Category: Dissociative Identity Disorder

Dissociative Identity Disorder (DID) has a long history, it was first discovered in 1791 when a woman was found to have both a French and a German personality. Many studies were completed between 1880 and 1920 and by 1944 it was reported that 67% of DID patients had been discovered. Dissociative identity disorder then fell off the radar as schizophrenia became increasingly diagnosed. There was a lack of focus on DID until the 1970’s when the book Sybil was released. The publication of this book led to an increased diagnosis of dissociative identity disorder and it is reported that in the 1970’s alone, more cases of DID were reported then all the cases documented since 1816. Furthermore, as more cases of DID came to light, more alternate personalities were also reported. The majority of DID cases in 1944 contained the manifestation of only 2 personalities, whereas in 1997 there was an average of 15.7 alters noted in the cases that were reported. It is now common for a patient to have between 8 and 13 alters, but there have been cases documented with more than 100 alters within one individual .

There are many famous cases of dissociative identity disorder, however, one of the most famous cases where the subject is still alive today is Karen Overhill. Her psychiatrist, Richard Baer’s account of treating Karen can be found in the novel Switching Time. Karen Overhill first discovered something was wrong when she woke up after the birth of her child unaware of who she was and her pregnancy. This led to her developing depression, which was the original reason for her seeing her psychiatrist. Throughout the novel we discover that Karen has suffered horrific abuse from multiple people in her life, both in her childhood and her adult life. She was abused physically by her husband and her father, who would often also leave her to die when she needed urgent medical care. She was also abused sexually by her father, grandfather, Grandma’s friend and by the cult her father took her too. These instances of abuse, specifically some of the sexual abuse she endured, was horrific and played a big part in the formation of her alters. An example is her alter Julie, who experienced intense pain in her legs to the point where she was unable to walk. It is later discovered that Julie was the dominant alter when Karen’s father lent her out to his friends for sex . Julie suffers from the intense pain and lack of ability to walk due to the weight of all the men on top of her. This depicts how an alter is affected by the environment of the person. The personalities helped Karen escape all forms of pain, while it was mostly the different forms of abuse, Karen was protected even from the simple things such as a headache. When forming a headache, she would often dissociate before becoming the dominant personality again once she no longer had a headache. While this did often help protect her, it was also dangerous. For example, she once stayed at her work for an entire day due to not feeling any pain, when in reality she needed an appendectomy. This portrays why it was so important for the alters to be in tune with each other.

Within Karen, as with most cases of DID, most alters had a specific role. Some examples are Holdon, a 34-year-old male, who was the protector that helped make decisions about which alter was allowed to be dominant; Katherine an older lady who helped organised Karen’s daily life and looked after the younger alters within Karen ; Julie who suffered the sexual abuse from her father’s friends; Miles who would become dominant when Karen was present at the cult and would help her keep the cult side of her life separate from her daily life; Jensen who was one of Karen’s earliest personalities and fought back against the abuse. He would often try to bind down Karen’s breasts to make her seem less feminine in an attempt to protect her from the sexual abuse . This illustrates how many of Karen’s alters had a role in attempting to protect her from all forms of abuse and from any events in her daily life that could be upsetting. Furthermore, each personality had distinct characteristics, ages, races and gaits, even the hand they wrote with altered with each personality. For example, 2-year-old Karen Boo was Hungarian, 5-year-old Sydney pathologically stole and 13-year-old Julie had Asthma.

Karen would sometimes get hint of the other personalities within her but wouldn’t be able to understand what she saw. The most common form of this was occasionally hearing voices in her head. Furthermore, she once had a dream were lots of people came to her and spoke before disappearing. Dr. Baer believed this to be her alters that she envisioned in a dream. Through time and patience Dr. Baer met all 17 personalities, even personalities such as Ann who had previously not been allowed to become dominant for over 19 years. Karen was treated as most people with dissociative identity disorder are. Each alter was made aware of each other in an attempt to ensure that she was not “losing time”. This allowed for Karen to live in harmony with her other alters and therefore she almost became a complete personality. As of April 1998, Karen Overhill has reportedly integrated all 17 of her personalities. Dr. Richard Baer stated that although her personalities have been integrated, she still has to continue her therapy and healthy lifestyle changers, which factor into the success of her treatments. She has not had a dissociative episode since April 1998.

