“Crazy” thoughts and feelings – Dissociative Identity Disorder and Psychotic spectrum symptoms

Can someone have both Schizophrenia & Dissociative Identity Disorder?
Yes, this is possible, or another psychotic or schizophrenia spectrum condition can exist with DID. It isn’t a particularly common combination (compared to, for example, Borderline Personality Disorder or an Anxiety Disorder existing alongside DID).

What are the key differences between Dissociative Identity Disorder and Schizophrenia?

Some people with DID find their symptoms are never confused with the psychotic symptoms found in Schizophrenia – but others may be misdiagnosed with Schizophrenia, or diagnosed only with Schizophrenia when DID is also present. Experiences like ‘hearing voices’, ‘seeing things which aren’t there’ (pseudo-hallincinations caused by flashbacks) can cause a lot of confusion.
The DSM-5 (full version, p297) gives some limited guidance on differences:

  • Individuals with dissociative identity disorder experience these [psychotic-like] symptoms as caused by alternate identities, do not have delusional explanations for the phenomena, and often describe the symptoms in a personified way (e.g., “I feel like someone else wants to cry with my eyes”).
  • Persecutory and derogatory internal voices in dissociative identity disorder associated with depressive symptoms may be misdiagnosed as major depression with psychotic features.
  • Chaotic identity change and acute intrusions that disrupt thought processes may be distinguished from brief psychotic disorder by the predominance of dissociative symptoms and amnesia for the episode, and diagnostic evaluation after cessation of the crisis can help confirm the diagnosis.

Dissociative Identity Disorder is also a dissociative disorder, meaning that symptoms are primarily dissociative in nature – even when it was known by the name Multiple Personality Disorder, DID was classified as a Dissociative Disorder; Schizophrenia is classified as a psychotic disorder, meaning in involves one or more of: delusions, hallucinations, disor­ganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms (flat emotions or severe lack of will).

Survivors of organized or ritual abuse may have some highly unusual beliefs which are not caused by any kind of delusions or psychosis, but result from the highly unusual abuse they have survived – including abuse designed to discredit survivors who tell.

Elizabeth Howell explains:

Kluft reported that patients with DID endorse 8 of the first-rank Schneiderian symptoms (Schneider, 1959, as cited in Kluft, 1987a) that are considered pathognomonic of schizophrenia.
These symptoms are voices arguing, voices commenting on one’s action, influences playing on the body, thought withdrawal, thought insertion, made impulses, made feelings, and made volitional acts.
In DID, rather than as indications of schizophrenia, the hallucinated voices and the made actions are understood as due to the activities of a dissociative identity. The psychotic person is more likely to attach a delusional explanation, such as “The CIA has implanted a chip in my brain.” In contrast, the person with DID, although probably unaware of the source, often knows that these experiences are not normal and does not seek to explain them in a delusional way (Dell, 2009c). In addition, the person with DID—as opposed to someone who is psychotic—often has the ability to be in two states of mind at once: While the person experiences the self as having the “crazy” thought, the person is able to hold the tension and know that it is just that, a crazy thought.
Of course, this knowledge that one is having thoughts that others would consider crazy only tends to contribute to the highly dissociative person’s fear or belief that he or she is crazy!

DID IS CONFUSING TO EVERYONE

The phenomena of full and partial dissociation are highly confusing to the person with DID as well as to those who notice them. Unlike someone who suffers primarily from depression or anxiety and who can label the problem, the person with DID generally suffers from amnesia about the very symptoms experienced and often cannot specfically identify the problem…
Understanding and Treating Dissociative Identity Disorder, Elizabeth Howell (2011)

CIA, Dissociative Identity Disorder and Ritual Abuse Survivors
While high profile organizations like the C.I.A. are often referred to by people who are experiencing psychotic symptoms (e.g., delusions of persecution), many people are unaware that the CIA has historically been involved in child abuse, including child abuse with the purpose of creating dissociative identity disorder. The involvement of the CIA in these human rights abuses is not a ‘conspiracy theory’ but is well documented, with hearings in the U.S. Senate held in the 1970s to investigate this, and other related abuse.
Karl Douglas Lehman and Ellen Lacter have produced guidelines to help clinicans differentiate between Schizophrenia and Dissociative Identity Disorder which may be helpful, see Ritual Abuse in the Twenty-First Century (2008) – chapter 4.

Alison Miller, a psychotherapist specializing in therapy for ritual abuse survivors, comments that that one lie about abuser’s power and knowledge (that children are told) is that “There is a microchip implanted in the survivor’s body that tells the abusers where s/he is and / or what s/he is thinking” Healing the Umimaginable, p122

Miller also points out that even if such as object was found, “that does not mean it is capable of collecting complex information and sending it back to abusers, or even sending them signals, for twenty or more years, as some survivors belief.” (p205)

Diagnostic and Screening Tools
A variety of different diagnostic and screening tools are available to help determine if a person has Schizophrenia or Dissociative Identity Disorder. Diagnostic interviews can give a definite diagnosis, and determine whether both or neither are present, for example the Structured Clinical Interview for Dissociative Disorders, or the Dissociative Disorder Interview Schedule, but these can only be carried out by clinicians (both involve a degree of observation).

Two screening tools which can be used to determine if a dissociative disorder is likely to be present are the SDQ-20 and the Dissociative Experiences Scale – both of which are mentioned in the Dissociative Identity Disorder Treatment guidelines for adults. Both of these questionnaires give a typical score for Dissociative Identity Disorder, Schizophrenia, Dissociative Disorder Not Otherwise Specified and other conditions – but they are actually intended to highlight of a clinical diagnostic interview is likely to be helpful rather than giving a specific diagnosis. Both questionnaires result in a single score, making it impossible to rule out or confirm a diagnosis of Schizophrenia in people likely to have Dissociative Identity Disorder.

