Dissociative Identity Disorder
Upon hearing about the requirements for this assignment I was puzzled on what to write about. I sought the advice of my peers and mentors, yet all of their answers tended to be somewhat the same. Every disorder that was given to me as an example seemed to be that of a common disorder that most people know about or would be familiar with such as schizophrenia or anxiety disorders and the like. What I found more difficult was to think of a disorder that isn’t well known and hasn’t been broadcasted much for everyone to be knowledgeable about. So I started searching to achieve the goal of writing a paper on something different. What I found was quite intriguing and caught my attention immediately upon hearing about it. My goal throughout this
…show more content…
paper is to research, gain knowledge on, and educated others about this strange and somewhat profound disorder known as Dissociative Identity Disorder, or “DID”. Dissociative Identity Disorder is a severe condition in which an individual experiences two or more distinct personalities that extremely affect their everyday routine, relationships, and interfere with distinct aspects of the individual’s life. We have all had those moments throughout the day where we “zone out” and go into a phase of day dreams and may not be fully aware of our surroundings. A person that suffers from DID also experiences these same types of dissociations; however the severity of them are much more profound from that of a normal individual who is simply just spacing out. These dissociations affect the person’s memory, feelings, and sense of identity among other things. ShobhaPais, PhD (2013) stated that:
Dissociative Identity Disorder (DID) is a condition in which a person has two or more distinct identity or personality states, which may alternate within the individual 's conscious awareness. The different personality states usually have distinct names, identities, temperament, and self-image. At least two of these personalities repeatedly assert themselves to control the affected person 's behavior and consciousness, causing long lapses in memory that far exceed typical episodes of forgetting.” (AAMFT)
DID is an extreme form of dissociation in which one or more personalities overtake the individual in an attempt to escape from and/or cope with a situation that is at hand. “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.” (WebMD, 2012) This is one of the most complex disorders and understanding the development of multiple personalities is extremely difficult even for highly educated professionals. However, this disorder does exist and is one of the most severe and chronic indicators of multiple personalities that affect thousands of individuals today.
Dissociative Identity Disorders have been known by many different names throughout history. The first case was said to be recorded by Jeanne Fery in 1584. In this case Fery wrote an account of her own exorcism which included mention of her multiple identities that were said to be internal devils that either aided in her protection or sought to torment her. The devils are blamed for her acts of sacrilege but also function as protectors…
Jeanne 's alters were at times visualized, at times heard arguing inside, and at times took over her body in violent pseudo seizures, rage attacks requiring restraints (from which she escaped), compulsive suicide attempts, regression to a childlike state, and episodes of prolonged sobbing and intense physical pain, especially headache. (Van der Hart, Lierens, & Goodwin, pg. 1)
She also experienced well known symptoms of dissociation disorders as classified by the ICD-10, or the “Internal Classification of Diseases and Related Health problems, such as amnesia, conversion blindness, hearing voices, and overwhelming sadness. In 1910, Eugen Bleuler introduced the term “Schizophrenia” which came from the Greek meaning split disorder. However, psychologist Colin Ross stated that the description of schizophrenia did not mirror the DSM-IV diagnosis but rather portrayed the conditions of dissociative identity disorder. In 1927, there was a rise in the number of reported cases of Schizophrenia. Likewise, there was also a significant decline in the number on multiple personality reports. “Bleuer 's description of schizophrenia was one of the reasons 1903 through 1978 showed a dramatic decline in the number of reports of "multiple personality" after the diagnosis of Schizophrenia became popular, especially in the United States.” (Johannessen, Martindale, & Cullberg, 2006) Ross also commented on the trouble between the distinction of the two different disorders and the fact that the common symptoms for schizophrenia were also much more present in DID and stated that this could have been a main reason as to why many people were being misdiagnosed. In 1952 the DSM-I or the “Diagnostic and Statistical Manual of Mental Disorders” was published by the American Psychiatric Association. This manual separated the effects of dissociated reactions from any other types of uncommon reactions. It stated that:
“This reaction represents a type of gross personality disorganization, the basis of which is neurotic disturbance; although diffuse dissociation may at times appear psychotic... The repressed impulse giving rise to the anxiety may be discharged by, or deflected into, various symptomatic expressions, such as depersonalization, dissociated personality, stupor, fugue, amnesia, dream state, somnambulism, etc" (pg.42)
In 1980 the DSM-III was published and Dissociated Identity Disorder was renamed to Multiple Personality Disorder.
