The Dissociative Identity Disorder Sourcebook - by Deborah Bray Haddock - 224 pages
Treating dissociative identity disorder: the ... - by Sarah Y. Krakauer - 246 pages
Forensic Aspects of Dissociative Identity Disorder - by Adah Sachs, Graeme Galton - 215 pages
Thursday, June 18, 2009
Recommended Treatment
What's the recommended treatment plan for dissociative identity disorder?
While there's no "cure" for dissociative identity disorder, long-term treatment is very successful, if the patient stays committed. Effective treatment includes talk therapy or psychotherapy, medications, hypnotherapy, and adjunctive therapies such as art or movement therapy.
Because oftentimes the symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, dissociative disorder may be treated using the same drugs prescribed for those disorders. A person in treatment for a dissociative disorder might benefit from antidepressants or anti- anxiety medication.
While there's no "cure" for dissociative identity disorder, long-term treatment is very successful, if the patient stays committed. Effective treatment includes talk therapy or psychotherapy, medications, hypnotherapy, and adjunctive therapies such as art or movement therapy.
Because oftentimes the symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, dissociative disorder may be treated using the same drugs prescribed for those disorders. A person in treatment for a dissociative disorder might benefit from antidepressants or anti- anxiety medication.
Dissociative Disorder vs. Schizophrenia
What's the difference between dissociative identity disorder and schizophrenia?
Schizophrenia and dissociative identity disorder are often confused, but they are very different.
Schizophrenia is a severe mental illness involving chronic (or recurrent) psychosis, characterized mainly by hearing or seeing things that aren't real (hallucinations) and thinking or believing things with no basis in reality (delusions). People with schizophrenia do not have multiple personalities. Delusions are the most common psychotic symptom in schizophrenia; hallucinations, particularly hearing voices in the person's head, are apparent in about half of people. Â Â
Suicide is a risk with both schizophrenia and dissociative identity disorder, although patients with multiple personalities have a history of suicide attempt more often than other psychiatric patients.
How does dissociation change the way a person experiences life?
There are several main ways in which the psychological processes of dissociative identity disorder change the way a person experiences living, including the following:
Depersonalization. This is a sense of being detached from one's body and is often referred to as an "out-of-body" experience.
Derealization. This is the feeling that the world is not real or looking foggy or far away.
Amnesia. This is the failure to recall significant personal information that is so extensive it cannot be blamed on ordinary forgetfulness. There can also be micro-amnesias where the discussion engaged in is not remembered, or the content of a meaningful conversation is forgotten from one second to the next.
Identity confusion or identity alteration. Both of these involve a sense of confusion about who a person is. An example of identity confusion is when a person sometimes feels a thrill while engaged in an activity (e.g., reckless driving, DUI, alcohol or drug abuse) which at other times would be revolting. In addition to these apparent alterations, the person may experience distortions in time, place, and situation.
It is now acknowledged that these dissociated states are not fully-mature personalities, but rather they represent a disjointed sense of identity. With the amnesia typically associated with dissociative identity disorder, different identity states remember different aspects of autobiographical information. There is usually a host personality within the individual, who identifies with the person's real name. Ironically, the host personality is usually unaware of the presence of other personalities.
Schizophrenia and dissociative identity disorder are often confused, but they are very different.
Schizophrenia is a severe mental illness involving chronic (or recurrent) psychosis, characterized mainly by hearing or seeing things that aren't real (hallucinations) and thinking or believing things with no basis in reality (delusions). People with schizophrenia do not have multiple personalities. Delusions are the most common psychotic symptom in schizophrenia; hallucinations, particularly hearing voices in the person's head, are apparent in about half of people. Â Â
Suicide is a risk with both schizophrenia and dissociative identity disorder, although patients with multiple personalities have a history of suicide attempt more often than other psychiatric patients.
How does dissociation change the way a person experiences life?
There are several main ways in which the psychological processes of dissociative identity disorder change the way a person experiences living, including the following:
Depersonalization. This is a sense of being detached from one's body and is often referred to as an "out-of-body" experience.
Derealization. This is the feeling that the world is not real or looking foggy or far away.
Amnesia. This is the failure to recall significant personal information that is so extensive it cannot be blamed on ordinary forgetfulness. There can also be micro-amnesias where the discussion engaged in is not remembered, or the content of a meaningful conversation is forgotten from one second to the next.
