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Treatment For Dissociative Identity Disorder | Health Share - dissociative identity disorder (plural personality disorder) is a mental disorder that comes from the side effects of severe trauma in childhood and adolescence. Individuals usually experience a traumatic experience which is quite extreme and occur repeatedly resulting in the formation of two or more personalities berbeda.Masing individual with his own memories, beliefs, behaviors, thought patterns, and how to view the environment and themselves sendiri.Setidaknya these two personalities repeatedly have full control over the body of the individual
The term dissociative identity disorder is a new term, the disorder formerly known as compound or multiple personality disorder who call it a split personality, this last term was introduced in 1987
The term dissociative identity disorder is a new term, the disorder formerly known as compound or multiple personality disorder who call it a split personality, this last term was introduced in 1987
In the 18th century, the skill of the shaman to transform into animals or spirits possessed event is regarded as someone who has a personality phenomenon ganda.Kasus Eberhardt Gmelin (1791) is regarded as the first of multiple personality cases were reported, although previously unheard of event that resembles the symptoms of amnesia dual personality which reported in 1664.
In 1812, Benjamin Rush, who is also dubbed as the father of American psychiatry, collecting cases of dissociative disorder and multiple personality. He wrote the first book about psychiatry multiple personality disorder titled "Medical Inquiries and Observations of Mental Illness" (original in English: "Medical Inquiries and Observations Upon Disesases of the Mind"), the theory says that multiple personality disorder occurs because of damage to the relationship 2 hemisper brain.
At the end of the 19th century, Eugene Azam, a professor of surgery interested in hypnosis, published a number of reports about Felida X, Felida X was born in 1843, lost his father in infancy and childhood living with experience menyakitkan.Felida X has 3 personality in which personality is the personality of the normal 1 and 2 again more personality Janet abnormal.Pierre reported several cases of multiple personality in the late 19th century and early 20th century, such as the case of Leonie, Lucie, Rose, Marie, and Marceline.
In the era of 1880-1920, many international medical conferences that discuss disosiasi.Jean-Martin Charcot introduced his idea of dissociative, he said that "vibe" (shock) on the nerve results in a variety of abnormal neurological conditions.
Cases of multiple personality first ever scientifically investigated the case Clara Norton Fowler in 1906. [citation needed] In 1987, the term Compound Personality Disorder (Multiple Personality Disorder abbreviated MPD) in DSM II is being replaced into dissociative disorders (Dissociative disorder) in DSM III. In 1989, Frank W. Putnam published the book "Diagnosis and Treatment of Multiple Personality Disorder" and in the same year Colin A. Ross noted and published research Compound Personality Disorders: Diagnosis, Clinical Characteristics, and Treatment (original title in English : "Multiple Personality Disorder: Diagnosis, Clinical Features, and Treatment".)
The new era began back in 1994 when the publication of DSM-IV disorders renamed dissociative identity disorder (Dissociative Identity Disorder). [10]
In Indonesia, these terms become better known since published a book adaptation of a true story and be sold (best-selling) in the 2000s. A book that tells the story of sufferers of dissociative identity disorder include: Sybil, Karen, and Billy.
Criteria for diagnosis Dissociative Identity
There are four criteria for the diagnosis of dissociative identity disorder in a person, namely:
- The presence of two or more personalities.
- The personality can control the behavior.
- Inability to remember important information that exceeds the normal forgetfulness.
- Disorders not due to the direct physiological effects of a substance or a general medical condition.
Signs and symptoms Dissociative Identity
Dissociative amnesia Dissociative Amnesia is memory loss after a stressful incident. A person suffering from this disorder are not able to remember important personal information, usually after a stressful episode. At total amnesia, the patient does not recognize family and friends, but still have the ability to speak, read and reasoning, also still has the talent and knowledge of the world that have been obtained previously.
Clinical development of dissociative amnesia:
Memory loss (in part / whole), usually about important events (stressful, traumatic) has just happened, is not due to organic mental disorders, forgetfulness, fatigue, intoxication.
People suddenly become unable to recall important personal information (usually after several stressful events).
During the period of amnesia, behavior or the ability of individuals may not be changed, except that the memory loss caused some disorientation, do not recognize the identity (origin, friends, family, etc.)
Memory loss
Can only to a particular event or all events of life
Usually takes place within a certain time period, can be a few hours to several years
Memory is usually re-emerge suddenly as well, complete as before (only less likely to relapse)
Loss of memory is not the same as those caused by brain damage or because of drug dependence.
Dissociative Fugue Dissociative fugue is memory loss accompanied by leaving the house and create a new identity. In a dissociative fugue, memory loss is greater than the dissociative amnesia. People who experience dissociative fugue not only suffered total amnesia, but suddenly leave home and move to a new identity.
