An overview of the psychotherapy of dissociative identity disorder.

Abstract

Dissociative Identity Disorder (DID) is identified and studied with increasing frequency. However, the controversy that often surrounds DID can make it difficult to approach its treatment in a circumspect manner. This paper will provide an overview of DID treatment as it is practiced by those experienced and skilled in the treatment of this group of patients. The treatment of DID resembles the treatment of other traumatized populations in that it is stage-oriented, beginning with supportive and strengthening work. Various stances toward the treatment of DID are reviewed, and specific issues that arise in the psychotherapy of DID are addressed, such as pragmatic arrangements, informed consent, work with alters, and the use of specific techniques, such as hypnosis. The employment of therapeutic modalities and ancillary therapies is discussed. The heterogeneity of DID patients is reviewed, and the characteristics of three general groups of DID patients, high, intermediate, and low in both function and prognosis, are explored. Considerations in the matching of DID patients to either exploratory or supportive treatments are discussed, and observations are made about both trauma work and the supportive psychotherapy of DID.