This was the first time that the symptoms had a separate diagnosis rather than being grouped together with all the other dissociative disorders. After this separation there were 200 reported cases which increased to 20,000 by 1990. The name of this disorder did not stay for long however, as it was renamed to its current name “Dissociative Identity Disorder” in 1987 when the DSM-IV was published. (Kluft, Steinberg, & Spitzer, 1988) Though the specific causes of DID or where it came from are difficult to comprehend even for qualified professionals, it is believed to brought on by severe or prolonged trauma that occurred during childhood including factors such as emotional, physical, or sexual abuse. Paulette Gillig, PhD stated that:
“In general, practitioners who accept the validity of DID as a diagnosis attribute it to the effects of exposure to situations of extreme ambivalence and abuse in early childhood that are coped with by an elaborate form of denial so that the child believes the event to be happening to someone else (perhaps starting out as an imaginary companion)” …show more content…
(2006)
A person suffering from DID may have “alters” or “multiple identities” that are present when difficult times arrive or when the individual cannot cope with a task at hand. The alters seem to be a coping mechanism and come into play and make the individual feel as though someone else is dealing with the stressful situation and that they are free from it. “At any given time, one of the sub personalities takes center stage and dominates the persons functioning.” (Comer, pg. 159) DID also affects brain function and memory. This is known as dissociative amnesia in which a person is unable to recall significant personal information. “The loss of memory is must more extensive than normal forgetting and is not caused by physical factors such as a blow to the head.” (Comer, pg. 156) This type of forgetfulness is usually caused by a traumatic event or stressful situation. Dissociative Identity Disorder also causes individuals to have repetitive suicidal thoughts and feelings, along with certain suicidal attempts. Because DID is associated with trauma or abuse, a majority of DID patients have decreased desire for sex or an inability to have an orgasm. They may also dress as that of the opposite gender, or even actually believe that they themselves are the opposite gender. Patients often refer to themselves as more than one person and may have experiences in which they hear voices or have a loss of memory. “They report hearing voices, periods of amnesia, periods of depersonalization, and may use the plural (“we” instead of “I”) when referring to the self.” (Gillig, 2006) Patients may experience amnesia, hallucinations, panic attacks, or mood swings. They may also have feelings of anxiety, nervousness as well as a change in eating patterns or sleeping habits. Patients will possibly experience so many somatic symptoms that they begin to be inconsistent with their job, family life, and/or relationships. There are some research findings that argue that DID is co-related to Post Traumatic Stress Disorder because symptoms that are found in PTSD seem to be magnified in DID. “DID is a disorder of extreme stress, possibly a form of complex PTSD, due to prolonged repeated trauma.” (Gillig, 2006) These symptoms can be dreadful to anyone who is experiencing them. Most patients who experience these symptoms may not be aware of the fact that they have DID. If this is the case, most individuals will seek the help of a professional therapist or doctor in hopes to gain more knowledge and hopefully, a diagnosis as to what they are suffering from. In order to properly diagnose DID, patients must meet a specific diagnostic criteria. According to the DSM-IV these are as follows: “the presence of two or more identities, at least two personality states that recurrently take control, inability to recall personal information, and that the disturbance is not due to the direct physiological effects of a substance or general medical condition.” (Gleaves, May, & Cardena, 2001) If a patient experiences these symptoms, the doctor or therapist may then begin the diagnosis procedure. The process of treatment for DID is long, strenuous, and time consuming. There are countless options that can be presented upon reviewing the patient. “The leading treatments for Dissociative Identity Disorder are psychodynamic therapy, hypnotic therapy, and drug therapy.”(Comer, pg. 164) Interventions, therapies, and treatments vary depending on the patient. Which option will be most effective is subject to the patient’s specific story along with the extent of the symptoms they are experiencing.
