Dissociative Identity Disorder: Skepticsm decreases with information and education about Dissociative Disorders 

Many studies have shown the majority of both psychiatrists and clinical psychologists view the diagnosis of Dissociative Identity Disorder (Multiple Personality Disorder) as valid. As understanding of Dissociative Disorders increases world-wide, skepticism decreases.

Warwick Middleton: Australian psychiatrist

Transcript

Now when the [trauma and dissociation] unit first started, there were psychiatrists in the hospital that was established who had the sort of reactions that were talked about here this morning, with raised eyebrows and shaking of heads, like borderline hell had just moved in. In fact, it’s sort of interesting that by not attacking, by not being overly defensive, by being warm, inviting, encouraging dialogue, giving appropriate information, research material, articles, books, et cetera, if they were requested, but certainly never attacking anyone for being a disbeliever or having a different paradigm, it’s very interesting over the years just how many of those psychiatrists that were openly incredulous and dismissive, have become stalwart admittants to the unit.  In fact, I can remember one psychiatrist … this is going back more than a decade and a half, who rang me, at that stage he was a senior registrar … it says something about the ambivalence about this area, he rang me saying he doesn’t believe that DID exists, but nevertheless he has a patient with it that he’s like to refer.

Research (Newest articles first)

Leonard, D., Brann, S., & Tiller, J. (2005). Dissociative disorders: pathways to diagnosis, clinician attitudes and their impact. Australian and New Zealand journal of psychiatry, 39(10), 940-946.
Abstract
Results: Of the 250 clinicians, 21% reported experience with more than six cases on average of any one of the dissociative disorders, 38% with less than six, 42% with none; 55% regarded them as valid diagnoses, 35% dubiously valid and 10% invalid. Of the 55 patients, 76% reported delays in diagnosis (57%, ❤ years and 25%, <10 years) with adverse consequences in 64%; 80% had experienced sceptical or antagonistic attitudes from clinicians, rated as destructive by 48%. They were disabled (60% rated as <50% impaired) and were heavy consumers of health services (48% hospitalized, 68% <5 times). There was considerable comorbidity including moderate or severe depression (96%), self-harm (68%), suicide attempts (69%), panic disorder (53%), eating disorders (75%), substance abuse (25%), poor physical health (44%), major interpersonal (70%) and sexual problems (90%). Patients rated individual psychotherapy as the most helpful treatment (90%) but medications, such as antidepressants, were also valued (60%). Conclusions: Although over half of the responding Australian clinicians thought that dissociative disorders were valid, the rest were dubious about their validity with 10% believing them to be invalid. Only 21% had considerable experience with the disorders. These findings may relate to some of the difficulties perceived by patients, which included delays in diagnosis, suboptimal treatment and negative experiences with clinicians. http://www.tandfonline.com/doi/abs/10.1080/j.1440-1614.2005.01700.x

Somer, E. (2000). Israeli mental health professionals’ attitudes towards dissociative disorders, reported incidence and alternative diagnoses considered. Journal of trauma & dissociation, 1(1), 21-44.
Results: Years  in clinical  practice  (including postgraduate  and registrar  training)  did not  differ  between psychologists  (mean =  16.1 years, SD  =  9.68)  and psychiatrists  (mean =  18.8 years, SD  =  10.05). Overall, there  was  a  greater  tendency to believe  in the  existence  of  the  condition with 48 (55.8%) respondents  replying “Yes,”  and 32 (37.2%)  replying “No”  to the  reality of  DID. Five  (5.8%) participants  replied “unsure,”  and one  did not  respond to this  item. Excluding the  unsure responses  and one  missing value, a  chi-square  analysis  between psychologists  and psychiatrists for  this  item  showed a  significant  relationship between profession and belief  (chi-square  =  13.00, p  <  .001). Psychologists  showed a  greater  tendency to believe  in the  existence  of  DID  (23 yes, 3 no), while  the  slight  majority of  psychiatrists  did not  believe  in the  clinical  reality of  DID  (25 yes, 29 no).

