Intervention and Treatment

Left untreated, DID can last a lifetime. While treatment for DID may take several years, it is effective. Persons with DID may find that they are better able to handle the symptoms in middle adulthood. Stress, substance abuse, and sometimes anger can cause a relapse of symptoms at any time. As a good standard of care, persons with DID should be treated by a mental health professional with specialized training and experience with dissociation. Since physical illness can sometimes mimic or contribute to a psychological disorder, a complete physical examination by a physician is warranted when there are concerns about physical conditions. For significant mood disorders and psychiatric conditions, a psychiatric consult is necessary.

  1. Psychotherapy.Treatment for DID consists primarily of individual psychotherapy and can last for an average of five to seven years in adults. Individual psychotherapy is the most widely used modality as opposed to family, group or couples therapy. The main goal for treatment is the integration of the separate personality states into one cohesive, unified personality, unless the person with DID is not ready or motivated to work with trauma. Psychotherapy for dissociative disorders often involves techniques that help work through the trauma that triggers dissociative symptoms. Treatment may include the following stages: uncovering and “mapping” the alters or parts; treating the traumatic memories and “fusing” the alters; and consolidating the newly integrated personality.
  2. Family Therapyis recommended to help educate the family about DID and its causes, to understand the changes that can take place as the personality is being reintegrated, as well as help family members recognize symptoms of recurrence. Family therapy for a person with DID may produce significant negative and traumatic memories of other family members which can hinder clinical progress.
  3. Group therapymay be beneficial in addition to individual therapy, provided the group is exclusively for people with dissociative disorders. Persons with DID can sometimes have setbacks in mixed therapy groups because others may be bothered or disturbed by the personality switches.
  4. Medications.There is no medication to treat DID since it is not an organic disorder or a chemical imbalance. However, antidepressants and anxiolytics might help with mood disorders.
  5. Clinical Hypnosis. Despite controversy about therapists implanting false memories by suggestion, clinical hypnosis can be used in conjunction with psychotherapy when conducted safely by a trained therapist. Hypnosis can help clients access repressed memories, control problematic behaviors, such as self-mutilation and eating disorders, and help fuse the alters during the integration process.

http://www.aamft.org/imis15/content/Consumer_Updates/Dissociative_Identity_Disorder.aspx

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