Hypnosis was one of the first recorded successful treatments when dealing with patients who suffered from DID. “Given the possibility that dissociative amnesia may be a form of self-hypnosis, hypnotherapy may be a particularly useful intervention.” (Comer p.164) In any case, it seems to be very closely associated. This technique uses positive imagery while giving the patient the chance to share their concerns in a safe and relaxed environment. It also allows patients to dive deeper into themselves with the hopes of determining the cause of this disorder.
Patients who have been diagnosed with DID may tend to be extremely sensitive or have interpersonal issues which may conflict with proceeding in therapy for a diagnosed patient. A patient may switch personalities during treatment in order to subconsciously try and escape the stress of being newly diagnosed with this disorder. “The focus of the intervention is to listen, empathize, and provide validation and reassurance that the patient is currently safe.” (Gentile, Dillon, & Gillig, p. 24) Dr. Richard Kluft believed that a person’s alternate identities or personalities states were the key phenomenon to DID. He believed that in order for a patient to show signs of improvement, one must also work with the individuals alter identities. He argued that without this step, no significant improvement could be hoped for. (Kluft, 1999)
Another strategy for dealing with DID can be known as Cognitive Behavioral Therapy. This approach seeks to help the patient find alternate ways of coping rather than switching identities when faced with a stressful situation. The therapist will incorporate breathing and relaxation exercises in order to help the patient be aware of what is transpiring and to also help them to gain control of the seemingly real distortions that they may face when switching identities. (Gillig, 2009)
Towards the middle and end stages of DID there are four interventions that therapists recommend be used frequently. Three out of the four are directly related to dealing with the individual’s trauma related symptoms. They are as follows: “Delayed recall of traumatic memories, using exposure or abreaction, and employing eye movement desensitization and reprocessing to process traumatic memories.” (Brand et al., pg. 497) The length of the interventions has shown to be one of the deciding factors in how successful the intervention proves to be. Being diagnosed with Dissociative Identity Disorder has proven to be a life long struggle for anyone faced with it. However, if given proper treatment, over time patients can begin to either recover from this disorder, or learn how to function, control, and cope with this setback throughout their life. The patients who have the most positive and successful recovery are those who have accepted their disorder and have sought the means to improve it. Joan Ellason M.A, and Colin Ross M.D. (1998) did a study to track the recovery process of individuals who had received treatment for a period of two years. “At follow-up, the overall group had improved considerably on dissociative symptoms.” (pg.835) Thankfully, the results for these individuals were positive as is the same with many other cases. No matter what the disorder, it can be very difficult for one to stay optimistic or to feel hopeful for a successful result. A crucial thing to remember throughout the process is that no matter what chaos has presented itself God is never far off. He is there in the midst of every struggle, ever tear, and every setback. He is able to provide joy and hope even when they may seem to be impossible to attain. Though we may never understand why He allows us to go through these trials, we can be certain that He has a will and a plan in every circumstance. He will give strength and power to those who love Him, and will be a constant source of peace. He has a love that surpasses all understanding. “Neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.” Romans 8:39
References
Association, A. P. (1968). Diagnostic and Statistical Manual of Mental Disorders. Washington: American Psychiatric Association.
Brand, B., Loewenstein, R., Lanius, R., Pain, C., Myrick, A., Classen, C., et al. (2011). A Survey of Practices and Recommended Treatment Interventions Among Expert Therapists Treating Patients With Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified. sychological Trauma: Theory, Research, Practice, and Policy, 4(5), 490-500. Retrieved April 21, 1994, from the Ebsco database.
Comer, R. J. (1996). Fundamentals of abnormal psychology. New York: W.H. Freeman and Co..
