The treatment of Dissociative Identity Disorder

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            It is hard to find a perfect treatment for people with Dissociative Identity Disorder (DID) because of its uncommonness. However, long-term treatments like music therapy and therapies that focus on traumatic events and attachment are suggested to use. The goal of the treatments is to retain and improve individual daily functioning.

            The length of time is important in treatment. It is a long process especially for people with comorbid disorders in DID. According to Chilebowski and Gregory’s (2012) study, the result of long-term and short-term Dynamic Deconstructive Psychotherapy (DDP) are different when treating people with DID and co-occurring Borderline Personality Disorder (BPD). DDP is one recent treatment that targets association deficits and focuses on helping the connection between individual emotions and personal episodes (2012). Dissociative experiences are reduced significantly after 12 months instead of 12 weeks of DDP. In other words, it decreases dissociative experiences by controlling emotions process in DID with co-occurring BPD. People with those comorbid symptoms are not able to verbally describe specific emotional experience in a short time. Ringrose (2011) also suggested that long-term treatment is necessary because the host and alters need time to learn communication and cooperation to make connections with each other. It is important to spent time to understand the differences in alters and map out their thinking process. Thus, maintaining the trust between psychiatrist and client requires some amount of time even before different treatments begin.  

            Focusing on trauma in treatments works for people with DID. According to Harper (2011), Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization Reprocessing (EMDR) are two therapies working through traumatic events. One of the models called Tactical Integration Model in CBT, restructures the thinking of dissociative identities by helping individuals to involve their alters noticing their feeling and thinking process. Cognitive thinking may help them to adjust and restructure their behaviors. On the other hand, EMDR helps people with DID to transfer disturbing events into narrative memories to reduce pass traumatic memories and prevent extreme physiological arousal (Harper, 2011). In addition, Ringrose (2011) believed that individuals with DID are automatically propelled back to traumatic events and dissociated memories with current events. On the same time, those alters share same trauma but with different perspectives. It is important to work on the traumatic events with the host and alters together because it helps to interact with them and share other alters’ thought to the host. Connecting stories and perceptions in one’s mind can reduce dissociative behaviors.  

            Music therapy helps people in symptoms relief, declines the feeling of stigmatization, increases self-esteem and prevents future self-abuse (Gleadhill & Ferris, 2010). Listening to music helps clients to cope with traumatic memories, because the melody and lyrics of the song may interact with individual feelings and provide a voice to trauma experience. It can build up a new attachment for them in their favorite and familiar music. Therefore, individuals may involve more in CBT therapy and group therapy because the music creates a good and familiar atmosphere for them to interact with others and also the psychiatrist. It also increases individual engagement and openness on expressing different alters’ perspectives by the influence of music. Moreover, writing and singing songs helps them to express their feeling and reduce anxiety. It is constructive because people with DID can increase their self-esteem, and also sharing perceptions of the songs with different alters. It creates a map for them to understand themselves and also giving information to the psychiatrist. Thus, combination of therapies is used between CBT and Music therapy. According to Gleadhill and Ferris (2010), song writing helps individuals to reconstruct their believes secondary emotion like shame and guilty through the combination of CBT. It regulates their thought and attitude on self-harm behaviors to prevent future abuse.

            There is no perfect treatment for DID. It takes time and it is a long-term process on treatments. Moreover, reconstructing trauma experience and attachment by difference treatments like CBT, EMDR and Music therapies, are the main focus for people with DID. Due to the lack of cases and studies in DID, there is no medical treatment to heal DID directly. However, multiple therapies are suggested to regulate individual daily functions, and increase their adaptation of interacting with the host and other alters. 

Reference

Chilebowski, S. M., & Gregory, R. J. (2012). Three cases of dissociative identity disorder and co-occurring borderline personality disorder treated with dynamic deconstructive psychotherapy. American Journal Of Psychotherapy, 66(2), 165-180.

Gleadhill, L., & Ferris, K. (2010). A theoretical music therapy framework for working with people with dissociative identity disorder. Australian Journal Of Music Therapy, 2142-55.

Harper, S. (2011). An examination of structural dissociation of the personality and the implications for cognitive behavioural therapy. The Cognitive Behaviour Therapist, 4(2), 53-67. doi:10.1017/S1754470X11000031

Ringrose, J. (2011). Meeting the needs of clients with dissociative identity disorder: Considerations for psychotherapy. British Journal Of Guidance & Counselling, 39(4), 293-305. doi:10.1080/03069885.2011.564606

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