Dissociative identity disorder (DID)

Dissociative Identity Disorder

Dissociative identity disorder (DID) is a mental disorder that arises when a person has numerous personality features. According to researchers, it is one of the most frequent mental ailments, with 1.5 percent of 658 people suffering from it. Furthermore, 6% of psychiatric outpatients have a dissociative identity disorder. The film Sybil depicts the causes of the illness as well as some of the approaches that can be utilized to treat DID victims. Sybil suffers from DID throughout the film as a result of the horrific events she had as a child. For instance, her mother – who was suffering from a mental disease – used to tie her on a chandelier in their green kitchen and pour water on her private parts, a trend that had far-reaching consequences on her. As a result of the trauma, she suffers from multiple personality traits and experiences blackouts now and then. In addition, she experiences memory lapses, thus, she cannot remember some of the things she might have done. For instance, when she wakes up one morning and finds that her room was trashed, but unfortunately she cannot recall that she was the one who did it. The movie illustrates that hypnosis and psychoanalysis are some of the methods that clinicians can make use of to treat the victims of dissociative identity disorder. After Dr. Wilbur hypnotizes Sybil, she (the doctor) is capable of recognizing some of the factors that might have adversely affected Sybil, thus, resulting in her present condition. After hypnosis, she is injected with a drug with some sedative hypnotic effect, which helps to restore her into the usual human state.

Dissociative Identity Disorder

Introduction

Dissociative identity disorder is a mental state that occurs when a person experiences at least two dissociated personality traits. The states are exhibited in an individual's behavior, which is also depicted through memory lapses. However, unlike most of the mental disorders, dissociative identity disorder cannot be linked to drug and substance abuse or other medical complications. According to Chlebowski and Gregory, it is estimated that 1.5 percent of 658 adults suffer from the disease (Chlebowski & Gregory, 2012). The scholars also cite that six percent of the psychiatric outpatients suffer from a dissociative identity disorder. The main symptoms of the dissociative disorder include difficulties in paying attention, daydreaming, and even becoming distracted from what one is doing with ease. This paper analyses the mental disorder by using Sybil, a character in the film Sybil.

Character Analysis and Symptoms

An in-depth examination of the movie Sybil reveals that Sybil – the main character – suffers from a dissociative mental disorder. Throughout the film, she exhibits some odd behavioral traits, which include memory lapses and keeps on talking to herself. For instance, she wakes up one morning and finds that her room is trashed, but unfortunately she cannot recall that she is the one who did it. Besides, she gets frightened after seeing the drawing because it is an illustration of her painful past and she cannot even recall that she is the one who drew it. In addition, she refers to her mother as 'the people,' which implies that she might be experiencing some hallucinations. The DSM – 5 is a diagnostic criterion that is used in the provision of treatment to victims of the dissociative mental disorder (DID). The basic steps in the treatment are as follows;

The disruption of identity

Victims of DID suffer from an identity disruption that occurs as a result of the subsequent discontinuation of the sense of self, which ends up affecting their behaviors, memory retention, and even perception. In this case, Sybil is unable to recognize her mother, thus, the reason why she refers to her as 'the people'. Besides, her memory retention is significantly low since she cannot comprehend what she might have done in the past – for example, she cannot remember that she is the one who trashed her room. As she is talking to Doctor Wilbur, she claims that she is unaware of what is happening to her as she points out that "I'm here and then I'm not and then I'm here again and everything is different. Things are different and people are different," which is an illustration of the disruption of identities that she is going through.

There must be a recurrence of amnesia

As aforementioned, people who suffer from DID also experience memory lapses (amnesia) now and then. This is exhibited by her failure to remember some of her actions such as the drawing and that she is the one who trashed her room. While at the hospital, the doctor also lets her know that she has changed the subject but unfortunately, Sybil cannot recall what they were discussing about and she even introduces a new topic as she shows the doctor the letter, which she claims was given to her by Stan.

The symptoms lead to a distress of the dysfunction

As a result of the disruption of the identities, the patient ends up suffering from stress. In the movie, Sybil is greatly distressed by her condition more so when she visits the doctor as she feels that soon everyone would know that she has been experiencing blackouts. When the doctor asks her for how long has it been happening, she claims that the trend has been recurring for as long as she can recall, she even claims that "Oh god – you know. Now everyone will know," which is a sign that she has been keeping it as a secret and she is afraid that other people would know about it soon.

