.. . A person with DID often presents symptoms that are common to many other mental disorders. Depression, panic disorders, sleep disorders, and suicidal tendencies are but a few of the reasons these people seek help. Furthermore, their host personality may be amnesiac with regard to their alters and/or the experiences of those alters. Their personality changes may be passed off as mood swings, or, they may have gone for a long time without experiencing a disassociative episode. These are compounded by reluctance on the part of professionals to diagnose DID, and the DID individual to be able or willing to provide necessary information.
At one time, some psychiatrists began to believe that DID was simply a “..artifact of hypnotic suggestion” (Alexander, et al. 101). Many are hesitant to believe that the bizarre abuse to which their patients were subjected as children actually occurred. (This is particularly true when incest was a part of the abuse, as it frequently is). Also, because DID was long thought to be extremely rare, it simply was not a considered diagnoses for many clinicians. The great majority of DID individuals know they have a problem: they may fear that they are crazy, but do not realize they have multiple personalities.
Once diagnosed, they may themselves be strongly resistant to the idea, spending months of therapy denying what their therapist has found. This is unfortunate, because of all the severe mental disorders, DID has one the best prognoses. However, in order to successfully help the patient, the therapist must first gain his/her trust and willingness to assist in the treatment. An acceptance of the diagnosis is the first step, and it may be many months in coming. Once contact and trust are accomplished, the therapist must “..establish communication with all of the alter personalities in order to learn their names, origins, functions, problems, and relationships to the other personalities” (Coons 6). The amount of time required to do this is dependent upon the degree of trust the patient places in the therapist. The host personality and his/her alter personalities must then be helped to begin coping with their traumatic experiences. Only after this has been done can the “..fusion of integration of the personalities..” (Coons 6) begin.
“The treatment of DID is excruciatingly uncomfortable for the patient. The dissociated trauma and memory must be faced, experienced, metabolized, and integrated into the patient’s view of him/herself” (Rainbow House pg. 5). As each alter exposes its trauma, it can “..yield its separateness and re-integrate (because that alter is no longer needed to contain undigested trauma)” (Rainbow House 5). Recovery from DID and the childhood trauma which perpetuates it can take years.
It involves a painful re-examination of one’s past and a long “..process of mourning” (Rainbow House 5). It is particularly difficult because the individual must come to terms with the fact that (in many cases) the beatings, sexual abuse, neglect, and other forms of trauma that were suffered as small children, were perpetrated by the very people they depended on to love, care for and protect them. In a case cited by Ross, paternal sexual abuse was related by a child alter whom he was neither aware of nor attempting to contact. When the adult female host personality was brought out of her trance, “..she suddenly declared, ‘those aren’t my pictures! Those are Doctor Ross’s pictures!'” (Ross 157). The woman insisted that Ross had “..implanted these memories by suggestion” (Ross 157).
“She was offended that I would ever think such a thing about her father, or try to get her to think the same” (Ross 157). However, Ross had never even mentioned sexual abuse by her father to the patient. In recent years, there has been a dramatic rise in the amount of interest paid to disassociative identity disorder. There are several reasons for this, not the least of which is “..the recognition of DID as a free-standing condition, and the provision of landmark clinical descriptions in The Diagnostic and Statistical Manual of Mental Disorders, third edition” (Alexander, et al. 339).
Feminism made a powerful impact by sensitizing the mental health professionals “..to the hitherto unacknowledged high incidence of child abuse, incest, and the exploitation of women” (Alexander, et al. 339). Therapists no longer dismiss their adult patients’ accounts of childhood abuse as a mere fantasy, and the recognition of disassociative identity disorder of sexually abused females has soared. Also, “..there has been an explosion of interest in post traumatic stress disorder, which, like DID, occurs consequent to trauma, and has been documented in children following their exposure to, among other things, natural disasters (i.e. the Oakland, California firestorm of 1991). The similarity between the two conditions brought credibility to disassociative identity disorder. The media has also played a role in the resurgence of interest, with its fictional representation of DID cases such as in the films “Primal Fear” and “The Color of Night”-much as it did with “Sybil” and “The Three Faces of Eve.” Perhaps with this increased interest in and acceptance of both DID and its causative roots, children trying to survive severely abusive situations will be removed from the perpetrators and provided with the proper therapy at a young age rather than having to face years of missed diagnoses and continued mental trauma. The consequences of childhood sexual abuse are not limited to disorders such as anxiety, depression, nightmares, amnesia, and DID. It also “..traps the person in complicated, self-destructive relationship patterns” (Ross 44).
It is for these reasons that adults eventually seek professional help, and only then do they sometimes learn that they suffer from DID. “Dissociation is a major way in which human beings cope with trauma” (Ross 45). This coping mechanism is but one example of how strong the human will to survive actually is. In the face of almost unbelievable trauma, a child as young as 3 or 4 years old can use dissociation to enable him/herself to continue to function normally. It is up to the non-abusive adults in such a child’s life to recognize signs of abuse, to believe the child when abuse is reported, and to take steps to stop the abuse.
Only then will the number of adults diagnosed with disassociative identity disorder decrease, and the number of children developing it diminish. Psychology.