When looking at Karen’s story we can determine that abuse has had a large part in in her DID. This conclusion can be made as many of her personalities have a role and become present during certain points of her abuse. Furthermore, some of her personalities have been affected permanently by the abuse, such as Jensen and Julie. This is because young children’s brains are less mature than adults and therefore, they are more susceptible to developing the disorder as their sense of self and personality are not yet cohesive . Furthermore, they are less able then adults to cope with and integrate traumatic experiences which can lead them to dissociate. This is especially relevant to children who live in a neglectful home as their parents will often not help them cope with difficult feelings and situations. This inability to discuss their trauma will lead to them dissociating to ensure that the child does not have to cope with the trauma. Therefore, a reasonable conclusion is that both the physical and the sexual abuse where the traumatic events that contributed to Karen’s DID.

It is important to note when referring to the book Switching Time, that the book was written by Karen’s psychiatrist and not Karen herself. This can influence the reliability with which you perceive the book. Some people may state that it is not completely reliable as Dr. Baer did not experience the dissociating and therefore, he may not accurately present it. Furthermore, he was unable to confirm whether the abuse was always accurate or whether it may have been exaggerated due to the young age (2 years) that Karen claimed she was when the abuse started. This is especially important when taking note that Karen was neglected by her mother and therefore, may have embellished some of the accounts as a form of attention. However, it is then also crucial to look at the counter part which states that her father was eventually jailed in 1993 on 19 accounts of sexual abuse. This ensure that there is more reliability that Karen truly was abused as her father had done it on many accounts. Furthermore, it is vital to note that at the young age Karen was it would have been incredibly hard for to imagine the trauma that occurred to her. A lot of the abuse described in the book was incredibly gruesome and specific. It would be hard for an adult to fabricate let alone for a young child. When looking at the data it is also imperative to understand that the book can also be viewed as more reliable coming from Dr. Baer. Baer was able to talk to Karen throughout her treatment. Even though if the book had been written by Karen it would have been written by the source, she would have not been in the right state of mind to fully understand what was occurring and to later write a book on the topic. This may have led to an unreliable account of Karen’s journey.

Another famous of case of dissociative identity disorder is Billy Milligan. Billy Milligan has become famous after being the first ever court case to plead insanity and win. Milligan was initially arrested on 3 accounts of mugging and rape. It would later be discovered that two different personalities had been in charge of this crime; Ragen Vadascovinich a Yugoslavian, and Adalana a lesbian who is lonely. It was Ragen, the protector and keeper of hate, who would initially attack the women. However, Adalana would then take over without Ragen’s permission and rape the women so that she was able to feel a sense of comfort and belonging. The sudden take over from Adalana led to her becoming an undesirable. Billy’s plea in court led to him seeing a psychiatrist who was able to interact with 10 of Billy’s personalities, the desirables. These interactions allowed him to win his case and from there he was taken to the Athens Mental Health Centre where he met Dr. David Caul. Dr. Caul was the first to see that Billy had more than 10 personalities. Billy ended up having 24 personalities; 10 desirable, 13 undesirables and the teacher. The teacher was the sum of all 23 personalities fused together. The teacher had almost a perfect recall of every event and allowed Billy to start recovery.

The next question is whether abuse was a contributing factor in Billy’s development of DID. David, who was eight and the keeper of pain, stated that Billy was sexually abused by his stepfather at the age of eight which led to the first ‘split’ in Billy’s personality and to the formation of David. However, this claim of abuse has been heavily scrutinized by many people and to this day we are unable to conclusively say that sexual abuse had occurred. Billy has been in and out of mental treatment throughout his life , whether this was due to the abuse or something else has never been stated.

It is important to look at the differences between Karen and Billy in the disorder. For example, the term undesirables was never mentioned in Karen’s accounts. In Karen’s case each personality was controlled by Holdon to ensure that they were as cohesive as possible. However, with Billy, Arthur was in charge and he had created the undesirables. The undesirables were 13 alters who Arthur stated would never become dominant again as they had undesirable traits. Furthermore, Karen accessed her personalities through a small cupboard which she viewed in her mind. Billy however, viewed it as having a spotlight in his head which all the personalities sat around, and the dominant alter at that time would be standing in the spotlight. This shows that dissociative identity disorder, like any mental illness, has different ways of displaying itself.

