What is the outlook in dissociative identity disorder?
Research has been carried out, looking at the progress of people with dissociative identity disorder (DID) in long-term therapy. The findings of the research have been encouraging.
Research evidence suggests that appropriate, one-to-one, long-term therapy has a positive effect on DID symptoms. It suggests that after two years of therapy, clients with DID report:
- Fewer mood and anxiety symptoms.
- Fewer dissociative episodes.
- Fewer distressing trauma symptoms.
There is evidence too of fewer hospitalisations, reduced use of psychiatric medication and fewer episodes of self-harm.
Despite fears to the contrary, evidence suggests that working sensitively with dissociated identities can be beneficial. It can increase the integration of personality parts and decrease the frequency of dissociative episodes. In the past, it had been thought that working directly with dissociated identities could make DID worse. Some believed that it could increase the characteristics of the dissociated identities, worsening DID symptoms. Evidence seems to suggest that this is not that case. If fact, working in the right way with identities can help to reduce distressing symptoms.
Treatment for DID can be challenging and time-consuming. However, over time, integration of identities and symptom improvement are possible. With the right therapy, the right support and good motivation, evidence shows us that change is possible.
Further reading and references
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
Brand BL, Sar V, Stavropoulos P, et al; Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder. Harv Rev Psychiatry. 2016 Jul-Aug24(4):257-70. doi: 10.1097/HRP.0000000000000100.
Reinders AA, Willemsen AT, Vos HP, et al; Fact or factitious? A psychobiological study of authentic and simulated dissociative identity states. PLoS One. 20127(6):e39279. doi: 10.1371/journal.pone.0039279. Epub 2012 Jun 29.
Brand, B. L., Myrick, A. C et al. A Survey of Practices and RecommendedTreatment Interventions Among Expert Therapists Treating Patients With Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified. Psychological Trauma:Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0026487 (2011)
Cronin E, Brand BL, Mattanah JF; The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders. Eur J Psychotraumatol. 2014 Mar 65. doi: 10.3402/ejpt.v5.22676. eCollection 2014.
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