Wednesday, September 2, 2009

Dissociative identity disorder: Time to remove it from DSM-V?

Gharaibeh, MD
Staff psychiatrist, Department of psychiatry, Danbury Hospital, Danbury, CT

Dr. Gharaibeh is a an attending psychiatrist on the inpatient unit at Danbury Hospital in Danbury, CT. He teaches psychiatric residents from New York Medical College during their rotation in Danbury Hospital and physician assistant students from Quinnipiac University, Hamden, CT.

What is it about dissociative identity disorder (DID) that makes it a polarizing diagnosis? Why does it split professionals into believers and nonbelievers, stirring up heated debates, high emotions, and fervor similar to what we see in religion?

The DID controversy is likely to continue beyond the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), slated for publication in 2012. Proponents and opponents claim to have the upper hand in arguments about the validity of the DID diagnosis and benefits vs harm of treatment. This article examines the logic of previous and new arguments.

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  1. The only disorder that is made up is false memory syndrome and oh what a surprise Dr Garaibeh writes articles for the FMS, a whole society based around a fictitious disorder.
    You asked what makes DID a polarizing diagnoses, people like the Dr Garaibeh and Peter J Freyd.
    This article does nothing but rehash old FMS propaganda.

  2. Dr Gharaibeh says that
    "Patients with a DID diagnosis seem to have a" “powerful vested interest” "in sustaining the DID diagnosis, symptoms, behaviors, and therapy as an end in itself."

    Well Dr. that may be true, some people just like attention, but I have a parent with DID I can asure you that they have a “powerful vested interest” in hidding their condition, and I would guess most DID suffers are the same.
    To read this article as child of a person with DID is insulting, DID is something that can be hidden, but not to the closest family members like spouses and children who have to suffer great pain when dealing with it also.

    Its is easy to pick some quotes, stats, and topics Dr. but what would really be an important perspective is real world experience in dealing with actual DID patients, which you aparently have none of!

  3. My mother was diagnosed with DID/MPD. It was fake. She spent years pretending to be all sorts of people she wasn't. She cast me in the role of parent when I was 10 and she was 35, and she spoke in baby voices and expected me to raise her. In her more psychotic moments, she accused me of abusing her. It took me years to fully realize I wasn't a child molestor and that none of it was real.

    My mother saw multiple psychiatrists, and her bills were paid by the US taxpayers because my father worked for the government. I think these doctors made hundreds of thousands of dollars off my mother's case.

    Im the beginning, DID seemed attractive to my mother. She has a real mental illness (NOT DID) and couldn't cope with life, and the MPD diagnosis gave her an excuse to avoid adult responsibilities. She also got a lot of attention. As time went on, though, the combination of drugs and therapists genuinely traumatized my mother and she attempted suicide, began self-harming, and became completely delusional.

    As a result of my mother's psychotic break, my family lost almost all our money, we moved several times, and I lost all my friend and our family pets. My parents couldn't afford things like music lessons or new clothing for us because of the costs of psychiatric treatment.

    I lost my mother to psychosis. My father spent all his time managing her illness, or avoiding the household because he was overwhelmed, so in a way I lost both parents. My sense of reality was disrupted because I was forced to live in this chaotic fantasy world.

    When my mother stopped seeing doctors, her alters went away. It took me years to piece together what had really happened and confront her about it. She then admitted the whole thing was faked.

    Having a parent with a mental illness is difficult under any circumstances, but a fake diagnosis like DID just makes things worse. My mother's real illness was never treated, and was actually made worse by the MPD diagnosis. My siblings and I were put through things children should not have to experience, while my mother's psychiatrists made money off our situation.

    I hope that DID is removed from the DSM, so that other families don't have to experience the sort of devastation and betrayl that my family went through.

  4. DID is a real diagnosis and there is a great deal of evidence backing its origins due to severe, repeated trauma and a variety of studies showing physiological differences between different personalities.

    see and type in
    "dissociative identity disorder" for more information

  5. Anon, if DID should be removed because one person faked it, then just about every diagnosis from the DSM should be removed and the whole thing called off. The truth is more important than lies, something anybody struggling with DID knows best. Between "false memory syndrome" and suggestions like yours, it seems people are all too willing to use shallow lies to ignore the deeper truth of DID. Denial will get us nowhere.

  6. This is why Psychology will never be taken seriously as a science. If through political pressure you can get any and all psychological illnesses removed, or added to the list based on the desires of some group with a particular agenda, then psychoanalysys is nothing more than modern mind control for the idiots incapable of thinking for themselves.

  7. All doctors around the world are called upon to develop their own codices according to the environment and circumstances in which they live.
    The APA is not perfect and it is only a guide. If they want to remove something from the DSM; fine but more likely these days that this will be removed based on politics and moneyed debates than on balanced evidence. If the APA decides that religious choice is a mental illness it will be coded as such. The important thing is that the doctors who treat mentally ill people should do their best for their patients and not base every decision on a group of guys sitting somewhere in Arlington America who may have very little idea of the biomedical and cultural issues in the case of that particular patient.