We will understand dissociative identity disorder, through a qualitative research, bringing academic concepts, famous cases that brought up this subject that is not much covered, and experiences of skilled professionals in the area, always having a humanized vision and a cautious look at the situation.

This approach is relevant because several cases are appearing, due to childhood traumas and among others, one cannot imagine that some fact experienced in the past can have great relevance in adult life and even prevent someone from being able to live normally.

Table of Contents

• Dissociative identity disorder
  • Psychopathologies in Society and Dissociative Identity Disorder
  • Autopilot
• Dissociative identity disorder and lifestyle
• Dissociative Identity Disorder.
  • THE TDI
• Media stories about TDI
  • A natural reaction
  • The diagnosis of dissociative identity disorder
  • Several personalities
• Conclusion on dissociative identity disorder
  • To treat...
  • Bibliographic references

Dissociative identity disorder

As a hypothesis, we assume that dissociative identity disorder is more present in society than we imagine, and needs to be treated with caution, because it is a chronic disorder; the person cannot remember what he or she did, because he or she was in "another body", Due to traumas that have occurred during one's life, it is something sudden, and the person has an amnesia that can last for hours or even days. It is as if he is not in his body, as if he were changing his body suddenly, several times. As objectives, we will seek to demonstrate in this work the importance of correctly identifying dissociative identity disorder, reports that have appeared in films and series, and how to proceed with the analysis, how the professional should behave and attend this patient. In the first part of thework, we will cover what dissociative identity disorder really is, in full In the second part, as a development of the work, examples will be given of patients who were highlighted in the media for having this disorder and for having made bad attitudes according to their state at the time. The methodology usedwas qualitative, based on a review of articles, books, interviews, and other academic records.

Psychopathologies in Society and Dissociative Identity Disorder

We live in a society where people go through great psychological difficulties, we are in a time where everything is instantaneous, there are many activities that we need to perform on a daily basis, many responsibilities, often putting aside even their health. "More recently, from another theoretical strand of psychoanalysis, Roudinesco (2000) has made an analysis from which he concludes that contemporary society is fundamentally depressive. He thus presents ideas that coincide with those of Bergeret (1974). The patients sought care to deal with what is called emptiness of desire (VAISBERG,2001)". People are getting sicker, especially, having psychological problems that in a few years ago were never seen. But why is the number of people with psychological illnesses increasing? Today we are faced with a society that aims for early development, both professionally and socially, wanting to develop as quickly as possible. We are faced with beauty standards, generating several eating disorders, which many times even lead to the death of the individual, due to a self-blame that he/she could not handle.

Autopilot

The continuous use of technology has led society to demand more, demanding standards that were never questioned by society, social networks end up generating a high rate of comparison, from children to the elderly. Nowadays we are faced with several situations that are often not in our control, due to the large number of tasks that need to be performed daily, work, family, friends, and among other situations that we face in our daily lives. Being on autopilot is very common, as we often find ourselves solving another everyday situation, while driving or even making a meal, in this way, you don't remember what you did during these tasks, unfortunately this is very common, You get so used to taking that road home after work that you take your mind to another state. After you arrive home your husband asks you this question, "Did you see the accident that happened on September 7th?remembering that you pass by this avenue every day, That way you answer, "gee, I didn't realize, my mind was elsewhere, This situation is very common, and we call it pathological dissociation; we forget basically everything during some task, because we were thinking about something else.

Dissociative identity disorder and lifestyle

It is essential to have a good lifestyle, to not go through these situations, to have a healthy diet, to practice mindfulness, to understand and appreciate every step of your daily life, because we go through a stressful life full of charges, we need to deal with all of this, deal with ourselves and know our limitations, there are factors in our lives that are uncontrollable, they are not in our hands, But there are things that we can change, taking care of ourselves and our difficulties. Read Also: Anxious people: characteristics, symptoms, and therapies Another important point to be discussed is childhood traumas, we can't imagine that many actions can generate blockages and even lead the individual to be who he is not, because the junction of all these factors discussed above, can reproduce situations that are not beneficial to anyone.

Dissociative Identity Disorder.

