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Kaiya Brand

Mrs. DeBock

English 4 Honors

April 6 2017

Treatment Methods for DID

Although the validity of Dissociative Identity Disorder (DID) is heavily disputed, the

treatment methods are not as debated. Both the doctors and the therapists have come together in

order to ensure that the client has the most effective form of treatment to help the client reach

his/her goals. Although a complete recovery is not expected, the client can merge alters together

as well as eliminate unneeded personalities. Doctors have worked hard to provide the client with

proper medications to decrease the symptoms of DID while the client is trying to process through

the therapy plan. Also, the therapists have created methods of psychotherapy that can work to

control the clients dissociation. Although the recovery process is long and difficult, it has proven

to be effective and to help the client live a more normalized life. Through several studies,

processes such as creating a safe environment, tactical integration, prescribing medicine,

physical therapy, and becoming involved in real-world activities have proven to be the most

effective forms of treatment for DID.

According to experts, one of the most critical necessities of DID therapy is creating a safe

environment while also encouraging the client to get involved in his or her community. Before

beginning any course of therapy, safety should be established and therapeutic expectations

should be discussed in order to prevent any miscommunications (Kluft 290-291). Due to

previous abuse, DID clients typically have extreme trust issues as well as over attachment; so the

client must know the counselor is a safe person to talk to. When a client feels they cannot confide
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in a counselor, the host will be less likely to share any details about previously inflicted trauma

or feel comfortable enough to change altars freely. While the role of religious coping is an

experimental DID treatment, results have found it to be relatively ineffective; however, getting

involved in social groups, such as a church, are effective steps of therapy (Bell 159-159).

Because many cases of DID were caused by satanic ritual abuse, many religious tactics were

tested to see if that form of therapy would be effective. The results showed that it was effective,

but not because of the spiritual aspect of it; rather, the DID clients were able to make

improvements due to the involvement of a church group. DID patients have a tendency to isolate

themselves and rely solely on themselves and their counselor. However, in order to achieve the

best therapeutic results, the counselor should encourage the client to get involved in several other

social relationships rather than just the one in the office. This social integration allows for the

regaining of social skills as well as giving the client an opportunity to use the skills that were

learned in the therapy sessions.

Other more medical approaches, such as medications, EMDR, and physical therapy, have

found to be effective in the progression of DID patients toward a more normal way of living.

Deville says that, Selective serotonin reuptake inhibitors (SSRIs) treatment allows for the

reduction of comorbidities, such as anxiety and depressive symptoms, although SSRIs have little

effect on the dissociative disorder itself (4). While most doctors resort to medication in order to

treat DID, studies have shown that the medications only help the symptoms of the disorder, such

as depression and anxiety. This is why it is critical to enforce a two-treatment plan that includes

both medication (for the symptoms) and psychotherapy (for the dissociation). When both forms

of treatment are enacted, it hinders anxiety, depression, and suicidal thoughts while

simultaneously controlling the dissociation. Eye Movement Desensitization and Reprocessing

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(EMDR) is another popular tactic used to help the client process the inflicted trauma by using

skills similar to hypnosis. When this mean of treatment clears the emotional blockade in the

clients brain, it allows for the brain to heal itself from the previous trauma (Kluft 293). Using

this technique allows for a more medical approach to the treatment process and will leave the

client feeling more comfortable with discussing the trauma through psychotherapy. Although it is

a less popular form of therapy, physical therapy has emerged as another mode of helping those

with DID to cope with their disorder. Precin gives an in depth look at the case of a client that

endured satanic ritual abuse for her entire childhood until she was admitted into a hospital where

several treatment tactics were used, including physical therapy, to help control her dissociation.

One of the most effective treatments was when the client was asked for each of her altars to run

for five minutes each on a treadmill (Precin 62). The combination of physical movement with the

psychological switching of alters forced communication between each personality. After each

alter walked the treadmill once per day for six months, studies were conducted and it was proven

that the physical therapy caused distinctive healing.

