Is cognitive behavioral therapy(CBT) effective for the treatment of Dissociative identity disorder(DID)???
Dissociative identity disorder is a mental disease that involves disruptions or breakdowns of memory, awareness, identity, and perception”.
DSM-5 has defines DID as “a disruption of identity characterized by two or more distinct personality states or an experience of possession (Gabbard, 2014)”.
In Dissociative identity disorder, a person develops one or more personalities that function with or without the awareness of a person’s usual personality. People with this condition are often victims of severe abuse or trauma in childhood. Females are more likely to be diagnosed with this condition. This condition is characterized by the presence of at least two personalities.
Many people with DID have grown up in an abusive family environment.
Causes of DID can be:
- Severe abuse (physical, verbal, sexual or mental) during childhood.
- Stressful situations like war or natural disasters.
- An early loss like the death of a parent.
People with DID disorder dissociate themselves from an outside world. They use dissociation as a defense mechanism against stressful events in their life.
Symptoms of DID are more likely as of PTSD and trauma.
- Depression, suicidal thoughts, anxiety, obsessive-compulsion.
- Depersonalization, derealization, sleep disorder, substance abuse.
- A lack of sense of self-identity.
- People experience gaps in memory of everyday events.
Diagnosis:- There is no specific definitive test, like a blood test, that can accurately assess that a person has dissociative identity disorder. The diagnostic criteria described within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for dissociative identity disorder are as follows:
1.The presence of two or more distinct identities or personality states (each with its own relatively persistent pattern of perceiving, concerning, and brooding about him or herself and the world)
2. At least two of the identities or personality states repeatedly take hold of the person's behavior.
3.An inability to recall important personal information that's too severe to be explained by ordinary forgetfulness
Many psychotherapies are used to treat DID. Treatment aims to help the person combat safe from painful memories, develop coping skills, recall memories integrate different personalities into one functional person.
Cognitive-behavioral therapy (CBT) is a goal-oriented psychotherapy treatment that has, practical approach to problem-solving. Its goal is to various patterns of thinking or behavior that are behind people’s difficulties, then change the way they feel. It is wont to help treat a good range of issues during a person’s life, from sleeping difficulties or relationship problems to drug and alcohol abuse or anxiety and depression. Cognitive-behavioral therapy are often thought of as a mixture of psychotherapy and behavioral therapy. Psychotherapy emphasizes the importance of the private meaning we place on things and the way thinking patterns begin in childhood. Behavioral therapy pays close attention to the connection between our problems, our behavior, and our thoughts.
People react emotionally and behaviorally to events consistent with their interpretation of these events. Our thoughts lead to our emotions and behavior. The way we interpret an event is linked to our core beliefs. Both nature and nurture interact to shape our personality. When our core belief is faulty, biased or distorted we end up drawing irrational conclusions.
CBT is predicated on a model or theory that it’s not events themselves that upset us, but the meanings we give them. our thoughts become too negative, that it blocks us seeing things or doing things that don’t fit – that disconfirm – what we believe is true.
CBT change dysfunctional thinking patterns. Also, it changes negative thinking and behavior. It identifies and challenges the faulty interpretation of the environment that is due to our core beliefs. It emphasizes on learning new ways of thinking. When a person with DID has a negative thought about the world, the CBT approach is beneficial to change their thinking. It helps you to identify and cope with specific challenges. It requires a few sessions. Our thinking patterns are found out in childhood and become automatic and comparatively fixed. So, a toddler who didn’t get much open affection from their parents but was praised for college work might come to think, “I need to have the best all the time. If I don’t, people will reject me.”
Actions, thoughts,, emotions are all connected to our mental health. CBT works on changing our thoughts and actions. Logics could be used to identify and discard false beliefs that lead to destructive emotions. We make decisions based on how we feel rather than logic.
There are several stages of CBT treatment:- establishing safety, stability working through and integrating traumatic memories, integration, and Rehabilitation.
In CBT we use a combination of verbal intervention and behavioral modification techniques to change the thinking patterns. Dissociative identity disorder patient has inaccurate thoughts about themselves, the world. CBT replace. These thoughts and practice new behavior. In this approach patients with dissociative identity disorder identify irrational beliefs and encourage clients to engage in activities that will counter their self defeating belief. The therapist must be interactive and active who can gain insight into their problem.
So, the treatment of the dissociative disorder is more complex and most drugs (e.g., antidepressants, anxiolytics) are suggested for comorbid anxiety and mood symptoms, but these medications do not specifically treat the dissociation. The most commonly recommended treatment orientation in particular cognitive behavioral therapy techniques is often modified to assist patients to explore and alter dysfunctional trauma-based beliefs or cognitions or manage stressful experiences.