# dissociative identity disorder and DP



## nav (Mar 30, 2015)

Okay this may sound really insane. I don't have enough knowledge on the topic so this may be wild. forgive me in advance.

But I've heard according to DSM both are types of dissociation. So could DP/DR be like a mild form of DID (dissociative identity disorder)? Or could DP/DR develop into DID???

I know the answer is probably no but just curious....


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## Guest (Apr 6, 2015)

There's no chance DPD can morph into DID as an adult or teenager. DID is developed before the age of 5 or 6 as a result of a desperate attempt to protect oneself.

However, it can remain hidden for decades, even from the person who has it. In most cases it's very hard to detect until things go wrong and the system can't cope anymore.

Hope that's not too confusing?


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## inferentialpolice (Nov 26, 2012)

Nav, there likely isn't anyone that is full D.I.D. who doesn't experience DP, so your question is better rephrased as, "I have noted DP symptoms, but is that the only dissociative symptom I evidence, or do I have additional symptoms that would be suggestive of a dissociative disorder further along the spectrum?" Those docs that assess ONLY for DP are missing making inquiry of these other symptoms, and thus I suspect many on this DP list with DPD diagnoses have additonal symptoms of DDNOS or DID, with DP being only a part of their symptom complex. I was chatting with a fellow on this list recently who acknowledged memory gaps for biographical information, so extensive that his friends commonly have to remind him of where they'd been together or what he said to them. This is a classic symptom of dissociative amnesia, a 2nd manifestation which ,along with DP, DR, and two other symptom groups, point to DDNOS or DID.


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## *Dreamer* (Feb 18, 2014)

All DP and DR, are feeling AS IF one is disconnected from one's body and AS IF the world seems unreal. Both of these are feelings/perceptions. Neither of these symptoms comes with amnesia for events.

There is some question if DP and DR should even remain in the DIssociative Disorder category. As I have said many times -- if you read the research, and the diagnostic criteria, DP and DR can come with many mental illnesses and brain disorders (migraine, stroke, severe brain trauma, epilepsy, etc.)

The criteria for the Dissociative Disorders has always been debated as many categories have been. I see nothing to indicate that DP/DR is on a spectrum with the other dissociative disorders.

The disorders which* specificall*y note AMNESIA (missing large periods of the time) in daily activities are:
1. Dissociative Amnesia -- which now includes Dissociative Fugue

2. DID -- Dissociative Identity Disorder (which used to be MPD)

And then there is DDNOS, which to this day has not been fully explained.

I know one individual who has DID and she does not have DP/DR. She does not know what DP/DR is. The main thing that happens to her is example:
She will be at work. She will have an appointment to go to 30 minutes away. She will recall leaving her office (going down the elevator). The next thing she remembers is standing in the waiting room at her appointment.

I also know one young woman who has fugue states. She can leave her house in the morning, and in the late afternoon "wake up" finding herself 10 miles away, walking down a street. This woman does not understand what DP/DR are either.

BOTH of these conditions are considered rare.

DP/DR is far more common.
To the best of my research, there is nothing to indicate that DP/DR will "become" DID.

Also, DP/DR can be associated wtih PTSD and acute stress disorder and panic attacks. If so, IMHO I feel DP/DR should be in the Anxiety Disorders category, not dissociative as we do not have amnesia.

MPD was always seen as VERY rare. There was a surge of diagnoses in the 1970s/1908s -- but they all seemed to involve women (who had over 10 personalities/alters a piece, and upwards of 100) ... and also women in North America. The alters were recognized as being encouraged by doctors --many who were sued. The name then changed to DID.

In the ICD ... I think DP/DR is in its own category ... something like "depersonalization neurosis" -- which makes no sense.

These disorders are not understood.

Bottom line, I don't think we should consider DP/DR on a spectrum of all the dissociative disorders. And it seems to me you don't "start out" with DP/DR then move on to DID. And again, DID is actually very rare per current statistics.

Read Sierra, Loftus, etc.


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## *Dreamer* (Feb 18, 2014)

inferentialpolice said:


> Nav, there likely isn't anyone that is full D.I.D. who doesn't experience DP


To the best of my understanding this is not true. The one individual I know who has "blackouts for time" in her daily life and would be called DID does not even know what DP/DR is. We've talked about this a lot. If you even look back at the famous stories of DID/MPD -- such as Sybil, etc. -- Sybil (Shriley Mason) never experienced DP/DR. She also indicated that she "became" other people to please her doctor. Very complicated and controversial.

As noted, many doctors were sued in the 1980s/1990s for creating alter personalities. Patients recanted. They also didn't talk aobut DP/DR.

There is a theory that DID could be a form of Borderline Personality ... but I honestly don't know if that is true.

The Dissociative Disorders are very poorly understood.


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## inferentialpolice (Nov 26, 2012)

Dreamer, I believe you are incorrect -- the studies *that make the effort* to assess those with dissociative disorders for DP *in the context* of their greater dissociative condition have shown that those with DID have severe levels of DP. You can see this in the basic papers establishing the diagnostic interview for dissociative disorders, with those papers available for download here:

http://ge.tt/40rP13s1?c

In those papers, note the "profile" of those with DID, and you will see that they have pathological levels (moderate to severe) of dissociative amnesia, DP, DR, identity confusion, and identity alteration.

In fact, if you want to learn about how dissociative disorders are underlying many external manifestations (eg, bi-polar, schiz, etc), then take a look at the entire SCID-D training handout at:

http://ge.tt/8BWdn2s1


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## Guest (Apr 9, 2015)

*Dreamer* said:


> All DP and DR, are feeling AS IF one is disconnected from one's body and AS IF the world seems unreal. Both of these are feelings/perceptions. Neither of these symptoms comes with amnesia for events.
> 
> There is some question if DP and DR should even remain in the DIssociative Disorder category. As I have said many times -- if you read the research, and the diagnostic criteria, DP and DR can come with many mental illnesses and brain disorders (migraine, stroke, severe brain trauma, epilepsy, etc.)
> 
> ...


Strange.


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## Guest (Apr 9, 2015)

*Dreamer* said:


> To the best of my understanding this is not true. The one individual I know who has "blackouts for time" in her daily life and would be called DID does not even know what DP/DR is. We've talked about this a lot. If you even look back at the famous stories of DID/MPD -- such as Sybil, etc. -- Sybil (Shriley Mason) never experienced DP/DR. She also indicated that she "became" other people to please her doctor. Very complicated and controversial.
> 
> As noted, many doctors were sued in the 1980s/1990s for creating alter personalities. Patients recanted. They also didn't talk aobut DP/DR.
> 
> ...


Stranger..


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## *Dreamer* (Feb 18, 2014)

Zed, not sure why this is strange.
If you look at Dr. Sierra's Medical Text Book, "Depersonalizaion: A New Look At A Neglected Syndrome" -- DP/DR -- viewed as a syndrome unto itself is not seen as on a spectrum of MPD/DID. Sierra mentions on one page in his book on page 79 that DP/DR are symptoms of all the dissociative disorders per certain studies.

The problem is, DID in particular is associated with Borderline Personality Disorder ... it may actually BE a form of BPD. Literally, before 1960s? I think there were 3 cases of MPD on record. After the films "The Three Faces of Eve" and "Sybil" the diagnoses went up to 40,000 cases in women in North America. So did the diagnosis of False Memory Syndrome of Satanic Ritual abuse -- these cases exploded in number -- fueled essentially by the extreme popularity of the books and movies "Three Faces of Eve" and "Sybil."

I am not saying that DID is not "something" we don't understand, and yet, the ISSMPD here in the US switched it's name to the ISST-D ... I always have that backwards. I was a member of that group in the 1980s. I was seen by two of the founding members -- in psychoanalysis.

