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Marlene Steinberg Books

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“Identity Confusion in Patients With DID We can locate the identity confusion characteristic of DID in the middle-to-upper range of severity. Identity confusion is a significant factor in DID, when an environment created and sustained by one personality conflicts with the expectations of another personality who is not prepared to function in this alternate environment.”

Dissociative Identity DisorderDissociationMultiple PersonalitiesAlter PersonalitiesDissociative PartsIdentity Confusion
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“Interviewer: Have you ever felt as if there was a struggle going on inside of you as to who you really are? Patient: Yes, for years, and I still can't find out who the fuck am I, man. Excuse my language, doctor. I don't know who the fuck l am. Interviewer: What do you mean by that? Patient: Who is [A.B.]? Who the fuck am I? I don't know. I don't know who I am. I really don't know who I am. I look at the rest of my family and I say, "I ain't part of this family, man, this can't be. They're all different than me. They also look alike, but they look different to me." (SCID-D interview, unpublished transcript) As the preceding example indicates, the theme of puzzlement is characteristic of patients at all levels of educational achievement and verbal ability. The clinician should be alert to the presence of this theme in the self-descriptions of all patients endorsing dissociative symptoms, not just in those of patients who completed a college degree or who are accustomed to introspection and self-analysis.”

IntrospectionDissociative Identity DisorderIdentity CrisisAlter PersonalitiesDissociative PartsIdentity ConfusionDissociative SymptomsDepersonalization DisorderPuzzlement
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“People with DID often experience conflicting advice or opinions emanating from their alter personalities. Individual alter personalities may have coherent, consistent identities, but, taken as a group, the incompatible internal personalities generate an atmosphere of conflict as well as incoherence. As one patient described it, "Do you know how hard it is to get a hundred and four minds to come together to a single decision?”

Dissociative Identity DisorderAlter PersonalitiesDissociative DisorderIdentity QuotesInternal ConflictInner StruggleIdentity ConfusionInternal Struggle
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“It is not unusual for subjects diagnosed with a Dissociative Disorder on the SCID-D to be surprised at having their symptoms validated by a clinician who understands the nature of their disorder.”

Mental IllnessDissociative Identity DisorderDiagnosisValidationMental DisorderDissociative DisorderDissociativeDissociative DisordersDidDdnosDepersonalization DisorderDiagnostic Criteria
Book:Interviewer's Guide to the Structured Clinical Interview for Dsm-IV Dissociative Disorders
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“Dissociative Disorders have a high rate of responsiveness to therapy and that with proper treatment, their prognosis is quite good.”

Mental IllnessTherapyDissociative Identity DisorderDissociationAbuse SurvivorsPsychotherapyMental DisorderTraumatizedDissociative DisorderDissociative AmnesiaDissociative DisordersMpdDepersonalizationDdnosPrognosisDerealizationDepersonalization DisorderDissociative Fugue
Book:Interviewer's Guide to the Structured Clinical Interview for Dsm-IV Dissociative Disorders
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“By contrast, moderate identity alteration differs from its milder countepart in that the alterations are not always under the person's control. In addition, moderate identity alteration does not always manifest the presence of distinct alter personalities. Someone who experiences moderate identity alteration may present with mood changes and behaviors that they perceive as uncontrollable. Patients with nondissociative psychiatric disorders (e.g., manic depressive illness) may report moderate alterations in behavior/demeanor that they cannot control; for example, one patient diagnosed as manic depressive mentioned being bothered by his inability to "keep his mind from racing" (SCID-D interview, unpublished transcript). However, these alterations do not coalesce around distinct personalities. Similarly, individuals who have borderline personality disorder tend to fluctuate rapidly between radically different behaviors and moods; however, these changes do not involve different names, memories, preferences, distinct ages, or amnesia for past events.”

Dissociative Identity DisorderBipolarBorderline Personality DisorderDissociative PartsDissociative StatesIdentity AlterationSelf States
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“The SCID-D may be used to assess the nature and severity of dissociative symptoms in a variety of Axis I and II psychiatric disorders, including the Anxiety Disorders (such as Posttraumatic Stress Disorder [PTSD] and Acute Stress Disorder), Affective Disorders, Psychotic Disorders, Eating Disorders, and Personality Disorders. The SCID-D was developed to reduce variability in clinical diagnostic procedures and was designed for use with psychiatric patients as well as with nonpatients (community subjects or research subjects in primary care).”

Mental IllnessPtsdDissociative Identity DisorderEating DisordersDiagnosisDissociationAnxiety DisordersSchizophreniaMental DisorderDissociative DisorderBorderline Personality DisorderDissociative DisordersPosttraumatic Stress DisorderMisdiagnosisPersonality DisordersDdnosAcute Stress Disorder
Book:Interviewer's Guide to the Structured Clinical Interview for Dsm-IV Dissociative Disorders
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“Another patient with DID described the visual images she had of the personalities inside her in the following way; Interviewer: What does she [the personality] look like? Patient: She wears jeans, she never wears a dress ... Interviewer: Does she look like Josie? Patient: Yes, they look identical except that their manners and their clothing and their hair.. .. Josie's hair is curly with ribbons and Julie has braids and could care less what she looks like. She's tomboy looking. Interviewer: Do they look like you? Patient: I think they look like me. Wthout the glasses. They don't wear glasses... Interviewer: Do you have an image of Diane? Patient: Blonde hair, she looks older. (SCID-D interview, unpublished transcript)”

Dissociative Identity DisorderAlter PersonalitiesDissociative DisordersDissociative PartsVisual Image
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“In some instances the patient will have a visual image of a contrasexual alter. For example, one female patient endorsed the presence of two male alters with the same name, one a boy of about age 10 wearing a baseball cap and the other a slightly older but still aggressive adolescent. Because a patient's use of visual images provides rich evidence for the degree of identity alteration, each of the SCID-D's follow-up sections incorporates questions about visual images to allow the patient to elaborate on this symptom.”

