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What is Dissociative Identity Disorder
DeAnna F Hubbard
LIberty University
PSYC 430 (B03)
Professor Jamie Clark
January 30, 2024
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What is Dissociative Identity Disorder
Introduction
Dissociative Identity Disorder acorrding to the Diagnostic and Stastical Manual for
Mental Disorders (or DSM for short) is “Dissociative identity disorder is characterized by a) the
presence of two or more distinct personality states or an experience of possession and b)
recurrent episodes of dissociative amnesia. The fragmentation/division of identity may vary
across cultural contexts (e.g., possession-form presentations) and with circumstance.” (DSM 5-
TR, 2024). Dissociative Identity Disorder is not a disorder that is only linked to adults, anyone
from the range of children, adolescents, adults. elderly. The reason for why this disorder
develops ranges from sexual assult to minor car accidents.
“Negative correlations between childhood maltreatment and hippocampal volume have
been reported in both unmedicated individuals from the general community and
transdiagnostically in people with psychiatric disorders.” (Reinders, Veltman, 2020). The Most
common reason that Dissociative Identity Disorder forms is due to childhood trauma. There are
many forms of childhood trauma like sexual abuse from family members, physical abuse from
parents or siblings. There are other forms of abuse such as mental and emotional.
The disorder is not one that tends to present with other disorders such as Depression,
PTSD, Anxiety and so on. It is common for disorders to have subdisorders that can amplify the
symptoms of the main disorder. In cases like Dissocitiave Identity Disorder triggers for things
like PTSD can worsen the identity switching.
Lets dive deeper into the causes for Dissocitative Identity Disorder and how they affect
an person on a day to day basis.
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Causes for the Illness
With the research on this disorder being so limited the only cause for this disorder to be
found to this day is childhood maltreatment. In the journal article “Four Selves of a Student- a
Case Report of Dissociative Identity Disorder” it describes on of the ways that Dissociative
Identiy is formed through childhood mistreatment, the report starts with telling about a student
who has all the basics, they are in school and they have a decently good health, the student has
been in and out of mental health services for thoughts of self harm that are life threatening.
Giving some basic back story to the student, they born and raised in the country that wasnt
specified however the student and mother of the patient moved to Finland as the mother found
herself in a new relationship that was not with the students birth father.
The student was interviewed many times throughout the process of the evaluation.
During the talk therapy it was told that the birth father of the student was physically abusive to
the family and this caused for mutiple personalities to form. In the therapy sessions there were
clear lines between the two personalities as they acted entirely separate from each other however
the personas both actively communicated. In the article it specifically says “if something needed
to be figured out, both A and B would take pen and write on paper” ( Haravuori et. al. 2021)
The journal article “Working with Trauma and Dissociation in the NHS” talks about a
fictional case of a woman who is named Beth. The article discusses how Beth was sexually
assaulted by two family members, this led to the development of Dissociative Identity Disorder.
This artice talks about the way certian treatment methods do not work for all patients, in cases
like Beth, one on one therapy sessions do not work well for her as they make her feel unsafe, on
the other hand one on one therapy can make others feel safe.
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Treatment
Understandin what the disorder is and how it affects someone is the best place to start
when it comes to treating the disorder and helping with managing the symptoms. In cases like
Dissociative Identity Disorder there is no cure however there are ways to treat the symptoms that
can help a person to feel less bothered by the disorder.
In “Treatment for Dissociative Identity Disorder in an Eating Disorder Residential
Treatment Setting” tells of in patient treatment for the disorder consisitng of three phases. The
first phase of this treatment involves making the patient feel safe with the therapist. They educate
the patient about what the disorder is and what the treatment plan is. This can hellp the patient to
feel more secure in what is going on as it gives them an understanding of what is going to
happen and how it is going to help them. From stage one it goes into stage two, this stage will be
the most difficult for the patient. This stage is going to bring out all the traumatic memories and
how theses memories affect the symptoms of Dissociative Identity Disorder. The final stage of
this method of treatment helps the patient to reintergrate to normal life it gets them out of the
inpatient treatment. The patients are set up with follow up care and taught about how to interact
with others in a more stable manner.
The next method of treatment is explained in “Psychopharmacological Treatment in
Dissociative Identity Disorder” this method of treatment is using neuropshycological drugs to
reintroduce chemicals to the brain. In this specific study the patient was first introduces to
serotonin at 500 mg per day, this gave no response the the dosage was upped to 1,000 mg per
day with no avail. The final result ended up being “Desvenlafaxine was adjusted to 100mg and
haloperidol to 0.5mg every 12 hours. The patient evolved favorably, decreasing anxiety,
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depressive symptoms and memory loss, in addition to disappearing psychotic symptoms.”