That group ... names like Putnam, Kluft, Braun, etc. are the doctors who diagnosed MPD. This is a small group of doctors who would diagnose this while other psychiatrists did not. Bennett Braun was sued in the 1990s I believe for causing alter personalities ... as well as a number of other doctors.

Sybil -- who was treated by THE founding member of the ISSMPD, Dr. Cornelia Wilbur - - recanted her story and research supported that Wilbur falsified records... Shirley functioned better when she was away from Dr. Wilbur.. She was also drugged and given shock therapy and made to feel completely dependent on Dr.Wilbur.

Read "Sybil Exposed" and the book that Sybil (Shirley Mason) wrote ... damn I have it and can't recall the title.

DP/DR is quite common in BPD. And BPD is considered on a spectrum of some OTHER disorders.

There is so much we don't understand.
And as I've said, DP/DR can come up in many situations.

I am making this SO simple. You would have to read the books. Or even look at Wikipedia re: the controversy of MPD and False Memory.

I think this is the link to one of the few institutions who treat DID .... (Former ISSMPD) http://www.isst-d.org/

Many doctors changed their mind on the concept of more than "two personalities" in someone. And still aren't clear what that is. Multiple alters from 3, to then 16, to upwards of 100s and even thousands, we disputed.

Also if you read the work of Elizabeth Loftus on False Memory Syndrome you will find rather convincing arguments that refute Satanic Ritual Abuse, etc.


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## *Dreamer* (Feb 18, 2014)

This is my POV after research into this topic and talking with many doctors. You don't have to agree.

BPD, even psychosis, and other disorders have been used to try and understand DID. The concept of multiple alters has been quietly removed from discussioin after all of the lawsuits regarding increasing diagnoses.

Early research in the DP/DR by the French in the late 1800s, did not mention MPD to the best of my understanding.

I don't claim to understand all of this, but I don't think any of us can.
The dissociative disorders are truly misunderstood.
And many disorders come with other disorders and are on a spectrum.


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## *Dreamer* (Feb 18, 2014)

Also, if someone can convince me otherwise, I am happy to be convinced. I have simply seen too much going on from the 1970s to the present to state anything more than that MPD/DID is very rare, and most likely can be attributed to many other disorders. A variation of those disorders. Here is a medical article about the controversy.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719457/

*Psychiatry (Edgmont). 2009 Mar; 6(3): 24-29.*
Published online 2009 Mar.
PMCID: PMC2719457
Dissociative Identity Disorder
A Controversial Diagnosis
Paulette Marie Gillig, MD, PhDcorresponding author
Paulette M. Gillig, MD, PhD, Series editorcorresponding author
Paulette M. Gillig, Professor of Psychiatry, Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio;
Author information ? Copyright and License information ?
This article has been cited by other articles in PMC.
:
*Abstract*
A brief description of the controversies surrounding the diagnosis of dissociative identity disorder is presented, followed by a discussion of the proposed similarities and differences between dissociative identity disorder and borderline personality disorder. The phenomenon of autohypnosis in the context of early childhood sexual trauma and disordered attachment is discussed, as is the meaning of alters or alternate personalities. The author describes recent neurosciences research that may relate the symptoms of dissociative identity disorder to demonstrable disordered attention and memory processes. A clinical description of a typical patient presentation is included, plus some recommendations for approaches to treatment.

Keywords: dissociative identity disorder, multiple personality disorder, borderline personality disorder, alters or alternates, childhood sexual trauma, attachment (disorganized or disoriented type)
:
*Case Example: Mary (As Mary, Edith, "Baby")*
Mary was a quiet 30-year-old woman who was meek and reticent and had many avoidant traits. She was talking about some of the events of her past, which included severe sexual abuse starting at the age of 20 months. She began to tell the psychiatrist about a crying voice she heard constantly:

Mary: Baby cries all the time-Baby-I hear her. She is sad all the time. She can't talk, but she cries all the time. (Mary stops speaking. Her demeanor and posture were now so different the psychiatrist was startled. It really felt as though a different person was in the room.)
Mary (now Edith): She is a wimp. I would never put up with any of that sh--. I'll kill him. I'll kill him. I'll kill you too and she deserves to die.
Psychiatrist: Who? Baby?
Mary (now Edith): Mary. She's a wimp.
Psychiatrist: What about Baby?
Mary (now Edith): What are you talking about?
Psychiatrist: May I speak to Mary?
Mary (now Edith): She doesn't have the guts to come here.
:
*A Controversial Diagnosis*
In 1988, Dell1 surveyed clinicians to assess the reactions they had encountered from others as a result of their interest in dissociative identity disorder (DID), previously called multiple personality disorder. Of 62 respondents who had treated patients with DID, more than 80 percent said they had experienced "moderate to extreme" reactions from colleagues, including attempts to refuse their patients' admissions to hospitals or to force discharge of their patients, even patients that the respondents felt represented a serious suicidal risk. Dell speculated that the emotional reactions to the diagnosis of DID stemmed from anxiety evoked by the disorder's "bizarre, unsettling clinical presentation,"1 similar to some clinicians' emotional reactions to psychiatric emergency patients

.2 Another reason for the heated controversy surrounding the diagnosis of DID is the dispute over the meaning of observed symptoms: Is DID a disorder with a unique and subtle set of core symptoms and behaviors that some clinicians do not see when it is before their eyes?3 Or is it willful malingering and/or iatrogenically caused symptoms created by the other clinicians who think something is there that is not?4-6 A third and very important reason for the controversy is the fear that criminals will "get off" without being punished by a gullible justice system, which attributes behavior to another personality7 and does not hold the perpetrator responsible.

The diagnosis of DID is controversial. Reported cases of DID by Frankel,8 Ganaway,9 and McHugh,10,11 among others, have been attributed instead to social contagion, hypnotic suggestion, and misdiagnosis. These authors have argued that the patients described as having DID are highly hypnotizable, and therefore are very suggestible. They argue that these patients likely would be prone to follow direct or implicit hypnotic suggestions, and that the majority of diagnoses of DID are made by a few specialist psychiatrists.

:
*Did Versus Borderline Personality Disorde*r
In 1993, Lauer, Black, and Keen12 concluded that DID was an epiphenomenon of borderline personality disorder, finding few differences in symptoms between the two diagnoses. They described, rather, a "syndrome" of symptoms that occurs in persons with disturbed personalities, particularly borderline personality disorder. They concluded that DID had "no unique clinical picture, no reliable laboratory tests, could not be successfully delimited from other disorders, had no unique natural history and no familial pattern." That same year, after yeomans' efforts to answer this question by empirically reviewing the literature, North et al13 concluded that the diagnosis has not been "truly" validated,14 but yet they "came to believe in (its) existence." They stated, "Current knowledge does not at this time sufficiently justify the validity of DID as a separate diagnosis," but this also does not disprove the concept. Subsequently, Spira15 edited a book by proponents of the existence of DID, describing treatment options.

Loewenstein16 and Bliss17 concluded that DID existed and spontaneous autohypnotic symptoms were basic to the phenomenology of DID. Gelinas18 described autohypnotic and posttraumatic stress disorder (PTSD) symptoms in DID patients that likely were a response to childhood sexual abuse. Spiegel and Rosenfeld19 attributed the "spontaneous age regression" (to a younger alter) seen in DID patients to early trauma and also believed that PTSD symptoms related to trauma were central to DID.

Horevitz and Braun20 found that 70 percent of patients who had been diagnosed with "multiple personality disorder (DID)" would just as likely, by chart review, meet the criteria for borderline personality disorder. However, they also found other patients that could not be so characterized, and they concluded that DID was in fact a distinct entity, but overdiagnosed.

