Wednesday, November 12, 2003

it's only natural...

Hollywood, sensationalistic media and other blow-smoke-up-your-ass-types provide to us a mystical view of ordinary pain and suffering. And so that's my take on the treatment of the subject of dissociative identity disorder (used to be multiple personality disorder).

That was the subject in last night psychopathology class. People often confuse schizophrenia and dissociative identity disorder, but they are extremely different illnesses. Schizophrenia is a disorder marked by severe disorganization of thought. Associations are terribly loose and sufferers battle against auditory hallucinations and often sound like they are just stringing miscellaneous words together (called "word salad").

Dissociative identity disorder is the occurence of two or more distinct personalities within one person. It is a rare disorder, although prevalence studies vary. It sounds like a Hollywood movie doesn't it? The Three Faces of Eve, Sybil...both real people; both recovered. In fact "Eve" later became an advocate for dissociative identity disorder research and treatment. We viewed an interview with Eve and she was a charming older lady at the time of the film's production. She was positive, compassionate and dedicated to helping others who suffered with the disorder. We also had the privilege of viewing another dissociative identity disorder patient who was 26 and had 10 personalities. Creepy, huh? And that's usually as far as people get---creepy.

But it isn't really creepy, it's an ingenious human survival reaction to situations that are beyond our tolerance. Most sufferers have been victims of tremendous abuse during childhood...things regular folks couldn't even dream up...being buried alive, burned, mutilated, tortured, sexually assaulted, beaten repeatedly, shocked...things that make us all shudder and recoil in disgust. So, these kids dissociate and become "separate" to survive. You've heard people say "I'm going to my happy place now" when things are unpleasant--it's the same concept, except to an unimaginable extreme. Different parts of their original personality become severely compartmentalized and they retreat to these different compartments to escape. The mind has protected the child, but the surviving adult is left with a highly complex and debilitating disorder. The goal of treatment is reintegration of the personality fragments and since these patients are usually highly motivated to get relief from the intense pain and confusion in their lives they supposedly have a good prognosis.

Great stuff for the cocktail party, eh?


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