Monday, 30 September 2019

Can You Recover from Dissociative Identity Disorder?

We used to refer to Dissociative Identity Disorder (DID) as multiple personalities or Multiple Personality Disorder (MPD). The creation of multiple identities occurs often in response to extreme abuse in childhood. Individuals who have developed different identities have described the experience as a way to escape the abuse. 

Recently, an Australian judge made a landmark ruling allowing six of Jeni Haynes’s personalities to testify against her father for the horrific abuse she suffered as a child. In response to the extreme and persistent abuse, the woman created 2,500 different personalities to survive.1 The ruling is a precedent where a person diagnosed with Multiple Personality Disorder (MPD) — or Dissociative Identity Disorder (DID) — testified in their other personalities. As a result of the testimony, the father was convicted and sentenced to 45 years in jail by a Sydney court.

In the words of Jeni Haynes, when asked about one of her personalities, a 4-year-old girl named Symphony, she explained, “he wasn’t abusing me, he was abusing Symphony.” Splitting into different people allows for an escape from a situation that cannot be escaped from. 

While the ruling in Australia is modern, the phenomenon that we describe as Dissociative Identity Disorder is not new. In fact, it is already described in ancient Chinese medical literature.4

Is it possible to recover from Dissociative Identity Disorder?

The short answer is yes. But what does recovery from DID look like? The goal of treatment for DID is integrated function and fusion. A person with multiple identities may feel like several different people each who have their own distinct personalities complete with individual names, memories, likes, and dislikes. However, these separate selves are part of one whole adult person. The subjective experience of the person with DID is very real and the goal of treatment is to achieve fusion of each personality so the person can begin to function as an integrated whole. Fusion occurs when identities merge together and become a unified whole. It is important to understand integrated function as a process that occurs over time, and fusion as an event where two aspects of identities merge together. 

Helping each identity become aware of the others and learn to negotiate conflicts is an important part of the therapeutic process.2 Established guidelines for the treatment of DID state that each personality must be acknowledged and allowed to participate in the therapeutic process. Disruptive or unpleasant personalities should not be ignored or treated as undesirable. The goal of therapy is to integrate each unique identity into the whole self. Therefore is is unhelpful for the therapist to encourage “getting rid of” any of the unique identities that exist within the person rather, each must be acknowledged and accepted by the therapist. 

What does recovery look like?

Successful treatment outcome results in an integration of each individual identity as part of the self. In addition to this, harmony among the alternate identities is desirable.3 When an individual achieves harmony among identities and ultimately merges each into one unified person, they can begin to feel whole and are no longer subjected to the feeling of being fractured within themselves. 

Not all individuals who experience Dissociative Identity Disorder are able to achieve complete and final fusion of each identity due to the difficulty of confronting painful memories. However, treatment is still helpful in moving towards recovery as it allows the individual to receive support and work to resolve past trauma. Healing can be achieved even without complete fusion and resolution of all trauma. 

Dissociative Identity Disorder is best treated with a practitioner who is experienced in complex trauma. Not all practitioners are aware of the relationship between DID and past trauma.5

References

  1. Mao, F. (2019). Dissociative Identity Disorder: The woman who created 2500 personalities to survive. BBC News. Retrieved from https://www.bbc.com/news/world-australia-49589160
  2. International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115-187.
  3. Kluft, R. P. (1993). Clinical perspectives on multiple personality disorder. American Psychiatric Pub.
  4. Fung, H. W. (2018). The phenomenon of pathological dissociation in the ancient Chinese medicine literature. Journal of Trauma & Dissociation, 19(1), 75-87.
  5. Connors, K. J. (2018). Dissociative and complex trauma disorders in health and mental health contexts: Or why is the elephant not in the room?. Journal of Trauma & Dissociation, 19(1), 1-8.


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