Thoughts on working with the dreams of DID and DDNOS patients

Abstract

Dissociative phenomena, including dissociative identity disorder (DID), are found throughout the world. International studies have found that DID is linked to repeated childhood abuse and poor attachment experiences. DID patients report more severe and earlier age of first abuse compared with other psychiatric patients. Two theories have arisen to explain the relationship between trauma and dissociation such as trauma model and fantasy model. Identity confusion, identity alteration and amnesia form the core symptoms differentiating DID from other disorders. DID patients showed different patterns of psychophysiological activation according to what type of self-state listened to the autobiographical trauma script. The research on DID shows that long-term therapy that focuses on dissociation is associated with significant improvements in nearly every type of symptom and functioning that is assessed. Assessment, neurobiological, and treatment outcome studies indicate that DID is a valid diagnostic entity which stems from severe childhood trauma that can be differentiated from feigned presentations when psychometrically sound measures are utilized.