Identity confusion or identity alteration. Both of these involve a sense of confusion about who a person is. An example of identity confusion is when a person sometimes feels a thrill while engaged in an activity (e.g., reckless driving, DUI, alcohol or drug abuse) which at other times would be revolting. In addition to these apparent alterations, the person may experience distortions in time, place, and situation.
It is now acknowledged that these dissociated states are not fully-mature personalities, but rather they represent a disjointed sense of identity. With the amnesia typically associated with dissociative identity disorder, different identity states remember different aspects of autobiographical information. There is usually a host personality within the individual, who identifies with the person's real name. Ironically, the host personality is usually unaware of the presence of other personalities.
Useful Webpages
www.webmd.com/mental-health/dissociative-identity-disorder
www.psychologytoday.com/conditions/did.html
www.nami.org/Content/ContentGroups/Helpline1/Dissociative_Identity_Disorder_(formerly_Multiple_Personality_Disorder).htm
www.people.ehe.ohio-state.edu/dgranello/files/2009/05/dissociative-identity-disorder-by-lauren-grubbs.pdf - pdf that gives websites.
www.psychologytoday.com/conditions/did.html
www.nami.org/Content/ContentGroups/Helpline1/Dissociative_Identity_Disorder_(formerly_Multiple_Personality_Disorder).htm
www.people.ehe.ohio-state.edu/dgranello/files/2009/05/dissociative-identity-disorder-by-lauren-grubbs.pdf - pdf that gives websites.
Tuesday, June 16, 2009
The United States of Tara - Showtime series
Television
The Four (at Least) Faces of Tara
By JEANNE DORIN McDOWELL
Published: January 9, 2009
LOS ANGELES
TWO years ago, when the Oscar-winning screenwriter Diablo Cody (“Juno”) began working on “United States of Tara,” Showtime’s new series about a woman with dissociative identity disorder (commonly known as multiple personality disorder), she knew she was tiptoeing onto a creative minefield.
Though “United States of Tara,” which begins next Sunday, was conceived as a comedic look at how a family copes under extraordinary circumstances, it also had to acknowledge the heartbreak of Tara Gregson (Toni Collette), a wife and mother, as she deals with a disorder that wreaks havoc on her life
.
“I was nervous at the outset,” Ms. Cody said. “The pilot couldn’t be ‘sitcomy’ but, at the same time, it had to be funny. It was a big challenge to find the humor in everyday life and not poke fun at the disorder. And I wanted to be as sensitive as possible.”
“Sensitive” is not exactly a prescription for great comedy. Humorous takes on subjects like split personality are few and far between, and when they show up — for example, in the Farrelly brothers’ “Me, Myself & Irene,” starring Jim Carrey — they tend toward outrageous antics. Typically dissociative identity disorder is given a more sober treatment, as in the 1976 television movie “Sybil” starring Sally Field or the 1957 melodrama “The Three Faces of Eve” with Joanne Woodward. Or it just veers into the land of the ludicrous, like soap operas. (Erika Slezak, playing Viki Lord Davidson on “All My Children,” wrestled with a bout of multiple personality disorder in the 1980s.)
But the show’s creators, and executives at Showtime, who have embraced deeply flawed characters and pathology-driven series like “Dexter” (about a serial killer) and “Californication” (about a sex addict), said they thought they had found a middle ground, a way for this combustible mix of humor, morbid fascination and empathy to find an audience. “We’re not trying to make a broad slapstick comedy; there’s nothing funny about” the disorder, said Robert Greenblatt, the president of Showtime Entertainment. “People who know nothing about dissociative identity disorder have to be able to watch and believe it could be real. We’re hoping to find funny repercussions as this family deals with Tara’s different personalities.”
Those personalities, or alters as they’re called, provide much of the color, conflict and dark comedy. Ms. Cody said thinking up Tara’s alters was the “magical part.” There’s T, a rebellious, hypersexual, thong-baring 16-year-old who steals Tara’s credit cards and smokes pot with her daughter Kate (Brie Larson); Alice, an aproned 1950s-type homemaker (like June Cleaver with O.C.D.); and Buck, a surly Vietnam vet with a cigarette dangling out of his mouth, a collection of porn tapes under the bed — which he watches with Tara’s husband Max (John Corbett) — and a shotgun he calls Persephone.
The series’s writers, who have worked on shows including “30 Rock” and “Six Feet Under,” were mindful of how easy it would be to depend too much on the alters’ antics. “We don’t want to fall into some kind of parody of ‘alter of the week,’ ” said the executive producer Alexa Junge, a veteran television writer (“Friends”) who was brought on to help Ms. Cody, a television novice. “We’ve taken great pains to make the alters very real. All the members of the family have relationships with them. If we just played it for comic relief, it would be a much more shallow show.”
