Posted by Toby on April 27, 1999, at 8:06:36
In reply to Re: MPD/DID----TOBY, posted by us on April 26, 1999, at 20:21:10
I posted here yesterday, but it seems to have been lost. I will repeat myself and if the other post shows up, I apologize for the repetition.
Dissociation is a natural phenomenon that nearly everyone can do. The average person experiences dissociation while driving down the road on long or very familiar trips: they can operate the car and respond to environmental stimuli while being completely unaware of doing so because they are deep in thought about something else. Other instances would be things like zoning out during boring conversations or lectures, having an old memory triggered and "going there" but still doing whatever you were doing before. During traumatic events many people dissociate from the sounds, pain, etc while others do not. Children who grow up in violent or otherwise abusive households dissociate more because it becomes a "learned" phenomenon; there's more opportunity and necessity to do so and kids use what they know works. Once a child learns to dissociate on a regular basis, it is a hard habit to break. If, in childhood, the person names different parts or emotions that they have (much like non-dissociative children name imaginary playmates), and then never "grows out of it," i.e., gets into a safe environment and stops needing to dissociate, then you have the makings of DID. Trouble arises for the adult who is able to dissociate and does so frequently, when a therapist begins asking them to name emotions or states of being and treating them as separate people, even though the patient him/herself has never done so before. All the problems and traumas of the past and the current problem of too much dissociation could be treated independently, but adding in problems that didin't exist before just complicates the picture and makes it difficult for the patient to resolve anything, because now they have to worry about treating every part of themselves as a separate entity and make sure everybody agrees with everything being done. I have never seen a dissociative person get better through addressing every emotion as a person (but that's just me), but I have seen many many dissociative people get way better through addressing the traumas that they remember (not creating memories for the times that they don't remember, because after all, the dissociation goes way back and they probably don't have memories for the times they were "zoned out" just like average people don't have memories for the trips they take during "road hypnosis") and through various techniques (and sometimes medications) to decrease the amount of time spent dissociating.
To the specific question of telling the difference between bipolar disorder and DID: of course, the two disorders could occur together, but the differences are that dissociation occurs sporadically, from minutes to hours and I suppose up to days (like in a fugue state) whereas mania and depression occur from days to months at a time and have more to do with one's mood state than specific emotions that come and go. Dissociation is not a "mood" but a state where one becomes unaware of what's happening in the environment but is aware of what's happening in the mind (most of the time a person should be able to recall what they were thinking about unless they were startled out of their reverie and immediately distracted by what's in the environment).
Some people will swear and declare that DID doesn't exist or is created by evil therapists while others swear and declare that DID is completely real and always should be believed when a therapist has made the diagnosis. What both of these extremes forget is that the "alters" or different "personalities" are not "real people," i.e., there aren't 2-20 "people" living inside one body. Those who "believe" in DID end up treating each emotion or ego state as a "real person" and catering to it as a "real person" (essentially adding fuel to unwanted behaviors) while those who don't "believe" end up ignoring the patient's ability to dissociate and thereby ignore the emotions and ego states that need to be addressed because the patient has indeed cut them off from consciousness due to past abuses.
I'm sure I've unintentionally said some inflammatory things here; but I'm open to further discussion.
poster:Toby
thread:4871
URL: http://www.dr-bob.org/babble/19990501/msgs/5350.html