The symptoms are not caused by religion, fantasy or cultural practices

The DSM – 5 treatment tool dictates that the symptoms exhibited by a DID victim must not be caused by the religious, fantasies, or even cultural practices. Therefore, they cannot be explained from any of these perspectives.

The symptoms cannot be attributed to the psychological effects arising out of substance or drug abuse

In addition, the model postulates that the causes of the symptoms cannot be traced to drug or substance abuse. As a result, it cannot be argued that the patient exhibits a respective behavior if he/she is under the influence of alcohol or drugs.

As the DSM – 5 model indicates, there are a number of reasons that make one convinced that Sybil fits in it. To start with, she experiences an identity disruption that makes her incapable of realizing people in the usual manner. In addition, she experiences a memory lapse quite often, which makes it difficult for her to recall some of the things he might have done. Her behaviors also depict that she is under stress, thus, the reason why she fears that people might know that she has been experiencing blackouts. Sybil's mental disorder is not caused by any substance or drug abuse, neither can it be linked to the religious and cultural dictations of her community. The film demonstrates that her psychological distress emanates from the abuse that was met on her by her mother. As a result of the mental illness Sibyl's mother suffered from, she (her mother) used to torture her while she (Sibyl) was young. For example, her mother used to trip her, kick her, tie her using a rope, and even enclosing her in a box. While in the green kitchen, Sybil's mother used to tie her legs to a chandelier and pour water on her private parts, a factor that might have frustrated her (Sybil), hence, making her suffer from the mental disorder.

Etiology

Causes of the physiological disorder

Scholars have proposed a number of factors that are believed to be the main causes of the dissociative identity disorder, one of them being trauma. Vermetten, Dorahy, Spiegel (2007) point out that a traumatic experience during the early childhood experience has the potential to make the individual suffer from DID. For instance, if a child is subjected to multiple types of malpractices while he/she is relatively young, there is a high probability that his/her mental state would be adversely affected, thus, making him/her more prone to mental ailments such as DID. The trauma can take place in the form of sexual abuse, physical abuse, or even as a natural disaster. Nevertheless, there exist some other causes that have been linked with the development of DID, such as the loss of one's parent or prolonged periods of loneliness, which might adversely affect an individual's mental state. The International Society for the Study of Trauma and Dissociation points out that four factors play a key role in the development of the dissociative identity disorders: potential for dissociation, occurrences that vanquish one's probability to cope with the nondissociative experiences, a secondary mechanism that structures DID by offering alternative identities such as individualized characteristics like age, gender, or even names, and the absence of a mechanism that would help one to feel consoled or soothed in order to help him/her overcome the traumatic experience, thus, making him/her feel lonely and isolated.