(Pinilla et.al, 2021)
Prevention
There is not much to be done to prevent childhood maltreatment or the development of
Dissociative Identity Disorder however there are methods of preventing the symptoms from
getting worse, thre is not a cure for the disorder however there is ways to manage the symptoms
to be more of what society deems as normal.
“A 28-Year-Old Man with Obsessive-Compulsive Disorder, Post-Traumatic Stress
Disorder, and Dissociative Identity Disorder Responding to Aripiprazole Augmentation of
Clomipramine Combined with Psychoeducation and Exposure and Response Prevention” is a
study that shows how treatment methods can help to prevent future outburst of symptoms from
Dissocitative Identity Disorder, Obsessive Compulsive Disorder, Post Traummatic Stress
Disorder among other comorbid disorders.
This study uses medication to prevent future outburst of symptoms associated with
Dissociative Identity Disorder as well as the other comorbid disorders. The medications that
were used in this study is serotonin reuptake inhibitors, clomipramine. While clomipramine has
more negative side effects it showed to really help prevent the symptoms of Dissociative
IDentity Disorder as weell as Obsessive Compulsive Disorder.
The next article explains the importance of how therapy can assist in preventing
psychosis in patients that have Dissociative Disorders including Dissociative Identity Disorder.
The article “Psychological Interventions for Dissociative disorders” shows the importance of
having a therapist that has training in this area, is cognizant or vigilant with their knowledge of
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these disorders as the goal of therapy in these patients is to reduse the ammount of dissociation
and amd help the patient with functioning to a more culturally acceptable manner.
Sociocultural
To understand the sociocultural aspects of Dissociative Identity Disorder, there must be
knowledge of what sociocultural is. Sociocultural is defined by the merriam webster dictionary
as “of, relating to, or involving a combination of social and cultural factors” meaning, that
everything about the society that we live in has an affect on DID.
The article “How do Patients Diagnosed with Dissociative IDentity Disorder Experience
Conflict? A Qualitative Study” did research on this topic and found that patients suffering from
this disorder had two main conflicting worldviews with their personalities . The first cinfluict
that they had was between religion and symptoms, it was described as a participant that had
church affiliations that were not specified as to which religion and the church goers told her that
she had a deamon possessions, her second affiliation was from african decent where she was told
they were a calling, the final thing she was told was that it was someone had wished bad fortune
on her.
The second conflict was between the peronalities them selves. In some cases the
personalities were incompatible with the others, in those cases some were aware of the conflicts
and some were unaware of the conflicts.
The next study that talks about the sociocultural effects “Firebug! Dissociative Identity
Disorder? Malingering? Or …? An Intensive Case Study of an Arsonist” talks about the
difficulties of a patient with Dissociatove Identity Disorder. This disorder is a fight against the
mind. The study talks about how the some of the people with Dissociative Identity Disorder
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have rocky relationships, and the most of the patients with this disorder have relationships that
are more on the stable side are abusive or unable to properly communicate in the relationships.
Biblical Worldview
The bible does not directly talk about having multiple personalities, there is no text book
way of helping someone with Dissociative Identity Disorder. In the research of this disorder
there is talk of the spiritual side of it. Christianity talks about demon possesions.
The first instance in the bible to that is prominent with talking about demon possession is
in Mark 5:1-20. The bible does not directly call them demons but it is a possession of unclean
spirits. There was a man in the mountains, he cut himself with stones and nothing could stop
him, no amount of force could hold the man down. Jesus went to the man and told the unclean
spirts to come out of the man and asked what thy name was. The unclean spirit responded to
Jesus and said that their name was “ Legion for we are many “ (Mark 5:9, KJV)
When the church is ealing with someone that has this disorder they treat them as if they
were the man in the mountain. They are prayed for and told that it is just a possession, that if
they have enough faith then the unclean spirit will run into the pig and jump off of the mountain
like legion did in the book of Mark. The Thought of how these things affect the person is not
something that is thought about very often, the biblical world view that is taught by christianity
is to forget the feelings of the individual and run the other direction and pray for them.
The biblical world view that is taught by Jesus and the bible is very different from what
religion teaches, Take the story of Mark 1:40 for example, lepers were very unclean people, they
were very contagious and most people would not go near them in fear of catching the leprosy,
Jesus on the other hand did the exact opposite, he touched the leper to heal him when no one else
would touch him.