Abstract Clinical diagnoses of dissociative disorders (DDs), including Dissociative Identity Disorder (DID), are controversial because there are mental health professionals in North America and elsewhere who are skeptical about whether these psychiatric disorders actually exist. This paper explores the attitudes of mental health professionals in Israel toward DDs and DID through a survey of 211 practicing clinicians (return rate of 39.5%). Of the sample, 95.5% scored at or above the point on a 5-point Likert scale measuring belief in the validity of DDs (m = 4.17, SD = 0.78); 84.5% declared at least a moderate belief in the validity of DID (M = 3.5, S.D. = 0.97). The average Israeli clinician surveyed had made 4.8 career-long DD diagnoses (S.D. = 18.06) and carried an average of 1.05 DD patients in his/her caseload (S.D. = 2.86). DID had a career-long diagnosis frequency of 0.14 patients per clinician (S.D. = 0.59) and was currently seen at a frequency of 0.03 cases per clinician (S.D. = 0.20). The five most frequently considered alternative diagnoses to DID in Israel were Borderline Personality Disorder (24%), Psychotic Disorder/Schizophrenia (23%), PTSD/Anxiety Disorder (10%), Malingering (8%) and Depressive Disorder (7%). The findings suggest that attitudes of Israeli clinicians are similar to those of North American clinicians despite the geographical and cultural differences between them. Full paper – https://www.researchgate.net/profile/Eli_Somer/publication/232909347_Israeli_Mental_Health_Professionals’_Attitudes_Towards_Dissociative_Disorders_Reported_Incidence_and_Alternative_Diagnoses_Considered/links/02e7e51cef1213f1df000000.pdf

Cormier, J. F., & Thelen, M. H. (1998). Professional skepticism of multiple personality disorder. Professional Psychology: Research and Practice, 29(2), 163.
Abstract
 If you saw a patient who appeared to have more than one personality, what diagnosis would you make? And how would you vary your clinical approach? Data from 425 respondents indicated that the majority of psychologists believed multiple personality disorder (MPD) to be a valid but rare clinical diagnosis. Respondents cited extreme child abuse as the foremost cause of MPD. Approximately one-half of all respondents believed that they had encountered a client with MPD, whereas less than one-third believed that they had encountered a client who feigned MPD. http://psycnet.apa.org/journals/pro/29/2/163/
Professional attitudes to Dissociative Identity Disorder (MPD) in Britain: More on treating DID where it doesn’t exist.  Paper presented at the 4th conference of the International Society for the Study of Dissociation-UK branch. J Mcintee. 1998. and

Davis, J.D. & Davis, M.L. (1997). The prevalence of dissociative disorders within the mental health services of a British urban district.Paper presented at the Fourth Conference of the International Society for the Study of Dissociation. Chester, UK, April 19-11.

Summarized by Somer, E. (2000) A recent survey conducted in Britain sought to test the prevailing view in the United Kingdom academic press that DID either did not exist or was fashionably over-diagnosed by gullible practitioners, influenced by ill-advised North American colleagues. The survey was designed to examine British psychologists’ and psychiatrists’ attitudes towards the identification and treatment of dissociative disorders (McIntee, 1998). Dissociative disorders had been encountered by 66% of respondents, of whom 14% attributed dissociation to iatrogenesis. The 965 British mental health professionals responding to the survey reported having seen a total of 3225 clients with DDs, 526 clients diagnosed as DID, and 596 clients with Dissociative Disorder–Not Otherwise Specified. The estimated life prevalence rates for a British research sample reported a year earlier were 15.2% for DDs in general and 5.7% for DID specifically, with clinical profiles resembling those described in the North American literature (Davis & Davis, 1997).
Hayes, J. A., & Mitchell, J. C. (1994). Mental health professionals’ skepticism about multiple personality disorder. Professional Psychology: Research and Practice, 25(4), 410.
Abstract
Three studies were conducted to investigate the nature of mental health professionals’ skepticism regarding multiple personality disorder (MPD). An initial pilot study was conducted to develop a psychometrically sound survey instrument. In Study 2, the results of a national survey of 207 mental health professionals supported the hypothesis that skepticism and knowledge about MPD are inversely related, r = –.33, p < .01, although the strength of this relationship varied among professions. Moderate to extreme skepticism was expressed by 24% of the sample. Results from Study 3 supported the hypotheses that MPD is diagnosed with less accuracy than is schizophrenia and that misdiagnosis of MPD is predicted by skepticism about MPD. Findings are related to literature pertaining to mental health professionals’ skepticism about MPD and consequential effects on treatment. http://psycnet.apa.org/journals/pro/25/4/410/

