Dissociative Identity Disorder (DID): Controversial or valid?

Dissociative Identity Disorder (DID), once called Multiple Personality Disorder (MPD), is said to be a post-traumatic condition resulting from experiences such as extreme levels of child abuse. The individual uses the dissociative response as a means of escaping the trauma.

According to the concept of DID, patients have multiple, distinct personalities that control their behavior at different times. Treatments of Dissociative Identity Disorder (DID) concentrate on alleviating the psychological shock's psychic, rational, and developmental repercussions and resolving conflicts between altering identities. A group of analysts and medical experts claim that no concrete evidence proves DID is a post-traumatic condition. Additionally, a socio-cognitive model suggests that psychotherapists contribute to the generation of DID by using hypnosis to create the symptoms and altering how a patient behaves through differential reinforcement. Broadcasting stations and the internet have also contributed to this psychological illness by presenting cases such as Eve and Sybil that have validated dissociative identity disorder and taught the public how to act like patients diagnosed with DID.

Presumptions of the socio-cognitive model concerning DID

Spanos (1994) believes the socio-cognitive prototype is determined by several theories related to DID concerning its fundamental derangement, clinical manifestations, evaluations, cure, and ubiquity. The initial belief is that the personification of multitudinous individuality is the fundamental delusion of dissociative personality disorder. Spanos's introductory statement includes, "People who receive the diagnosis of multiple personality disorder (MPD) behave as if they have two or more distinct identities."

The next surmise is that individuals confirmed to have dissociative problems are usually histrionic, which is evident in their psychical results. The model depends on a perceived notion based on several aspects. Before anything else, it is used to clarify reasons for which an individual may want to pretend that they have been confirmed to have dissociative identity disorder.

Besides this, the speculation proves that Dissociative Identity Disorder should not be difficult to identify because of its conspicuous manifestations. Another assumption is that DID patients receive privileged treatment. Thus pretending to be experiencing DID can be beneficial.

The fourth and fifth assumptions involve the analysis and remedy of DID. Based on the model, the procedures of analysis and remedy of DID can generate or deteriorate the patient's state. The perceived notions are (a) that DID can be induced by a physician's words and (b) that routine evaluation and therapy practices utilize procedures that can generate disorder. The last belief of the socio-cognitive model is that the statistics indicate that iatrogenic procedures have contributed to generating DID or changing its phenomenology.

Treatment of dissociative disorders

People who believe in the socio-cognitive model of the disorder argue that the prevalent treatment could generate or exacerbate the disorder. Spanos (1994) mentions that due to the treatments, MPD patients start to think their alternate identities are authentic personalities rather than fragments of their imagination.

The purpose of treatments for DID is to convince patients that the concept of other personalities existing within them is all in their heads. Patients often receive treatments, assuming that separate entities or people reside in their bodies. This belief is classified as a cognitive-perceptual error.

However, DID patients talk about encountering detached fragments of themselves as different individuals or identities. This belief may give rise to cases where patients tend to inflict physical wounds on themselves. For instance, "It is not my body. It is hers".

Child abuse and DID

DID and childhood trauma are interrelated. Nearly all of the patients have mentioned incidents related to their youth, which have affected them to a great extent, such as physical abuse, sexual abuse, or both. The patients often talk about mistreatment that is usually acute, immense, and fiendish. Other variations of childhood trauma have been set forth, including ignorance, desertion, occurrences relevant to war, witnessing the murders of family members, terminal lucidity, and agonizing medical processes.

There is a prevailing affinity between trauma and dissociative symptoms. Furthermore, primary post-traumatic stress disorder (PTSD) occurrences include dissociative symptoms, such as flashbacks and emotional numbing. It has been noticed that few of the patients with extreme levels of post-traumatic stress disorders have advanced personality disorders. The controversy that suggests disbelieving the records of abuse has different variations.

Psychotherapists and hypnosis

A different explanation states that psychotherapists hypnotize their patients and create these memories. This argument is based on the belief that hypnosis is often utilized to help patients recall previous incidents of assaults. Nevertheless, instances in the prodigious explanations of DID patients mentioned previously came from different resources with extensively diverse circumstances for treatment. It is found that many patients were not hypnotized when the assault was charted.

DID and trauma

There is no evidence supporting the idea that childhood trauma leads one to develop DID. It is recently seen that DID patients almost always relay backgrounds of childhood trauma and endeavors to confirm the ill-treatments have succeeded. Manifestations of dissociation are distinctly linked to incidents related to trauma. In addition, patients diagnosed with a Dissociative Identity Disorder (DID) display features similar to those with identifiable post-traumatic stress disorder. This may not necessarily signify that patients' recollections are unerring or that all explanations provided are accurate. Nonetheless, discovering that fragments of a narrative are likely to be deformed is not enough to justify that the background of abuse should be disregarded or comprehended as delusion.

References

Spanos, N. P. (1994). Multiple identity enactments and multiple personality disorder: A sociocognitive perspective. Psychological Bulletin, 116(1), 143–165. https://doi.org/10.1037/0033-2909.116.1.143