The personalities — funny, tragic, disruptive, even protective — do feel like members of the Gregson family. When Tara’s son, Marshall (Keir Gilchrist), provokes his English teacher, a fierce Alice takes up his fight. Wearing a dated shirtwaist dress, white gloves and flaming orange lipstick, she eviscerates the teacher and, in the process, gets Marshall a chance to improve his grade. Later Marshall marvels at Alice’s aplomb. “Oh, piffle,” she chirps.
But the alters are also an expression of Tara’s deepest, and still not understood, anguish. They wear clothes that Tara wouldn’t be caught dead in, try to seduce her husband (Tara and Max have agreed he won’t have sex with them) and steal chunks of her memory. They emerge and recede, and Tara has no idea where she has been or what she has done. When Max reminds her that they knew the gang would come out when she went off her meds, she snaps, “Yeah, it’s a regular multiple personality reunion tour.”
“They’re all a reflection of what’s going on internally with Tara,” Ms. Collette said. “The humor is inherent in the material, but there’s always the ache under there somewhere and a yearning to understand what’s caused this.” The writers constantly ask themselves where the comedy is. “It never comes from making fun of a woman who can’t control herself,” Ms. Junge said. “It’s in getting the right tone for the show. The flip side of that is how funny do we make it? How much funny is too funny?”
That said, “United States of Tara” is bound to ruffle a few feathers among mental health professionals as well as those with the disorder. Dissociative identity disorder is a contentious diagnosis: some professionals say the disorder is overdiagnosed; others say it doesn’t even exist. The writers have given that point of view a place on the show. Tara’s sister, Charmaine (Rosemarie DeWitt), is the voice of skepticism, saying that Tara is “pretending” for the attention.
But the series’s writers and producers have done their research. Richard Kluft, a professor at the Temple University School of Medicine who is an expert on the disorder, reviews scripts and steers the show away from inaccuracies.
Ultimately the creators and Showtime executives hope that the obvious metaphor in “United States of Tara” — that we all struggle with our fragmented selves — will be easy for viewers to relate to. (The show’s genesis was a conversation between Steven Spielberg, an executive producer on the show, and his wife, the actress Kate Capshaw, about the ways in which we compartmentalize our lives.)
At its heart is a close-knit family with good kids who love their mother (most of the time), a staple of the family comedy from television’s beginnings. “We’re lucky, mom,” Marshall tells Tara. “Because of you we get to be interesting.” You get the feeling that these people are in it together — even if Mommy did turn into a man and beat the tar out of Kate’s boyfriend in front of the school.
This article has been revised to reflect the following correction:
Correction: February 1, 2009 An article on Jan. 11 about the television show “United States of Tara,” whose protagonist has dissociative identity disorder (once known as multiple personality disorder), misidentified a soap opera character who has the illness and the actress who portrays her. Viki Lord Davidson, a character on ABC’s “One Life to Live” played by Erika Slezak, has the disorder — not Erica Kane, a character on ABC’s “All My Children” portrayed by Susan Lucci.
The Four (at Least) Faces of Tara
By JEANNE DORIN McDOWELL
Published: January 9, 2009
LOS ANGELES
TWO years ago, when the Oscar-winning screenwriter Diablo Cody (“Juno”) began working on “United States of Tara,” Showtime’s new series about a woman with dissociative identity disorder (commonly known as multiple personality disorder), she knew she was tiptoeing onto a creative minefield.
Though “United States of Tara,” which begins next Sunday, was conceived as a comedic look at how a family copes under extraordinary circumstances, it also had to acknowledge the heartbreak of Tara Gregson (Toni Collette), a wife and mother, as she deals with a disorder that wreaks havoc on her life
.
“I was nervous at the outset,” Ms. Cody said. “The pilot couldn’t be ‘sitcomy’ but, at the same time, it had to be funny. It was a big challenge to find the humor in everyday life and not poke fun at the disorder. And I wanted to be as sensitive as possible.”
“Sensitive” is not exactly a prescription for great comedy. Humorous takes on subjects like split personality are few and far between, and when they show up — for example, in the Farrelly brothers’ “Me, Myself & Irene,” starring Jim Carrey — they tend toward outrageous antics. Typically dissociative identity disorder is given a more sober treatment, as in the 1976 television movie “Sybil” starring Sally Field or the 1957 melodrama “The Three Faces of Eve” with Joanne Woodward. Or it just veers into the land of the ludicrous, like soap operas. (Erika Slezak, playing Viki Lord Davidson on “All My Children,” wrestled with a bout of multiple personality disorder in the 1980s.)