***** et al21 performed assessments with the Structured Clinical Interview for DSM Disorders (SCID) and Structured Interview for DSM-III-R Personality Disorders (SIDP-R), Dissociative Disorder Interview Schedule (DDIS), the Beck Depression, Beck Hopelessness, and Dissociative Experiences Scale (DES) and Shipley Institute of Living Scales on patients who had been diagnosed with DID. They found that 64 percent of patients diagnosed with DID met criteria for borderline personality disorder, but of those who did not, they met many of the criteria for borderline personality.

However, as found by Horevitz and Braun,20 one third of persons previously diagnosed with DID on Axis I on the basis of the above-mentioned assessment scales did not meet criteria for any Axis II disorder. Of special note was that the DES was higher in DID-diagnosed subjects than in other subjects. ***** et al21 concluded that DID was a "syndrome" that occurred in persons with disturbed personalities, particularly borderline personality disorder, and that both borderline personality disorder and DID were on the same character disorder spectrum, with DID representing its more severe end. They argued that DID arises from a substrate of borderline traits. The authors argued that the multiplicity of symptoms associated with DID, including insomnia, sexual dysfunction, anger, suicidality, self mutilation, drug and alcohol abuse, anxiety, paranoia, somatization, dissociation, mood changes, and pathologic changes in relationships, supported their view. Herman22 has characterized DID as a disorder of extreme stress, possibly a form of complex PTSD, due to prolonged repeated trauma.

:
*The Meaning of Alters, or Alternates*
Although the alters described in DID are sometimes referred to as ego states, Watkins and Watkins23 draw a distinction between the two concepts. They define ego state as an "organized system of behavior and experience whose elements are bound together by some common principle but that is separated from other such states by boundaries that are more or less permeable." Watkins and Watkins and others differentiate the concept of alters from that of ego states because the alters in DID have "their own identities, involving a center of initiative and experience, they have a characteristic self representation, which may be different from how the patient is generally seen or perceived, have their own autobiographic memory, and distinguish what they understand to be their own actions and experiences from those done and experienced by other alters, and they have a sense of ownership of their own experiences, actions, and thoughts, and may lack a sense of ownership of and a sense of responsibility for the action, experiences, and thoughts of other alters."23

*Trauma, Attachment, and Did*
In general, practitioners who accept the validity of DID as a diagnosis attribute it to the effects of exposure to situations of extreme ambivalence and abuse in early childhood that are coped with by an elaborate form of denial so that the child believes the event to be happening to someone else (perhaps starting out as an imaginary companion).23 Because of the stage of life a child is in when imaginary companions "exist," the "solution" to severe trauma at that stage may be a dissociated identity. In contrast, PTSD symptoms would more likely occur when trauma is experienced later in childhood or during adult life.24

Severe child abuse, a disorganized and disoriented attachment style,25,26 and the absence of social and familial support seem to precede the development of DID. The tendency to dissociate seems to be related as much to a pathogenic family structure and attachment disorder acquired early in the life of the child as to original temperament or genetics. Parenting style toward these patients was usually authoritarian and rigid, but paradoxically with an inversion of the parent-child relationship.27 Blizard28 speculated that children who display a disorganized/disoriented pattern of attachment29 might be in the process of dissociating their representations of contradictory parent behavior and that, in DID, distinct patterns of attachment may have been incorporated into the various personalities. The disorganization that is observed in the DID patient's attachment pattern is particularly interesting in view of some of the recent neursciences findings about this disorder.

:
*Recent Neurosciences Research on Dissociative Identity Disorder: Attention and Memory*
Attention. In one study, a subsample of DID patients manifested abnormal interest scatter on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) verbal subtests, and this variability was attributed to subtle neuropsychological deficits on the memory/distractibility factor similar to what is seen in attention deficit disorder.30 In another study, when compared with other dissociative disorder patients, DID patients showed a prepulse inhibition (PPI) of the acoustic startle reflex, suggesting maladaptive attentional processes when functioning at a controlled level, but not at a preattentive automatic level. DID patients showed increased vigilance, resulting in reduced habituation of startle reflexes and increased PPI. This response is a voluntary process that directs attention away from unpleasant or threatening stimuli. The authors concluded that aberrant voluntary attentional processes may thus be a defining characteristic of DID.31 In a third study, regional cerebral blood flow (rCBF) in patients diagnosed with DID was decreased in the orbitofrontal cortex regions bilaterally (similar to what is seen in attention deficit disorder), and increased in median and superior frontal regions and occipital regions bilaterally.32

*Memory*.

In a study of memory in subjects who were diagnosed with DID, Nissen et al33 found that the degree of apparent compartmentalization of learned items depended on the extent to which the information was interpreted and stored in ways that conveyed a unique meaning to the alter or "personality state." They concluded that "implicit" memories could be best stored and retrieved mainly during discrete behavioral states of consciousness. By contrast, one identity could recognize neutral words learned by the other identity.34 Also, memories of presumably neutral words,35 which were presented via auditory input but retrieved visually, showed interidentity memory transfer. Huntjens et al36 recommend that clinical models of amnesia in DID should exclude impairments for emotionally neutral material.

In one study of patients with DID that did not exclude patients also suffering from PTSD symptoms, hippocampal volume was 19.2-percent smaller and amygdala volume was 31.6-percent smaller compared to healthy subjects.37 In another study, when compared with controls, trauma-exposed subjects with PTSD symptoms but without DID had significantly reduced amygdalae and hippocampi and significantly impaired cognition in comparison to trauma-exposed patients with DID symptoms but without PTSD, who had normal amygdalae and hippocampi and normal cognition.38

Further research is needed to clarify whether or not the symptoms of DID actually perform a protective, defensive function neurologically by creating a neuroprotective environment that ameliorates the neurotoxic effects of traumatic stress. This would be predicted by the adaptive hypothesis described by Stankiewicz and Golczynska.39

*Making the Diagnosis: Clinical Description*
*The typical patient who is diagnosed with DID is a woman, about age 30. A retrospective review of that patient's history typically will reveal onset of dissociative symptoms at ages 5 to 10, with emergence of alters at about the age of 6. *Typically by the time they are adults, DID patients report up to 16 alters (adolescents report about 24), but most of these will fade quickly once treatment is begun. There generally is a reported history of childhood abuse, with the frequency of sexual abuse being higher than the frequency of physical abuse. Patients who have been diagnosed with DID frequently report chronic suicidal feelings with some attempts. Sexual promiscuity is frequent but patients usually report decreased libido and an inability to have an orgasm. Some patients report that they dress in clothing of the opposite gender or that they, themselves, are of the opposite gender. Patients often report "extrasensory experiences" related to dissociative symptoms, sometimes called hallucinations.* They report hearing voices, periods of amnesia, periods of depersonalization, and may use the plural ("we" instead of "I") when referring to the self. These patients experience so much dissociation and also many somatic symptoms (some cases resemble Briquet syndrome or somatization disorder)40 that they have a very inconsistent work history.41 Patients usually have periods of time for which they cannot account, may meet people who know them but whom they do not recognize, and find clothes in their possession that they do not recall purchasing and normally would not wear.*

Most DID patients come into treatment because of *affective, psychotic-like or somatic symptoms.* However, in an emergency situation with a new patient who does not know his or her name,* it is important to consider that the patient may have a true psychosis, because most "Jane and John Does" who present in psychiatric emergency settings have turned out to be psychotic, rather than in a dissociated state42 or to have an associated functional or organic psychosis.43 Although DID patients often describe hearing voices, North et al13 found that in DID, the reported hallucinations often also had a complex visual quality.*

*Approaches to Treatment*
Patients who have been diagnosed with DID tend to possess extreme sensitivity to interpersonal trust and rejection issues, and this makes brief treatment in a managed care setting difficult.14 Therapists who commonly treat patients with DID see them as outpatients weekly or biweekly for years, with the goal of fusion of the personality states while retaining the entire range of experiences contained in all of the alters.

