- Dissociative identity disorder exists and is the result of childhood trauma
- Dispelling Myths About Dissociative Identity Disorder Treatment: An Empirically Based Approach
- Evaluation of the Evidence for the Trauma and Fantasy Models of Dissociation
Dissociative identity disorder exists and is the result of childhood trauma
In the movies, people with multiple personality disorder are nearly always psychopaths. But according to these contributing academics, most people who have dissociative identity disorder, as the condition is now known, aren’t psychopaths – they’re victims of society’s most heinous crimes. 08/11/2019
By Dr Michael Slater, Dr Warick Middleton, Prof. Martin Dorahy
....But research hasn’t found people with the disorder are more prone to “false memories” than others. And brain imaging studies show significant differences in brain activity between people with dissociative identity disorder and other groups, including those who have been trained to mimic the disorder.
....Dissociative identity disorder comes about when a child’s psychological development is disrupted by early repetitive trauma that prevents the normal processes of consolidating a core sense of identity. Reports of childhood trauma in people with dissociative identity disorder (that have been substantiated) include burning, mutilation and exploitation. Sexual abuse is also routinely reported, alongside emotional abuse and neglect.
In response to overwhelming trauma, the child develops multiple, often conflicting, states or identities. These mirror the radical contradictions in their early attachments and social and family environments – for instance, a parent who swings unpredictably between aggression and care.
According to the DSM-5, the major characteristic of dissociative identity disorder is a disruption of identity, in which a person experiences two or more distinct personality states
....But the causal relationship between trauma and dissociation (alterations of identity and memory) has been repeatedly shown in a range of studies using different methodologies across cultures.
....a contemporary survey of clinical practice among specialists of dissociative identity found those treating the disorder weren’t focused on retrieving memories at any phase of the treatment.
A recent literature analysis concluded that criticisms of dissociative identity disorder treatment are based on inaccurate assumptions about clinical practice, misunderstandings of symptoms, and an over-reliance on anecdotes and unfounded claims.
Dispelling Myths About Dissociative Identity Disorder Treatment: An Empirically Based Approach
Article· Literature Review in Psychiatry Interpersonal & Biological Processes 77(2):169-89 · June 2014
DOI: 10.1521/psyc.2014.77.2.169 · Source: PubMed
Bethany L Brand
Richard J Loewenstein
Objective: Some claim that treatment for dissociative identity disorder (DID) is harmful. Others maintain that the available data support the view that psychotherapy is helpful.
Method: We review the empirical support for both arguments.
Results: Current evidence supports the conclusion that phasic treatment consistent with expert consensus guidelines is associated with improvements in a wide range of DID patients' symptoms and functioning, decreased rates of hospitalization, and reduced costs of treatment. Research indicates that poor outcome is associated with treatment that does not specifically involve direct engagement with DID self-states to repair identity fragmentation and to decrease dissociative amnesia.
Conclusions: The evidence demonstrates that carefully staged trauma-focused psychotherapy for DID results in improvement, whereas dissociative symptoms persist when not specifically targeted in treatment. The claims that DID treatment is harmful are based on anecdotal cases, opinion pieces, reports of damage that are not substantiated in the scientific literature, misrepresentations of the data, and misunderstandings about DID treatment and the phenomenology of DID. Given the severe symptomatology and disability associated with DID, iatrogenic harm is far more likely to come from depriving DID patients of treatment that is consistent with expert consensus, treatment guidelines, and current research.
Evaluation of the Evidence for the Trauma and Fantasy Models of Dissociation
Psychological Bulletin - American Psychological Association 2012, Vol. 138, No. 3, 550 –5880033-2909/12 DOI: 10.1037/a0027447
The relationship between a reported history of trauma and dissociative symptoms has been explained in 2 conflicting ways. Pathological dissociation has been conceptualized as a response to antecedent traumatic stress and/or severe psychological adversity. Others have proposed that dissociation makes individuals prone to fantasy, thereby engendering confabulated memories of trauma. We examine data related to a series of 8 contrasting predictions based on the trauma model and the fantasy model of dissociation. In keeping with the trauma model, the relationship between trauma and dissociation was consistent and moderate in strength, and remained significant when objective measures of trauma were used. Dissociation was temporally related to trauma and trauma treatment, and was predictive of trauma history when fantasy proneness was controlled. Dissociation was not reliably associated with suggestibility, nor was there evidence for the fantasy model prediction of greater inaccuracy of recovered memory. Instead, dissociation was positively related to a history of trauma memory recovery and negatively related to the more general measures of narrative cohesion. Research also supports the trauma theory of dissociation as a regulatory response to fear or other extreme emotion with measurable biological correlates. We conclude, on the basis of evidence related to these 8 predictions, that there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support fort he hypothesis that the dissociation–trauma relationship is due to fantasy proneness or confabulated memories of trauma
Dissociative Identity Disorder
The causes of dissociative identity disorder are theoretically linked with the interaction of overwhelming stress, traumatic antecedents, insufficient childhood nurturing, and an innate ability to dissociate memories or experiences from consciousness. Prolonged child abuse is frequently a factor, with a very high percentage of patients reporting documented abuse often confirmed by objective evidence. The Diagnostic and Statistical Manual of Mental Disorders states that patients with DID often report having a history of severe physical and sexual abuse. The reports of patients suffering from DID are "often confirmed by objective evidence," and the DSM notes that the abusers in those situations may be inclined to "deny or distort” these acts. Research has consistently shown that DID is characterized by reports of extensive childhood trauma, usually child abuse. Dissociation is recognized as a symptomatic presentation in response to psychological trauma, extreme emotional stress, and in association with emotional dysregulation and borderline personality disorder. A study of 12 murderers established the connection between early severe abuse and DID. A recent psychobiological study shows that dissociative identity disorder (DID) sufferers' "origins of their ailment stem more likely from trauma" than sociogenic or iatrogenic origins.