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Treatment progress in 20 patients with multiple personality disorder
The Journal of Nervous and Mental Disease
|December 1, 1986
Summary
Treatment for dissociative identity disorder (DID) is challenging, but this study shows progress is possible. While many patients experience trauma, perseverance in psychodynamic psychotherapy and hypnosis can lead to integration.
Area of Science:
- Psychiatry
- Psychology
- Trauma Studies
Background:
- Treatment progress for dissociative identity disorder (DID) has been historically difficult to track.
- Previous studies often focused on successfully treated cases, limiting understanding of the broader patient experience.
Purpose of the Study:
- To longitudinally track the treatment progress of 20 patients diagnosed with dissociative identity disorder (DID).
- To identify factors influencing treatment outcomes and common therapeutic challenges in DID patients.
Main Methods:
- Detailed patient histories, neurological examinations, and psychological testing were conducted at intake.
- Follow-up involved patient interviews and therapist questionnaires assessing treatment response over a mean of 39 months.
Main Results:
- Nine out of 20 patients achieved partial or full integration; only five maintained complete integration.
- Unintegrated patients reported emotional trauma at double the rate of integrated patients.
- Psychodynamic psychotherapy and hypnosis were the most common treatment modalities.
Conclusions:
- Improvement in DID appears to be a stepwise process, moving from diagnosis acceptance to integration.
- Therapy was hindered by repression, denial, secrecy (linked to childhood abuse), and frequent crises.
- Therapist countertransference commonly included anger, exasperation, and exhaustion.
- Despite challenges, DID psychotherapy can be successful with sustained effort from both patient and therapist.