Monday, March 5, 2018


Split Personality Disorder

Split Personality Disorder, also referred to as Dissociative Identity Disorder (DID), is a disorder of the psyche. DID is a condition in which the personality is fragmented into two or more distinct personalities, each of which has its own gender, age, personal history, vocabulary, accent, interests, and characteristics. The following is the criteria needed in order to be diagnosed with DID:

1.“Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to and thinking about the environment and self.”

2. “Amnesia must occur, defined as gaps in the recall of everyday events, important personal information and/or traumatic events.”

3. “The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.” This is a common criteria when it comes to mental health disorders. If the disorder doesn’t cause major difficulties when it comes to coping with life and daily living then it likely wouldn’t be appropriate to diagnose this patient with a mental health disorder.

4. “The disturbance is not part of normal cultural or religious practices.”

5. “The symptoms are not due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition.”

While these are the criteria that must be met in order to be diagnosed with DID there are many other factors and signs that point toward this disorder. To name a few: sleepwalking and automatic writing, auditory hallucinations, difficulties in trusting others, and an inclination toward anger and hostility.  The list goes on.

History of DID

The first documented case of DID was in 1584 in which a women, named Jeanne Fery, was thought to be possessed. Her situation was recorded as an exorcism. Her files were later studied and it is now thought that she actually suffered from Split Personality Disorder. Jeanne had multiple alters, each having their own name, personality, and characteristics. Her various personalities would be classified under archetypes such as: Internal Self Helper (ISH), persecutor, protector, and child alter. These archetypes are seen regularly within those who have this disorder.  These are not the sum of the archetypes, but are the few that will be covered. The Internal Self Helper (ISH) is an alter that usually comes first. The ISH is a helper that comes in the form of a voice in ones head that brings logic and reason into the conversation. Internal Self Helpers are usually seen as observers. They are behind the scenes carrying vast amounts of knowledge about the other alters within the body, trauma within the mind/body, and internal workings of the individual.

The persecutor personality is vastly different in relation to the ISH alter. The persecutor is an outlet. This alter provides the system with a filter for self hatred and demeaning thoughts. Self harm is usually inflicted. This personality seems to be created in order to control the rest of the alters and the system so they will learn how to behave and no longer be abused by the external world.


The third of the personalities of Jeanne Fery was the protector. There are several subcategories within the protector archetype. There are emotional protectors which work to soften emotional pain. This archetype takes the brunt  of emotional abuse. Physical protectors might take physical abuse and/or try to protect the alters from physical abuse. Verbal protectors will dish out and take the brunt of verbal abuse when necessary. Sexual protectors might take sexual abuse or may even instigate sexual abuse to gain control of a situation or to protect the alters. Interestingly persecutors are also seen as protectors. The persecutor personality inflicts harm to the body and alters, which teaches them how to behave and how to avoid harm from the outside world.

Lastly Jeanne had a child alter. Child alters manifest in various ways. Sometimes these alters maintain the age at which they were first born into this body. This could be caused by an inability to accept changes that comes with life, time, and experience. They refuse to accept anything beyond the particular traumatic experience that bore them into existence.  These alters vary dramatically; A child alter may be wise beyond their years, they may do the taxes, balance the checkbook, run the business. Although they are wise and responsible, they are still children and have the attributes of a child. They may very well desire sweets, have inquisitive minds, and be naïve on many levels. There are child alters that are merely children and lack the wisdom or responsibility to do such tasks as run a business or balance the checkbook.   

 Although Jeanne’s case was the first to be documented it certainly wasn’t the first official diagnosis of DID. That title goes to a man named Louis Auguste Vivet, who was first diagnosed in 1882. Louis, as a child, was physically abused and neglected which resulted in a split of his psyche. By 1888 he had a total of 10 personalities, although recent re-evaluation by psychologists suggests that he had only two personalities, and that all others were brought on by states of hypnosis through work with therapists. Interestingly enough, Louis was subject to a variety of treatments for what doctors thought to be hysteria. Morphine and injections of pilocarpine and other methods were used to cure him. However, the only treatment that helped to stop Louis’s “attacks” was pressure on the Achilles tendon or the tendon just below the kneecap.

Although DID has been prevalent for decades doctors and psychiatrists have notoriously misdiagnosed this disorder for hysteria, schizophrenia, or other mental oriented diseases.

Treatment

As I stated earlier, many individuals with DID have been misdiagnosed thusly their treatments were misapplied. There is no specific diagnostic test for DID. Mental health professionals go through a series of mental diagnostic tests to rule out various possibilities. Talk therapy is the general treatment plan.