Patients tend to switch personality states when there is a perceived psychosocial threat. This switching allows a distressed alter to retreat while an alter who is more competent to handle the situation emerges. The alter system may replicate the DID patient's experience of the relationships and circumstances that prevailed in the family of origin.3 In Kluft's view,3 alternate identities or personality states are the core phenomena of DID. Kluft does not view the alters as obstacles, distractions, or artifacts to be bypassed or suppressed. In fact, he argues that he has found no evidence of improvement if the therapist does not work with these alternate personality states.

A cognitive behavioral therapy (CBT) approach is often recommended that incorporates communicating effectively with the alters and helping the patient find more adaptive coping strategies than "switching" when distressed. This can be enhanced by teaching relaxation exercises, suggesting breaks from the setting for a few minutes, and helping the patient gain control over cognitive distortions of the self and world. The therapist tries to model an appropriate relationship and model appropriate, calm, and considered reactions to crises.

According to Kluft, large systems of alters usually collapse as the treatment moves forward and so it is not necessary to be overly concerned if the patient experiences a large number of personality states. It is important to get to know the prominent personality states, however, because sometimes one assumes that the host personality constitutes the patient's true identity, but this may not be the case.3

*One of the most important issues to deal with in treatment is the fear on the part of an acting-out or antisocial personality state that he or she will be obliterated by therapy-that the psychiatrist's goal is to "get rid" of an "alter" who may have committed illegal, even violent, acts. This would not be an appropriate goal of treatment. The personality state was created to defend the self against abuse and injury and can become a strong and important element when integrated more adaptively into the overall personality structure.23*

Link has list of references, etc.

-------------------------------------------------------
The understanding of dissociation is far from being clearly understood as you can see.
I do not deny something exists here, I wouldn't call it DID or the old MPD. I would place it, as many doctors do, in BPD or other personality disorder categories.

And again, those of us with DP/DR, IMHO, are not going to become DID. In all the years I have been on this board, very few people mentioned MPD/DID. A very small number.


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## inferentialpolice (Nov 26, 2012)

Dreamer said "I am not saying that DID is not "something" we don't understand, and yet, the ISSMPD here in the US switched it's name to the ISST-D ... I always have that backwards. I was a member of that group in the 1980s. I was seen by two of the founding members -- in psychoanalysis."

Did they offer a diagnosis, and if so, and if you feel it appropriate to disclose, what was their suggested diagnosis?


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## *Dreamer* (Feb 18, 2014)

nav said:


> Okay this may sound really insane. I don't have enough knowledge on the topic so this may be wild. forgive me in advance.
> 
> But I've heard according to DSM both are types of dissociation. So could DP/DR be like a mild form of DID (dissociative identity disorder)? Or could DP/DR develop into DID???
> 
> I know the answer is probably no but just curious....


Nav, to go back to your question. The simple answer IMHO is no. Don't worry about this. 
Best,

D


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## *Dreamer* (Feb 18, 2014)

inferentialpolice said:


> Dreamer said "I am not saying that DID is not "something" we don't understand, and yet, the ISSMPD here in the US switched it's name to the ISST-D ... I always have that backwards. I was a member of that group in the 1980s. I was seen by two of the founding members -- in psychoanalysis."
> 
> Did they offer a diagnosis, and if so, and if you feel it appropriate to disclose, what was their suggested diagnosis?


I never mind answering.

1. Firstly, when I was 16 (1975) I was diagnosed by an M.D. psychiatrist who did talk therapy ... the diagnosis ... *clinical depression, anxiety disorder (but depression and anxiety come together so depression was key diagnosis), and he told me that the "weird feeling" I'd had for years was called Depersonalization. He started me on an old tricyclic antidepressant.*

2. T*he first ISSMPD psychoanalyst I saw, was an M.D. from the ISSMPD (this was in Los Angeles) diagnosed the presense of the same three things.* However, I was not on medication (nothing had worked to help the DP/DR for years). 
His diagnosis for me was the same. Depresion, anxiety, and depersonalization. He believed the depersonalization could be treated through psychoanalysis. I sometimes took Valium as I was a ball of anxiety and my DP/DR then was terrible. I was also very depressed. I don't remember anymore if he had me on any medication, but I don't think so. Prozac had just come on the market, but he didn't really believe medication would help me.

NO MPD diagnosis -- ever. Also, this doctor saw people with all mental disorders. He treated individuals with medication as well as do psychoanalysis.

3. In 1987, that psyhoanalyst was gone for several months and I saw the other ISSMPD doctor ... Lowenstein for whom I have more respect. He worked for a long time with trauma patients and is now at Sheppard-Pratt. He also saw the same diagnosis. Depression (and at the time I was suicidal), anxiety, and chronic DP/DR.

*Lowenstein had the same diagnoses for me *as the one I was given at age 16. He also told me that he had found that patients at Sheppard-Pratt with chronic DP/DR were getting some relief from Klonopin. What an irony. For me that has been the one constant medication for me. He took me up to 8mg/day, then we went down to 6mg/day. I didn't kill myelf. It was the first time I felt some releif from the DP/DR.

He left Los Angeles and I later got rid of the first psychoanalyst.

--------------
*No one, has ever diagnosed me with MPD or DID or BPD.* And what stunned me was in the 1990s all of the law suits came out involving, Bennet Braum, Colin Ross, etc. (more ISSMPD members). I was terrified and figured I had really dodged a bullet. The thing is, I am more and more convinced that what "became" MPD for a while IS Borderline Personality Disorder and I don't have BPD.

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So finally.
1. I believe that DID/MPD is most likely BPD or a form of BPD itself. (which involves psychotic episodes, self harm, etc.) which the bulk of us here do not have.
2. The dissociative disorders as a whole are associated with childhood trauma. I had verbal abuse and neglect. But many with DP/DR had loving famlies who continue to be supportive of them. 
3. I have never had amnesia for events but have severe anxiety -- this is why I associated DP/DR with Anxiety Disorders. And it is clearly part of panic attacks. It is indeed listed as a panic attack symptom.
4. Hence I do not see DID really as a dissociative disorder, and then DP/DR are not going to advance to DID or are not "on a spectrum"

However, all mental illnesses come with many symptoms. It is known that DP/DR is common in individuals with BPD. When I heard of that and researched further, it seemed that part fell into place. But this is in HOT debate -- whether or not DID is different from BPD. Etc.

My current diagnosis today is Depersonalizaton DIsorder - chronic. Depression and Anxiety. Same three things I was diagnosed with 40 years ago.


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## Guest (Apr 10, 2015)

You're really standing on your own here Dreamer. Some of the things you've said are incorrect for a start and the rest of it - is just weird. I doubt you'd get much support from the folks who are well trained on the dissociative disorders with some of the things you believe.

People with DID don't necessarily have psychosis. Some do, but generally not. The voices we hear are not considered a form of psychosis.

And you're saying the idea of a disorders being on a 'spectrum' is debatable?

I'd be very interested to start a thread on 'Amnesia' on these boards. You believe DPD sufferers here have NO amnesia whatsoever. I highly doubt it.

So you're saying DID should be moved out of the dissociative disorders category? And DPD as well? Pheww.. that's a big call. You say it's hotly debated. By whom?

Ritual abuse is real. Accept it. Court cases have been won in many countries around the world by people who have been ritually abused. The internet is littered with stories of experiences. There're websites devoted to the survivors of RA. One organisation I know of has been around for over 20 years. They run conferences multiple times a year with presentations from therapists and survivors&#8230; So you're trying to tell me they're just lying and they always have been?? There's also being a woman (possibly more) who successfully sued the US government for the trauma based mind control they carried out on her as a child. People have won cases for being ritually abused&#8230; And this is only scratching the surface of what's out there already.

