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Understanding and Treating Dissociative Identity Disorder

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Elizabeth F. Howell

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“When treating their first few DID cases, therapists typically focus too much attention on the alters. This focus tends to distract from what is fundamental–the patients’ pervasive dissociative/posttraumatic distress and maladaptation. Has something similar occurred in psychiatry’s view of DID? Have the compelling phenomena of alters distracted us from the matrix of dissociative and posttraumatic symptoms in which alters are embedded? - Dell, P. F. (2001). Why the Diagnostic Criteria for Dissociative Identity Disorder Should Be Changed, Journal of Trauma and Dissociation, 2 (1).”

PsychiatryDissociative Identity DisorderDissociationPsychotherapyAlter PersonalitiesDissociative DisorderDissociative PartsAlter IdentitiesPosttraumatic Stress
Author:Paul F. Dell
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“Several recent studies (Bliss, 1980; Boon & Draijer, 1993a; Coons & Milstein, 1986; Coons, Bowman, & Milstein, 1988; Putnam et al., 1986; Ross et al., 1989b) are largely consistent in terms of the general trends that they demonstrate. At the time of diagnosis (prior to exploration) approximately two to four personalities are in evidence. In the course of treatment an average of 13 to 15 are encountered, but this figure is deceptive. The mode in virtually all series is three, and median number of alters is eight to ten. Complex cases, with 26 or more alters (described in Kluft, 1988), constitute 15-25% of such series and unduly inflate the mean. Series currently being studied in tertiary referral centers appear to be more complex still (Kluft, Fink, Brenner, & Fine, unpublished data). This is subject to a number of interpretations. It is likely that the complexity of the more difficult and demanding cases treated in such settings may be one aspect of what makes them require such specialized care. It is also possible that the staff of such centers is differentially sensitive to the need to probe for previously undiscovered complexity in their efforts to treat patients who have failed to improve elsewhere. However, it is also possible that patients unduly interested in their disorders and who generate factitious complexity enter such series differently, or that some factor in these units or in those who refer to them encourages such complexity or at least the subjective report thereof.”

Dissociative Identity DisorderDissociationMultiple Personality DisorderAlter PersonalitiesMpdDissociative PartsAltersAlter Personality
Author:Richard P. Kluft
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“The classic host personality, which usually (over 50% of the time) presents for treatment, nearly always bears the legal name and is depressed, anxious, somewhat neurasthenic, compulsively good, masochistic, conscience-stricken, constricted hedonically, and suffers both psychophysioiogical symptoms and time loss and/or time distortion. While no personality types are invariably present, many are encountered quite frequently: childlike personalities (fearful. recalling traumata, or love-seeking), protectors, helpers-advisors, inner self-helpers (serene, rational, and objective helpers and advisors first described by Allison in 1974), personalities with distinct affective states, guardians of memories and secrets (and of family boundaries), memory traces (holding continuity of memory), inner persecutors (often based on identification with the aggressor), anesthetic personalities (created to block out pain), expressers of forbidden impulses (pleasurable and otherwise, such as defiant, aggressive, or antisocial), avengers (which express anger over abuses endured and may wish to redress their grievances), defenders or apologists for the abusers, those based on lost love objects and other introjections and identifications, specialized encapsulators of traumatic experiences and powerful affects, very specialized personalities, and those (often youthful) that preserve the idealized potential for happiness, growth, and the healthy expression of feelings (distorted by traumata) in others (Kluft, 1984b).”

Dissociative Identity DisorderMultiple PersonalitiesAlter Personalities
Book:Handbook of Dissociation: Theoretical, Empirical, and Clinical Perspectives
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“I suggested that the system put all the potential offending [sexually abusive] alters in an internal prison. Jennifer said that would take too long. An alter popped out and said, "Just a minute," and then, after a brief silence, announced that they had "killed" all the offender alters; they were lying in the inside world dead, covered in blood! I was not very happy with such drastic measures, but accepted it for the interim, knowing I could rely on Jennifer to tell me if the risk recurred. I made a list of the "dead" alters. The next morning Jennifer called; she had dreamed about sexually abusing a child. I asked her to look for more related memories before we met in the evening. She had to "reincarnate" all the dead alters to find the memories. (We already had a method for doing this, as some alters had previously experienced internal "death" in "disasters" in the inner world; when they were made new internal bodies, they became alive again.)”

Dissociative Identity DisorderAlter Personalities
Book:Healing the Unimaginable: Treating Ritual Abuse and Mind Control
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“Types of Alters Most people who have DID have at least several different personalities. Each personality is typically referred to as an alter or alternate personality. Alters may vary in terms of age, gender, and sexual orientation, much in the same way that members of a family differ. Each of these personalities will be distinct from one another and may have differing interests, talents, abilities, and functions. And as different as these personalities are from one another, there are some common types of alters found within individuals with DID.”

Dissociative Identity DisorderAlter PersonalitiesDissociative IdentitiesPersonality States
Book:Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder
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“The reported numbers of MPD alter personality states are given great play by critics. As usual, these critics rarely consult the research. Although cases with dozens or scores of alters have been reported, the mode is 3 and the median typically 8-10 (see, e.g., Putnam et al., 1986; Coons et al., 1988; Ross, Norton, and Wozney, 1989f; Kluft, 1991).”

Dissociative Identity DisorderMultiple Personality DisorderAlter PersonalitiesDissociative Parts
Book:Dissociation in Children and Adolescents: A Developmental Perspective
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