Dissociative identity disorder(English) dissociative identity disorder , or DID listen)) - a psychiatric diagnosis taken into account "an individual's behavior, as well as memory loss, beyond the limits of normal forgetfulness. Memory loss is commonly described as "switching." Symptoms must occur regardless of any substance abuse (alcohol or drugs) or general medical condition.
Jean-Martin Charcot, chief physician of the Salpêtrière hospital in Paris, although he discovered a new disease. He called this new disease hystero-epilepsy. As you can tell from the name, the disorder is believed to combine some features of two already recognized mental disorders, hysteria and epilepsy. Ever since it was first discovered, people have been fascinated by what later became known as Multiple Personality Disorders.
Critical attitude towards the diagnosis
Symptoms when the disease was first discovered were heartburn, cramps, fainting and impaired consciousness. Charcot was considered the preeminent French psychologist at the time and was able to demonstrate the symptoms in his patients to his staff throughout the hospital. Since the disease was first discovered, we have learned more about it and it has evolved into what is called multiple personality disorder.
Dissociative identity disorder is also known as multiple personality disorder(English) multiple personality disorder, or MPD) . In North America, the disorder is commonly referred to as "dissociative identity disorder" due to differences of opinion in the psychiatric and psychological communities regarding the concept that one (physical) individual can have more than one personality, where personality can be defined as the sum total of mental states of a given (physical) individual.
As we move forward, Multiple Personality Disorder is increasingly being diagnosed. As a result, more and more students are questioning whether the disease really exists at all. Not everyone believed Charcot when he first came up with hystero-epilepsy. One of the most famous doubters of Charcot's original discovery was actually one of his students, Joseph Babinsky. He felt that Charcot had actually invented this disease. He said he showed symptoms of convincing patients who were in fact much more mentally healthy and had only milder complaints that they had this serious illness.
Diagnostic criteria
The criteria for diagnosing dissociative identity disorder published by DSM-IV have been criticized. In one of the studies (), a number of shortcomings of these diagnostic criteria were highlighted: in this study they are claimed to be inconsistent with modern psychiatric classification, not based on a taxometric analysis of the symptoms of dissociative identity disorder, to describe the disorder as a closed concept, to have poor content validity, to ignore important data, to interfere with taxonomic research, to have low reliability, and to often lead to misreporting diagnosis, they contain a contradiction and the number of cases with dissociative identity disorder is artificially low. This study proposes a solution to the DSM-V in the form of what researchers consider to be more user-friendly polythetic diagnostic criteria for dissociative disorders.
Multiple personality disorder and schizophrenia
Once he convinced them that they had the disease, he would invite them to join other patients who he said had the disease. Babinski felt that they started having seizures not because they had epilepsy, but because they had been stuck in Charcot's treatment ward for so long that they were imitating other epilepsy patients and making it seem like they had hystero-epilepsy.
Babinski eventually proved his point with Charcot. He proved that some patients may believe they had mental illnesses that they did not have. This is especially true for women suffering from problems or other mentally vulnerable patients. This led to Babinsky and Charcot working together to develop a treatment program for their patients. Because of Babinski's claim, one of the tenants of this treatment procedure was to reduce the effect that other patients had on the symptoms of other patients in the ward.
Multiple personality disorder and schizophrenia
Timeline of the development of understanding multiple personality
1640s - 1880s
1880s - 1950s
After 1950s
Definition of dissociation
Divergence of opinion about multiple personality
Until now, the scientific community has not come to a consensus on what constitutes multiple personality, since there were too few documented cases of this disorder in the history of medicine before the 1950s. In the 4th edition "personality". The same designation was adopted in ICD-9, but in ICD-10 the variant “disorder” is used multiple personality" It should be noted that a serious mistake is often made in the media when multiple personality disorder and schizophrenia are confused.
The first patients who had the disease hysteroepileptic disease were admitted to the general ward of the hospital, still separated from each other. This means that they were separated from those who were experiencing the same symptoms associated with the disease they had. This treatment was very effective in reducing symptoms.
After isolation there was one more step towards treatment, this step was called a counter offer. This step was designed to give his patients a different way of seeing. This adjusted self-esteem may result in patients no longer experiencing symptoms associated with the disease. Some of these counterproposals would be considered inhumane today. These included electroshock therapy. Most in an efficient way treatment was a complete disregard for the fact that the patient was exhibiting symptoms at all.
A 1944 study of 19th- and 20th-century medical literature on the topic of multiple personality found only 76 cases. In recent years, the number of cases of dissociative identity disorder has increased sharply (some estimates estimate that approximately 40,000 cases were reported between 2000 and 2000). However, other studies have shown that the disorder does have a long history, stretching back about 300 years in the literature, and it affects less than 1% of the population. According to other data, dissociative identity disorder occurs among 1-3% of the general population. Thus, epidemiological data indicate that in the population, dissociative identity disorder is actually as common as schizophrenia.
