MCCC PSY 210 - Psy210-Lecture12 What is Dissociative Identity Disorder?

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11/1/20101What is Dissociative Identity Disorder?Ch. 5-Somatoform and Dissociative disordersClass ObjectivesWhat are Dissociative Disorders?What is Dissociative Identity Disorder (DID)?‐ What are the features of DID?What is the etiology of DID?How can DID be treated?11/1/20102Stop and reflect. Have you ever spaced out?Where do you go when you daydream?Dissociative experiences are somewhere in between a dream state and reality. Dissociation is a psychological state that produces a lack of connection from the psyche.‐ Thoughts/feelings‐ Memories ‐ Sensations‐ IdentityDissociationWhy do we dissociate?Even when daydreaming, these dissociative moments result in a temporary mental escape. In situations involving trauma, this provides a break from the fear and pain of the trauma.‐ This, in some cases, produces a memory gap surrounding the experience11/1/20103Two Types of Dissociative experiences:If you have an episode of Depersonalization, your perception becomes altered so that you temporarily feel unreal or removed from your self, at times you can lose sense of your own identity.The person feels like an observer of his life and may actually feel as if he were watching a movie.During an episode of Derealizationyour sense of the reality of the external world is lost. This refers to experiencing familiar persons and surroundings as if they were strange or unreal.‐ Things may seem to change shape or size, people may seem dead or mechanical. I can’t remember…What if we can’t remember who we are or how we got to a certain place?? (non-alcohol-related!)Dissociative amnesia is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature.11/1/20104Review and reflect while watching the following video clip What did you think about Dissociative Amnesia?Test your Knowledge about Dissociative Identity Disorder!True or False?Dissociative Identity Disorder is the same as Schizophrenia. Test your Knowledge!True or False?DID is a VERY controversial psychological disorder.11/1/20105Test your Knowledge!True or False?Four times as many women are diagnosed as men. Test your Knowledge!True or False?DID is the result of genetics and biology.Dissociative Identity Disorder (DID)This is one of the most controversial disorders, formerly called Multiple Personality Disorder. This dissociation disorder involves the creation of “alters” , which are partiallyindependent identities that exist within one body and mind.‐ For DID to be diagnosed 2 or more distinct identities must be present.11/1/20106Who’s Effected?The estimated prevalence of DID in the U.S. population is from 1 in 500 - 1 in 5,000‐ Between 250,000 and 2,500,000 people. ‐ Women are 4 times more likely to be diagnosed‐ Research suggests that 3-4% of people hospitalized for psychiatric and drug treatment are affected.Separate People?People with DID may adopt as many as 100 new identities, all simultaneously coexisting. ‐ The average is 10When under the control of one alter, they may exhibit different behaviors, mannerisms, personalities, gender orientation, and physical properties‐ such as handedness, allergies and eyesightSwitch!!The transition from one alter to another is called a “switch”. The alter takes control of the host identity and controls their behavior. Due to this, amnesia is required for diagnosis, because sections of time are missing once the alter takes over.11/1/20107Review and reflect…Watch the following video on DIDWhat features of DID were displayed by the patient? Also, take note of the role of the therapist. What changes did you see?When the switch occurs, physical changes are evident, such as posture, facial expressions, personality, handwriting, even physical disabilities emerge.‐ In one study, changes in handedness occurred in 37% of the cases (Putnam et al., 1986).The person who usually becomes the patient and seeks treatment is the “host” identity. They usually become overwhelmed trying to hold the fragmented identity together.The alters are usually character-like, often serving specific roles: ‐ “The Protector”‐ Handles conflict situations ‐ “The Whore” ‐ Handles sexuality, sometimes generating income as a prostitute. ‐ “The child”‐ Usually represents the age when the child’s psyche became fragmented.11/1/20108It is important to recognize that these identities are not usually fully formed While we see movies and characters with DID portrayed as completely different individuals they are often fragments of the host personCan this disorder be faked?This is a very controversial disorder and is difficult to determine whether or not the identities are “real” of if the person is faking them for several reasons.Research supports that persons with DID are highly suggestible (Bliss, 1984). The power of suggestion?There has been a lot of evidence to suggest that many alters can be created in response to leading questions from therapists during psychotherapy or while under hypnosis (Spanos, 1996).‐ In extreme cases, unethical therapists have encouraged the creation of additional alters by coercion and suggesting false memories.11/1/20109Can professionals CREATE this disorder??Some psychologists believe that MPD is an iatrogenic (physician-induced) behavioral syndrome, promoted by suggestion. ‐ It is thought by some that MPD, like hystero-epilepsy, is created by therapists. This previously rare and disputed diagnosis became popular after the appearance of several best-selling books and movies. Just faking??Although the high suggestibility of these clients is a factor in the development of alters, research suggests that many people with fragmented identities are not consciously and voluntarily faking these alters.‐ Miller (1989) confirmed that DID patients display changes in visual acuity, manifest retraction, and eye muscle balance would be difficult to fake.Changes in brain function have also been detected by using MRIs to observe brain changes during the time of the switch. Research has shown specific changes in hippocampal and medial temporal areas after the switch (Tsai et. Al, 1999)11/1/201010The escape into a fantasy world is done to escape the physical and/or emotional pain to survive.Most surveys report a very high rate of childhood trauma in cases of DID.CausesPutnam et al., (1986) found that 97-98% of patients had experienced significant trauma, including sexual or physical abuse.‐ 68%


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MCCC PSY 210 - Psy210-Lecture12 What is Dissociative Identity Disorder?

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