Dunn, G. E., Paolo, A. M., Ryan, J. J., & Van Fleet, J. N. (1994). Belief in the existence of multiple personality disorder among psychologists and psychiatrists. Journal of clinical psychology.
Abstract
Surveyed the attitudes of 664 psychologists and 456 psychiatrists with regard to the existence of dissociative and multiple personality disorders (MPDs). 97.5% of the Ss indicated that they believed in dissociative disorders, while 80% reported a belief in MPD. 12.3% did not believe in MPD, and 7.7% were undecided. Belief in MPD was related significantly to profession, age, and years of experience. Young Ss with less professional experience believed more in MPD than did older Ss. Ss who had worked with patients with MPD would tend to believe in the entity. http://psycnet.apa.org/psycinfo/1995-21368-001

Barton, C. (1994). Backstage in psychiatry: The multiple personality disorder controversy.
Abstract
Arguments about the existence of multiple personality disorder (MPD) are creating a professional dispute. Skepticism is manifested in literary as well as behavioral forms. The most widely cited recent skeptical paper is that of H. Merskey (see record 1992-31500-001). Merskey uses arguments that are sociological in nature but with little attention to empirical evidence. Merskey’s skepticism about MPD differs from skepticism in natural science. Proponents’ research is ignored rather than being subjected to critical examination and disproof through attempted replication. His skepticism appears largely based on challenges to the integrity of MPD patients and questions about the competence of therapists. http://psycnet.apa.org/psycinfo/1995-29438-001 Mersky’s response – and Barton’s response to it

Dell, P. F. (1988). Professional skepticism about multiple personality. The Journal of nervous and mental disease, 176(9), 528-531.
Abstract
Therapists who have treated patients with multiple personality disorder (MPD) were surveyed about professional skepticism regarding the existence of MPD. Of these therapists, 78% reported that they had encountered intense skepticism from fellow professionals. Much of this skepticism appears to be explainable in terms of a) the lengthy decline of psychiatry’s interest in dissociation, b) under appreciation of the prevalence of individuals with dissociative ability, and c) misconceptions about the natural clinical presentation of patients with MPD. These factors, however, could not explain the behavior of those skeptics who deliberately interfered with the clinical care of patients and who engaged in repeated acts of harassment against the patient and/or therapist. Half of the survey respondents reported that they had encountered these latter forms of extreme skepticism. http://journals.lww.com/jonmd/Abstract/1988/09000/Professional_Skepticism_about_Multiple.2.aspx


The Cupcake incident – a personal story of Shame and Guilt

'Unlike guilt, which is the feeling of doing something wrong shame is the feeling of being something wrong.' Marilyn J. Sorensen 

Unlike guilt, which is the feeling of doing something wrong, shame is the feeling of being something wrong – Marilyn J. Sorensen

If something bad happens, do you normally think it is your fault and search for what you did wrong?

Many survivors of child abuse automatically blame themselves for anything bad, and feel guilty and ashamed most of the time – especially about anything related to their immediate family.

Can you remember how old you were when you first felt this way?

Where do our feelings of guilt and shame come from?

Darlene, a survivor of multiple types of child abuse, explains one of the things that gave her the core belief that bad things were always her fault, and that the abuse was her fault.

The Cupcake incident – How Shame and Guilt get misapplied to the Self

Related Links

Suffering and scars quote

sufferigkahlilgira

“Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.”

― Kahlil Gibran

Related links

Have you been blamed for your mental health problems? For not recovering ‘fast enough’?

Why this repeated tenancy to blame those with problems for their problems?

Why this repeated tenancy to blame those with problems for their problems? The mentally ill are likely to be told to just snap out of it. For most people who have a mental illness snapping out of it is only slightly more difficult than growing a few inches because you should be taller.

David Joel Miller’s post goes on to explain some of the difficulties overcoming problems like homelessness, addiction, and anxiety.

“all too often treatment programs are organized to meet the needs of the system not the individual”
David Joel Miller

20 of the best mental health jokes and humorous quotes

 

Patients Verses Psychiatrists Q. What's the difference between the psychiatrists and the patients at the mental hospital? A. The patients are the ones that eventually get better and go home!