Dissociative Fugue clinical development:
A disorder in which individuals forget that important personal information and establish a new identity, also moved to a new place.
Individuals not only suffered amnesia in total, but also a sudden move (escape) from home and work, as well as forming a new identity.
It usually occurs after a person experiences some severe stress (conflict with a spouse, job loss, suffering because of natural disasters).
The new identity is often associated with the name, home, work and even new personality characteristics. The new life, the individual can be successful despite not being able to remember the past.
Recovery is usually complete and individuals usually do not remember what happened during the fugue.
Depersonalization disorder Depersonalization disorder is a condition in which a person's perception or experience of oneself changed. In this episode of depersonalization, which is generally triggered by stress, people suddenly lose their sense of self. The people with this disorder experience a sensory experience that is not unusual, for example, the size of their hands and feet changed drastically, or their voices sounded strange to themselves. Patients also feel are outside their body, looking at themselves from a distance, sometimes they feel like a robot, or they seemed to move in the real world.
Personalized clinical development disorders:
Disorders in which the change in the perception or experience of the individual about himself.
Individuals felt "unreal" and feels alien to himself and around him, quite disturbing function itself.
Memory does not change, but people lose sense of self.
These disorders cause stress and pose obstacles in the various functions of life.
It usually occurs after experiencing severe stress, such as an accident or a dangerous situation.
Usually begins in adolescence and chronic journey (in a long time).
Dissociative identity disorder dissociative identity disorder is a condition where a person has at least two or more conditions that alternated ego, which act independently of each other. According to the DSM-IV-TR, a diagnosis of dissociative disorder (GID) can be enforced if a person has at least two separate ego state, or changeable, different conditions in existence, feelings and actions of each other do not affect each other and the emerging and control at different times.
Dissociative Identity Disorder developments:
Individuals have at least two different personalities (the difference in being, feeling, behavior), there is even the opposite.
The existence of two or more separate and distinct personalities in person. Each personality has a pattern of behavior, relationships and memory respectively.
The original personality and sometimes can realize their fractions period of time is lost, the other personality. The voice of the other personalities often resonates, go into their consciousness but is not known to belong to whom.
Gap in memory may occur if a personality is not related to other personality.
The existence of different private-pribadiyang cause disruption in a person's life and can not be cured instantly by drugs.
It usually appears in early childhood (severe trauma in childhood), but is rarely diagnosed until adolescence. Heavier than other forms of dissociative disorders
Women> men
Patients with dissociative identity disorder has the following symptoms:
Depersonalization and derealization Patients experiencing unreal feeling, feeling detached from oneself both physically and mentally. Patients feel like watching himself, as if they were watching themselves in a movie. Patients feel not inhabit their own bodies and consider themselves as strangers or unreal.
Distorted time, amnesia, and lapses of time sufferers often experience a loss of time, which sometimes they find something that is not known, nor realized somewhere unknown, while they do not know when to go where it is.
Headache and suicidal patients often feel a headache, and heard a lot of voices in his head (similar to the symptoms of schizophrenia). Some personality drove him to commit suicide.
Fluctuations in the level of ability and self-image-ubahnya Changing patient conditions occur when one personality exchanging with other personalities. For example, when the A personality appears, then the personality is the personality that have good numeracy skills. Meanwhile, when other emerging personality, a personality capabilities disappeared. Thus, the ability to change depending on which personality emerge. As well as a picture of himself, fluctuate according presence of each personality.
Self-harm behavior
Anxiety and depression Individuals generally suffer anxiety and depression because of repeated experience things that are not remembered.
Diagnosis Dissociative Identity
Making the diagnosis of dissociative identity disorder is not easy and takes time lama.Diagnosis can be done with a structured interview and through a variety of psychological tests.
Structured Clinical Interview (Structured Clinical Interview for DSM-IV (SCID-D)). Interview method also has a guide, using Diagnosis and Scheduling Structured Interview for People with dissociative identity disorder (Diagnosis and Dissociative Disorders Interview Schedule (DDIS)).
A simple test is considered to remain valid for a diagnosis called dissociative Genesis Measurements in Patients (English: Dissociative Experience Scale (DES)). The diagnosis must be made by a psychiatrist or psychologist who is competent and certified.
Sometimes mistakes often occur because the dissociative personality disorder are often similar and / or present with other disorders such as dissociative amnesia, depression, anxiety, or panic disorder. Therefore comorbidity factors need to be monitored carefully in order to avoid wrong diagnostic, especially one comparing with schizophrenia.
Guide diagnosis
Various guide diagnosis of dissociative identity disorder can be seen at:
- ICD-10 code F44.9
- DSM-IV TR with code 300.14
- PPDGJ III with code F60.2
Cause Dissociative Identity
There are several factors that can cause dissociative identity disorder, [14] namely:
- Innate ability to separate personalities with ease.
