Monday, November 5, 2012

The DID Debate (Dissociative Identity Disorder)

I know...I am entering shaky ground here...

The debate surrounding the existence of DID continues.  So many of those I work with who present with this diagnosis doubt their own perception and the "truth" of their experience.  On the contrary, people who come in with depression, for example, don't have an argument with themselves about whether or not they are indeed depressed; people with anxiety are generally fairly certain of their experience.  In the case of DID, I wonder how many folks would have pervasive doubt if it weren't imposed upon them?  I can't think of any other circumstances where someone comes in for help, tells their therapist or psychiatrist "these are my symptoms" and they are met with "those symptoms do not exist" or "I don't believe in those symptoms" or "you are faking it."

So, let's ponder that for a moment.  A few questions come to mind.  First and foremost is why is it that clients who present with DID talk in the same way?  It's a very idiosyncratic way of referencing both the self and the world.  Additionally, why is it that the organization of their internal family is very patterned and very similar.  The types of alters, the types of conflicts between alters, the kinds of voices they hear that are not necessarily assigned to an alter~I could go on and on.  Why is it that many people with DID often have what appears of a sort of veil over their eyes~something quite distinctive?  And I guess finally, why would someone fake this particular disorder?  Why not something else?  And how would they know how to do it in a way that is so similar to other people who present with the same disorder?  And let's say it's true, that the disorder isn't "real."  In considering the response to someone who presents in a particular way, how therapeutic is it to dispute their truth without investigation or curiousity? What does that do, exactly?  And with the dispute of the diagnosis, what is offered in its' place~a different diagnosis?  

Just a few things for pondering...