Dissociative Identity Disorder (Multiple Personality Disorder): Signs, Symptoms, Treatment. (n.d.). WebMD. Retrieved April 25, 2014, from http://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder
Gentil, J., Dillon, K., & Gillig, P. (2013). Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder. Innovations in Clinical Neuroscience , 10(2), 22-29. Retrieved April 20, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615506/
Gillig, P. (2006). Dissociative Identity Disorder. National Center for Biotechnology Information. Retrieved April 24, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719457/
Gleaves, D., May, M., & Cardena, E. (n.d.). An examination of the diagnostic validity of dissociative identity disorder. An examination of the diagnostic validity of dissociative identity disorder. Retrieved April 19, 2014, from http://www.sciencedirect.com/science/article/pii/S0272735899000732
Johannessen, J.
O., Martindale, B., & Cullberg, J. (2006). Evolving psychosis different stages, different treatments. London: Routledge.
Kluft, R., Steinberg, M., & Spitzer, R. (n.d.). Revisions in the Dissociative Disorders: An Exploration of their Derivation and Rationale . Scholarsbank. Retrieved April 23, 2014, from https://scholarsbank.uoregon.edu/xmlui/bitstream/handle/1794/1329/Diss_1_1_4_OCR_rev.pdf?sequence=4
Kluft, R. P. (1999). An Overview of the Psychotherapy of Dissociative Identity Disorder. American Journal Of Psychotherapy, 53(3), 289.
Pais, S. (n.d.). Dissociative Identity Disorder. Dissociative Identity Disorder. Retrieved April 23, 2014, from http://www.aamft.org/imis15/content/consumer_updates/Dissociative_identity_disorder.aspx
Ross, C., & Ellason, J. (1997). JOAN W. ELLASON AND COLIN A. ROSS DISSOCIATIVE IDENTITY DISORDER Am J Psychiatry 154:6, June 1997 Two-Year Follow-Up of Inpatients With Dissociative Identity Disorder. American Journal of Psychiatry, 184, 832-839. Retrieved April 20, 2014, from the Ebsco database. der Hart, O. v., Lierens, R., & Goodwin, J. (2006). Jeanne Fery: A Sixteen Century Case of Dissociative Identity Disorder. The Journal of Psychohistory, 24(1), 12. Retrieved April 22, 2014, from the Ebsco
database.
paper is to research, gain knowledge on, and educated others about this strange and somewhat profound disorder known as Dissociative Identity Disorder, or “DID”. Dissociative Identity Disorder is a severe condition in which an individual experiences two or more distinct personalities that extremely affect their everyday routine, relationships, and interfere with distinct aspects of the individual’s life. We have all had those moments throughout the day where we “zone out” and go into a phase of day dreams and may not be fully aware of our surroundings. A person that suffers from DID also experiences these same types of dissociations; however the severity of them are much more profound from that of a normal individual who is simply just spacing out. These dissociations affect the person’s memory, feelings, and sense of identity among other things. ShobhaPais, PhD (2013) stated that:
Dissociative Identity Disorder (DID) is a condition in which a person has two or more distinct identity or personality states, which may alternate within the individual 's conscious awareness. The different personality states usually have distinct names, identities, temperament, and self-image. At least two of these personalities repeatedly assert themselves to control the affected person 's behavior and consciousness, causing long lapses in memory that far exceed typical episodes of forgetting.” (AAMFT)
DID is an extreme form of dissociation in which one or more personalities overtake the individual in an attempt to escape from and/or cope with a situation that is at hand. “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.” (WebMD, 2012) This is one of the most complex disorders and understanding the development of multiple personalities is extremely difficult even for highly educated professionals. However, this disorder does exist and is one of the most severe and chronic indicators of multiple personalities that affect thousands of individuals today.