I don't think you have much expertise in regards to DID and I don't think you have the expertise to start trying to re-categorise the diagnosis's. The couple of DID people you mentioned you've talked to are far from typical cases. Someone with DID who doesn't even know what DP or DR is?? 'Almost unheard of' (that's what my therapist said). Even the language you've (and the DSM) use is derogatory. We're NOT mere 'identities' or 'personality' states. A line like that comes across as one person 'thinking' they are more than one person, rather than the reality of several people living in one body&#8230; And we don't 'become' someone else. Again, it shows a poor understanding of the subject.

Why is it that every time the subject of DID or ritual abuse comes up you bring out the same OLD articles about a handful of unethical psychiatrists who obviously did the wrong thing and got caught out? They're a drop in the ocean. Since those times psychotherapy has come a long long way and it's highly doubtful a therapist would put their neck or reputation on the line and actually 'induce' DID.

And the articles from the 'false memory syndrome' people start to come out. To any ethical and experienced therapist the FMS holds no water. You obviously have an agenda to discredit everything and anything around DID, ritual abuse and no doubt trauma based mind control. Like I said&#8230; you're on your own here, b/c the facts far outweigh the handful of articles you have to 'prove' it's all lies&#8230; It's 2015, not 1990. The world has moved on a long way and people talk!

Have you been keeping an eye on the high level organised pedophile cases coming out from the UK? The politicians are running for cover, and indeed even committing suicide (or are being 'hit') to try and hide the truth of their past. Jimmy Saville was right in the thick of it. Just wait.. more and more people are coming out and talking about being abused within these institutions.. it's only a matter of time before the whole thing gets blown into the wide open spaces which is the public domain. In fact, it's almost there. I suppose you're going to tell me they all lying too?


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## mana_war (Jul 3, 2014)

guess im not the only one that had that thought. Obviously i know nothing but when i first started reading I always felt that dissociative disorders were different levels of the same thing, i highly doubt they are separate things..
and i at first had dp and it developed into dissociative amnesia after more traumatic events occured to me, and i have had symptoms that cause me to believe that they are all levels of the same thing for ex in different situations i can physically feel a change in my brain, my posture voice, thought process,attitude but i do not have seperate personalities within myself , its just as if certain parts of my cognitive faculties shut down and let the others work.
That does not mean i think dp will become DID, that's a diff conversation. I am saying that they might be the same disease with variation in the specifics of the intensity of the trauma or time of life it happened, environment etc.


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## *Dreamer* (Feb 18, 2014)

As I said, we all have our own opinions. I have made it very clear how I have come to mine.

And I am not alone in my beliefs ... I cited an article from 2009 ... and if you go on PubMed or Elseiver, FierceBioTech, for current (2014) articles on DID and the dissociative disorders you will come upon the same debate.

As noted, there is great similarity between BPD and DID (formerly MPD). Hence, it has been debated for a long time, and many researchers feel it does not belong in the Dissociative disorder category, but could be considered a dissociative aspect of BPD.

As noted, those of us with chronic DP/DR or DP/DR that comes and goes ... those with that specific symptom do not suffer from amnesia. The other dissociative disorders include amnesia. Hence, it is debated that DP/DR should remain as a dissociative disorder.

This takes DP/DR our of the "spectrum" so to speak ... as DP/DR may be experienced by those with DID, but it is very common with those with BPD.

The explosiion of MPD cases in the 1970s, 1980s, and 1990s in the UNITED STATES -- I cannot speak for the UK have declined sharply. As noted, MPD was considered very rare. It then went from virtually unknown to 40,000 cases over a period of two decades. As far as Satanic Ritual Abuse. The key cases here in the US -- Little Rascals Daycare and others proved to be false. Children were testifying that they were taken up into spaceships and raped. They told therapists that they were told to sacrifice rabbits, etc. Well, investigators -- police, forensic teams of all sorts in ALL of these cases dug up the area around these areas and found NOTHING.

Many of the children, as many individuals under duress, confessed to things to get therapists from asking them questions over and over again. It is common for individuals to confess to a murder they never did when grilled for 12 hours by police. They feel if they confess they will be allowed to go home, go to the bathroom. They are sleep-deprived, screamed at. They will recant the testimony. And sure enough another perpetrator will be found.

Thank God for DNA, and better forensics.

All of the satanic ritual accusations really destroyed any belief in the dissociative disorders. As I said, doctors were sued. Innocent people went to jail. Patients who believed they had 100 alters had to be deprogrammed. The storm began to blow away by the end of the 1990s. And again, the continuing work of Elizabeth Loftus, and in depth research into famous individuals who supposedly had MPD, even came forward themselves to say they were drugged, threatened, wanted to please, etc.

Here in the US -- the concept of DID is in limbo. And DP/DR has been left out in the cold.

This isn't to say that with many mental illnesses don't experience memory problems, etc. Many have DP/DR, and as noted AGAIN, MPD/DID is believed to be BPD by a large number of researchers. You didn't read the article I cut and pasted.

I would have to look up DID in the ICD and I can't find it though it's there somewhere. But in different countries, different individuals have completely different symptoms. No two people are alike. I believe in India, those who are diagnosed with DID only "chage" states after they go to sleep. However brain scans and complex tests show DID is NOT understood but looks more and more like BPD, and some doctors interpret some of the symptoms, including hearing voices, as DID.

The two founding ISSMPD members that I worked with changed their stance from MPD to DID. There are a group of doctors who remain believing even in alters, and therapists without medical degrees do so.

I did not make any of this up. This is also taught in seminars I have gone to, etc.

I was seen, as someone the product of verbal abuse and neglect as NOT having dissociated from the abuse. I was viewed as someone who was prone to disconnect as I was severely overstimulated by screaming, chaos, and threates of abandonment. On the other hadn there is a lot of mental illness in my family .. so I have a high genetic component to having mental illness. Also, if you have a mentally ill parent -- said parent may be "odd" at minimum and abusive or sick themselves.

No doctor I have ever seen has claimed to know how much is Nature and how much is Nurture.

I don't stand on my own with this. You can talk with plenty of researchers and therapists aof all kinds who have the same theories as I do. I happen to agree with them.

And believe me, doctors who treat trauma these days do not avoid medication. They are moving more and more towards a holistic approach which is very refreshing.

No use discussing this anymore. Unfortuantely many here self-diagnose. I try to discourage that. Also, you don't have to believe whatever a doctor says. You can refuse treatment or medication. Here in the US also, we do not have public health insurance. We have private health insurance which does not cover much re: mental health care. Very sick people get no help or very poor assistance. This is why I volunteer as an advocate and have worked with mentally ill individuals for about 30 years.

Peace.


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## *Dreamer* (Feb 18, 2014)

Also, the definition of dissociation itself is in dispute, and the definition of DID is in dispute.
Meantime DP/DR has gotten lost and dropped by the wayside. My current psychiatrist however is very knowledgeable about DP/DR. She saw it in medical school in many young people taking rec drugs. I believe she also was mentored by a psychiatrist interested in the topic. She says she has not seen MPD or DID (or given that diagnosis) over a 10 year period. She is still has to complete her fellowship.


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## Guest (Apr 11, 2015)

I've got a question or 2..

In your 30 years experience working with psychiatrists, psychologists, doctors, counsellors and researchers, have you ever met anyone who's said they can successfully treat people with dissociative disorders?

During your time within the metal health sector, have you ever spoken at length with a patient who's successfully been treated for dissociative disorders and gone on to live content and fulfilling lives?