When analyzing Billy’s case, it is important to take into consideration that the book was written by an outside source who was not related to the case until they started writing the book. Therefore, some of the information inside the book may not be completely factual or reliable. Daniel Keyes, the author, does however explain in the preface how he has tried to maintain integrity within his work. Keyes ensured that when he spoke to Billy to understand his story, he spoke to the teacher who had a more collated memory. Keyes also accepted that there were people who believed that Billy truly did have dissociative identity disorder, and there were people who believed that Billy was an incredible con man who was willing to fake this disorder to escape prison. Therefore, Keyes tried to ensure that he spoke to as many people from both groups so that he would be able to form a well-rounded view of the situation. Additionally, Keyes approached Billy with an attitude of scepticism to ensure that he did not favour a certain side when writing his book.

Another famous case of dissociative identity disorder is the case of Chris Costner Sizemore. Chris Costner Sizemore remembers her first personality split at the age of two when she witnessed a man being pulled out of a ditch and thought he was dead . After witnessing that event and later witnessing a gory factory accident, Sizemore started acting strangely and would often be blamed for things that she had no memory of. The main difference between Sizemore and the other two cases of dissociative identity disorder, is that Sizemore never suffered any abuse and came from a loving family. Sizemore first sought help after the birth of her child when one of her personalities Eve Black tried to strangle the baby. It was only due to the alter Eve White stepping in that the baby was saved. She saw 8 different psychiatrists in a span of 25 years, during which time she developed a total of 22 alters. It was only in July 1974 that Sizemore was able to integrate all of her personalities to leave her with just one personality.

The book The Three Faces of Eve, which was later adapted into a movie, was written by Sizemore’s first doctor Thigpen and another doctor named Hervey M. Cleckley. The book states that Sizemore only had three personalities; Black Eve, White Eve and Jane, however we know this to be untrue. Therefore, we must question whether the rest of the account can be regarded as reliable. On the other hand, Sizemore herself stated that the movie adaption of the book was accurate in many ways. Sizemore praised the movie for its accuracy in 1977 and stated that the abrupt changes in personality were accurately presented even though it was an area of the movie that was often criticised by the media. Therefore, we can assume that there is an element of truth in the accounts.

Throughout all three cases, and most cases of dissociative identity disorder around the world, not all alters are aware of each other and the suffering they have experienced. Therefore, an important part of treatment is helping the patients find a way to merge all their personalities into one personality. This can be incredibly difficult and time-consuming as seen in Sizemore’s case where it took 8 years of therapy. A part of the therapy would be in ensuring that the alters felt safe. This is because many of the alters will have only truly suffered abuse and may not have been conscious when the patient escaped from the abuser, whether it was by running away, the abuser dying, or the abuser being locked up. This can be a massively influential part in them being able to relinquish control. For many of the alters, protecting the patient is their only goal. For example, in Karen Overhill some of the younger alters were still in fear of Karen’s father who had been locked up and this led to huge amounts of emotional distress. Therefore, helping each alter understand that they are safe is hugely important. It is also important, considering some alters can be harmful to themselves or others, that they are spoken to so that they are able to understand their reasoning for hurting themselves or others. The alters will be able to interact with one another through gradual assistance. This allows them to work cohesively and can be less frightening for those who are ‘losing time’ and don’t understand why.

Psychiatrists need to be considerate and understanding when treating a patient. Abuse is so often a factor in the development of dissociative identity disorder. It can often be incredibly gruesome accounts of this trauma during their childhood. Therefore, they must be treated gently so that personalities feel comfortable showing themselves and re-accounting these moments.

While abuse may not be influential factor throughout these three cases, childhood trauma is. It is believed that dissociative identity disorder is a form of PTSD, also known as post-traumatic stress disorder. Dissociative identity disorder is form of coping that usually occurs when the trauma transpires during their childhood, and they are not given the right tools by parents to cope with that trauma. The prevalence of a DID diagnosis increases among clients of counsellors who offer trauma-focused counselling which suggest that dissociation is often linked to traumatic experiences . It has been documented that the main form of trauma is abuse. A study showed that among those reported to have DID in the US, Canada and Europe, approximately 90% report a history of abuse during their childhood . From these reports of abuse in America, 71% of clients with DID have experienced childhood physical abuse and 74% have experienced sexual abuse. However, while it does seem to be a contributing factor, researchers have never investigated whether abuse was also a factor that contributed to other mental illnesses such as anxiety, eating disorders and other personality disorders . Therefore, while abuse may be a factor for dissociative identity disorder, we are still unable to conclude whether abuse is a factor that is truly linked to only dissociative identity disorder or whether it is generally detrimental to someone’s mental health. Furthermore, we cannot always be certain that the abuse that is stated in cases truly occurred, or even that the disorder is truly present in certain patients. For example, a famous case of DID that turned out to be a lie was Sybil. Sybil, who is really called Shirley Mason, initially sought psychiatric help as she was emotionally unstable . However, she then became attached to her psychiatrist Dr Connie Wilbur who had an interest in dissociative identity disorder. Due to this attachment Shirley started faking having multiple personalities by changing voices and posture. After that Dr. Wilbur had started spending more time with Shirley whether in therapy or having dinner with her. Shirley eventually tried to set the record straight and sent out an email saying that she had lied about the personalities. This case has become famous due to the extent of the lie that occurred, and it has caused many people to question whether dissociative identity disorder is real or whether it is just a “fad” that allows people to get away with crime, or helps them become famous.

