40 Quotes About Dissociative Disorder

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). Marlene Steinberg

FLATOW: So you would - how would you treat a patient like Sybil if she showed up in your office B R A N D: Well, first I would start with a very thorough assessment, using the current standardized measures that we have available to us that assess for the range of dissociative disorders but the whole range of other psychological disorders, too. I would need to know what I'm working with, and I'd be very careful and make my decisions slowly, based on data about what she has. And furthermore, with therapists who are well-trained in dissociative disorders, we do keep an eye open for suggestibility. But that research, too, is not anywhere near as strong as what the other two people in the interview are suggesting. It shows - for example, there's eight studies that have a total of 11 samples. In the three clinical samples that have looked at the correlation between dissociation and suggestibility, all three clinical samples found non-significant correlations. So it's just not as strong as what people think. That's a myth that's not backed up by science." Exploring Multiple Personalities In 'Sybil Exposed' October 21, 2011 by Ira Flatow . Bethany L. Brand

The second factor helping to bring the dissociative disorders back into the mainstream was the Vietnam War. For sociological reasons originating outside psychology and psychiatry, the Vietnam War and the posttraumatic stress disorder (PTSD) that arose from it were not forgotten when the veterans returned home, as had been the case in the two world wars and the Korean War. The realization that real, severe trauma could have serious long-term psychopathological consequences was forced on society as a whole by Vietnam. Once this principle was accepted, it as a short leap to the conclusion that severe childhood trauma might have serious sequelae lasting into adulthood. . Colin A. Ross

The most chronic and complex of the dissociative disorders, multiple personality disorder, was renamed multiple personality disorder, was renamed 'dissociative identity disorder' in 1994 in DSM-IV (American Psychiatric Association). The rationale for the name change, was among other things, to clarify that there are not literally separate personalities in a person with dissociative identity disorder; 'personalities' was a historical term for the fragmented identity states that characterize the condition. Colin A. Ross

Beneath the surface of the protective parts of trauma survivors there exists an undamaged essence, a Self that is confident, curious, and calm, a Self that has been sheltered from destruction by the various protectors that have emerged in their efforts to ensure survival. Once those protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process . Unknown

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 Revision James A. Chu

Although it is important to be able to recognise and disclose symptom of physical illnesses or injury, you need to be more careful about revealing psychiatric symptoms. Unless you know that your doctor understands trauma symptoms, including dissociation, you are wise not to reveal too much. Too many medical professionals, including psychiatrists, believe that hearing voices is a sign of schizophrenia, that mood swings mean bipolar disorder which has to be medicated, and that depression requires electro-convulsive therapy if medication does not relieve it sufficiently. The “medical model” simply does not work for dissociation, and many treatments can do more harm than good.. You do not have to tell someone everything just because he is she is a doctor. However, if you have a therapist, even a psychiatrist, who does understand, you need to encourage your parts to be honest with that person. Then you can get appropriate help. . Alison Miller

The essential feature of the Dissociative Disorders is a disruption in the usually integrated functions of consciousness, memory, identity, or perception American Psychiatric Association

People with dissociative disorders are like actors trapped in a variety of roles. They have difficulty integrating their memories, their sense of identity and aspects of their consciousness into a continuous whole. They find many parts of their experience alien, as if belonging to someone else. They cannot remember or make sense of parts of their past. David Speigel

Amnesia, which is a loss of memory, is a symptom of many different trauma and/or dissociative disorders, including PTSD, Dissociative Fugue, Dissociative Disorder Not Otherwise Specified and Dissociative Identity Disorder. Amnesia can affect both implicit and explicit memory. Ruth A. Lanius

Dissociation is the common response of children to repetitive, overwhelming trauma and holds the untenable knowledge out of awareness. The losses and the emotions engendered by the assaults on soul and body cannot, however be held indefinitely. In the absence of effective restorative experiences, the reactions to trauma will find expression. As the child gets older, he will turn the rage in upon himself or act it out on others, else it all will turn into madness. . Judith Spencer

However, we have to acknowledge that living with DID presents huge challenges; it is complex and complicated. But our diagnosis was the key to us accessing services and funding, which has enabled us to return to life within the community and to have a positive future. We can see constructive, productive elements in our life, and our faith plays a strong part in this. Carol Broad

Dissociation appears to be... the internal mechanism by which terrorized people are silenced. Judith Lewis Herman

We can think of dissociation as psychological disconnection from one or more of three major spheres of experience: (a) the here and now, i.e., orientation to time and place; (b) other people, i.e., interpersonal communion; and (c) one’s own subjective experience, e.g., visceral sensation, physical pain, affect, or sense of identity. The various manifestations of pathological dissociation e.g., amnesia, depersonalization, identity fragmentation—can be understood as manifestations of these dimensions of disconnection. Steven N. Gold