Dissociative Identity Disorders have been known by many different names throughout history. The first case was said to be recorded by Jeanne Fery in 1584. In this case Fery wrote an account of her own exorcism which included mention of her multiple identities that were said to be internal devils that either aided in her protection or sought to torment her. The devils are blamed for her acts of sacrilege but also function as protectors…
Jeanne 's alters were at times visualized, at times heard arguing inside, and at times took over her body in violent pseudo seizures, rage attacks requiring restraints (from which she escaped), compulsive suicide attempts, regression to a childlike state, and episodes of prolonged sobbing and intense physical pain, especially headache. (Van der Hart, Lierens, & Goodwin, pg. 1)
She also experienced well known symptoms of dissociation disorders as classified by the ICD-10, or the “Internal Classification of Diseases and Related Health problems, such as amnesia, conversion blindness, hearing voices, and overwhelming sadness. In 1910, Eugen Bleuler introduced the term “Schizophrenia” which came from the Greek meaning split disorder. However, psychologist Colin Ross stated that the description of schizophrenia did not mirror the DSM-IV diagnosis but rather portrayed the conditions of dissociative identity disorder. In 1927, there was a rise in the number of reported cases of Schizophrenia. Likewise, there was also a significant decline in the number on multiple personality reports. “Bleuer 's description of schizophrenia was one of the reasons 1903 through 1978 showed a dramatic decline in the number of reports of "multiple personality" after the diagnosis of Schizophrenia became popular, especially in the United States.” (Johannessen, Martindale, & Cullberg, 2006) Ross also commented on the trouble between the distinction of the two different disorders and the fact that the common symptoms for schizophrenia were also much more present in DID and stated that this could have been a main reason as to why many people were being misdiagnosed. In 1952 the DSM-I or the “Diagnostic and Statistical Manual of Mental Disorders” was published by the American Psychiatric Association. This manual separated the effects of dissociated reactions from any other types of uncommon reactions. It stated that:
“This reaction represents a type of gross personality disorganization, the basis of which is neurotic disturbance; although diffuse dissociation may at times appear psychotic... The repressed impulse giving rise to the anxiety may be discharged by, or deflected into, various symptomatic expressions, such as depersonalization, dissociated personality, stupor, fugue, amnesia, dream state, somnambulism, etc" (pg.42)
In 1980 the DSM-III was published and Dissociated Identity Disorder was renamed to Multiple Personality Disorder.
This was the first time that the symptoms had a separate diagnosis rather than being grouped together with all the other dissociative disorders. After this separation there were 200 reported cases which increased to 20,000 by 1990. The name of this disorder did not stay for long however, as it was renamed to its current name “Dissociative Identity Disorder” in 1987 when the DSM-IV was published. (Kluft, Steinberg, & Spitzer, 1988) Though the specific causes of DID or where it came from are difficult to comprehend even for qualified professionals, it is believed to brought on by severe or prolonged trauma that occurred during childhood including factors such as emotional, physical, or sexual abuse. Paulette Gillig, PhD stated that:
“In general, practitioners who accept the validity of DID as a diagnosis attribute it to the effects of exposure to situations of extreme ambivalence and abuse in early childhood that are coped with by an elaborate form of denial so that the child believes the event to be happening to someone else (perhaps starting out as an imaginary companion)” …show more content…
(2006)
A person suffering from DID may have “alters” or “multiple identities” that are present when difficult times arrive or when the individual cannot cope with a task at hand. The alters seem to be a coping mechanism and come into play and make the individual feel as though someone else is dealing with the stressful situation and that they are free from it. “At any given time, one of the sub personalities takes center stage and dominates the persons functioning.” (Comer, pg. 159) DID also affects brain function and memory. This is known as dissociative amnesia in which a person is unable to recall significant personal information. “The loss of memory is must more extensive than normal forgetting and is not caused by physical factors such as a blow to the head.” (Comer, pg. 156) This type of forgetfulness is usually caused by a traumatic event or stressful situation. Dissociative Identity Disorder also causes individuals to have repetitive suicidal thoughts and feelings, along with certain suicidal attempts. Because DID is associated with trauma or abuse, a majority of DID patients have decreased desire for sex or an inability to have an orgasm. They may also dress as that of the opposite gender, or even actually believe that they themselves are the opposite gender. Patients often refer to themselves as more than one person and may have experiences in which they hear voices or have a loss of memory. “They report hearing voices, periods of amnesia, periods of depersonalization, and may use the plural (“we” instead of “I”) when referring to the self.” (Gillig, 2006) Patients may experience amnesia, hallucinations, panic attacks, or mood swings. They may also have feelings of anxiety, nervousness as well as a change in eating patterns or sleeping habits. Patients will possibly experience so many somatic symptoms that they begin to be inconsistent