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Conclusion
Dissocitative Identity Disorder is a disorder that casues an array of problems for the
patient with the disorder and those who are around the patient. It can be confusing and it can
cause self harm. Then to add to it there are people that have care for the patients telling them
conflicting things based on religion.
Dissociative Identity Disorder is more than one person being in a body due to childhood
trauma like sexual assault or physical abuse, and in some cases both. This disorder affects mostly
women as they have a higher rate of being traumatized. This disorder more oftem than not comes
with more comorbid disorders suuch as Post Traumatic Stress Disorder, Anxiety, Depression and
so on.
There are treatment methods for this disorder. Talking with a therapist is one of the most
common treatment for this disorder, however for some patients one on one with a therapist can
make it worse and not help the patient in any way. For some the best treatment is group therapy ,
talking with others that have this disorder and talking about the symptoms and how it affects
them is a good way to reduce the symptoms. The last method that was found for treating
Dissociative Identity Disorder is psychopharmasutical, the use of medications like mood
stabilizers and serotonin reuptake inhibitors. These kinds of medications do a lot for treating this
disorde and making the symptoms much more manageable. Among the research it was found
that there was no cure for this disorder just symptom management.
The bible plays a key role for this disorder as it teaches to be like Jesus and not to turn
our backs on those who have this disorder and to care for them, keep in mind that the love for
others is what Jesus taught, even those with unclean spirits and unclean bodies like those of the
lepers.
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References
Association, A. P. (2022). Diagnostic and Statistical Manual of Mental Disorders.
https://doi.org/10.1176/appi.books.9780890425787
Reinders, A. a. T. S., & Veltman, D. J. (2020). Dissociative identity disorder: out of the
shadows at last? The British Journal of Psychiatry, 219(2), 413–414.
https://doi.org/10.1192/bjp.2020.168
Haravuori, H., MD PhD. (2021, November 1). FOUR SELVES OF a STUDENT – A
CASE REPORT OF DISSOCIATIVE IDENTITY DISORDER.
https://doaj.org/article/0035bfb868934659972e0b6350b4c630
Stubley, J. (2022). Working with Trauma and Dissociation in the NHS. British Journal of
Psychotherapy, 39(1), 170–181. https://doi.org/10.1111/bjp.12799
Brewerton, T. D., Perlman, M. M., Gavidia, I., & Suro, G. (2023). The treatment of dissociative
identity disorder in an eating disorder residential treatment setting. International Journal
of Eating Disorders. https://doi.org/10.1002/eat.24106
Pinilla, R., Sabaté, C. R., Méndez, B. O., Sotillos, A. E., & Mata, A. H. (2021).
Psychopharmacological treatment in dissociative identity disorder (DID). European
Psychiatry, 64(S1), S151. https://doi.org/10.1192/j.eurpsy.2021.412
Su, W., Zhao, D., Zhao, H., Zheng, W., & Zhang, W. (2023b). A 28-Year-Old Man with
Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, and Dissociative
Identity Disorder Responding to Aripiprazole Augmentation of Clomipramine Combined
with Psychoeducation and Exposure and Response Prevention. American Journal of Case
Reports, 24. https://doi.org/10.12659/ajcr.941534
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Subramanyam, A. A., Somaiya, M., Shankar, S., Nasirabadi, M., Shah, H., Paul, I., & Ghildiyal,
R. (2020). Psychological Interventions for Dissociative disorders. Indian Journal of
Psychiatry, 62(8), 280. https://doi.org/10.4103/psychiatry.indianjpsychiatry_777_19
sociocultural. (n.d.). In Merriam-Webster Dictionary.
https://www.merriam-webster.com/dictionary/sociocultural
Marais, L., Bezuidenhout, M., & Krüger, C. (2022). How do Patients Diagnosed with
Dissociative Identity Disorder Experience Conflict? A Qualitative Study. Journal of
Trauma & Dissociation, 24(1), 125–140. https://doi.org/10.1080/15299732.2022.2119630
Loewenstein, R. J. (2020b). Firebug! Dissociative identity disorder? malingering? or . . .? An
intensive case study of an arsonist. Psychological Injury and Law, 13(2), 187–224.
https://doi.org/10.1007/s12207-020-09377-8
Mark 5:1-20 (KJV). (n.d.). Bible Gateway. https://www.biblegateway.com/passage/?
search=Mark+5%3A1-20%2CLuke+8%3A26-39&version=KJV
Mark 1 (KJV). (n.d.). Bible Gateway. https://www.biblegateway.com/passage/?search=Mark
%201&version=KJV