Treating Abuse Today (Tat), 3(4), pp. 26-33Freyd: I see what you're saying but people in psychology don't have a uniform agreement on this issue of the depth of -- I guess the term that was used at the conference was -- "robust repression." T A T: Well, Pamela, there's a whole lot of evidence that people dissociate traumatic things. What's interesting to me is how the concept of "dissociation" is side-stepped in favor of "repression." I don't think it's as much about repression as it is about traumatic amnesia and dissociation. That has been documented in a variety of trauma survivors. Army psychiatrists in the Second World War, for instance, documented that following battles, many soldiers had amnesia for the battles. Often, the memories wouldn't break through until much later when they were in psychotherapy. Freyd: But I think I mentioned Dr. Loren Pankratz. He is a psychologist who was studying veterans for post-traumatic stress in a Veterans Administration Hospital in Portland. They found some people who were admitted to Veteran's hospitals for postrraumatic stress in Vietnam who didn't serve in Vietnam. They found at least one patient who was being treated who wasn't even a veteran. Without external validation, we just can't know --TAT: -- Well, we have external validation in some of our cases. Freyd: In this field you're going to find people who have all levels of belief, understanding, experience with the area of repression. As I said before it's not an area in which there's any kind of uniform agreement in the field. The full notion of repression has a meaning within a psychoanalytic framework and it's got a meaning to people in everyday use and everyday language. What there is evidence for is that any kind of memory is reconstructed and reinterpreted. It has not been shown to be anything else. Memories are reconstructed and reinterpreted from fragments. Some memories are true and some memories are confabulated and some are downright false. T A T: It is certainly possible for in offender to dissociate a memory. It's possible that some of the people who call you could have done or witnessed some of the things they've been accused of -- maybe in an alcoholic black-out or in a dissociative state -- and truly not remember. I think that's very possible. Freyd: I would say that virtually anything is possible. But when the stories include murdering babies and breeding babies and some of the rather bizarre things that come up, it's mighty puzzling. T A T: I've treated adults with dissociative disorders who were both victimized and victimizers. I've seen previously repressed memories of my clients' earlier sexual offenses coming back to them in therapy. You guys seem to be saying, be skeptical if the person claims to have forgotten previously, especially if it is about something horrible. Should we be equally skeptical if someone says "I'm remembering that I perpetrated and I didn't remember before. It's been repressed for years and now it's surfacing because of therapy." I ask you, should we have the same degree of skepticism for this type of delayed-memory that you have for the other kind? Freyd: Does that happen? T A T: Oh, yes. A lot. David L. Calof

Treating Abuse Today 3(4) pp. 26-33Freyd: The term "multiple personality" itself assumes that there is "single personality" and there is evidence that no one ever displays a single personality. T A T: The issue here is the extent of dissociation and amnesia and the extent to which these fragmentary aspects of personality can take executive control and control function. Sure, you and I have different parts to our mind, there's no doubt about that, but I don't lose time to mine they can't come out in the middle of a lecture and start acting 7 years old. I'm very much in the camp that says that we all are multi-minds, but the difference between you and me and a multiple is pretty tangible. Freyd: Those are clearly interesting questions, but that area and the clinical aspects of dissociation and multiple personalities is beyond anything the Foundation is actively.. T A T: That's a real problem. Let me tell you why that's a problem. Many of the people that have been alleged to have "false memory syndrome" have diagnosed dissociative disorders. It seems to me the fact that you don't talk about dissociative disorders is a little dishonest, since many people whose lives have been impacted by this movement are MPD or have a dissociative disorder. To say, "Well, we ONLY know about repression but not about dissociation or multiple personalities" seems irresponsible. Freyd: Be that as it may, some of the scientific issues with memory are clear. So if we can just stick with some things for a moment; one is that memories are reconstructed and reinterpreted no matter how long ago or recent. T A T: You weigh the recollected testimony of an alleged perpetrator more than the alleged victim's. You're saying, basically, if the parents deny it, that's another notch for disbelief. Freyd: If it's denied, certainly one would want to check things. It would have to be one of many factors that are weighed -- and that's the problem with these issues -- they are not black and white, they're very complicated issues. David L. Calof

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 Revision James A. Chu

Sadly, psychiatric training still includes far too little on the very serious psychiatric sequelae of childhood trauma, especially CSA [child sexual abuse]. There is inadequate recognition within mental health services of the prevalence and importance of Dissociative Disorders, sufferers of which are frequently misdiagnosed as Borderline Personality Disorder (BPD), or, in the cases of DID, schizophrenia. This is to some extent understandable as some of the features of DID appear superficially to mimic those of schizophrenia and/or Borderline Personality Disorder. Joan Coleman