with their job, family life, and/or relationships. There are some research findings that argue that DID is co-related to Post Traumatic Stress Disorder because symptoms that are found in PTSD seem to be magnified in DID. “DID is a disorder of extreme stress, possibly a form of complex PTSD, due to prolonged repeated trauma.” (Gillig, 2006) These symptoms can be dreadful to anyone who is experiencing them. Most patients who experience these symptoms may not be aware of the fact that they have DID. If this is the case, most individuals will seek the help of a professional therapist or doctor in hopes to gain more knowledge and hopefully, a diagnosis as to what they are suffering from. In order to properly diagnose DID, patients must meet a specific diagnostic criteria. According to the DSM-IV these are as follows: “the presence of two or more identities, at least two personality states that recurrently take control, inability to recall personal information, and that the disturbance is not due to the direct physiological effects of a substance or general medical condition.” (Gleaves, May, & Cardena, 2001) If a patient experiences these symptoms, the doctor or therapist may then begin the diagnosis procedure. The process of treatment for DID is long, strenuous, and time consuming. There are countless options that can be presented upon reviewing the patient. “The leading treatments for Dissociative Identity Disorder are psychodynamic therapy, hypnotic therapy, and drug therapy.”(Comer, pg. 164) Interventions, therapies, and treatments vary depending on the patient. Which option will be most effective is subject to the patient’s specific story along with the extent of the symptoms they are experiencing.
Hypnosis was one of the first recorded successful treatments when dealing with patients who suffered from DID. “Given the possibility that dissociative amnesia may be a form of self-hypnosis, hypnotherapy may be a particularly useful intervention.” (Comer p.164) In any case, it seems to be very closely associated. This technique uses positive imagery while giving the patient the chance to share their concerns in a safe and relaxed environment. It also allows patients to dive deeper into themselves with the hopes of determining the cause of this disorder.
Patients who have been diagnosed with DID may tend to be extremely sensitive or have interpersonal issues which may conflict with proceeding in therapy for a diagnosed patient. A patient may switch personalities during treatment in order to subconsciously try and escape the stress of being newly diagnosed with this disorder. “The focus of the intervention is to listen, empathize, and provide validation and reassurance that the patient is currently safe.” (Gentile, Dillon, & Gillig, p. 24) Dr. Richard Kluft believed that a person’s alternate identities or personalities states were the key phenomenon to DID. He believed that in order for a patient to show signs of improvement, one must also work with the individuals alter identities. He argued that without this step, no significant improvement could be hoped for. (Kluft, 1999)
Another strategy for dealing with DID can be known as Cognitive Behavioral Therapy. This approach seeks to help the patient find alternate ways of coping rather than switching identities when faced with a stressful situation. The therapist will incorporate breathing and relaxation exercises in order to help the patient be aware of what is transpiring and to also help them to gain control of the seemingly real distortions that they may face when switching identities. (Gillig, 2009)
Towards the middle and end stages of DID there are four interventions that therapists recommend be used frequently. Three out of the four are directly related to dealing with the individual’s trauma related symptoms. They are as follows: “Delayed recall of traumatic memories, using exposure or abreaction, and employing eye movement desensitization and reprocessing to process traumatic memories.” (Brand et al., pg. 497) The length of the interventions has shown to be one of the deciding factors in how successful the intervention proves to be. Being diagnosed with Dissociative Identity Disorder has proven to be a life long struggle for anyone faced with it. However, if given proper treatment, over time patients can begin to either recover from this disorder, or learn how to function, control, and cope with this setback throughout their life. The patients who have the most positive and successful recovery are those who have accepted their disorder and have sought the means to improve it. Joan Ellason M.A, and Colin Ross M.D. (1998) did a study to track the recovery process of individuals who had received treatment for a period of two years. “At follow-up, the overall group had improved considerably on dissociative symptoms.” (pg.835) Thankfully, the results for these individuals were positive as is the same with many other cases. No matter what the disorder, it can be very difficult for one to stay optimistic or to feel hopeful for a successful result. A crucial thing to remember throughout the process is that no matter what chaos has presented itself God is never far off. He is there in the midst of every struggle, ever tear, and every setback. He is able to provide joy and hope even when they may seem to be impossible to attain. Though we may never understand why He allows us to go through these trials, we can be certain that He has a will and a plan in every circumstance. He will give strength and power to those who love Him, and will be a constant source of peace. He has a love that surpasses all understanding. “Neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.” Romans 8:39
References
Association, A. P. (1968). Diagnostic and Statistical Manual of Mental Disorders. Washington: American Psychiatric Association.
