*Responses Maria Fernanda Man-Gingclinical psychologist, Instagram: psic.mfmanging.
How common is this disorder detected and in what age range?
The prevalence of this disorder varies between countries and cultures, but is generally low. In places where statistical studies have been carried out (United States, Canada and some sectors of Europe) it is present in 1%-1.5% of the general population, transiently or chronically, in people predisposed to dissociation who suffered great stress or trauma in childhood. It can be detected at any age, although its onset is usually at an early age when personal identity is still being built. Hence, it is atypical to find a case of dissociative identity disorder (DID) with onset in adulthood.
What causes this disorder in those who suffer from it?
It appears as a reaction to early traumatic experience, such as having suffered neglect, physical abuse, sexual abuse or sustained psychological abuse. Abused children may use dissociation as a coping mechanism to keep their perceptions, thoughts, memories, and emotions separate from their life experiences. Over time, these children may develop an increasing ability to dissociate from the environment, withdraw into their own mind or produce a different identity, thereby attempting to master, minimize, or tolerate stressincluding conflict and boredom.
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Some people with the disorder may not have experienced abuse, but have experienced tragic loss, serious illness, or other events of overwhelming stress, such as living in frightening home environments or highly unpredictable settings during war or natural disasters. Cases have also been described where identities arise to cover a need or desire of the individual.existing for limited periods with specific purposes, in which simulation has been ruled out.
What effects does it have on your personal and work life and how can it be perceived by those close to you?
The TID is usually disabling as it affects autobiographical memory, perception, consciousness and will control. Each identity or state of the personality has its own pattern of experience, motor skills and perception, relating in a particular way to the self, the body and the environment. Although some symptoms may spontaneously remit and many people manage to be productive and functional, the disorder does not resolve on its own and tends to become chronic, especially in unfavorable environments and in the absence of support networks.
In our society stillThere is still prejudice and ignorance in relation to mental health. The symptoms of DID can be misinterpreted or minimized, being confused with pretense, manipulation or what is culturally described as states of possession. Reactions could range from fear to isolation and abuse.
If the person himself does not perceive his condition, how does he come to be discovered? Are there symptoms to watch for?
Awareness of one’s own symptoms varies depending on how they present themselves. There are cases where one or more dissociative identities recurrently take executive control and are easily detected by others (different way of speaking, dressing, writing, different abilities, performance, memories, roles in relation to the trauma), but not so much for the affected individual, who presents episodes of amnesia. Only the records, recordings, reports from others, and the lack of continuity in their own experiences function as a warning sign for the person.
Another way of presenting the disorder is when there are occasional, limited, transient episodes of dissociative intrusion, where a distinct personality state assumes executive control in response to extreme or related situations. with the trauma. The affected person feels a sudden alteration in his sense of himself, as if he had the impression that, instead of being the agent of his own actions, perceptions, emotions and thoughts, he was an observer. While this form may be less obvious to others, the person experiencing these intrusions typically experiences them aversively.
These symptoms are not better explained by another disorder and they are not due to the effects of any substance, general medical condition, or sleep disorder.
What treatment do specialists recommend for these patients and for what purpose?
The psychotherapy is the main route for treatment, with the purpose of regulating emotions, reprocessing traumatic memories and integrating personality states. Not all people want integration, as often it is emotionally painful when dissociative identities are very well defined or have existed for many years. It is important to remember that the origin of DID lies in a coping mechanism for traumatic experiences and that the symptoms protect the individual from what was excessively overwhelming when they were in a vulnerable situation.
In your professional opinion, when would you say that a patient with this disorder has a good prognosis? Does this duality disappear?
The prognosis depends on multiple factors, being the main one that the person has a support network that provides security, that understands and gets involved in the treatment and do not replicate situations of abuse. The early separation from the aggressor(s) it also has a good prognosis, since it increases the chances of therapeutic success. Likewise, when there is no comorbidity with another psychological, behavioral or developmental disorder.
What dangers exist if it is not diagnosed correctly and on time?
Many times, DID is not as obvious, especially if the person only experiences dissociative intrusions, or the symptoms accompany other disorders requiring psychiatric care, being a diagnostic confounding factor. The danger of delaying appropriate treatment is that episodes of dissociation can be exacerbated, discomfort increased and quality of life diminished, since the symptoms significantly deteriorate personal areas, family, social, educational and occupational.
Seen from the cultural field, is it what Jekyll and Hyde suffer from?
For a long time it was seen in the novel The Strange Case of Dr Jekyll and Mr Hydeby Robert Louis Stevenson a representation of TID, emphasizing the difference in identity characteristics, ways of relating, perceiving and conceiving the world. Jekyll would be the main or host identity, who creates a drink (allegory of dissociation) capable of separating the most evil part of the person, in his case, an alternate identity called Hyde.
Although DID is not incompatible with psychopathy, it is not so common to find that association either, despite what popular culture proposes. This view only stigmatizes those with the diagnosis, mostly survivors of childhood abuse or neglect, whose Alternate identities were created with the sole function of protection and survival from traumatic events.
Source: Eluniverso
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