Treatment

“As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on ... It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make sense of it.”

― Deborah Bray Haddock, The Dissociative Identity Disorder Sourcebook

DID Research

Treatment

 

Individuals with dissociative identity disorder (DID) are in therapy for an average of ten years before they are diagnosed and spend an additional average of ten years in therapy for their DID. Patients with DID may benefit from some combination of: talk and behavioral therapies including cognitive behavioral therapy and dialectic behavior therapy; art, music, and play therapy; eye movement desensitization and reprocessing; family therapy; medication. Hypnotherapy is inappropriate for patients with DID because hypnosis risks strengthening the dissociative barriers between alters, changing or falsifying memories, flooding the patient with flashbacks, and invalidating the individual’s testimony in court. Details about specific treatments for DID can be found here.

 

Some individuals with DID choose to integrate, or assimilate all of their alters into one personality, but others choose cooperation and communication instead. Many find the idea of integration difficult to swallow, find integration unnecessary after posttraumatic stress disorder (PTSD) symptoms have been treated and co-consciousness has been achieved, or find it impossible to integrate all of their parts or cannot maintain one integrated personality over time or when faced with stress. Some question if integration is even permanently possible, and many therapists are less insistent on integration as the only possible treatment for DID as many were in the past. However, even individuals with DID who are vocal about their desire not to integrate are likely to spontaneously integrate some alters and fragments as they process and heal, some individuals who are integrated are convinced that integration is the best option, and some studies (such as this one) do suggest that integration is the option most likely to result in long-term stability and healing.

 

Full integration requires accepting one's alters, accepting and processing one's trauma history, and owning all thoughts, feelings, memories, urges, skills, etc that were previously assigned to various parts of the self. Integration is complete when there are no subjective differences between the parts involved. For deliberate integration of more developed alters, the remaining identity is not meant to be any of the parts involved in the integration but a more well rounded and stable part or individual who to some degree contains and owns all of the conflicting aspects that the parts involved contained before merging. However, when integration involves one alter who is significantly more well developed than the other alters or fragments involved, the result may be that the more developed alters feels only that they have gained some of the skills, traits, preferences, or views of the other parts involved, if that.

Resources on Integration Versus Cooperation

 

Here is an article by an individual with DID who wants to integrate. It details the difference between wanting alters to disappear (which is impossible) and accepting them fully (which is necessary for integration).

 

Here is an article by an individual who had DID and chose to integrate. It details what integration is and why the author views it as the best goal for healing.

 

Here is a blog post from a therapist who specializes in trauma and dissociation and who believes that integration is neither necessary nor always helpful.

"Dissociating feels like building a jig-saw puzzle and you're missing a piece. It bothers you that the picture will never be complete despite how hard you try to look at it. The best thing to do is focus on how beautiful that incomplete picture can be."

-Alpha

“I believe the perception of what people think about DID is I might be crazy, unstable, and low functioning. After my diagnosis, I took a risk by sharing my story with a few friends. It was quite upsetting to lose a long term relationship with a friend because she could not accept my diagnosis. But it spurred me to take action. I wanted people to be informed that anyone can have DID and achieve highly functioning lives. I was successful in a career, I was married with children, and very active in numerous activities. I was highly functioning because I could dissociate the trauma from my life through my alters. Essentially, I survived because of DID. That's not to say I didn't fall down along the way. There were long term therapy visits, and plenty of hospitalizations for depression, medication adjustments, and suicide attempts. After a year, it became evident I was truly a patient with the diagnosis of DID from my therapist and psychiatrist. I had two choices.

 

First, I could accept it and make choices about how I was going to deal with it. My therapist told me when faced with DID, a patient can learn to live with the live with the alters and make them part of one's life. Or, perhaps, the patient would like to have the alters integrate into one person, the host, so there are no more alters. Everyone is different.

 

The patient and the therapist need to decide which is best for the patient. Secondly, the other choice was to resist having alters all together and be miserable, stuck in an existence that would continue to be crippling. Most people with DID are cognizant something is not right with themselves even if they are not properly diagnosed. My therapist was trustworthy, honest, and compassionate. Never for a moment did I believe she would steer me in the wrong direction. With her help and guidance, I chose to learn and understand my disorder. It was a turning point.”

 

― Esmay T. Parker, A Shimmer of Hope