Brand, B., Loewenstein, R., Lanius, R., Pain, C., Myrick, A., Classen, C., et al. (2011). A Survey of Practices and Recommended Treatment Interventions Among Expert Therapists Treating Patients With Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified. sychological Trauma: Theory, Research, Practice, and Policy, 4(5), 490-500. Retrieved April 21, 1994, from the Ebsco database.
Comer, R. J. (1996). Fundamentals of abnormal psychology. New York: W.H. Freeman and Co..
Dissociative Identity Disorder (Multiple Personality Disorder): Signs, Symptoms, Treatment. (n.d.). WebMD. Retrieved April 25, 2014, from http://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder
Gentil, J., Dillon, K., & Gillig, P. (2013). Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder. Innovations in Clinical Neuroscience , 10(2), 22-29. Retrieved April 20, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615506/
Gillig, P. (2006). Dissociative Identity Disorder. National Center for Biotechnology Information. Retrieved April 24, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719457/
Gleaves, D., May, M., & Cardena, E. (n.d.). An examination of the diagnostic validity of dissociative identity disorder. An examination of the diagnostic validity of dissociative identity disorder. Retrieved April 19, 2014, from http://www.sciencedirect.com/science/article/pii/S0272735899000732
Johannessen, J.
O., Martindale, B., & Cullberg, J. (2006). Evolving psychosis different stages, different treatments. London: Routledge.
Kluft, R., Steinberg, M., & Spitzer, R. (n.d.). Revisions in the Dissociative Disorders: An Exploration of their Derivation and Rationale . Scholarsbank. Retrieved April 23, 2014, from https://scholarsbank.uoregon.edu/xmlui/bitstream/handle/1794/1329/Diss_1_1_4_OCR_rev.pdf?sequence=4
Kluft, R. P. (1999). An Overview of the Psychotherapy of Dissociative Identity Disorder. American Journal Of Psychotherapy, 53(3), 289.
Pais, S. (n.d.). Dissociative Identity Disorder. Dissociative Identity Disorder. Retrieved April 23, 2014, from http://www.aamft.org/imis15/content/consumer_updates/Dissociative_identity_disorder.aspx
Ross, C., & Ellason, J. (1997). JOAN W. ELLASON AND COLIN A. ROSS DISSOCIATIVE IDENTITY DISORDER Am J Psychiatry 154:6, June 1997 Two-Year Follow-Up of Inpatients With Dissociative Identity Disorder. American Journal of Psychiatry, 184, 832-839. Retrieved April 20, 2014, from the Ebsco database. der Hart, O. v., Lierens, R., & Goodwin, J. (2006). Jeanne Fery: A Sixteen Century Case of Dissociative Identity Disorder. The Journal of Psychohistory, 24(1), 12. Retrieved April 22, 2014, from the Ebsco
database.