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Why do people believe the lies of child molesters?

Charles Whitfield (2011) researched the defense tactics of accused and convicted child molesters and found that of all the defenses that a child molester has at his/her disposal, the most effective is our collective desire not to know. We all so much want the abuser not to have happened that when an accused person says they didn't do it, it resonates with our own personal hopes and beliefs about the incident.

How Society Enables Child Molesters
Charles Whitfield (2001) researched the defense tactics of accused and convicted child molesters and found that of all the defenses that a child molester has at his disposal, the most effective is our collective desire not to know. We all so much want the abuse not to have happened that when an accused person says they didn’t do it, it resonates with our own personal hopes and beliefs about the incident.

Read more about this research from The Leadership Council’s post

“Society gives the image of sexual violators as weird, ugly, anti-social, alcoholics. Society gives the impression that violators kidnap children are out of their homes and take them to some wooded area and abandon them after the violation. Society gives the impression that everyone hates people who violate children. If all of these myths were true, healing would not be as challenging as it is.
Half of our healing is about the actual abuse. The other half is about how survivors fit into society in the face of the myths that people hold in order to make themselves feel safe. The truth is that 80% of childhood sexual abuse is perpetrated by family members. Yet we rarely hear the word “incest”. The word is too ugly and the truth is too scary. Think about what would happen if we ran a campaign to end incest instead of childhood sexual abuse. The number one place that children should know they are safe is in their homes. As it stands, as long as violators keep sexual abuse within the family, the chances of repercussion by anyone is pretty low. Wives won’t leave violating husbands, mothers won’t kick their violating children out of the home, and violating grandparents still get invited to holiday dinners. It is time to start cleaning house. If we stop incest first, then we will strengthen our cause against all sexual abuse.”
― Rosenna Bakari, Talking Trees facebook page

Related Posts

What is it like to be suffering from something that isn’t adequately recognized?

Today I stumbled across an excellent article by UK psychotherapist Valerie Sinason about Dissociative Identity Disorder and the difficulties in both diagnosis and treatment which exist within the very traditional British public health care system.

Sinason writes:

Without early specialist training on the consequences of abuse, professionals are attacking each other’s contradictory diagnoses without realising the aptness of Walt Whitman’s words “I am large. I contain multitudes”.

 

truth hidden attachment John Bowlby

We cannot see what we cannot bear – John Bowlby, psychoanalyst

Compared with Freud’s ability to recognise the traumatic aetiology of hysteria one hundred years ago (Freud, 1896), contemporary clinicians have found it extremely hard to bear the horrors of patients’ objective lives. Sometimes (Hale & Sinason 1994) psychotherapists’focus on the internal narrative is a defence against the historic external reality.

However, as de Zulueta (1995) comments: “a refusal on the part of psychiatrists and therapists to validate the horrors of their patients’ tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable.

Both quotes come from the revised edition of Attachment, Trauma and Multiplicity by Valerie Sinason (Editor), which contains contributions by both survivors of trauma with Dissociative Identity Disorder and professionals working with psychological trauma.

Does the NHS have (undiagnosed) Dissociative Identity Disorder?

Recently I heard a therapist who does a great deal of trauma work in the UK refer humourusly to the British NHS health care as having a so many separate states that do not communicate with each other, and typically have different and opposing ideas, that it felt as if the NHS system itself was in fact suffering from dissociative identity disorder… Sinason writes about “Fragmentation within professional teams” as well as between them:

“the psychiatrist who meets a frozen DID patient who shows only one state (as a result of correctly assessing their psychiatrist’s inability to deal with the subject) then attacks the other psychiatrist/social worker/psychologist/psychotherapist who points out the fragmentation into states. We are then witnessing the trauma-organised systems… that systemically mirror the DID experience.”

Read more (Details may trigger.)

 

Stress relieving tips and quotes for the Holiday Season

5 tips for reducing holiday stress

  • Plan ahead, and plan time for relaxing quietly
  • Practice saying “No” if you have to much to do already, or are already feel tired or ill
  • Spend time outdoors, stretch your legs with some gentle exercise and fresh air
  • Remember to take care of yourself, and do things for yourself, not just for others
  • Try practicing mindfulness, which can help with traumatic memories

The Science of Mindfulness (Oxford University)

For fast-acting relief, try slowing down.
Lily Tomlin

“If you want to conquer the anxiety of life, live in the moment, live in the breath.”
Amit Ray, Om Chanting and Meditation

Don’t underestimate the value of Doing Nothing, of just going along, listening to all the things you can’t hear, and not bothering
Pooh’s little Instruction Book

What is your favorite way to relieve stress and relax?

Read more stress-relieving quotes…

15 Inspiring and Positive Quotes

Inspiring and positive quotes to help you through difficult times

wiki ad simplify steve marabolia

Your dream is not impossible

Your dream is not impossible

wiki ad pain to blossom

wiki ad my past destroyed strengthened Steve Maraboli

Belief in ourselves EE Cummings

wiki ad blue people treat you

cannot protect from sadness protect from happiness

wiki ad weakest is strongest-DV

snow mindfulness Sylvia Plath

life needs space beach

today is a new beginning

image

wiki ad strawberries purpose

The world needs more warm hearts and fewer hot heads

we always have a choice