Did's And Dsm

The existence of multiple personalities within an individual is diagnosed as Dissociative Identity Disorder (DID) in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Prior to the publication of the DSM-IV, it was termed multiple personality disorder (MPD). The International Statistical Classification of Diseases and Related Health Problems (ICD) continues to list it as Multiple Personality Disorder. Neither term (dissociative identity or multiple personality) should be confused with schizophrenia, although the media often incorrectly use the term split personality to describing the latter, as well as interchangeably with DID.

As a diagnosis, DID remains controversial, with many professional psychiatrists and commentators arguing that there is no empirical evidence to support the disorder, or its diagnosis. On the other hand, some psychiatrists contend that they have encountered cases that appear to confirm the existence of this condition and some mental health institutions, such as McLean Hospital, have wards specifically designated for Dissociative Identity Disorder.

Counselling4you's view on this subject is that DID does most definitely exist. This view is based on our research, our counselling experiences and experiences based on meetings and the teachings of highly experienced professionals such as Valerie Sinason.  

The Diagnostic & Statistical Manual of Mental  Disorders defines DID as:-

The presence of two or more distinct identities or personality states, each with its own relatively enduring Patten or perceiving, relating to and thinking about the environment and self.

At least two of these identities or personality states recurrently take control of the persons behaviour.

Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

The disturbance is not due to the direct physiological effects of a substance or general medical condition . In children the symptoms are not attributed to imaginary playmates or fantasy play

Symptoms may include:

Depersonalization, which refers to feeling unreal, removed from one's self, and detached from one's physical and mental processes. The person feels like an observer of his/her life and may actually see him/herself as if he/she were watching a movie. Derealisation refers to experiencing familiar persons and surroundings as if they were unfamiliar and strange or unreal.

Amnesia, A common initial coping mechanism is to escape the body. It is the beginning of clinical (amnesic) dissociation, which allows a shutting out of an unbearable reality. It is held unassimilated---in effect, frozen in time. A dissociated experience can be split up to store the emotions separate from bodily sensations, and the sensations separate from the knowledge of an event. In essence it is the inability to recall blocks of time, (large or small) important information and other noticeable blank areas in ones life.

Derealisation, A change in the persons experience of the environment when the world around them feels unreal and /or unfamiliar. This would include friends, family, home, work, possessions, places etc. Being spaced out, dream like, in a sensory fog, being a spectator at some event, these are some of the feelings and experiences one may have.

Identity Alteration, People with DID are often told of things they have done but do not remember and of notable changes in their behaviour. They may discover objects, possessions, productions, or handwriting that they cannot account for or recognize; they may refer to themselves in the first person plural (we) or in the third person (he, she, they);

Identity Confusion, Who an I ? A question we all ask ourselves in periods of our lives, but for people with DID this is far more than an infrequent question. It is far more than the "normal" monkey chatter that goes on in our heads every day. It can be a serious problem because the decision making process maybe overpowering and cause a fierce battle for the consciousness, inner survival and power. The resulting turmoil due to conflicting or opposing attitudes and views about every subject helps lead to a unwelcome and confusing state of no real self or identity.

DID is a vast and extremely complex subject, one that I cannot possibly explain in my web pages, there will be many useful link should you wish to find out more about it. Below are just some of the basic points of DID and the ground that will be covered on dedicated sites...

A dissociated identity, like a dissociated experience, can hold the entire event or parts of it. Alters (inner personalities) may hold only a bodily feeling, only an emotion, or only the knowledge. It is possible for one hundred abusive/traumatic incidents may be held by one identity or conversely one hundred identities may hold the same, similar or parts of one incident, each identity is holding an abusive experience. In this context, taken together, the identities hold a person's overwhelming traumas and express a survivor's entire life story.

Our instinctive reactions to a traumatic incident or assault are fight, flight or freeze. Fight & flight do not work when children are abused by sadistic adults. The only option left is to freeze and take flight through the mind. In dissociating an experience, children split off a part of their self to hold the trauma. In some cases the dissociated aspects of self, immediately or over time, form their own and separate sense of self. When the abuse is over, the original self "returns" and resumes "normal" life, having no/little awareness of what has just transpired. If severely abused children were forced to experience the trauma they just lived through, they would probably NOT survive.

Dissociation is defined as a complex mental process that provides a coping/surviving mechanism for individuals confronting painful and/or traumatic situations. It is characterised by a shattering of the ego. As abused children grow, their problems typically begin to mount. The load on their unconscious becomes increasingly great, and they feel overwhelmed. As some identities stay out more and more, they may begin to take over and operate in the child's day-to-day world. If the abuse continues or increases, the original self may stay out less and less and in time stop coming out at all. The survivor is then functioning through identities who "switch" to cope with day-to-day life. Because the person suffering a dissociation does not completely disengage from reality, he/she may appear to have multiple personalities to deal with different situations. When an alter cannot cope with stress, the consciousness of the person is given over to another personality to eliminate the trigger or pressure causing the stress.
 
 Pushed beyond normal limits, initially for survival and then managing day to day life survivors have discovered extraordinary abilities and coping skills. These abilities are in evidence by survivors who used their powers of the mind to survive. Although these abilities may be wonderful in some respects, they have come at an exorbitant price. Multiples are slowly introducing the world to new realms of possibilities that have yet to be fully understood. With knowing and understanding comes appreciation. Regardless of an identity's name, description, or personality, its main and common purpose is always to protect the child. Alters can manage extraordinary feats in their determination to keep the child safe. Sometimes these feats are beyond the range of normal human experience or comprehension.

  While no two survivors are alike, there are some common themes, such as having both male and female alters, different colours and races within, other more commonly observed abilities in multiples are perfect memory, ability to heal unusually fast, ability to tolerate extreme levels of pain, and ability to self-anesthetize. By "switching," some survivors are also able to work almost continually with minimal rest. Each identity within the same person may have unique neurological and physiological responses. For example, some identities may require glasses, while others have perfect vision: some identities are allergic to smoke, while others may be chain smokers: some identities are almost deaf, while others have exceptionally good hearing: different alters within one person will register unique electrocardiograph, blood pressure, and pulse readings. Alters may have different allergies and different ailments and unique responses to medications. One identity may be diagnosed with an ailment, but a different identity may be "out" when the medication is taken. In this case, the original alter isn't helped, and the receiving alter may have unfavourable side effects. Prescribing medication to survivors who are multiple should be done with special care and extra monitoring.

Counselling for people with DID can take many years depending on the severity of abuse/trauma experienced. We work with every tool possible, including many creative interventions, dolls, drawing, painting, sand play, story telling, picture cards and so on. Just talking is not enough because we are dealing with both sexes within one body, ages that vary from 3 months up to the present age of the host and each alter may respond to very different interventions because as you read above they each have their own character which makes them unique. If a DID client has for example 50 alters( this will dependant on the level of abuse and for how long) the counsellor will in reality possibly have 50 different clients each with their unique personality.

I hope you have found this helpful and please don't hesitate to contact us if you have any questions, we will try our best to answer them.