Have you ever heard of people who cannot remember long periods (months, days, hours), forgetting even their identity, emotions, personality, feeling disconnected in the world and from the people around them? In the international manual made for diagnosing mental disorders, this is classified as dissociative identity disorder, which can be divided into five, dissociative identity disorder, depersonalization/derealization disorder, dissociative amnesia, The first specialist to study this subject was Pierre Janet, who described about multiple personalities (MPD), and only in 1980, the American Psychiatric Association published in its manual of mental disorders the dissociative identity disorder, being the target of several studies and researches, In this way, the term was further developed, because it was not very well known by society, being the target of several neglects. In this disorder the person may find him/herself in two or more personality states, totally forgetting what he/she experienced at that moment. "[...] TDI is a mental condition that sometimes comes to be confused with post-traumatic disorder, for several factors, for example; being a recurrent mental condition of a suffered trauma. Where this differs by having dissociation as a necessary escape, because this dissociation arises as a way of dealing with this event, separating the Self from itself (FREIRE, 2016)."

THE TDI

TDI can be generated, due to traumas that occurred in childhood, usually in the first years of life, as if the individual could not cope with that whole situation, or by issues of abuse, even confrontations with himself. In these cases, the patient presents sudden changes in behavior, such as change in tone of voice, personality, physiognomy, and even gender. The diagnosis is not simple, because: "Trauma produces a dissociation, which is a discontinuity of experience (consciousness) and memory. Such psychic processes initially can function as defensesadaptive, preserving the ego from annihilation. Over time, according to Gabbard, Dissociation distorts personality development and the ongoing integration of experiences, self-perceptions and perception of other people's emotions, obliterating the development of mentalization skills, development of metacognitive skills that allow critical reflection on one's own or other people's state of mind "(DAL'PIZOL 2015).

Media stories about TDI

Imagine the following situation: three young students are doped and kidnapped by Kevin, a mysterious and disturbed man. Later, they wake up in a dark place and discover that he only kidnapped them because he considers them to be impure. Kevin presents variations of humor and personality, sometimes presenting himself with a childlike shyness and gentleness, sometimes showing his colder and scarier face. While the threeyoung people struggle for survival, follow the transformations of this man who varies between 23 different personalities.

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It sounds like a movie scene, right? Well, in this case it is. This 2016 cinematic work is called "Fragmented" and portrays a severe case of dissociative identity disorder, which is a real pathology, having its first recorded case around the 16th century, when Paracelsus (Swiss physician, alchemist and philosopher) featured a woman who was amnesic before an alter ego who had stolen her money. This pathology is often used in movies, literature, and TV, but it is important to look for information outside the artistic realm, trying to demystify some stereotypes.

Driving somewhere and realizing that you can't remember some details of the trip due to stress and worries of everyday life, or being distracted in a conversation and only later realizing that you weren't paying attention is common, it is called non-pathological dissociation. Occasionally, We all experience failure in the normal automatic integration of memories, perceptions, identity, and consciousness, About 50% of the general population has had at least one transitory experience of depersonalization or derealization in their lifetime. But only about 2% of people have the criteria for depersonalization/derealization. Read Also: Chemical dependency: treatment, therapy and ways to help

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A natural reaction

The big difference between this natural reaction and dissociative disorders is the degree of dissociation. People with dissociative disorder may completely forget a series of behaviors that lasted minutes, hours, days, or weeks. Experiencing a sense of detachment from their self (depersonalization), fragmentation of identity (personality dissociation), Loss of memory regarding important personal information (dissociative fugue), alteration of consciousness, as in a trance (dissociative trance), the latter often confused with spirit possession in religious cultural environments. Dissociative identity disorder (DID) often develops after oppressive stress, which can be generated by traumatic events or intolerable internal conflict. Basically it is a self-defense of the mind seeking to protect the individual from traumatic memories and situations. In interviews, it is common for patients suffering from this condition to state that the emergence of an alter ego (another self) occurred to spare the ego (self) from dealing with a very traumatic experience. The personalities may or may not interact with each other, and may or may not be aware of each other. It is possible for one personality to have memory of the experiences of another or all of them, and that personality is dominant. The cause is almost invariably oppressive childhood trauma. Diagnosis is based on history, sometimes with hypnosis or drug-facilitated interviews. Childrenare not born with a unified sense of identity; it develops from various sources and experiences. In oppressed children, many parts of what should have been integrated remain separate. Chronic and severe abuse (physical, sexual, or emotional) and neglect during childhood are almost always reported and documented in patients with IDD. Some patients were not abused, but experienced significant early loss (such as the death of a parent), serious illness, or other severe stressful events.