Although current technologies inhibit DID from being completely healed, tactical

integration helps move toward the second best possible outcome: the integration of two or three

altars rather than several. In short, tactical integration focuses on increasing communication

between each alter about the trauma, with the hope that the sharing of the information will lead

to the joining of alters (Slack 1). The treatment recommends that the counselor talks mostly to

the host in order to perceive the other alters as less real, but it also requires the occasional

confrontation of separate altars. When a person develops DID, he separates the memories of

abuse into several different personalities in order to prohibit the host from having to remember

the entirety of the abuse. Tactical integration forces all of these separate memories to come out
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simultaneously and to form one cohesive memory of what actually happened at time of the abuse

(Fine 363-264). This causes the personalities that were formed during close periods of abuse to

finally form into one person that understands everything that happened during the trauma. It can

also lead to the eliminating of the alters that come out less frequently, since the little information

they held about the trauma had been shared with a more dominant alter. Although, on average,

this tactic has proved to be the most effective way of integration, it works differently for every

client and there is no improvement guarantee. However, it is highly recommended that the

counselor combines this approach with the use of several other tactics which were previously

mentioned.

Just as DID is a combination of several distinct personalities, its treatment is a mixture of

different means of therapy in order to reach the best outcome. While each form of therapy

mentioned has proved to be successful in helping a client cope with DID, the combination of all

forms of therapy into one coherent treatment plan is the most effective approach. Many doctors

and scientists recommend the use of medical approaches, such as medications and EMDR, to

best treat the symptoms of the disorder. The use of these medical tactics allows for the

controlling of the depression, anxiety, and suicidal actions that are typically associated with the

disorder. Once these symptoms are controlled, the counselor can set up a psychotherapeutic plan

to help the client process and grieve over the previously inflicted trauma. One of the most critical

steps in the therapy plan is to ensure that the client feels like he/she is in a safe environment and

that he/she can freely share information to the counselor in total confidentiality. The counselor is

also recommended to encourage the patient to go out of his/her comfort zone and become

involved in a group or relationship outside of the one with his/her counselor. Once these

preliminary precautions are put into place, the therapist can begin the tactical integration method
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in which he/she works to increase communication between each alter. Each tactic alone is

successful, but when each method merges into one thought-through plan, it benefits the client.

Although they may have differences, the doctor and the counselor need to merge their plans into

one coherent method in the same way that the DID patient must merge his/her personalities into

one.

Works Cited

Bell, Hope, et al. "The Role of Religious Coping and Resilience in Individuals with Dissociative

Identity Disorder." Counseling & Values, vol. 60, no. 2, Oct. 2015, pp. 151-163.

EBSCOhost, 15 March 2017.

Devill, C., et al. "Dissociative Disorders: Between Neurosis and Psychosis." Case Reports in
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Psychiatry, Jan. 2014, pp. 1-6. EBSCOhost, 16 March 2017.

Fine, Catherine G. "The Tactical-Integration Model for the Treatment of Dissociative Identity

Disorder And.." American Journal of Psychotherapy, vol. 53, no. 3, Summer 1999, p.

361. EBSCOhost, 16 March 2017.

Kluft, Richard P. "An Overview of the Psychotherapy of Dissociative Identity Disorder."

American Journal of Psychotherapy, vol. 53, no. 3, Summer 1999, p. 289. EBSCOhost,

15 March 2017.

Precin, Patricia. "Return To Work: A Case Of PTSD, Dissociative Identity Disorder, And Satanic

Ritual Abuse." Work 38.1 (2011): 57. Advanced Placement Source. Web. 21 Feb. 2017.

Slack, Cath. "Dissociative Identity Disorder: Improving Treatment Outcomes." Healthcare

Counselling & Psychotherapy Journal, vol. 14, no. 1, Jan. 2014, pp. 43-45. EBSCOhost.