But the show’s creators, and executives at Showtime, who have embraced deeply flawed characters and pathology-driven series like “Dexter” (about a serial killer) and “Californication” (about a sex addict), said they thought they had found a middle ground, a way for this combustible mix of humor, morbid fascination and empathy to find an audience. “We’re not trying to make a broad slapstick comedy; there’s nothing funny about” the disorder, said Robert Greenblatt, the president of Showtime Entertainment. “People who know nothing about dissociative identity disorder have to be able to watch and believe it could be real. We’re hoping to find funny repercussions as this family deals with Tara’s different personalities.”
Those personalities, or alters as they’re called, provide much of the color, conflict and dark comedy. Ms. Cody said thinking up Tara’s alters was the “magical part.” There’s T, a rebellious, hypersexual, thong-baring 16-year-old who steals Tara’s credit cards and smokes pot with her daughter Kate (Brie Larson); Alice, an aproned 1950s-type homemaker (like June Cleaver with O.C.D.); and Buck, a surly Vietnam vet with a cigarette dangling out of his mouth, a collection of porn tapes under the bed — which he watches with Tara’s husband Max (John Corbett) — and a shotgun he calls Persephone.
The series’s writers, who have worked on shows including “30 Rock” and “Six Feet Under,” were mindful of how easy it would be to depend too much on the alters’ antics. “We don’t want to fall into some kind of parody of ‘alter of the week,’ ” said the executive producer Alexa Junge, a veteran television writer (“Friends”) who was brought on to help Ms. Cody, a television novice. “We’ve taken great pains to make the alters very real. All the members of the family have relationships with them. If we just played it for comic relief, it would be a much more shallow show.”
The personalities — funny, tragic, disruptive, even protective — do feel like members of the Gregson family. When Tara’s son, Marshall (Keir Gilchrist), provokes his English teacher, a fierce Alice takes up his fight. Wearing a dated shirtwaist dress, white gloves and flaming orange lipstick, she eviscerates the teacher and, in the process, gets Marshall a chance to improve his grade. Later Marshall marvels at Alice’s aplomb. “Oh, piffle,” she chirps.
But the alters are also an expression of Tara’s deepest, and still not understood, anguish. They wear clothes that Tara wouldn’t be caught dead in, try to seduce her husband (Tara and Max have agreed he won’t have sex with them) and steal chunks of her memory. They emerge and recede, and Tara has no idea where she has been or what she has done. When Max reminds her that they knew the gang would come out when she went off her meds, she snaps, “Yeah, it’s a regular multiple personality reunion tour.”
“They’re all a reflection of what’s going on internally with Tara,” Ms. Collette said. “The humor is inherent in the material, but there’s always the ache under there somewhere and a yearning to understand what’s caused this.” The writers constantly ask themselves where the comedy is. “It never comes from making fun of a woman who can’t control herself,” Ms. Junge said. “It’s in getting the right tone for the show. The flip side of that is how funny do we make it? How much funny is too funny?”
That said, “United States of Tara” is bound to ruffle a few feathers among mental health professionals as well as those with the disorder. Dissociative identity disorder is a contentious diagnosis: some professionals say the disorder is overdiagnosed; others say it doesn’t even exist. The writers have given that point of view a place on the show. Tara’s sister, Charmaine (Rosemarie DeWitt), is the voice of skepticism, saying that Tara is “pretending” for the attention.
But the series’s writers and producers have done their research. Richard Kluft, a professor at the Temple University School of Medicine who is an expert on the disorder, reviews scripts and steers the show away from inaccuracies.
Ultimately the creators and Showtime executives hope that the obvious metaphor in “United States of Tara” — that we all struggle with our fragmented selves — will be easy for viewers to relate to. (The show’s genesis was a conversation between Steven Spielberg, an executive producer on the show, and his wife, the actress Kate Capshaw, about the ways in which we compartmentalize our lives.)
At its heart is a close-knit family with good kids who love their mother (most of the time), a staple of the family comedy from television’s beginnings. “We’re lucky, mom,” Marshall tells Tara. “Because of you we get to be interesting.” You get the feeling that these people are in it together — even if Mommy did turn into a man and beat the tar out of Kate’s boyfriend in front of the school.