The diagnosis of dissociative identity disorder

"Differential diagnosis in adults includes comorbidities such as somatization disorder, post-traumatic stress disorder, seizures, and amnesia. Pseudoconvulsions and conversion phenomena are psychological processes similar to dissociative disorders. schizophrenia, schizoaffective disorder, Bipolar and unipolar mood disorders should be equally excluded" (DAL'PZOL 2015). Over time, severely abused children may develop the ability to escape abuse by "distancing" themselves, that is, disconnecting from their adverse physical environments or seeking refuge in their own minds. Each developmental stage or traumatic experience can be used to generate a different identity. One of the most striking TDI stories is of Chris Sizemore, who suffered a severe trauma as a child watching a dead man being pulled from a ditch. At the time, she told her parents that there was another girl there with her, but no one knew who it was. during childhood,Chris was scolded for actions she swore she had not committed. However, the discovery of the disease came only when she had a baby and one of her personalities, known as Eva Black, Chris spent many years in treatment and 22 very different personalities were discovered, which eventually merged into one. The story became a movie entitled "The Three Masks of Eva".

Several personalities

Billy Milligan was the first person in the world to be acquitted of a crime due to a diagnosis of TDI. In the 1970s, three women were raped in the United States, The description of the victims was quite distinct with regard to the personality of the offender, However, they had all been attacked by Billy who, at the time, was only 22 years old. It was discovered that the young man suffered from the disorder, having 24 personalities, and that at the time of the crimes, was in charge the personality of a Yugoslavian man named Ragen and a woman named Adalana. Although he was acquitted of the crimes, Milligan spent years in psychiatric treatment until doctors reached the consensus that the personalities had merged.

Conclusion on dissociative identity disorder

The cases cited above manifested themselves in the possession form, where identities are easily visible to family members and co-workers. Patients speak and act in an obviously different way, as if another person or being is taking control. In the non-possession form, the different identities are often not so evident. Instead, patients experience feelings ofdepersonalization, they feel unreal, removed from their own self, and disconnected from their physical and mental processes. Patients say they feel like an observer of their lives, as if they are in a movie over which they have no control.Read Also: Dissociative Identity Disorder: definition and symptoms Depersonalization/derealization disorder occurs equally in men and women.The average age at onset is 16.The disorder can begin in early or mid childhood;Only 5% of cases develop after the age of 25, and it rarely starts after the age of 40. IDT demands psychiatric follow-up throughout the individual's life. He can choose whether or not to merge the different identities into one. Integration of the identity states is the most desirable outcome for treatment. Drugs are widely used to help treat symptoms of depression, anxiety, impulsivity and substance abuse, but do not alleviate the dissociation itself. For patients who cannot or do not strive for integration, treatment with psychotherapy aims to facilitate cooperation and collaboration between identities and reduce symptoms.

To treat...

To treat this psychopathology is not easy at all, first of all it is necessary to have a careful and kind look at the family, pay attention to each change and be very patient, it is not something that will be cured overnight. Unfortunately in our country we have a great lack of resources, trained doctors, even access to medications that are beneficial for these patients, This disease is still seen with pejorative eyes, it is not seen as a disease by lay people, but as "freshness" or even "demonic possession", as mentioned before. But the accompaniment of a multidisciplinary team is essential, a doctor, psychologist, psychoanalyst, and family, which is a base that will help the individual in his healing process. Making the individual understand that he is no more than a person is a time-consuming job; eliminating this belief is not simple, but demands attention and care (MARALDI 2020), but it is not an impossible cause, with the correct treatment and trained professionals, we can reach the desired result.

Bibliographic references

BERGERET, J. (1984) Normal and Pathological Personality. Porto Alegre, Artes Médicas, 1974.

VAISBERG, T.(2001) A Função Social da Psicologia na Contemporaneidade, Congress of Clinical Psychology, 2001.

SANTOS MP dos, Guarienti LD, Santos PP, Dal'pzol AD. dissociative identity disorder (multiple personalities): case report and study. Debates in Psychiatry [Internet]. 30th April 2015 [cited 19th July 2022];5(2):32-7. Available from: /revistardp.org.br/revista/article/view/173

MIRALDI, E. (2020) Dissociative identity disorder: diagnostic aspects and clinical and forensic implications. Magazine: Interdisciplinary Frontiers of Law 2020. This article on dissociative identity disorder (DID) was written by ANA PAULA O. SOUZA, completing the Psychoanalysis Training Course.