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Switches among identities occur in response to changes in emotional state or to environmental demands, resulting in another identity emerging to assume control. Because different identities have different roles, experiences, emotions, memories, and beliefs, the therapist is constantly contending with their competing points of view. Helping the identities to be aware of one another as legitimate parts of the self and to negotiate and resolve their conflicts is at the very core of the therapeutic process. It is countertherapeutic for the therapist to treat any alternate identity as if it were more “real” or more important than any other. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision .James A. Chu
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The primary treatment modality for DID is individual outpatient psychotherapy. Guidelines for Treating Dissociative Identity Disorder in Adults, Third RevisionJames A. Chu
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Treatment for DID should adhere to the basic principles of psychotherapy and psychiatric medical management, and therapists should use specialized techniques only as needed to address specific dissociative symptomatology. Guidelines for Treating Dissociative Identity Disorder in Adults, Third RevisionJames A. Chu
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The DID patient should be seen as a whole adult person with the identities sharing responsibility for daily life. Despite patients’ subjective experience of separateness, clinicians must keep in mind that the patient is a single person and generally must hold the whole person (i.e., system of alternate identities) responsible for the behavior of any or all of the constituent identities, even in the presence of amnesia or the sense of lack of control or agency over behavior. From p8 International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision: Summary version. Journal of Trauma & Dissociation, 12, 188—212.James A. Chu
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A substantial minority of DID patients report sadistic, exploitive, and coercive abuse at the hands of organized groups. Guidelines for Treating Dissociative Identity Disorder in Adults, Third RevisionJames A. Chu
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The DID patient is a single person who experiences himself or herself as having separate alternate identities that have relative psychological autonomy from one another. At various times, these subjective identities may take executive control of the person’s body and behavior and/or influence his or her experience and behavior from “within.” Taken together, all of the alternate identities make up the identity or personality of the human being with DID.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p7 .James A. Chu
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Unspeakable feelings need to find expression in words. However... verbalization of very intense feelings may be a difficult task.James A. Chu
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Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse, somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions.- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5 .James A. Chu