Introduction

Psychology is the academic discipline dealing with the study of human behaviour and mental functions (Burton, 2010). As such, psychologists are described as social or cognitive scientists. The scientists and professionals explore human characters, such as perception, emotions, and personality. The aim of such exploration is to assess and treat psychological disorders.

Numerous studies have been conducted in the past to try and explain why people act and behave the way they do. Information gathered from such analyses is taken into consideration when making decisions in many contemporary organisations (Barlow & Durand, 2011).

Organisations that use such information in their operations include the government and private companies and corporations. The information is especially important when hiring personnel. Individual’s psychological information helps other people in making informed decisions when dealing with the individual. The information can also be used in assigning work to the individual.

Dissociative Identity Disorder (herein referred to as DID) and Post Traumatic Stress Disorder (herein referred to as PTSD) are classified as mental disorders. The two have formed the basis of research for many psychologists. The psychologists have made efforts to identify the root causes, treatment, and diagnostic procedures associated with the conditions. According to Dr. Brad Wright (and as cited in Farrell, 2011), the two conditions are significantly different from each other.

Post traumatic stress disorder develops when an individual is exposed to any form of psychological trauma. Dissociative identity disorder is known by several other names. One of them is “Multiple Personality Disorder”. The condition is associated with individuals who exhibit two distinct personalities. It is characterised by forgetfulness or amnesia (Shettleworth, 2010).

In this essay, the author will analyse the two conditions, comparing and contrasting their various aspects. The author will focus on the similarities and differences between the conditions’ etiology, diagnosis, and treatment.

The Etiology of DID and PTSD: A Comparison

Etiology of DID

Etiology is the study of the origin and cause of a given phenomenon (Overskeid, 2007). It is commonly used in medicine to determine why and how things take place. The concept aims at providing a mythical explanation for a certain condition or phenomenon.

Over the years, many researchers and philosophers have come up with various possible causes of dissociative identity disorder. However, most are in agreement that the disorder is brought about by maladjusted reactions to trauma. Such trauma is in most cases linked to childhood physical and sexual abuse (Hergenhahn, 2005). Most individuals suffering from this disorder had a traumatic experience in their childhood.

Neglect and lack of parental care are largely associated with the disorder. Individuals exposed to extreme physical abuse in the past tend to be violent and brutal in later life. Psychologists associate this phenomenon with attempts by individuals to forget their past miseries. The failure to forget leads to frustration, which is expressed through acts of violence and brutality.

Individuals who were exposed to acts of violence in the past are likely to try and expose others to similar conditions. The attempt explains the rising cases of violence in the society. Research has shown that criminals suffering from dissociative identity disorder expose their victims to ordeals that are similar to those they were exposed to in the past.

Such developments give rise to a cycle of crime and violence, which turns victims into offenders. Self destructive behaviours have also been identified as possible causes of the disorder (Pinel, 2010). Individuals exhibiting such traits tend to be violent towards themselves and towards others.

Etiology of PTSD

Post traumatic stress disorder develops after an individual is exposed to an event associated with intense fear, horror, and a sense of helplessness (Reisner, 2005). However, psychologists have identified other possible causes of post traumatic stress disorder. They include past life experiences and inherited traits, such as individual personality. Individuals who had traumatic experiences in their past make the bulk of patients diagnosed with this disorder.

Personality aspects that may influence the individual’s susceptibility to the disorder include, among others, temperament and ability to deal with stress. Regulation of hormones and such other chemicals as adrenaline by the brain is also associated with the condition.

Exposure to risk factors is another possible cause of post traumatic stress disorder. Such exposure explains why many soldiers and people living in war torn areas are more likely to suffer from post traumatic stress disorder compared to other individuals.

There are several similarities between the etiologies of the two psychological disorders. For example, both conditions are associated with past traumatic experiences. Individuals suffering from either of the two conditions are likely to have witnessed traumatic events in their life (Carver & Scheier, 2004). Individuals react variously to such traumatic events.