When the staff who treated these patients began to ignore the symptoms they were exhibiting, they did so gradually. They ignored the hysteria the patient was experiencing and instead talked to them as if they wanted to treat some other problem that might be causing the symptoms in the first place. When this happens, the patient does not feel the need to develop symptoms because they begin to understand that the disease is not real. Babinski and Charcot would then later realize who was actually sick because of the people who were still showing symptoms of hysteresis after the proposal had been accepted.
Dissociation is now viewed as a symptomatic manifestation in response to trauma, critical emotional stress, and is associated with emotional dysregulation and borderline personality disorder. According to a longitudinal study by Ogawa et al., the strongest predictor of dissociation in young adults was lack of access to mother at age 2 years. Many recent studies have shown a link between disrupted attachment in early childhood and subsequent dissociative symptoms, and there is also evidence that childhood abuse and neglect often contribute to the development of disturbed attachment (manifested, for example, when the child is very closely monitoring whether the parents are paying attention to on him or not).
Timeline of the development of understanding multiple personality
Other patients simply found much more constructive ways to solve their problems, other than hysterical outbursts. These rules and guidelines that Charcot and Babinsky discovered when diagnosing hist epilepsy are not used today by psychiatrists who diagnose patients with multiple personality disorder. This is causing a nationwide problem with more diagnoses of multiple personality disorder across the country. The illness will respond to standard treatments because, like other mental illnesses, it operates if the person has a hidden view of themselves.
Critical attitude towards the diagnosis
Some psychologists and psychiatrists believe that dissociative identity disorder is iatrogenic or contrived, or argue that cases of true multiple personality are very rare and most documented cases should be considered iatrogenic.
The most obvious way that these two illnesses have become misdiagnosed and misdiagnosed by mental health professionals is due to their origins. Both hystereo-epilepsy and multiple personality disorder were diseases that were invented by humans. They are not a virus or bacteria that occur in nature. Therapists have discovered and invented guidelines by which they diagnose patients. The disease is well known in homes everywhere and has been somewhat romanticized by Hollywood and the media.
Critics of the dissociative identity disorder model argue that the diagnosis of multiple personality disorder is a phenomenon more common in English-speaking countries. Until the 1950s, cases of split personality and multiple personality were sometimes described and treated as rare in the Western world. That year, the publication of the book The Three Faces of Eve and later the release of the film of the same name contributed to the growth of public interest in the phenomenon of multiple personalities. In 1973, the filmed book “Sybil” was subsequently published, describing the life of a woman with multiple personality disorder. However, the diagnosis of multiple personality disorder itself was not included in the Diagnostic and Statistical Manual of Mental Disorders until 1980. Between the 1980s and 1990s, the number of reported cases of multiple personality disorder increased to between twenty and forty thousand.
Here are some tips on how to attract people to alternative people. He says that most alternate personalities will emerge within the time that the patient is assessed by their therapists. It is peculiar and makes the disease doubtful in the person who is believed to have it. A great way to get other personalities to come forward is to ask the patient questions and start very broadly, simply suggesting that they have alternate personalities in their psyche. Then clarify who the different personalities are until one emerges during the interview.
Main article: Multiple Personality as a Healthy State
Some people, including those who self-identify as having multiple personality, believe that the condition may not be a disorder, but a natural variation of human consciousness that has nothing to do with dissociation. One of the staunch supporters of this version is Trudy Chase, author of the bestseller “When Rabbit Howls.” While she acknowledges that in her case the multiple personalities were the result of violence, she claims that her group of personalities refused to be integrated and live together as a collective.
Divergence of opinion about multiple personality
Sometimes you can talk to other individuals simply by asking permission to do so. When a patient allows their doctor to talk to one of their alternate personalities, they have then committed themselves to the idea of the disease. Typically they will receive some kind of help depending on the severity of their particular case of multiple personality disorder. It is usually easier for psychiatrists to find other changes after the first alter has been found. This is because the line between fantasy and reality has become more blurred for the patient.
Intercultural studies
Anthropologists L. K. Suryani and Gordon Jensen are convinced that the phenomenon of pronounced trance states in the Bali community has the same phenomenological nature as the phenomenon of multiple personality in the West. It is argued that people in shamanic cultures who experience multiple personalities define these personalities not as parts of themselves, but as independent souls or spirits. There is no evidence of a relationship between multiple personality, dissociation, and memory retrieval and sexual violence in these cultures. In traditional cultures, plurality, such as that exhibited by shamans, is not considered a disorder or disease.
