Friday, May 09, 2008

Treatment guidelines?

Q: How is Dissociative Identity Disorder treated? What about children who have DID? - Peter

A: The International Society for the Study of Trauma and Dissociation have created treatment guidelines for Adults and Children with Dissociative Identity Disorder. These documents which cover diagnosis, assessment, and treatment information can be attained here.

Additional books that may be useful include:
Dissociative Identity Disorder: Diagnosis, Clinical Features, and Treatment of Multiple Personality by Colin A. Ross
Not Trauma Alone: Therapy for Child Abuse Survivors in Family and Social Context by Steven Gold
Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-Traumatic and Dissociative Disorders by James A. Chu

Monday, May 05, 2008

Diagnosis from MMPI?

Q: Can you diagnose Dissociative Identity Disorder from an MMPI? - Anna

A: Dissociative Identity Disorder can not be diagnosed from an MMPI.

The MMPI was originally designed to measure the following symptoms/disorders:
1 Hs - Hypochondriasis
2 D - Depression
3 Hy - Hysteria
4 Pd - Psychopathic Deviate
5 Mf - Masculinity–Femininity
6 Pa - Paranoia
7 Pt - Psychasthenia
8 Sc - Schizophrenia
9 Ma - Hypomania
0 Si - Social Introversion

Over the years, people have found that they can measure other symptoms/functioning using the same questions, and have created other scales (measuring protocols). They are too numerous to list here, but you can see them all here. Post-Traumatic Stress Disorder is one of these additional scales, so it may be diagnosed from the MMPI.

Saturday, May 03, 2008

Do all memories need to be recovered?

Q: Do all our memories need to be recovered and processed to heal? - Tom

A: No, not at all. If that was the case, you'd probably spend a VERY long time in counseling and miss out on a lot of the life you could be living NOW! You have to remember enough to know what happened, why you have parts, and what needs to be done to feel safe again. Most Multiples have gone through repeated abuse events, sometimes with more than one abuser. Each abuser has to be addressed in counseling, but many of the types of abuse events were repeated. As you deal with a few memories related to one abuser and one type of abuse event, you'll also be dealing indirectly with the other similar events (and usually the same alters). Some memories stand out as major turning points, major traumas, or other life-changing events which tend to require a lot of processing in therapy so not all memories are created equal!

Are my memories true?

Q: How do I know if my memories are true? - Jane

A: That is a question survivors ask themselves and their counselors over and over again. Unfortunately, there isn't an easy answer. No one can be totally sure of the accuracy of all of their memories unless they have been followed by video cameras their entire lives! So save yourself the torture and accept that your memories, and the memories that your alters have, are true... but they may not be accurate.

What that means is they are true to the personality that has them, but they may contain inaccuracies such as:
1. Symbolic material that helps convey emotions, memories, fears, and other information,
2. Combination of more than one similar event into an amalgam that appears to be one memory,
3. Deception or misinformation purposely added by the perpetrators of abuse to further scare, manipulate, discredit and silence the victim,
4. Merging of real events with internal imagery used to dissociate (for example, being abused by the child imaging they were really somewhere else taking a hot air balloon could create a memory of being abused while in a hot air balloon,
5. Blocking of information or denial which removes some of the events, emotions, or sensations involved in the original event.

The key is using therapy, internal dialogue, journaling, and other methods to help distill the truth of the memory, the emotional content of the memory, and how the information needs to be handled in order to help heal from the damage. Therapy should not be seen as an arena to gather memory evidence to use in court against your perpetrators, but rather a place to let every part of yourself be heard, validated, and thanked for helping you get through difficult times and confusing emotions.