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## nav (Mar 30, 2015)

*Dreamer* said:


> Nav, to go back to your question. The simple answer IMHO is no. Don't worry about this.
> Best,
> 
> D


Thanks D,

Much appreciated


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## nav (Mar 30, 2015)

You're a really clever chap D.


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## *Dreamer* (Feb 18, 2014)

Zed said:


> I've got a question or 2..
> 
> In your 30 years experience working with psychiatrists, psychologists, doctors, counsellors and researchers, have you ever met anyone who's said they can successfully treat people with dissociative disorders?
> 
> During your time within the metal health sector, have you ever spoken at length with a patient who's successfully been treated for dissociative disorders and gone on to live content and fulfilling lives?


It is so difficult to have a simple answer to these questions.

1. Yes. Over all of these years I have had doctors, therapists, etc. who said they have had success eliminating DP/DR in other patients -- but my first doctor told me DP/DR is impossible to cure -- (that was in 1975 and didn't give me a great deal of hope). I am referring specifically to DP/DR, not to any other dissociative disorder. However, NO doctor, has ever said to ME they can eliminate MY DP/DR. They have offered various forms of help, and the help available to me was minimal really until the late 1980s.

In psychiatry as with every other profession, some think they have the answers to everything, and others admit they don't. I admire those who don't claim to have all the answers. No one does.

In my case what has helped is Klonopin and Lamictal, Dialectical Behavioral Therapy, talk therapy (to sort out my psychological isssues -- low self esteem, getting into destructive relationships, understanding my parents, etc.) Also, exercise, volunteering, taking university classes, yoga, mindfulness, socializing, helping others etc.

As for researchers, if you read the literature, I have not come upon any research that says, "Here, this is the cure for DP/DR." You really should read Maricio Sierra's textbook. I can't write it out here. It is the first medical textbook dedicated entirely to DP/DR ALONE. ONLY DP/DR.

2. Re: patients of all kinds ... with DP/DR and with other mental illness ... MANY can have fulfilling lives and I know several people personally who had EPISODIC DP/DR which has gone into remission -- it seems when this is chronic (as with me -- you don't get "relief" which reminds you you felt better and build upon that, but I can cope FAR better than I did as a young girl and teen). Or they may only have brief episodes. And they are not afraid of it. Many still have anxiety, depression, or some have other major disorders.

If you look on the board, and look at individuals online (I did not get online and find so many DP folks until I was 42 ... I felt very alone for years). ... you will find stories by peole who say they are cured. How that happened, I don't know. They explain their story and say what they did or didn't do.

I won't go on, as this is so complicated. Whatever works for someone is great. But right now medicine doesn't have all the answers to everything. Humanity does not have the answers to all the problems of life.

We do the best we can, advocate for ourselves. And what helped me a lot -- but not eveyone can do this -- is speak out, talk to others openly about my DP. Working with others with mental illness -- you aren't judged. Everyone understands, no matter what they have.

*Oh, and Nav ... thank you for calling me clever. But I am a lass not a lad. *

There are no absolutes in this life. None. No guarantees for anyone. Whatever path you take, have faith in what you are doing.
I also think love and support is critical. I did not have that for decades. My parents were never there for me. I have no siblings or extended family.
My story is mine alone.

I HIGHLY recommend Dr. Sierra's textbook -- full of decades of research, and other books I have listed on my website. I'll post that.


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## *Dreamer* (Feb 18, 2014)

http://www.dreamchild.net/Advocate/Advocate/books.html

From my website -- books, links, films.


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## *Dreamer* (Feb 18, 2014)

http://www.amazon.com/Depersonalization-New-Look-Neglected-Syndrome/dp/1107406390/ref=sr_1_1?s=books&ie=UTF8&qid=1428804563&sr=1-1&keywords=depersonalization+a+new+look+at+a+neglected+syndrome

MUST READ MEDICAL TEXTBOOK ON DP/DR. I recommend it to every doctor and therapist I see/talk to.

"This is a fascinating and clinically relevant phenomenon neglected within psychiatry. Far from being a rare condition, it can be as prevalent as schizophrenia or bipolar disorder and frequently occurs in association with other neuropsychiatric conditions. This book is a review of depersonalization, dealing with the subject from a wide range of perspectives and covering historical, conceptual, clinical, trans-cultural, pharmacological and neurobiological factors. It discusses recent neuroimaging studies providing fresh insights into the condition and opening up new opportunities to manage the symptoms with pharmacologic and psychotherapeutic interventions. It will be relevant to psychiatrists and clinical psychologists, as well as primary care practitioners, neurologists and psychiatric nurses."

(Because I read medical journals as much as possible, this was not difficult reading for me. But I do not understand all of the complexities of neurology by a long shot.)


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## inferentialpolice (Nov 26, 2012)

Dreamer, a dissociative disorder and BPD are not mutually exclusive, so it is not a case of having one OR the other.

Those who study DP/DR exclusively as opposed to the full spectrum of dissociative disorders tend to miss the fact that many if not most of their "DPD" sufferers are further along the dissociative spectrum, about which DP/DR is only one of the symptom clusters. But if one doesn't ask about and explore for the other symptom clusters, one misses the greater aspects of the patients true condition, resulting in treatment aimed ONLY at the DP symptom relief and consequentially the DD patient fails treatment, leading the doc to declare DP resistant to treatment. This is akin to bandaging a complex bone fracture and calling it "treated" without having set the bone -- no one should be surprised that the limb continues to hurt despite the medical intervention.

In general, if a medical condition is resistant to known treatments, one should question BOTH the treatment AND the diagnosis. With all the Failed treatment cases in the world, one should be open to the idea of an undetected underlying disorder.


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## *Dreamer* (Feb 18, 2014)

Well, again, I don't think you understand my point.

The very debate that exists in the medical community reflects the evolution of understanding brain disorders.

OF COURSE there is a spectrum of all sorts of disorders. I said everyone is different. MY csae is different from every other person's on this board and any other person with DP.

This is true of all of medicine.

As reserach moves on, research goes into a blind alley, then finds something fascinating, then turns around and go backward, etc.

Blame it all on everything from Freud to the Genome Project.

I have my own theories. I have NEVER siad, "THIS IS THE ANSWER" ...

And to become a researcher you have to have years of experience, or a doctor, then you CHOOSE your focus. No matter what anyone does in any field you have to have some sort of focus. Each bit of information is shared at conferences, and some info may influence the reserach into another disorder.

I am not going to sit down and rewrite anythng here, I am expressing my opinion.
And I know we are all infinitely complex, etc. I don't think you read the medical article I posted either. It expresses all of the confusion as well as some insight.

:facepalm:
Going on vacation thank God, LOL

Cheers.
D


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## inferentialpolice (Nov 26, 2012)

Dreamer, yes I did read the "DID controversy" paper you referred to. I thought it was shameful in its ignoring nearly a 100 papers that since 1993 established the "gold standard" means of assessing for a possible dissociative disorder, including differential diagnosis vs BPD. For instance, Here is a link to a 1993 speaking to the use of the SCID-D to differentially establish a dissociative diagnosis:

http://ge.tt/99RBoPE2/v/0?c

Other than poor scholarship, or possibly having some surreptitious agenda, I cannot speak to why a paper written in 2006 would ignore this significant body of literature.


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## *Dreamer* (Feb 18, 2014)

I have read Steinberg's work and her book "Stranger In The Mirror" ... I have taken all of the tests myself in her book. I also participated on this board some years back re: The Cambridge Depersonalization Scale. I have taken yet another test through the University of Michigan (I live in this town, my doctors/therapists are here).