It is interesting to note that patients are known to develop more changes as the disease progresses. Sometimes patients will start with 2 or 3 characters and they will develop to almost a hundred. There are even some patients who have changes that are animals such as dogs, cats or some kind of farm animal.
It is believed that what troubles trauma is that a person breaks away from himself and creates other personalities that do not have the problem. They may also have a personality that stops developing from the age at which the trauma occurred. The therapist and patient can search together for alternate personalities that remember this trauma so that they can hash it and work through it.
Potential Causes of Multiple Personality Disorder
Dissociative identity disorder is believed to be caused by a combination of several factors: intolerable stress, the ability to dissociate (including the ability to separate one's memories, perceptions or identity from consciousness), the manifestation of defense mechanisms in ontogenesis and - during childhood - a lack of care and participation in relation to the child with a traumatic experience or lack of protection from subsequent unwanted experiences. Children are not born with a sense of a unified identity; the latter develops based on a variety of sources and experiences. In critical situations child development encounters obstacles, and many parts of what should have been integrated into a relatively unified identity remain segregated.
The problem with this disease is that people become so distracted by the dramatic symptoms that they fail to meet the patient's needs. When therapists only treat the symptoms, it can never end with the patient just walking in and the endless cycle associated with the disease.
Potential Causes of Multiple Personality Disorder
Charcot came to the realization that he was helping patients invent this disease and get them out of the special hospital places he had created for them. It has been found that isolation is much more effective method treatment of hysteroepilepsia, since it helped get rid of those patients who actually did not have this disease. He came to the realization that it was better to ignore the altered personalities that patients exhibited and look only at the problems of the original personality.
North American studies show that 97-98% of adults with dissociative identity disorder describe situations of violence in childhood and that violence can be documented in 85% of adults and 95% of children and adolescents with multiple personality disorder and other related forms of dissociative disorder. These findings indicate that childhood violence plays a role main reason disorders among North American patients, while in other cultures the effects of war or natural disaster may play a major role. Some patients may not have experienced violence but have experienced an early loss (eg, the death of a parent), serious illness, or other extremely stressful event.
Dissociative identity disorder, often called multiple personality disorder, has fascinated people for more than a century. However, although they are a very well-known disorder, mental health professionals aren't even sure if they exist. It is possible that this is a form of another illness such as schizophrenia. Another theory is that it doesn't exist at all and those who have it, including the following people, are simply acting.
One of the first recorded cases of multiple personalities belonged to the Frenchman Louis Vivet. By the time he was eight, he had turned to crime. He was arrested and lived in a treatment home in his late teens. When he was 17 years old, he was working in a vineyard and a viper wrapped itself around his left arm. Until the viper bit him, it scared him so much that he had convulsions and was psychosomatically paralyzed from the waist down. Paralyzed, he was placed in an asylum, but within a year he began walking again.
Human development requires the child to be able to successfully integrate different types of complex information. In ontogenesis, a person goes through a number of developmental stages, in each of which different personalities can be created. The ability to generate multiple personalities is not observed or demonstrated in every child who has experienced violence, loss or trauma. Patients with dissociative identity disorder have the ability to easily enter trance states. This ability, coupled with the ability to dissociate, is thought to be a factor in the development of the disorder. However, most children who have these abilities also have normal adaptive mechanisms and are not in an environment that can cause dissociation.
Vivet now seemed like a completely different person. He didn't recognize any of the people in the shelter, his mood was much darker, and even his appetite was different. When he was 18 years old, he was released from the asylum, but did not last long. Over the next few years, Vivet was in and out of hospitals. Using hypnosis and metal therapy, the doctor discovered up to 10 different personalities with their own characteristics and history. However, after reviewing the case in subsequent years, some experts believe that he may have only had three personalities.
Growing up in New York State, Judy Castelli suffered from physical and sexual abuse, and then she battled depression. Over the next few years, Castelli struggled with voices in her head that told her to burn and cut herself. She almost ruined her face, almost losing the sight in one eye and almost losing the use of one of her hands. She was hospitalized several times for suicide attempts. Each time she was diagnosed with chronic undifferentiated schizophrenia.
Treatment
The most common approach to treating multiple personality disorder is to relieve symptoms to ensure the individual's safety and to reintegrate the various personalities into one well-functioning identity. Treatment can occur using various types psychotherapy - cognitive psychotherapy, family psychotherapy, clinical hypnosis, etc.
Insight-oriented psychodynamic therapy has been used with some success, helping to overcome the trauma received, revealing conflicts that determine the need for individuals and correcting the relevant