Patients Verses Psychiatrists
Q. What’s the difference between the psychiatrists and the patients at the mental hospital?
A. The patients are the ones that eventually get better and go home!

 

“Psychiatrists urge me to take my tranquilizers. When I don’t they become agitated. I take their pills to calm them down.”

Brian Spellman

 

“Talking to yourself is okay. Answering back is risky.”

Brian Spellman, If the mind fits, shrink it

 

“The statistics on sanity are that one out of every four people is suffering from a mental illness. Look at you 3 best friends. If they’re ok then it’s you.”

Rita Mae Brown

 

“1 in 5 people have dandruff. 1 in 4 people have a mental health problem. I’ve had both. ”

Ruby Wax

 

“My therapist told me that I over-analyze everything. I explained to him that he only thinks this because of his unhappy relationship with his mother.”

― Michel Templet

 

“A question that always makes me hazy is it me or are the others crazy? ”
Albert Einstein

 

“Ambien might have mentally just tossed my salad. WITH CROUTONS.”

Jen Lancaster

 

“I learned to smile, avoiding happiness advice. ”

Brian Spellman, The Cartoonist’s Book Camp

 

“I’m afraid to see a psychiatrist about the voices in my head. She might know who they are.”

Stanley Victor Paskavich, Stantasyland: Quips Quotes and Quandaries

 

“They called me mad, and I called them mad, and damn them, they outvoted me.”

Nathaniel Lee

 

“The good part about having a mental disorder is having a valid reason for all the stupid things we do because of a damaged prefrontal cortex. However, the best part is seeing someone completely sane do the exact same things, without a valid excuse. This is the great equalizer of God and his little gift for all us crazy people to enjoy.”

Shannon L. Alder

 

“If you don’t belong in a mental institution, you must be a very boring person.”

Gala Siegel

 

“Show me a sane man and I will cure him for you.”

C. G. Jung

 

“I decided early in graduate school that I needed to do something about my moods. It quickly came down to a choice between seeing a psychiatrist or buying a horse. Since almost everyone I knew was seeing a psychiatrist, and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse.”

Kay Redfield Jamison, An Unquiet Mind: A Memoir of Moods and Madness

 

“There is, incidentally, no way of talking about cats that enables one to come off as a sane person.”

Dan Greenberg

 

“I became insane, with long intervals of horrible sanity.”

Edgar Allen Poe

 

“I told my wife the truth. I told her I was seeing a psychiatrist. Then she told me the truth: that she was seeing a psychiatrist, two plumbers, and a bartender.”

― Rodney Dangerfield

 

“The reason I talk to myself is because I’m the only one whose answers I accept.”

George Carlin


Generation X Delusions

by Dave Robinson, M.D.

Copyright Rapid Psychler Press http://www.psychler.com

I was the leading supplier of smoked salmon to the city’s restaurants until I inhaled too many fish-bits into my lungs.

I served in the regiment commanded by Colonel Sanders in the Great Chicken War.

The dots and dashes on the highways are a secret message in Morse Code that I alone must decipher.

Somebody urinated in my genetic pool.

There is a rotund man in a red suit who sees my therapist before I do. He has a fear of crawling down small chimneys on Christmas Eve – he suffers from santaclaustrophobia.

Every now and then I go to the driving range to hit a bucket of chicken.

My career as an arsonist came to an end when I was arrested for trying to start a fire in a rainforest.

My imaginary companion parlayed my childhood fantasies into a multi-million dollar burger franchise.

I was never happy being depressed.

I was the world’s most unfortunate Multiple Personality victim – each of my alters had its own Personality Disorder.

I lost a bet that I could quit gambling.

I do not recall being voted the Village Idiot, but my name was on the ballot.

They named a medical syndrome after me called the Generation X triad: substance ingestion, amnesia & priapism.


The bathtub test

During a visit to the mental asylum, a visitor asked the Director what the criterion was which defined whether or not a patient should be institutionalized.

 

“Well,” said the Director, “we fill up a bathtub, then we offer a teaspoon, a teacup and a bucket to the patient and ask him or her to empty the bathtub.”

 

“Oh, I understand,” said the visitor. “A normal person would use the bucket because it’s bigger than the spoon or the teacup.

 

“No.” said the Director, “A normal person would pull the plug. Do you want a bed near the window?


 

Related links

More info: http://traumadissociation.com
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