This disorder was once thought to be extremely rare but has recently been shown to be more common than was previously thought. This is likely due to the continual misdiagnosis from years past, when those with DID would instead be diagnosed with schizophrenia or borderline personality disorder. The estimated number of cases is 1 in 10,000, most of which are female. It was actually believed that only females suffered from this disorder. We know today that approximately 20 percent of all cases are male, the remaining 80 being female.

Psychotherapy is generally the primary source of healing and repairing from this disorder. The therapist will usually try to improve the clients relationships and gradually confront the client with uncomfortable yet necessary feelings. The therapist will often guide the client in an attempt to find a way to allow the alters to coexist. This helps to build a state of peace and equilibrium within the client. Psychotherapists used to try to achieve reintegration which is the merging of all the personalities back into one. The issue with this is that this often left the client feeling that the therapist was trying to “kill” pieces of them.

Hypnosis is used to help clients sleep and to mitigate symptoms of anxiety and stress. Through the use of hypnosis the client is more easily able to move through traumatic memories by maintaining a relative distance from the experience. This emotional distance helps the client to not be too heavily encumbered by traumatic memories.

Medication is sometimes used in conjunction with psychotherapy. When these two fail to make any real impact, electroconvulsive therapy (ECT) can be used. Lastly, eye movement desensitization and reprocessing (EMDR), a treatment that helps integrate traumatic memories, is being used more often, now that it has been shown to aid in increased information processing and healing.

How Massage can help

The personality that came in for the massage will likely be the one to leave as well. However, if a personality shift does occur then all you must do is stop for a moment, inform the newly surfaced personality of their whereabouts, and ask them if they wish to continue. A shift would likely be caused by an emotional upsurge brought on by the massage, bringing about a personality that is more equipped to handle these particular emotions.

Massage would help in daily living and performance amongst the personalities by reducing stress levels, increasing dopamine, serotonin, and oxytocin levels (also known as the bonding or love hormone). With reduction of stress and an increase of various beneficial hormones a change in the perception of the reality around you and your internal experience of self can occur. Massage would help the development of altruism, increase sociability, self-esteem, and empathy.  This therapy would benefit the client physically, physiologically, as well as emotionally.







Bibliography

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Natasha Tracy. Dissociative Identity Disorder (DID) DSM-5 Criteria. Healthy Place For Your Mental Health. Health on the Net Foundation. May 23, 2017. https://www.healthyplace.com/abuse/dissociative-identity-disorder/dissociative-identity-disorder-did-dsm-5-criteria/

DID Research. DID in History. Creative Commons Attributions-ShareAlike 4.0 International License. January 30, 2016. http://did-research.org/did/history/index.html

Natasha Tracy. Dissociative Identity Disorder (DID) Statistics and Facts. Healthy Place For Your Mental Health. Health on the Net Foundation. May 23, 2017. https://www.healthyplace.com/abuse/dissociative-identity-disorder/dissociative-identity-disorder-did-statistics-and-facts/

Roxanne Dryden-Edwards, MD. Dissociative Identity Disorder. MedicineNet. February 12, 2016. https://www.medicinenet.com/dissociative_identity_disorder/article.htm#what_are_dissociative_identity_disorder_symptoms_and_signs

Dr. Christopher L. Heffner. Dissociative Identity Disorder. Alejandra Swartz. Dissociative Identity Disorder. AllPsych Psych Central’s Virtual Psychology Classroom. December 10, 2001. https://allpsych.com/journal/did/

Dissociative Identity Disorder (Multiple Personality Disorder). Psychology Today. HealthProfs.com. February 24, 2017. https://www.psychologytoday.com/conditions/dissociative-identity-disorder-multiple-personality-disorder

Margarita Tartakovsky, M.S. Dispelling Myths about Dissociative Identity Disorder. PsychCentral. July 17, 2016. https://psychcentral.com/lib/dispelling-myths-about-dissociative-identity-disorder/?all=1

Karina Lamontagne. Alter Functions. DID Research. Alter Functions/Jobs. Creative Commons Attribute-ShareAlike 4.0 International License. August 10, 2016.  http://did-research.org/did/alters/functions.html

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Phoenix J. Hocking. Multiple Personalities and Massage. Natural Health Is Our DNA. http://www.encognitive.com/node/6295

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Written by: Dakota Vikdal

Date: January 12, 2018