As a result of this, some of the individuals exposed to the traumatic events may fail to develop the condition. For example, those suffering from dissociative identity disorder are violent towards other people. On the other hand, those suffering from post traumatic stress disorder live in perpetual fear of being abused or experiencing the traumatic events again.

Diagnosing DID and PTSD: A Comparison

Overview

In most cases, individuals suffering from these disorders are unaware of their condition. It is also hard for family members and the society at large to diagnose the disorders. The inability to diagnose is attributed to the fact that the effects of these disorders are mainly psychological.

As such, it is not easy to point out the characteristics. The case is different for other disorders, whose effects are expressed physically (Gelder & Geddes, 2005). In most cases, the individual is not aware of their condition when they seek medical assistance.

Diagnosing DID

To diagnose dissociative identity disorder, the psychologist needs to conduct a thorough psychological examination of the patient. A medical examination is necessary to determine whether the patient has any physical disorders that may explain their symptoms (Glaser & Strauss, 2005).

Examinations are carried out through oral interviews or questionnaires prepared in advance. Hypnosis or drugs are also used to make it easy for the patient to reveal personal information to the doctor (Barlow & Durand, 2011).

In most cases, patients complain of amnesia. The individual is unable to remember events that took place within a particular period of time. They also suffer from memory loss. In extreme cases, the patient may forget about close friends and family members. The individuals are depressed and may exhibit suicidal tendencies in extreme cases (Ron, 2008). In addition, some patients diagnosed with dissociative identity disorder complain of either audio or visual hallucinations.

Diagnosing PTSD

To diagnose post traumatic stress disorder, the professional needs to take into consideration the signs and symptoms exhibited by the individual. Patients are asked to explain their signs and symptoms. They try to explain what the signs are, the time they occur, and their intensity (Reinders, 2008). Individuals are also required to narrate the events preceding the symptoms. A patient has to meet a set of pre-defined criteria before the professional comes to a conclusion.

Diagnosing post traumatic stress disorder and dissociative personality disorder calls for a series of psychological and medical assessments. Assessments are carried out orally or through the use of a questionnaire. Examinations to check for other medical problems are carried out to ensure that the correct diagnosis is made (Boysen, 2011).

Treating DID and PTSD: A Comparison

Treating DID calls for the combination of various states of personality (Stern, 2012). Interaction between the different personalities helps the person to function normally. Drug therapy is used to relieve such symptoms as fear, anxiety, and depression.

Psychotherapy is considered as emotionally painful. Individuals undergoing therapy experience emotional crises especially when recalling traumatic memories during therapy sessions. Hypnosis is also applied in therapy. Therapy sessions take place over a long period of time, usually over 3 to 6 years. Individuals are treated for other serious health problems that are exhibited, such as drug and substance abuse.

Treating PTSD aims at helping individuals gain control over their own life. Individuals suffering from the disorder are advised to accept their condition. They are also empowered to cope with stress and such other phenomena. Unlike dissociative personality disorder, treating post traumatic stress disorder requires a combination of drug therapy and psychotherapy.

There are various forms of drugs administered to those suffering from the disorder. They include antipsychotics, antidepressants, and prazosin (Spiegel, 2006). Each of these drugs has a particular function.

In psychotherapy, various interventions are used. The interventions include cognitive therapy, which involves empowering the individual to perceive things accurately to reduce trauma. Cognitive therapy is used together with other interventions, such as exposure therapy.

The latter encourages the patient to face or confront the situations that scare them the most (Ross, 2009). Other interventions, such as eye movement desensitisation and reprocessing therapy, help the individuals in processing traumatic memories.

There are obvious similarities between the treatment procedures for the two disorders. In both cases, the doctor attending to the patient aims at reducing the effects of the trauma (Farrell, 2011). In addition, treating the two conditions involves psychotherapy. A close relationship between the patient and the doctor in-charge must be maintained. The aim here is to increase the efficiency of the therapy sessions.

Conclusion

Psychology is a field of study dealing with human behaviour and brain functions. The discipline involves the assessment of such human characteristics as perceptions and emotions in efforts to explain individual actions (Singh & Chakrabarti, 2008). Psychology has helped in diagnosing and treating various mental disorders, among them post traumatic stress disorder and dissociative identity disorder.

Many people suggest that DID and PTSD are the same. However, significant disparities exist between the two with regard to etiology, diagnosis, and treatment. But there are also similarities between the two conditions. For example, the two disorders are associated with past traumatic experiences.

