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Dissociative Identity Disorder: Difference between revisions

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Dissociative Identity Disorder, formerly Multiple Personality Disorder, is a psychological diagnosis listed in the dissociative disorders section of the DiagnosticsDiagnostic Standardsand Statistical Manual of Mental Disorders (DSM-V) and also in the International Statistical Classification of Diseases and Related Health Problems (ICD-10). It has had a highly controversial history, falling into and out of popularity amongst psychologists. An internet communityculture, theformed from Healthypeople Multiplicityexperiencing communityplurality, has a very different take on the diagnosis, and on related conditions.
 
It is similar to [[tulpamancy]], in that it is an experience of [[plurality]]. These personpersons experience alters, which are like other personalities, that can take over the body. The original idea is that all persons experiencing this condition must have had advanced trauma at some time in the past, causing it, but this is controversial.
 
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== Diagnosis ==
The Diagnostic Standards ManualDSM is the de facto standard for the diagnosis of this condition. However, in practise, diagnostics often diverge from the standards.
 
With theThe DSM, revision 5, has five criteria for DID, all of which must be met. Several other dissociative disorders use the same criteria, but need fewer of them to be met.
 
# Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
:"The dissociative amnesia of individuals with dissociative identity disorder manifests in three primary ways: as 1) gaps in remote memory of personal life events (e.g., periods of childhood or adolescence; some important life events, such as the death of a grandparent, getting married, giving birth); 2) lapses in dependable memory (e.g., of what happened today, of well-learned skills such as how to do their job, use a computer, read, drive); and 3) discovery of evidence of their everyday actions and tasks that they do not recollect doing (e.g., finding unexplained objects in their shopping bags or among their possessions; finding perplexing writings or drawings that they must have created; discovering injuries; "coming to" in the midst of doing something)."
 
:"Possession-form identities in dissociative identity disorder typically manifest as behaviors that appear as if a "spirit," supernatural being, or outside person has taken control, such that the individual begins speaking or acting in a distinctly different manner. For example, an individual's behavior may give the appearance that her identity has been replaced by the "ghost" of a girl who committed suicide in the same community years before, speaking and acting as though she were still alive. Or an individual may be "taken over" by a demon or deity, resulting in profound impairment, and demanding that the individual or a relative be punished for a past act, followed by more subtle periods of identity alteration. However, the majority of possession states around the world are normal, usually part of spiritual practice, and do not meet criteria for dissociative identity disorder."
before, speaking and acting as though she were still alive. Or an individual may be "taken over" by a demon or deity, resulting in profound impairment, and demanding that the individual or a relative be punished for a past act, followed by more subtle periods of identity alteration. However, the majority of possession states around the world are normal, usually part of spiritual practice, and do not meet criteria for dissociative identity disorder."
 
:"Many features of dissociative identity disorder can be influenced by the individual's cultural background."
background.:
 
The DID further discusses comorbidity, suggestingshowing that depression, anxiety, substance abuse, self-injury and non-epileptic seasures areseizures all possiblecorrelate signs ofwith DID. It suggests that those with DID are often unaware, or conceal their symptoms at first. It says that disorienting flashbacks can occur. The DSM discusses the reporting of maltreatment and other trauma, but as you see, it's not part of the diagnostic criteria. The DSM lists higher than average hypnotizability and dissociativity, and transient psychotic events as furtheralso signs.correlating Andwith attemptedDID. Attempted suicide is ridiculously common, atwith 70% having attempted it.
 
Prevalence is estimated, roughly, at 1.5% of the population, based on the study of a U.S. town.
Other Specified Dissociative Disorder: The division of identity (aka plurality) is shared with one variant of OSDD. OSDD does not require amnesia symptoms, and it can be supported by dissociative symptoms not strong enough to meet the first criteria of DID.
 
Major Depressive Disorder: Most people with DID are also depressed, and this can disguise symptoms of DID.
 
Bipolar: Personality changes can easily be misinterpreted as mood swings.
 