This article has been revised to reflect the following correction:
Correction: February 1, 2009 An article on Jan. 11 about the television show “United States of Tara,” whose protagonist has dissociative identity disorder (once known as multiple personality disorder), misidentified a soap opera character who has the illness and the actress who portrays her. Viki Lord Davidson, a character on ABC’s “One Life to Live” played by Erika Slezak, has the disorder — not Erica Kane, a character on ABC’s “All My Children” portrayed by Susan Lucci.
Thursday, June 11, 2009
Dissociative Identity Disorder
Dissociative Identity Disorder (Multiple Personality Disorder)
Dissociative identity disorder (previously known as multiple personality disorder) is a fairly common effect of severe trauma during early childhood, usually extreme, repetitive physical, sexual, and/or emotional abuse.
What is dissociative identity disorder?
Most of us have experienced mild dissociation, which is like daydreaming or getting lost in the moment while working on a project. However, dissociative identity disorder is a severe form of dissociation, a mental process, which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism -- the person literally dissociates himself from a situation or experience that's too violent, traumatic, or painful to assimilate with his conscious self.
Is dissociative identity disorder real?
You may wonder if dissociative identity disorder is real. After all, understanding the development of multiple personalities is difficult, even for highly trained experts. But dissociative identity disorder does exist. It is the most severe and chronic manifestation of the dissociative disorders that cause multiple personalities.
Other types of dissociative disorders defined in the DSM-IV, the main psychiatry manual used to classify mental illnesses, include dissociative amnesia, dissociative fugue, and depersonalization disorder.
What are the symptoms of dissociative identity disorder?
Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over the person's behavior. With dissociative identity disorder, there's also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which fluctuate with the person's split personality.
The "alters" or different identities have their own age, sex, or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the alters are imaginary people; sometimes they are animals. As each personality reveals itself and control's the individuals' behavior and thoughts, it's called "switching." Switching can take seconds to minutes to days. When under hypnosis, the person's different "alters" or identities may be very responsive to the therapist's requests.
Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience any of the following symptoms:
Depression
Mood swings
Suicidal tendencies
Sleep disorders ( insomnia, night terrors, and sleep walking)
Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
Alcohol and drug abuse
Compulsions and rituals
Psychotic-like symptoms (including auditory and visual hallucinations)
Eating disorders
Other symptoms of dissociative identity disorder may include headache, amnesia, time loss, trances, and "out of body experiences." Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). As an example, someone with dissociative identity disorder may find themselves doing things they wouldn't normally do such as speeding, reckless driving, or stealing money from their employer or friend, yet they feel they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice.
Dissociative identity disorder (previously known as multiple personality disorder) is a fairly common effect of severe trauma during early childhood, usually extreme, repetitive physical, sexual, and/or emotional abuse.
What is dissociative identity disorder?
Most of us have experienced mild dissociation, which is like daydreaming or getting lost in the moment while working on a project. However, dissociative identity disorder is a severe form of dissociation, a mental process, which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism -- the person literally dissociates himself from a situation or experience that's too violent, traumatic, or painful to assimilate with his conscious self.
Is dissociative identity disorder real?
You may wonder if dissociative identity disorder is real. After all, understanding the development of multiple personalities is difficult, even for highly trained experts. But dissociative identity disorder does exist. It is the most severe and chronic manifestation of the dissociative disorders that cause multiple personalities.
Other types of dissociative disorders defined in the DSM-IV, the main psychiatry manual used to classify mental illnesses, include dissociative amnesia, dissociative fugue, and depersonalization disorder.
What are the symptoms of dissociative identity disorder?
Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over the person's behavior. With dissociative identity disorder, there's also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which fluctuate with the person's split personality.
The "alters" or different identities have their own age, sex, or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the alters are imaginary people; sometimes they are animals. As each personality reveals itself and control's the individuals' behavior and thoughts, it's called "switching." Switching can take seconds to minutes to days. When under hypnosis, the person's different "alters" or identities may be very responsive to the therapist's requests.
Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience any of the following symptoms:
Depression
Mood swings
Suicidal tendencies
Sleep disorders ( insomnia, night terrors, and sleep walking)
Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
Alcohol and drug abuse
Compulsions and rituals
Psychotic-like symptoms (including auditory and visual hallucinations)
Eating disorders
Other symptoms of dissociative identity disorder may include headache, amnesia, time loss, trances, and "out of body experiences." Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). As an example, someone with dissociative identity disorder may find themselves doing things they wouldn't normally do such as speeding, reckless driving, or stealing money from their employer or friend, yet they feel they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice.
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