*I have found faults in every dissociative disorder scale that is available -- and researchers agree as well. NONE is a "gold standard." There are questions one can ask on any number of these tests where someone who is perfectly mentally healthy says, "OMG, I must have DP!" Questions such as:
"I feel spacey." -- everyone feels "Spacey" at one time or another
"At work I stare off into the distance and daydream and lose time." -- common with anyone*

*I won't write all of these down. But the point is, even the MMPI and other tests are imperfect. Tests are endlessly updated, and if you look at the article I provided they used quite a number of tests.

I am not saying I have all the answers, and neither is anyone else for that matter. There is a debate, and that is a fact.
This all began when the OP asked if his/her having DP/DR would mean he/she would develop DID. I don't this person at all, but I have never found that to be the case. And I do not claim to be an expert. But there are faults in ALL diagnoses. I have several friends with children who HAVE NO SPECIFIC DIAGNOSIS as they fit no specific category.*

One friend has a child who has been diagnosed with everything from schizophrenia to autism to severe social anxiety, etc. Often there is no clear cut diagnosis for brain disorders, not to mention these various tests. When a doctor attempts to treat a psychiatric patient, he/she looks at an entire picture (if they are any good).

There have been cases where psychiatrists have misdiagnosed patients who actually have a neurological disorder, and neurologists have misdiagnosed patients who actually have a psychiatric disorder. This is not cut and dried. And much of this must be studied FOR YEARS TO COME.

*I posted ONE article.

Here are many more. I am no expert, but I have read, studied, spoken to people, gone to seminars, etc. TO HAVE AN OPINION, NOT AN ANSWER. IMHO is the word.

If you wish, here are a bazillion other articles. Take your pick. As the saying goes, if you read an article dated 2015 it is out of date. Work done 10 years ago is out of date.

There is no need to debate this further. I don't know why I'm defending myself. I would have to write a 50 page Master's Thesis to present my POV. And I very well could be very wrong.*

Here's a million more things, or look in Wikiepdia, a medical library (I go to the one here at U. of M. -- I am an alumni and am allowed access but can't check things out.)

Here's more. ONE artitcle or ONE test or ONE person's opinion is never THE answer to everything. I grabbed that article to prove that my BPD vs. DID theory wasn't something I made up. It is a REAL debate. Some doctors/psychoanlysts still believe there is MPD ... multiple alters, upwards of 10 or more in people. I am not of that school of thought and have found the BPD model fascinating.

*Choose any one of these articles. There are a bazillion more. The one I chose is one amongst thousands of research papers.*

• Axis I dissociative disorder comorbidity in borderline personality disorder and reports of childhood trauma.[J Clin Psychiatry. 2006]
• The scientific status of childhood dissociative identity disorder: a review of published research.[Psychother Psychosom. 2011]
• [Dispute over the multiple personality disorder: theoretical or practical dilemma?].[Psychiatr Pol. 2006]
• Dissociative phenomena in women with borderline personality disorder.[Am J Psychiatry. 1994]
• [Dissociative disorders: from Janet to DSM-IV].[Seishin Shinkeigaku Zasshi. 2000

• Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder[Innovations in Clinical Neuroscience. ]
• An Archetype of the Collaborative Efforts of Psychotherapy and Psychopharmacology in Successfully Treating Dissociative Identity Disorder with Comorbid Bipolar Disorder[Psychiatry (Edgmont). ]
See all...
Links

• MedGen
• PubMed
Recent Activity

ClearTurn Off
• Dissociative Identity Disorder
See more...

• Professional skepticism about multiple personality.[J Nerv Ment Dis. 1988]
• Clinicians' self-reported reactions to psychiatric emergency patients: effect on treatment decisions.[Psychiatr Q. 1990]
• Review Dealing with alters: a pragmatic clinical perspective.[Psychiatr Clin North Am. 2006]

• Hypnotizability and dissociation.[Am J Psychiatry. 1990]
• Review Hypnosis, childhood trauma, and dissociative identity disorder: toward an integrative theory.[Int J Clin Exp Hypn. 1995]

• Multiple personality disorder and borderline personality disorder. Distinct entities or variations on a common theme?[Ann Clin Psychiatry. 1993]
• Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia.[Am J Psychiatry. 1970]

•  An office mental status examination for complex chronic dissociative symptoms and multiple personality disorder.[Psychiatr Clin North Am. 1991]
• Spontaneous hypnotic age regression: case report.[J Clin Psychiatry. 1984]

• Are multiple personalities borderline? An analysis of 33 cases.[Psychiatr Clin North Am. 1984]

• Initial and follow-up psychological testing on a group of patients with multiple personality disorder.[Psychol Rep. 1986]

• The psychological organization of multiple personality disordered patients as revealed in psychological testing.[Psychiatr Clin North Am. 1991]
• Review Familial and social support as protective factors against the development of dissociative identity disorder.[J Trauma Dissociation. 2008]

•  Intellectual functioning of inpatients with dissociative identity disorder and dissociative disorder not otherwise specified. Cognitive and neuropsychological aspects.[J Nerv Ment Dis. 1996]
• Dissociative identity disorder and prepulse inhibition of the acoustic startle reflex.[Neuropsychiatr Dis Treat. 2008]
• Frontal and occipital perfusion changes in dissociative identity disorder.[Psychiatry Res. 2007]

• Memory and awareness in a patient with multiple personality disorder.[Brain Cogn. 1988]
• The objective assessment of amnesia in dissociative identity disorder using event-related potentials.[Int J Psychophysiol. 2000]
• Interidentity memory transfer in dissociative identity disorder.[J Abnorm Psychol. 2008]
• Interidentity amnesia for neutral, episodic information in dissociative identity disorder.[J Abnorm Psychol. 2003]

• Hippocampal and amygdalar volumes in dissociative identity disorder.[Am J Psychiatry. 2006]
• Amygdala and hippocampal volumes and cognition in adult survivors of childhood abuse with dissociative disorders.[Acta Psychiatr Scand. 2008]

• Review [Dispute over the multiple personality disorder: theoretical or practical dilemma?].[Psychiatr Pol. 2006]

• Review Recent research on multiple personality disorder.[Psychiatr Clin North Am. 1991]

• Jane and John Doe in the psychiatric emergency service.[Psychiatr Q. 1989]
• Review Dissociative identity disorder and schizophrenia: differential diagnosis and theoretical issues.[Curr Psychiatry Rep. 2008]

• Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia.[Am J Psychiatry. 1970]

•  Review Dealing with alters: a pragmatic clinical perspective.[Psychiatr Clin North Am. 2006]

• Review Dealing with alters: a pragmatic clinical perspective.[Psychiatr Clin North Am. 2006]

*Well, these posts are good to print out and use as notes and references. I am not a neuroscientists. I am not a doctor. I am not a psychiatrist.
I am a mental health advocate who is trying to understand the complexity of the brain. I have never said I was anything more.
I still really insist everyone on this board read Dr. Sierra's medical textbook on DP/DR *

You are here: NCBI > Literature > PubMed Central (PMC)
Write to the Help Desk


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## *Dreamer* (Feb 18, 2014)

inferentialpolice said:


> http://ge.tt/99RBoPE2/v/0?c
> 
> Other than poor scholarship, or possibly having some surreptitious agenda, I cannot speak to why a paper written in 2006 would ignore this significant body of literature.


Poor scholarship? One of a bazillion articles. And you might as well say that EVERY researcher has a surreptitious agenda!
I chose that as ONE example of the debate regarding MPD and BPD. And it is a challenging debate. And human beings are not cookie cut-outs, and researchers and doctors are imperfect human beings as we all are.