Treatment

Several modes of treatment have been proposed as effective means of getting rid of the dissociative identity disorder. According to Chlebowski and Gregory, some of the treatment models that can be adopted include hypnosis, family therapy, group therapy, cognitive behavioral therapy (CBT), and psychodynamic psychotherapy (Chlebowski & Gregory, 2012). Nevertheless, the scholars point out that the most common treatment that is used by most clinicians is hypnosis, which involves organizing for several meetings with the physician over a given period. During the meetings, most doctors talk directly to the patients even if he/she (the patient) might be experiencing an identity disruption. By doing so, the therapists strive to uncover some of the traumatic experiences that would be linked to the client's behaviors, hence, identifying the best way of making sure that a favorable solution is offered. However, enough evidence in favor of the hypnosis mode of treatment has not been gathered, thus, the therapists rely on case reports. According to Coons, five out of twenty patients suffering from dissociative identity disorder have been successively integrated back into society through hypnosis (Chlebowski & Gregory, 2012). The International Society for the Study of Trauma and Dissociation (2011) argues that appropriate clinical diagnosis of DID enables the patient to fully recover. According to the organization, some of the challenges in treating the disease arise from the failure of the therapists to have a comprehensive knowledge of the dissociative ailments, the clinicians' biases, and the far-reaching consequences of the psychological trauma. To guarantee the delivery of effective treatment services, the medical practitioners are taught 'standard diagnostic interviews and mental status examinations' that are applied during the therapy sessions (International Society for the Study of Trauma and Dissociation, 2011). In addition, the organization dictates that the treatment for the dissociative identity disorders should be carried out as outlined by the psychotherapy principles and that therapists should make use of any specialized techniques in only some specified areas where the medical officer wants to address a specified dissociative symptom. In the movie, Sybil is taken to see a physician – Doctor Wilbur. However, this is against her father's wish as he is a very religious man who is convinced that God is the Mighty Healer, hence, people who seek the services of doctors have very little faith. Dr. Wilbur organizes three meeting with Sybil as she treats her. During the first meeting, she recognizes that Sybil suffers from a dissociative disorder after she fails to recall what had happened in the last thirty minutes. During their second meeting, Dr. Wilbur discusses her experience with Sybil with Dr. Lazarus and claims that she (Dr. Wilbur) was planning to use the psychoanalysis method to treat Sybil. In addition, Dr. Wilbur plans to use the hypnosis method, but unfortunately Sybil dissociates into a child. However, after Sybil is disguised as Vicki, the doctor starts the hypnosis process. It is at this time that the doctor realizes the traumatic experiences Sybil had undergone in her early years due to the constant mistreatment she faced from her mother. Later, she injects Sybil with a drug whose main objective is to offer a sedative-hypnotic effect. In their final meeting, Dr. Wilbur asks Sybil whether she was still contemplating committing suicide, but she (Sybil) denies it and even claims that she has never thought about it. In addition, she claims that she does not suffer from multiple personalities, which is a sign that the treatment rendered to her was effective. She even agrees with Dr. Wilbur to get hypnotized once more to prove that she was not suffering from any mental condition.

Conclusion

Dissociative identity disorder is a mental condition that has been noted to affect quite a significant population all over the globe. In addition, as Chlebowski and Gregory suggest, it has been found that most of the patients suffering from mental disorders are victims of the dissociative identity disorder. The movie Sybil illustrates some of the causes of DID and the treatment mechanisms that can be adopted as well. Sybil – the main character in the film – suffers from DID as a result of the past mistreatment that had been meted out to her by her mother – who was also suffering from a mental disorder. Nevertheless, it is paramount to note that DID is not caused by misuse of drugs and abuse and it cannot be attributed to the cultural and religious practices of one's society. As the International Society for the Study of Trauma and Dissociation claims, the disease advances due to four conditions: the occurrence of the traumatic incidence, the inability of an individual to cope with the dissociation, secondary factors such as age or gender that play a critical role in advancing the development of the ailment, and the lack of consolation that can help one to overcome the trauma, hence, making him/her feel isolated. To ensure that the therapists administer the right treatment to victims of DID, the International Society for the Study of Trauma and Dissociation has put in place various standards that the clinicians must adhere to at all times. In addition, medical officers are supposed to make use of the DSM – 5 treatment tool to justify whether one might be suffering from the dissociative identity disorder. DID is exhibited in various forms, which may include the change (alteration) in one's personalities. At such a point, one assumes various personalities, which makes it difficult for him/her to identify their real identity. Additionally, individuals with DID experience frequent memory lapses, making it impossible for them to recall recent events. As exhibited by Sybil, DID victims also experience blackouts quite often. There are various methods that can be used to offer treatment to a DID victim, which include hypnosis, psychoanalysis, group or family therapy, psychodynamic psychotherapy, and cognitive behavioral therapy. However, the most commonly used technique is the hypnosis model, whereby the doctor strives to gather any information that is related to any traumatic experience that might have taken place in the life of the victim.

References

Chlebowski, S. M., & Gregory, R. J. (2012). Three cases of dissociative identity disorder and co-occurring borderline personality disorder treated with dynamic deconstructive psychotherapy. American journal of psychotherapy, 66(2), 165-180.

International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115-187.

Vermetten, E., Dorahy, M. J., & Spiegel, D. (Eds.). (2007). Traumatic dissociation: Neurobiology and treatment. American Psychiatric Pub.