References

Barlow, D. H., & Durand, V. M. (2011). Abnormal psychology: An integrative approach (6th ed.). Belmont, CA: Wadsworth Cengage Learning.

Boysen, G. (2011). The scientific status of childhood dissociative identity disorder: A review of published research. Psychotherapy and Psychosomatics, 80(6), 329-34.

Burton, L. (2010). An interactive approach to writing essays and research reports in psychology. Queensland, Australia: John Wiley and Sons.

Carver, C., & Scheier, M. (2004). Perspectives on personality. Boston, USA: Pearson.

Farrell, H. (2011). Dissociative identity disorder: Medicolegal challenges. The Journal of the American Academy of Psychiatry and the Law, 39(3), 402–406.

Gelder, M., & Geddes, A. (2005). Psychiatry. New York, USA: Oxford University Press.

Glaser, B., & Strauss, A. (2005). The discovery of grounded theory: Strategies for qualitative research. Chicago, USA: Aldine.

Hergenhahn, B. (2005). An introduction to the history of psychology. Belmont, USA: Thomson Wadsworth.

Overskeid, G. (2007). Looking for Skinner and finding Freud. American Psychologist, 62(6), 590–595.

Pinel, J. (2010). Biopsychology. New York, USA: Prentice Hall.

Reinders, A. (2008). Cross-examining dissociative identity disorder: Neuroimaging and etiology on trial. Neurocase, 14(1), 44–53.

Reisner, A. (2005). The common factors, empirically validated treatments, and recovery models of therapeutic change. The Psychological Record, 55(3), 377–400.

Ron, S. (2008). The Cambridge handbook of computational psychology. New York, USA: Cambridge University Press.

Ross, C. (2009). Errors of logic and scholarship concerning dissociative identity disorder. Journal of Child Sexual Abuse, 18(2), 221–231.

Shettleworth, S. (2010). Cognition, evolution and behaviour. New York, USA: Oxford University Press.

Singh, S., & Chakrabarti, S. (2008). A study in dualism: The strange case of Dr. Jekyll and Mr. Hyde. Indian Journal of Psychiatry, 50(3), 221–223.

Spiegel, D. (2006). Recognizing traumatic dissociation. American Journal of Psychiatry, 163(4), 566–568.

Stern, D. (2012). Witnessing across time: Accessing the present from the past and the past from the present. The Psychoanalytic Quarterly, 80(1), 53–81.

Introduction

This essay explores dissociative disorders as forms of abnormal psychology and abnormal behavior with specific reference to the case of Anna O. These disorders entail abrupt distraction or changes in generally integrated functions of perception. The conditions are not common, and they are prone to faking in some cases. There are several subcategories of dissociative disorders. These conditions affect memory function, sense of identity, cause conflicting or competing personalities, and distort a sense of reality temporarily. Some of these abnormal psychology disorders and abnormal behaviors are not easy to diagnose because they do not have clear symptoms (Hansell & Damour, 2008). Sleep disorders also involve a changed in a state of consciousness, but not as severe as cases of dissociative disorders. Multiple personality disorder (MPD) or Dissociative Identity Disorder is an intense type of dissociative disorders. Most cases occur among women, there are few documented cases, which occurred after several years.

A Brief Overview Of The Case Of Anna O

Anna O was a patient of Breuer (Meyer, Chapman & Weaver, 2009). She first visited a doctor because of a persistent cough, but Breuer used hypnosis to elicit memory and reconstruct the past. He focused on the client’s reaction to her childhood experiences and caring for her father to understand her distress.

Anna had problems with her vision, hearing, headaches, neck weakness, and anesthesia on her limbs. She was mute and thereafter showed two different personalities, which changed without any warning.

Anna was “melancholic, experienced unconsciousness, mood swings, and potential hallucinations” (Meyer, Chapman & Weaver, 2009). Anna’s second personality presented antisocial qualities characterized by abuse and odd, rebellious behaviors.

After the death of Anna’s father, only Breuer was close to her. The patient would be sleepy during the day, then the therapist would mesmerize her or conduct autohypnosis for the day’s events.

The patient’s situation deteriorated and she developed suicidal tendencies. Breuer had to implore his patient in order to address the condition. Anna claimed that she could not recognize Breuer visually. She got better and attributed the recovery to ‘talking cure’.