Post Traumatic Stress Disorder: Has heavy overlap of symptoms with DID. This can mean the presence of PTSD can hide further evidence of DID. Dissociation unrelated to trauma is a sign it's not just PTSD.
 
Psychotic disorders: Personified voices can be mistaken for hallucinations, one of the criteria for various psychotic disorders. Furthermore, possession events can be confused for formal thought disorder, thought insertion, and thought withdrawal, other symptoms. People with DID may also experience trauma related hallucinations. However, people with DID do not have delusional explanations for their symptoms.
 
 
== Alters ==
=== The Clinical Perspective ===
 
The diagnosis was largelyinitially created in the eighteen hundreds, at a time when efforts to standardise psychological diagnosis were underway. The subject of multiple personalities were discussed amongst psychologists as a topic of fascination. Around this time, it became recognised that traumatic events could indeed cause long lasting mental harm.
 
Around the start of the nineteen hundreds, interest in this topic began to wane. This is most likely because the condition was seen as very rare, though accusations of fraud also factored in. Around this time, the diagnosis of Schizophrenia was broadened to be more inclusive, capturing much of what dissociative identity disorder was. This overbroadening of Schizophrenia persisted and got worse, mainly in the united states, but has since been largely rectified, with the creation of a new category of dissociative disorders, one that contains DID, as well as other categories for PTSD and similar, and stricter diagnostic standards for Schizophrenia.
More modernly, starting roughly in the 1980s, an alternate interpretation of this diagnosis has been put forward. Though it is not to say that those with DID are free of disorder, it may be that they are specifically DID for cultural reasons. This phenomenon is more strongly recognised in the category of culture bound disorders, a category for diagnoses that seem to only happen in one place or time on earth. Many of these are also examples of multiplicity or possible multiplicity, and DID could be an American example of this. One example of this is Ian Hacking's concept of multiplicity within his dynamic nominalism theory.
 
Also starting roughly in 1980, the diagnosis came back with a vengeance, with a dramatic uptake in the number diagnosed, but fell off sharply again near the end of the millennium. Also roughly during this period, this diagnosis has been refined and split, creating the new dissociative diagnoses, Dissociative Disorder Not Otherwise Specified and Other Specified Dissociative Disorder.
 
The word hysteria has been associated with this diagnosis during various historical periods, but it was its own diagnostic category.
 
=== The Healthy Multiplicity Perspective ===
After the invention of the internet, starting in the 2000s, A number of people experiencing plurality, many of whom are diagnosed with DID or similar, formed an internet subculture. This is a group most represented by a group of vocal bloggers, and it consists primarily of a loose collection of websites. As a subculture, this group has no unified goals or opinions. They are related by a shared experience of plurality. Nonetheless, certain ideas and opinions have come out of the writings of this group. One such idea is the idea that the alternate personalities are persons in their own right. Another is that multiplicity is not a disorder. Though it is unclear if this means more that people with plurality should not be diagnosed with DID or that DID is not a diagnosis of disorder. Those in the community still recommend that people should look at getting psychological support if they feel that is best for them.
 
Dealing with plurality is not easy. In asserting that their condition is not a disorder, the community has created the problem that they need to provide support and methods for dealing with the conditionplurality in a non-clinical setting. This community has done so, establishing several ideas. A system of organisation should be established, such that the alters can cooperate with each other, schedule with each other, and communicate with each other, creating a mode of organised plurality. Instead of seeking "integration", the psychological process where the personalities are blended into one, those in the healthy multiplicity community seek conflict resolution strategies, so that the various personalities can work together and live as a family.
 
There has been some feedback from this culture's coping strategies back into psychological theory and practise. Many professional psychologists no longer pursue integration as the first solution to this diagnosis, as one example, and now also look towards conflict resolution strategies.
 
== References ==
 
== External links ==
https://tulpa.io/clinical-perspectives
 
http://www.isst-d.org/downloads/GUIDELINES_REVISED2011.pdf
 
https://pdfs.semanticscholar.org/5105/09b4c28c60d1c4d28681af633784d0a4af26.pdf
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