Cheers.
Leaving tomorrow morning!
Peace,
D


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## inferentialpolice (Nov 26, 2012)

Dreamer ... Oy Vey ... I am not referring to your mentioned paper's lack of acknowledging one study, I was referring too its failure to incorporate the 100 papers that have applied systematic assessment to diagnose dissociative disorders. If they had paid attention to these papers, they would see that dissociative disorders, especially and including D.I.D, can be diagnosed and distinguished from other disorders with high accuracy. I previously referred you to a handout that links to many of the papers I am writing about, however I don't believe you downloaded and considered it. If you are game, here is the link once again: http://ge.tt/8BWdn2s1/v/1?c

Enjoy your vacation.


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## *Dreamer* (Feb 18, 2014)

inferentialpolice said:


> Dreamer ... Oy Vey ... I am not referring to your mentioned paper's lack of acknowledging one study, I was referring too its failure to incorporate the 100 papers that have applied systematic assessment to diagnose dissociative disorders. If they had paid attention to these papers, they would see that dissociative disorders, especially and including D.I.D, can be diagnosed and distinguished from other disorders with high accuracy. I previously referred you to a handout that links to many of the papers I am writing about, however I don't believe you downloaded and considered it. If you are game, here is the link once again: http://ge.tt/8BWdn2s1/v/1?c
> 
> Enjoy your vacation.


Before I split, LOL.

OY VEY -- indeed. We reall need to talk about this. Not go back and forth here. But it's all we have.

I did read the article. It has to do with Marlene Steinberg's work.
1. Her work as the work of many others is in dispute. I may be completely wrong, but the article states that dissociative disorders occur in all manner of mental illnesses. I have a lot of trouble with that concept, again, considering I personally know many mentally ill people.

2. No one said that the SCID-D was NOT used in these studies to screen individuals for DID vs. BPD. In forming control groups, many standardized tests are given. You can't conduct a study if you aren't certain you are dealing with a proper diagnosis you want to study.

3. SCID (without the D) is used in diagnosing all medical disorders, so it is one basic test ... a list to tick off so to speak. In a sense, it would be a given in screening individuals. As someone who has participated in mental health trials, I have had to go through a rigorous screening process. Pagees of questions, and if one is in a control group -- you must fit very specific criteria.

Also, since this is a university town, many young people here get paid small sums to be healthy controls. You need to be certain individuals who represent themselves as healthy truly ARE healthy or the study is worthless.
What is a pain for me is often sex and age must be kept constant, so I am eliminated from trials. Even that wouldn't be mentioned as it is a given.
I didn't read all of the footnotes to that article, but I would find it highly unlikely that reserachers would exclude testing methods to be clear of their hypothesis.

I was tested for depression, and new ways to treat it without medication. Well, I was depressed and ON medication. So I was the depressed control group. Just to be in the control group I had to PROVE I was clinically depressed with an extensive interview ... maybe 10 hours of interviews and questoinnaires, etc. I then wore a watch type thing. It would beep at various times of the day and I would have to write in a journal how I was feeling.

Those in ALL the groups, including healthy people (writing on a scale of 1-10 say -- forgot) would indicate level of depression and other symptoms.

So, the questionnaire I took included many screening questions ... many culled from multiple tests (including MMPI, depression rating scales, etc.)
In tallying results one must have scientific protocol regardless of the source of the testing criteria.

I still see in the article, and I have taken the SCID-D myself, that if one argued the point, many of the symptoms do match up with BPD.
There was also a claim that individuals with OCD for example presented with dissociative symptoms. IDK, that may be so, but I would suggest that in that article, they were looking for something. And I have no complaint -- it adds to our knowledge -- but this is again bias.

If you feel that the article I offered has bias, I would say the same of yours.

This is why many researchers must replicate results many times. Many groups must challenge results.
For all I know the depression study I was in was crap. But it would be duplicated if the findings bore out something interesting to follow up on.
I never read the concluding paper -- which may have never made it to press as it didn't live up to peer reviewed standards, and sadly, you would be astounded at how many very reputable medical journal articles are falsified -- one can go online and buy a Master's thesis paper in just about any topic. Friends of mine who are in the teaching profession have software that looks for plagiarism and must look for heavy bias.

This is not simple.

OK, in the spirit of good debate. Off I go! Late!
Cheers.


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## *Dreamer* (Feb 18, 2014)

> The *Structured Clinical Interview for DSM-IV* Axis I Disorders (*SCID-I*) is a diagnostic exam used to determine DSM-IV Axis I disorders (major mental disorders). The SCID-II is a diagnostic exam used to determine Axis II disorders (personality disorders). There are at least 700 published studies in which the SCID was the diagnostic instrument used. Major parts of the SCID have been translated into other languages, including Danish, French, German, Greek, Hebrew, Italian, Portuguese, Spanish, Swedish, Turkish, and Zulu.
> 
> An Axis I SCID assessment with a psychiatric patient usually takes between 1 and 2 hours, depending on the complexity of the subject's psychiatric history and their ability to clearly describe episodes of current and past symptoms. A SCID with a non-psychiatric patient takes 1/2 hour to 1-1/2 hours. (See editions below.) A *SCID-II* personality assessment takes about 1/2 to 1 hour.
> 
> The instrument was designed to be administered by a mental health professional, for example a psychologist or psychiatrist. This must be someone who has relevant professional training and has had experience performing unstructured, open-ended question, diagnostic evaluations. However, for the purposes of some research studies, non-clinician research assistants, who have extensive experience with the study population in question, and who have demonstrated competence, have been trained to use the SCID. The less clinical experience and specific education the potential interviewer has had, the more training is required.


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## Guest (Apr 19, 2015)

Dreamer&#8230; Back to the reality of ritual abuse. Here's a link to dozens of court convictions related to ritual abuse. This list was compiled in 1997 so it's very old. Obviously there's been a lot of other cases in the 22 years since.

Some of the information is very confronting so I'll put a warning on it..

TRIGGER WARNING

http://ra-info.org/faqs/ra-convictions/

This organisation is devoted to stopping ritual abuse and has been around since 1995 and if this list is not sufficient enough proof for you on the existence of RA, I don't know could be&#8230;..


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## *Dreamer* (Feb 18, 2014)

Zed, it is unlikely you and I will ever come to an agreement on anything! However, I can state that one of the cases mentioned in the article, "The West Memphis Three" accused of killing 3 boys was overturned 18 years after those men had been in jail. There have been several documentaries on it, news articles, legal arguments, etc.

Jumping to "Satanic Ritual Abuse" as a cause for criminal behavior is a more complex conspiratorial view of most crimes.

The Memphis Three were pardoned (in a complex deal) in 2011. It was a special plea deal due to mishandling of the case, and discovery of DNA from another individual responsible for the crime.

The famous cases I noted that occurred in the 1980s and 1990s ... all were found to be false. Unfortunately some individuals are still imprisoned for things they could not possibly have done ... such as rape children in space ships. If you read anything about the McMartin PreSchool Case, and The Little Rascals Day Care Case, you will see a pattern of miscarriage of justice.

Many of the same names come up. Colin Ross, M.D. is one, who is seen as a charlatan. He has been sued as was Bennet Braun. Certain psychoanalysts insist in MPD to this day. Most other doctors do not believe it exists (in multiples or satanic abuse). You may choose to believe what you wish. I have no control over that.

I won't argue this. I can imagine there could be criminals who believe they are motivated by the Devil (psychotic individuals for example), but most of these cases have been disproved.

Also, re: accusations against parents have destroyed families when accusations were made that were later recanted.

Sure, people do hideous things to their children, but the concept of Satanic Ritual Abuse as it played out in those years proved to be false as did the creation of multiple alter personalities in individuals. You would have to go on a case by case basis. These cases are often very difficult to prove and don't hold up in court, and are overturned even decades later.

We see this from a different POV, so we agree to disagree.


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