Anna had altered personalities, and Breuer tested this by using oranges, which was the only food she wanted. Anna avoided water for six weeks. Breuer recognized Anna’s healing process as catharsis. Anna released her repressed feelings during hypnosis. Symptoms reappeared but were relieved through insights and ‘working through’.

Several symptoms disappeared as Anna experienced ‘disagreeable event’.

Anna became addicted to morphine because of ‘time missing’, loss of consciousness, and her inability to speak German. Five years after therapy, the patient displayed two distinct individuality traits.

Anna could have been sexually abused while her mother abused her emotionally, but she did eventually recover and spearheaded the rights of women.

Anna’s Disorder

Although causes of MPD remain vague, studies show that a combination of biological and environmental factors could be responsible for it (Kendler et al., 2008). Anna had a parent who was severely disturbed. She also had histories of contradictory personalities, distress, and cough during sensitive periods of her developmental stages.

Her mother emotionally abused her. In addition, the girl’s family and surrounding society stifled her attempts to be independent. Anna had unstable moods. She exhibited antisocial behaviors accompanied by abusive tendencies. After her father’s death, the client could not identify anybody except for her therapist. For example, she could only eat if fed by Breuer. In some cases, Anna appeared emotionally stable, and she would not respond to Breuer’s talks. She could only respond after establishing that it was Breuer by touching his hands.

Anna had strange conscious gaps and changes in perceptions, which defined her cognitive abilities. Although she was intelligent and curious, the girl developed suicidal tendencies and dramatic shifts in personalities. She also expressed potential cases of hallucinations. Anna informed Breuer that she was pregnant while indeed she was not. Freud later attributed this to sexual attraction between Anna and Breuer.

Anna’s behaviors continued to be odd, naughty, antisocial, abusive, and rebellious. She became somnolent and would only talk to Breuer at specific times. Anna had mood swings, which controlled her behaviors toward others. The client did not drink water for several weeks and would only eat oranges as her main food.

Conclusion

This essay has explored Multiple personality disorder (MPD) or Dissociative Identity Disorder with specific reference to the case of Anna O. It shows that MPD and other disorders are not common conditions and could be extremely difficult to diagnose.

Individuals with Dissociative Identity Disorder have two competing personalities. They experience breakdowns in consciousness, aggression, mood swings, abusive toward others, antisocial behaviors, hallucinations, and suicidal tendencies among others. The condition results from both genetic and environmental causes, including severe past experiences, emotional and sexual abuse.

Breuer used catharsis (emotional release) to treat Anna by engaging in hypnosis or autohypnosis to elicit repressed childhood experiences. Hypnosis helps patients to dissociate and transit to a favorable personality in a managed manner. Therapists also use fusion to help clients reconcile conflicting personalities and behaviors. In some cases, therapists use antipsychotic drug in managing the condition, but outcomes have limited success. In addition, there are also anti-anxiety medications for extreme cases and stress.

References

Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: John Wiley & Sons, Inc.

Kendler, K., Aggen, S., Czajkowski, N., Røysamb, E., Tambs, K., Torgersen, S.,… Reichborn-Kjennerud, T. (2008). The Structure of Genetic and Environmental Risk Factors for DSM-IV Personality Disorders. Arch Gen Psychiatry, 65(12), 1438–1446. Web.

Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case studies in abnormal behavior (8th ed.). Boston, MA: Allyn & Bacon/Person Education Inc.

Abstract

Psychopathological disorders are not as common as other forms of illnesses. In this analysis, I will look at the nature of Dissociative identity disorder with a special analysis of the movie Sybil.

Dissociative identity disorder is a mental condition in which a person suffering from it experiences two or more different identities or personalities. In each of these personalities, the person usually has different patterns of perceiving information as well as interacting with the surrounding environment. In addition to this, the disorder involves abnormal memory loss. This abnormal memory loss is commonly referred to as acute Dissociative disorder

Introduction

Psychopathology is a medical or scientific term that refers to mental distresses or mental illnesses. In another context, the term can be used to refer to the manifestation of characteristic behaviors and or experiences that are usually indicative of psychological impairment or mental illnesses.

In the context of this paper, I will look at one movie and or book that have a psychological theme. In addition, I will analyze the plot as well as the characteristic features of the disease and how it is analyzed or dramatized in the movie/book.

Analysis: Book/Movie Review

Sybil

The movie Sybil analyzes the life of a person living with Dissociative Identity Disorder. The movie revolves around the true life of Shirley Ardell mason. Shirley was born in 1923 and died in 1998. She was a psychiatric patient, although she was a commercial artist. Shirley’s life was documented in a book by the name Sybil and later it was made a movie under the same name.