There needs to be a nationwide awareness programme for all NHS staff, to educate them about dissociative disorders. Diagnoses need to be more obtainable within the NHS; people's lives should be placed ahead of funding restraints and bureaucratic red tape. We need minimum standards of care and treatment agreed and implemented within the NHS to end the current nightmare of the postcode lottery–not just guidelines that can be ignored but actual regulations. Carol Broad

Those with dissociative disorders face a big enough battle living as multiples and dealing with past trauma. Like everyone else, they deserve to be heard and recognised, not stigmatised. Carol Broad

The primary driver to pathological dissociation is attachment disorganization in early life: when that is followed by severe and repeated trauma, then a major disorder of structural dissociation is created (Lyons-Ruth, Dutra, Schuder, & Bianchi, 2006). Frank M. Corrigan

Dissociative Disorders have a high rate of responsiveness to therapy and that with proper treatment, their prognosis is quite good. Marlene Steinberg

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. Marlene Steinberg

Many people with Dissociative Disorders are very creative and used their creative capacities to help them cope with childhood trauma.p55 Marlene Steinberg

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. Marlene Steinberg

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). Marlene Steinberg

I cut myself up really badly with the lid of a tin can. They took me to the emergency room, but I couldn’t tell the doctor what I had done to cut myself– I didn’t have any memory of it. The ER doctor was convinced that dissociative identity disorder didn’t exist. . . . A lot of people involved in mental health tell you it doesn’t exist. Not that you don’t have it, but that it doesn’t exist. Unknown

Early identification of patients who suffer from dissociative symptoms and disorders is essential for successful treatment, because these disorders do not resolve spontaneously. In addition, dissociative disorders are not alleviated by treatment directed toward an intercurrent disorder. However, because the dissociative disorders are among the few psychiatric syndromes that appear to respond favorably to appropriate treatment (Spiegel, 1993), improved accuracy in differential diagnosis is critical. Marlene Steinberg

Early identification of patients who suffer from dissociative symptoms and disorders is essential for successful treatment, because these disorders do not resolve spontaneously. Marlene Steinberg

In the same way that the women's movement of the seventies and eighties brought rape and incest into public consciousness, we can do the same with the causes and reality of dissociation and multiplicity. Carolyn Spring

My own studies on the natural history of DID indicate only 20% of DID patients have an overt DID adaption on a chronic basis, and 14% of them deliberately disguise their manifestations of DID. Only 6% make their DID obvious on an ongoing basis. Eighty percent have windows of diagnosability when stressed or triggered by some significant event, interaction, situation or date. Therefore, 94% of DID patients show only mild or suggestive evidence of their conditions most of the time. Yet DID patients often will acknowledge that their personality systems are actively switching and/or far more active than it would appear on the surface (Loewenstein et al., 1987).R.P. Kluft (2009) A clinician's understanding of dissociation. pp 599-623. . Paul F. Dell

The lifetime prevalence of dissociative disorders among women in a general urban Turkish community was 18.3%, with 1.1% having DID (ar, Akyüz, & Doan, 2007). In a study of an Ethiopian rural community, the prevalence of dissociative rural community, the prevalence of dissociative disorders was 6.3%, and these disorders were as prevalent as mood disorders (6.2%), somatoform disorders (5.9%), and anxiety disorders (5.7%) (Awas, Kebede, & Alem, 1999). A similar prevalence of ICD-10 dissociative disorders (7.3%) was reported for a sample of psychiatric patients from Saudi Arabia (AbuMadini & Rahim, 2002). Paul H. Blaney

Dissociation is adaptive: it allows relatively normal functioning for the duration of the traumatic event and then leaves a large part of the personality unaffected by the trauma. Unknown

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

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. Marlene Steinberg

With respect to the acceptance of dissociative disorders, as with most issues in life, it is counterproductive to spend time trying to convince people of things they don't want to know. Warwick Middleton

A refusal on the part of psychiatrists and therapists to validate the horrors of their patients' tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable. Such a denial is, however, no longer ethical, for it is in the human capacity to dissociate that lies part of the secret of both childhood abuse and the horrors of the Nazi genocide, both forms of human violence so often carried out by 'respectable' men and women. Felicity De Zulueta

Denial is commonly found among persons with dissociative disorders. My favorite quotation from such a client is, "We are not multiple, we made it all up." I have heard this from several different clients. When I hear it, I politely inquire, "And who is we? Alison Miller

Some mental healthcare workers are aware of clients with high needs, such as dissociative disorders and personality disorders, who have histories of sexual abuse (contact offences), usually from early childhood, involving two or more adults acting together and multiple child victims (Gold et al., 1996; McClellan et al., 1995; Middleton & Butler, 1998). This has been defined as “organised abuse” (Bibby, 1996; La Fontaine, 1993). Excluded from this definition arecases where a child is sexually abused by multiple perpetrators who are unaware of one another, such as survival sex amongst homeless youths, or where abuse is limited to a single household or family and there are no extra-familial victims (La Fontaine, 1 . Michael Salter