Dissociative identity disorder Dissociative identity disorder, formerly known as a multiple personality disorder. The nature of the disorder consists in the presence of two or more persons replacing each other, and inability to recall the basic personal information that is associated with one of the personalities. A common cause is severe shock or trauma during childhood. The diagnosis is established on the basis of anamnesis, sometimes in combination with hypnosis or an interview with the use of medications. Treatment consists in psychotherapy, sometimes in combination with drug therapy.


Information unknown to one person is known to another. It happens that some people know about others and interact with them in the inner virtual world.

Causes of

disorder Dissociative identity disorder is associated with severe stress( usually severe abuse), lack of attention and compassion during periods of extremely negative life experience in childhood and with a predisposition to dissociative manifestations( separation of one's memory, sensations, identity from awareness).

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Initially, children do not have a sense of a complete personality. The development of this feeling is influenced by many factors. Those parts of the personality in children who need to integrate are in an abandoned state if the children have suffered excessive stress. In patients with dissociative disorder, there was often evidence of chronic and severe violence during childhood( physical, emotional or sexual).Some of the patients were not subjected to violence, but experienced an early loss( eg, death of a parent), excessive stress or severe illness.

Children who grew up in negative conditions, different emotions and feelings remain scattered, unlike other children, who form a comprehensive, holistic assessment of themselves and others. Such children develop the ability to detach themselves from cruel conditions, "leaving" into their own world. Each phase of this development can lead to the development of different personalities.

Symptoms of identity disorder

A number of symptoms are characteristic of such a disorder:

  • a changing level of activity, from highest to total inactivity;
  • fluctuating clinical picture;
  • severe headaches or other painful sensations in the body;
  • temporal distortion, amnesia and memory dips;

Derealization and depersonalization of

Depersonalization is a feeling of unreality, detachment from oneself, detachment from one's mental and bodily processes. The patient feels like an outside observer of his life, as if he sees himself in the film. The patient may even have transient feelings that his body does not belong to him. The manifestation of derealization occurs through the perception of the situation and familiar people as if they are unfamiliar, abnormal or unreal.

It may be that any objects, handwriting samples, products, patients are not able to identify. They can call themselves in the plural( we) or in the 3rd person( he, she, they).

Switching between personalities and the amnestic barriers that separate them often lead to chaos in life. In view of the fact that individuals often interact with each other, the patient claims to hear the inner voice of other personalities who discuss the patient or address him. Therefore, a patient may be misdiagnosed with a diagnosis of psychosis. Although these votes are taken for hallucinations, they are fundamentally different from typical hallucinations during psychotic disorders such as schizophrenia.

Often, patients exhibit symptoms similar to those with mood disorders, anxiety disorders, post-traumatic stress disorder, personality disorders, eating disorders, epilepsy, schizophrenia. Suicidal intentions and attempts, as well as cases of self-harm, are quite common in such patients. Many of the patients abuse psychoactive drugs.

Diagnosis of identity disorder

Patient history usually indicates 3 or more psychiatric disorders with treatment resistance that preceded these disorders. Skeptical position of some doctors to the reasonableness of the detection of dissociative disorder also has its significance in the errors in establishing the diagnosis.

Diagnostics requires a special survey for dissociative phenomena. From time to time, long-term interviews, hypnosis and even using drugs( metohexital) are used, the patient can be asked to keep a diary between visits to the doctor. Such measures contribute to the change of personality in the process of diagnosis. Special questionnaires can help.

In addition, the psychiatrist can try to establish direct contact with other personalities by offering to speak to that area of ​​consciousness that is responsible for the behavior during which the patient manifested amnesia or during which derealization and depersonalization were observed.

Forecast of dissociative disorder

Symptoms spontaneously increase and decrease, but dissociative identity disorder suddenly does not go away. Patients are divided into 3 groups. The

  1. group of patients predominantly has dissociative symptoms and signs of the consequences of the trauma, in general they function well and with the help of treatment they completely recover. The
  2. group of patients has dissociative symptoms in combination with symptoms of other disorders, for example, mood disorders, personality disorders, eating disorders, eating disorders. Patients of this group recover slowly, the treatment is less effective or more prolonged and is difficult to tolerate by the patient.

Patients belonging to the 3rd group not only have the expressed symptoms of other mental disorders, but in some cases there remains an emotional attachment to those who allegedly committed violence over the patients. Such patients often require long-term treatment, the main purpose of which is to control symptoms, rather than integration.

Treatment of identity disorder

Integration of personality is the most ideal result of treatment. Medications help to ease the symptoms of depression, anxiety, substance abuse, impulsivity, but treatment, whose goal is integration, is based on psychotherapy. If the patient is unable or unwilling to achieve integration, the goal of treatment is to reduce symptoms and to facilitate cooperation and cooperation between individuals.

First of all, to assess the traumatic experience and to explore problematic personality in the process of psychotherapy is very important to provide the patient a sense of security. Some patients need hospitalization, in which constant monitoring and support help with the appearance of painful memories. Hypnosis is often used to study traumatic memories and reduce their impact. In addition, hypnosis can help gain access to individuals, facilitate communication between them, stabilize and interpret them. When the root causes of dissociation are worked out, therapy can lead to a state in which the patient's personality, social functioning and relationships are reunited, integrated and restored. Certain integration can happen spontaneously. Integration can be facilitated by negotiation and the installation of a union of personalities or integration can be facilitated by hypnotic suggestion and by the "imposition of images".