The book was written by Floria Schreiber and was published in 1973. The movie by the same name was adopted in 1976. The book and movie, in order to protect mason’s privacy and identity, used the name, Sybil Isabel Dorsett.

The movie starred sally field (Sybil Dorsett), Joanne Woodward (Doctor Cornelia Wilbur), brad Davis (Richard Loomis) amongst others. The movie was directed by Daniel Petrie and was nominated for the globe awards.

The plot outline of the movie reveals the true story of a beautiful young woman, Sybil Dorsett. Dorset’s childhood upbringing was so traumatizing, to a point that she developed more than twelve different personalities.

For purposes of this paper I, will look analyze the movie and point out the key issues of Dissociative identity disorder (formerly multiple personality disorder). In this analysis, I will also look at the issue of whether the disorder really exists or it is just a medical creation.

Shirley Mason was born and brought up in Dodge Centre, Minnesota. Within the early years of the 1950s, she was a teacher and a student at Columbia University. Mason had suffered for a long time from blackouts and emotional breakdowns. After this lengthy suffering, she finally entered psychotherapy under the guidance of Doctor Cornelia B. Wilbur. Doctor Wilbur was a Freudian psychiatrist. Shirley’s sessions under Wilbur are the core basis of the book and movie.

The book and movie made the implication that Shirley suffered from Dissociative identity disorder as a result of several incidences of sexual abuse from her mother who unfortunately is speculated to have been suffering from schizophrenia. Schizophrenia lies on axis one on clinical disorders. It is classified in the field of schizophrenia and other psychotic disorders.

Schizophrenia is a psychiatric or medical diagnosis that describes a mental illness that is usually characterized by perception or expression of reality impairments. In most cases, schizophrenia manifests itself as aural hallucinations, bizarre or paranoid delusions. It also manifests itself in the form of disorganized thinking and speech coordination problems. There are no laboratory tests that are currently available to test for schizophrenia.

Shirley’s parents were Mr. Walter Mason and Martha Hageman Mason. Shirley underwent treatment for eleven years after which she was well adjusted to living in the society. After the publication of the book, Shirley moved to Lexington.

Comparison With Other Psychopathological Illnesses

Mental disorders vary depending on the time of diagnosis and or the cause of the disorder. This is why diagnostic systems like DSM are used in order to facilitate the level of communication between professionals as well as standardizing the criteria for diagnosis.

In this movie, Daniel Petrie takes us through real-life aspects of personality disorders to their fullest. By introducing a mix of schizophrenia, suffered by Sybil’s mother, and the Dissociative identity disorder that Sybil suffered.

In addition to this Sally Field provides an awesome award-winning performance when she plays Sybil, a disturbed woman who is suffering from a multiple personality disorder. Since Sybil was living alone in an apartment, she was tormented by numerous flashbacks and disturbing visions of her painful childhood. Since she was unable to live a normal life, Sybil met Doctor. Wilbur (Joanne Woodward). Dr. Wilbur was a kind-hearted psychiatrist who ended up being extremely dedicated to help Sybil heal the wounds that were haunting her. Dr. Wilbur was able to diagnose the 16 different personalities that Sybil was suffering from.

Conclusion

The Dissociative identity disorder, that Shirley is believed to have suffered from is not very common. Regardless of this fact, issues arose after the publication of the book that indeed mason never suffered from the disorder; rather it was a deal between her and doctor Wilbur to seal a book deal.

Although there are claims of sexual abuse these claims are rather hard to verify. Recent interviews with some of Shirley’s former friends have revealed that indeed she had an unusual relationship with her mother. On the other side of the story, if indeed Shirley’s mother was indeed schizophrenic, this then complicates issues further.

On the other hand, Schizophrenia, as a mental disorder is very hard to detect. This is because not unless it is detected by people or the person suffering from it tells about it, it can never be detected. John Nash’s decision to deal with the disorder, with the help of his wife is a great motivation to people living with the disease. Although the prevalence of the disease is quite small, it is necessary for the wider public to accept and help people living with the disorder.

References

Flora, Schreiber. (1973). University of Michigan: Michigan. Web.

Keen, M. (1999). Schizophrenia: orthodoxy & heresies. A review of alternative possibilities. Journal of Psychiatric and Mental Health Nursing. 3(2).

Sims, A. (2002). Symptoms in the Mind: Introduction to Descriptive Psychopathology. London: Elsevier Sybil: internet movie database. Web.