Treatment
Since Dissociative Identity Disorder is
a mental disorder, treatment involves much time and patience.
Also, there are very few effective methods for such a problem.
One method is group therapy in which people with the disorder
come together to talk to and help each other. As far as
medication is concerned, it is not recommended.
Another good method, which is considered the most effective
treatment is long-term psychodynamic/cognitive psychotherapy,
which is further, facilitated by hypnotherapy. This type of
therapy consisting of trauma work can take anywhere from 3 to 5
years. Before this type of work can be done, however, there must
be a period of assessment and stabilization.
The assessment covers a wide range of topics. These include
history, symptoms (e.g. depression, rage, flashbacks, anxiety,
one's self), relationship difficulties, family history, eating
disorders, substance abuse, social support system, safety (of
self, to and from others), and medical status.
The next step is stabilization of the patient. The therapist, as
well as the patient should develop a plan for stabilization using
different types of treatments. These include individual
psychotherapy, expressive therapies (such as poetry, art,
movement, music), group therapy, and psychoeducation. For a more
comprehensive assessment and stabilization, hospital treatment
may be necessary.
Stabilization includes ensuring both emotional and physical
safety as well as developing a "cognitive framework".
This framework involves sorting out the thoughts and feelings of
the patient as well as undoing damaging self-concepts. Basically,
"Stabilization is a time to learn how to ask for help and
build support networks. This particular stage of treatment may
take years to complete. Generally it should take, as much time as
is necessary for the patient to move safely in the next stage
which is the trauma stage.
This stage includes revisiting and re-working the trauma. One way
to accomplish this arduous task is to "re-experience a
traumatic event accompanied by the release of related emotion and
the recovery of repressed or dissociated aspects of that event .
This is an example of an abreaction. An abreaction can be defined
as a method to release pain and allow dissociated trauma back
into the normal memory track.
A useful tool in abreactive work is hypnosis, which not only
safely contains the abreaction, but also releases the painful
emotions more quickly. When doing this type of work, one must
keep in mind to keep it "paced and contained" as to
prevent retraumatization as well as giving the patient a feeling
of "mastery" .
To ensure this is done correctly, the speed of the work must be
carefully monitored. Also, the release of the painful material
must be well managed and controlled so as not to be overwhelming.
One last point to keep in mind is that an abreaction of a person
diagnosed with DID may involve different alters of the individual
which must "all" participate in the work .
When ready, the individual must move into the final stage of
therapy. This stage involves further processing of traumatic
memories and cognitive distortions in order to let go of the
gathered shame. Towards the end of therapy, "the survivor
can reclaim self-worth and personal power and rebuild life after
so much focus on healing".