- Sexual abuse in childhood are repeated.
- Lack of people who protect or entertain suffered from a bad experience.
- The influence of other family members who have psychological disorders.
The main cause of dissociative identity disorder is actually a prolonged trauma experienced in childhood. Trauma is formed due to a variety of torture and abuse, such as: torture and sexual abuse, physical violence, psychological violence, and also strange rituals that harm the victim (Satanic Ritual Abuse).
Theory of Psychoanalysis
According to the Theory of Psychoanalysis by Sigmund Freud, trauma in childhood are most likely to result in the incidence of personality disorder seseorang.Pada childhood that personality begins to develop and take shape. When there is a bad experience, these experiences as much as possible to be on tap (repress) into the subconscious. [Citation needed] However, there are some events that really can not be handled by the patient, thus forcing it to create more personal figure capable to face the situation. This is a self-defense mechanism, a system that is formed when a person can not face a tremendous anxiety. New personalities will continue to appear in the event again an event that could not be resolved.] The appearance of personalities it depends on the situation at hand. Original personality tend not to know the whereabouts of other personality, as indeed it is desirable, namely forgetting things that have been taken over by another personality.
Handling
Some of the symptoms of dissociative identity disorder may appear and disappear as volatile, but the problem itself will continue ada.Pengobatan for this disorder consists primarily of psychotherapy and hypnosis.
The therapist seeks to uncover and discover all the personalities contained within the patient with the process of hypnosis. [Citation needed] At the time of hypnotic and individuals into the threshold condition, the therapist can call / meeting with personalities lainnya.Memahami roles and functions of each personality , The therapist will try to establish a good relationship and effective with every personality and trying to be a figure that can be trusted and give perlindungan.Setelah know, understand, and have a good relationship with each personality, the next process is to create the original personality to be able to receive and open ourselves to other personalities. In most cases the original personality is not aware of the existence of another figure in dirinya.Namun, other personalities aware of the existence of the original figure.
Normally the ultimate goal of therapy is to integrate a personality where it is managed for Karen Sybildan case. The process takes place with hypnotic individuals to accept and reunite with lainnya.Proses personality is not running easily, because after the unification of the individual usually will feel again the things experienced by other personalities, such as the experience of being hurt, abused, and also attempted suicide , The return of these memories create new problems for individuals, and requires handling lainnya.Namun, this does not work for some kasus.Banyak cases ended without penyembuhan.Obat medical drugs such as anti-depressants and anti-psychotics are also sometimes used, to control thoughts and feelings of the individual to remain in normal conditions.
Dissociative disorders shows, perhaps better than any other disorder, the possibility of relevance theory of psychoanalysis. In three dissociative disorder, amnesia, fugue and GID, the patient showed very convincingly that behavior indicates that they are not able to access various parts of life in the past is forgotten. Therefore, there is a hypothesis that there is a big part of their lives that direpres.
Psychoanalytic therapy chosen more for dissociative disorders than other psychological issues. Goal to lift the repression becomes law daily, achieved through the use of various basic psychoanalytic techniques.
GID therapy. Hypnotic commonly used in the treatment of GID. In general, the thinking is that the painful memories direpres recovery will be facilitated by recreating the situation assumed torture experienced by the patient. Generally, a person is hypnotized and encouraged to restore their minds back to childhood events. The hope is that by accessing the traumatic memories will enable the persons concerned to realize that the danger of his childhood is now gone and that her life is now no need to be controlled by such past events.
There are some widely agreed principles in the handling of GID, regardless of the clinical orientation. The goal is the integration of multiple personalities. Each personality should be helped to understand that he is part of the people and personalities that appear by themselves.
The therapist should use the name of each personality just for comfort, not as a way to assert the existence of a separate and autonomous personality. The whole personality must be treated fairly. The therapist should encourage empathy and cooperation among the various personalities. Required softness and support related to childhood trauma that may have triggered the emergence of various personalities.
The goal of each approach to the GID must be to convince people that splits up into several different personalities is no longer necessary to deal with the trauma, whether the trauma in the past that triggered the initial dissociation, trauma in the present or trauma in the future.
Prognosis Dissociative Identity
The prognosis of individuals with dissociative identity disorder depends on the symptoms and features they alami.Misalnya, people who have additional serious mental health disorders, such as personality disorders, disorders of feelings, eating disorders, and substance abuse disorders, the prognosis is more buruk.Sayangnya no long-term systematic research menelitinya.Beberapa experts believe that the prognosis for recovery is excellent for children anak.Meskipun treatment requires several years, often at the end efektif.Walaupun returned again on patient factors and general terapisnya.Secara is known that the better treatment , then the better the prognosisnya.Pasien may experience disruption of their symptoms when entering the age of four puluhan.Stres or abuse of substances also play an important role in the recurrence of symptoms disorders
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