Dissociative Identity DisorderAlter PersonalitiesDissociative DisordersDissociative PartsDissociative SymptomsDissociative StatesIdentity AlterationVisual Image
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“Due to previous lack of systematic assessment of dissociative symptoms, many subjects experience the SCID-D as their first opportunity to describe their symptoms in their own words to a receptive listener.”

ListeningDissociative Identity DisorderDiagnosisAlter PersonalitiesDissociative DisorderDissociative DisordersDdnosDissociative IdentitiesDissociative States
Book:Interviewer's Guide to the Structured Clinical Interview for Dsm-IV Dissociative Disorders
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“Escape from reality. In some instances, dissociation induces people to imagine that they have some kind of mastery over intractable environmental difficulties. Dissociation is often implicated in magical thinking or self-induced trance states. This aspect of dissociation is frequently found in abuse survivors. It is not uncommon for abused children to engage in magical thinking to retain an illusion of control over the situation (e.g., believing that they "cause" the perpetrator to act out).”

RealityPowerIllusionBlameChild AbusePowerlessEscapeDissociative Identity DisorderDissociationPowerlessnessTranceTraumatizedDissociative DisordersMagical ThinkingAbused ChildrenEscape From RealitySelf BlameIllusion Of ControlEscaping From RealityTrance States
Author:Marlene Steinberg
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“Isolation of catastrophic experiences. Dissociation may function to seal off overwhelming trauma into a compartmentalized area of conscious until the person is better able to integrate it into mainstream consciousness. The function of dissociation is particularly common in survivors of combat, political torture, or natural or transportation disasters.”

ConsciousnessPsychologyMemoryTraumaTortureSurvivorCombatCatastropheSoldiersDissociationAmnesiaDissociativeTrauma SurvivorsPolitical PrisonersComplex TraumaDissociatedConcentration CampsConcentration Camp Survivor
Author:Marlene Steinberg
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“Identity confusion is defined by the SCID-D as a subjective feeling of uncertainty, puzzlement, or conflict about one's own identity. Patients who report histories of childhood trauma characteristically describe themes of ongoing inner struggle regarding their identity; of inner battles for survival; or other images of anger, conflict, and violence. P13”

PsychologyMental HealthPsychiatryDissociative Identity DisorderDissociationMultiplicityMultiple Personality DisorderDissociativeDsmTextbookReference WorksScid DSteinburg
Book:Interviewer's Guide to the Structured Clinical Interview for Dsm-IV Dissociative Disorders
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“Although Dissociative Disorders have been observed from the beginnings of psychiatry, the Structured Clinical Interview for DSM-III-R Dissociative Disorders (Steinberg 1985) was the first diagnostic instrument for the comprehensive evaluation of dissociative symptoms and to diagnose the presence of Dissociative Disorders.”

Mental IllnessSkepticismDissociative Identity DisorderDiagnosisSkepticDissociationMultiple Personality DisorderMultiple PersonalitiesDissociative DisorderDissociativeDissociative DisordersMpdDissociative StatesDiagnostic Criteria
Book:Structured Clinical Interview for Dsm-IV Dissociative Disorders (Scid-D)
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“Levels of identity alteration can run from absent to severe (see Figure 11-1 and Table 11-1). What differentiates the various degrees of severity are the distinctness and complexity of the personality states involved and the ability of these states to control a person's outward behavior. Mild identity alteration is widespread in the general population. Many, perhaps most, people are aware of occasions in their lives in which they have assumed different roles or demeanors but remained conscious of their role-switching or alteration, and perceived themselves having been in control of the transition.”

IdentityPersonalityIdentity AlterationDifferent RolesEho StatesRole Switchibg
Book:Handbook for the Assessment of Dissociation: A Clinical Guide
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“To achieve a diagnostic assessment, it is important to remember that diagnosis does not hinge on the subjects answer to any single question on the SCID-D. A positive response regarding one dissociative symptom often has several possible ramifications, which must be explored through persistence with related questions. Isolated dissociative symptoms may occur in a number of different psychiatric syndromes, both dissociative and nondissociative. An isolated dissociative symptom, such as use of an alternate name or an amnestic episode, is insufficient grounds for diagnosis. To provide evidence sufficient for an accurate diagnosis, the symptom must exist in combination with other symptoms that, as a group, conform to the characteristic pattern of one of the five disorders oudined in the Diagnostic Work Sheets in Appendix 2.”

Dissociative Identity DisorderDiagnosisDissociationDissociative DisorderDissociative SymptomsScid DScid D R
Book:Interviewer's Guide to the Structured Clinical Interview for Dsm-IV Dissociative Disorders
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