitated by actors, validating its authenticity. Despite being recognized in the DSM-5, DID remains a controversial diagnosis, with some researchers and clinicians disputing its existence or cause. This topic is contentious due to the uncomfortable nature of discussing child abuse and the widespread prevalence of unacknowledged instances of abuse, particularly in institutions. Society's reluctance to confront trauma contributes to the ongoing debate.
Understanding the avoidance of traumatic experiences in DID: Mental health providers should approach clients with care and accuracy, using validated measures to assess and diagnose DID, while acknowledging the natural avoidance of traumatic experiences in individuals with DID and other forms of trauma.
People who have experienced trauma, including those with Dissociative Identity Disorder (DID), often avoid thinking or learning about traumatic experiences due to human nature and the symptoms of PTSD. This avoidance is natural and can be compared to growing tired of hearing about ongoing events like the coronavirus or the Ukrainian war. However, it's important to note that DID exists in various forms across cultures, and mental health providers should use validated measures to accurately assess and diagnose individuals who believe they may have the disorder. The prevalence of DID in the population is slightly above 1%, which is similar to the prevalence of bipolar disorder and schizophrenia. Mental health providers should approach clients with care and accuracy, avoiding dismissive or hurtful behavior, and instead using evidence-based measures to ensure a thorough assessment process.
Seeking help for dissociative disorders: Individuals with suspected dissociative disorders should consult mental health professionals with expertise in trauma and dissociation, utilize resources from ISSTD, and await results from ongoing research.
Dissociative disorders, including DID, are complex conditions that require specialized care. Individuals who suspect they may have a dissociative disorder should seek out mental health professionals with training in trauma-related disorders, including dissociation. The International Society for the Study of Trauma and Dissociation (ISSTD) is a valuable resource for both professionals and individuals, offering information, questionnaires, and treatment guidelines. Researchers are currently conducting the first randomized controlled trial, the TOP DD study, to evaluate the effectiveness of standardized treatment for dissociative disorders. There is a need for more research on neurobiological markers to aid in assessment and understanding of these conditions. If you're interested in learning more, visit ISSTD's website or listen to previous episodes of Speaking of Psychology.
