Dissociative Identity Disorder (Multiple Personality) Treatment at Helios West Palm

What Are Dissociative Disorders?

Dissociative disorders are a type of mental health disorder that involves disruptions in consciousness, memory, identity, emotion, behavior, perception, and sense of self that go beyond ordinary distraction or forgetfulness.[1] These disruptions of consciousness are involuntary and often rooted in a history of trauma, particularly childhood trauma that involved abuse or neglect.[2]

According to the DSM-5, dissociative disorders involve disruptions in the normal integration of consciousness, memory, and identity and are often understood to be responses to overwhelming stress or trauma.[3] They are not psychotic disorders or schizophrenia, though they are often confused with them, and should be treated as separate disorders with different criteria for diagnosis and treatment.

Types of Dissociative Disorders

According to the DSM-5, there are three types of dissociative disorders:

• Dissociative identity disorder (DID) — Formerly known as multiple personality disorder, DID is identified as the existence of two or more distinct personality states, or identities, that have their own particular way of understanding, perceiving, relating to, and thinking about the world. These identities may have their own name, age, gender, and other identifiable attributes. Recurrent gaps in memory for everyday events, personal information, and traumatic events are a defining feature
• Dissociative amnesia — Inability to recall important memories specifically regarding significant, traumatic life events. This type of amnesia is too extensive to be explained by ordinary forgetting and may include dissociative fugue, where a person travels or appears to act normally but does not remember doing so.
• Depersonalization/derealization disorder — Persistent or recurrent feelings of being detached from one’s own body, mind, or thoughts (depersonalization), or that the entire external environment is unreal (derealization), without interfering with the person’s ability to distinguish reality.

People with dissociative disorders frequently experience post-traumatic stress disorder (PTSD), depression, anxiety, or engage in self-destructive behaviors, with the common factor of having experienced an overwhelming traumatic event.[4]

What Causes Dissociative Disorders?

There is a general consensus that dissociative disorders are primary trauma responses, the psyche’s attempt to manage an overwhelming event that the brain cannot process normally. 

Below are some underlying causes:

• Childhood trauma —  Many with DID and other dissociative disorders have histories of severe, repeated childhood trauma, including physical, emotional, or sexual abuse and neglect. [5]
• Attachment disruption — Disruptions in early caregiving, typically neglect or inconsistent attachment, are associated with difficulties in developing a stable sense of self and may increase the risk of dissociative responses.[6]
• The nature of traumatic memory — Traumatic memory is encoded differently than ordinary life experiences. Memories of a traumatic situation can be fragmented, sensory, and emotional, with the person dissociating from the traumatic experience as a coping mechanism.[7]
• Biological factors — Individual differences in biological stress responses and neurobiology can influence how a person reacts to trauma and their likelihood of experiencing dissociative symptoms.[8]

Symptoms of Dissociative Disorders

There are multiple types of dissociative disorders and many ways the symptoms can present themselves. 

Examples of dissociative symptoms include:

• Memory gaps — Inability to remember important personal information, periods of time, or events, or having evidence of conversations or actions that can’t be remembered.
• Distinct identities or personality states — In DID, each identity or alter has their own sense of self, voice, memories, and ways to interact in the world. The person may or may not be aware of their alters.
• Depersonalization — A disconnect from one’s thoughts, feelings, sensations, or body, such as watching yourself from outside.
• Derealization — The external world appears unreal, foggy, dreamy, or distorted.
• Identity confusion — A lack of certainty regarding who they are, what they value, and whose thoughts or feelings belong to them.
• Voices or internal communication — Hearing voices or experiencing different identity states internally, particularly in DID.
• Risky behavior and self-harm — Dissociative disorders are linked with increased risk for self-harm, suicidal ideation, and substance use, particularly when co-occurring with trauma-related conditions.[9]
• Past traumatic experiences — Especially in people who meet the criteria for DID or dissociative amnesia with a history of trauma.

When to Seek Professional Help

If your dissociative symptoms are causing distress, impairing your ability to function, or threatening your safety, then a professional evaluation is warranted.

Residential treatment is particularly appropriate when:

• Symptoms are severe or are significantly disrupting day-to-day life, relationships, or safety
• Co-occurring disorders, including self-harm, suicidal ideation, depression, or substance use, require integrated clinical care
• There has been little to no stabilization or progress from prior outpatient treatment
• The presentation is complex, such as multiple alters, requiring consistent and structured support in a residential environment
• A trauma-informed and clinically competent treatment approach is required to work on the underlying trauma at the root of the disorder

Dissociative Disorder Treatment at Helios West Palm

To be effective, treatment for dissociative disorders such as DID requires clinicians who are trained and experienced in both trauma and dissociation, working within trauma-informed environments that prioritize safety and the patient’s autonomy. At Helios West Palm, the treatment team is trained to approach assessment and treatment with the sophistication and sensitivity these conditions require. After completing a comprehensive psychiatric evaluation, an individualized treatment plan will be developed to address the dissociative disorder as well as any co-occurring disorders. 

Benefits of Dissociative Disorder Treatment

The right clinical help over an extended period of time can provide a person with a dissociative disorder with many therapeutic gains in stability, functioning, and quality of life. Some of the benefits include:

• Improved internal stability, and in the case of dissociative identity disorder, improved communication and cooperation between identity states
• Decreased frequency and intensity of dissociative episodes
• Reprocessing of traumatic memories to decrease their remaining intrusiveness
• Better emotional regulation and less self-harm
• A stronger and more coherent sense of self and identity
• Improvement in how co-occurring disorders such as depression, PTSD, and anxiety are managed
• Improvement in the ability to function daily, in relationships, and to engage more fully in life