Dissociation

DID is Dissociative Identity Disorder (once called Multiple Personality Disorder).  Alters are the alter-egos or other personalities that appear to be dissociated in this type of client.

I would expect to see relatively high levels of deep theta/high delta, perhaps around 3Hz, since this could relate to dissociation.  One of the early uses of neurofeedback with these clients was to use Alpha/Theta training to take them down to the point where 3Hz spikes began to occur (which most of us avoid these days) to trigger abreactions, where the client re-experienced the early traumatic material that had led to the dissociative strategy in the first place, and then the therapist could work to re-integrate that material.

I’ve been very interested in MPD/DID since I was involved in setting up the 2nd inpatient program focused on treating it back in 1988. It’s a very seductive idea, but I would strongly recommend you follow our usual approach: instead of training someone else’s diagnosis, train the client’s symptom constellation. Instead of speaking as if YOU were doing something (“bringing her to neutral”), recognize that the client is making the changes and doing the work, and you are the “personal trainer.”

There were quite a rash of people discovered with this diagnosis around the end of the 80s with experts springing out of the woodwork. The rush was pretty short-lived, with several of the main players ending up losing their licenses.

Several were sued by the family of a patient (and the patient herself) who had gone down the road of remembering horrific abuse and MGSC (multi-generational satanic cults) activity in great detail, taking a patient who had come for help with anxiety and turning her into a multiple, destroying her family and the lives of others who had known her before she was finally pulled from “treatment.” This was one of several cases which had all the elements of witch-hunts at the time before the backlash finally set in.

Early in the 90s, information began to be presented that (as turned out to be the case in our unit) literally none of these people had symptoms of MPD before they started therapy–which almost always entailed hypnosis and suggestive questioning, etc. Even when events “remembered” in these sessions were proven to have been impossible, the SOP at the time was to point out that these MGSC’s of course included judges and police chiefs, family physicians and others who were able to make up the facts that disproved the memory.

Even the famous Sybil case (treated by Cornelia Wilbur–a highly respected psychiatrist) followed the pattern that has appeared in literally all MPD cases: The patient and family had no awareness or suspicion of child abuse and THERE WERE NO ALTERS until AFTER treatment began. This may have been one of the earliest examples of fad psychiatry (e.g. the huge and sudden increase in cases of ADHD or bipolar disorder that occurred in the 90s and 2000s). Prior to Sybil (the book and movie) there had been a grand total of less than 70 diagnoses of MPD. Since then, there have been 40,000+–nearly all in North America. I’m not claiming that the therapists who “find” these cases are venal, but it is–as you have already found–pretty exciting to think you might have one of them and that you can fix it.

If you really want to help such a client, look at her brain patterns (maybe there’s a reason why you didn’t find the disconnect you expected) and train them. Don’t tell the client you are going to fix her, but rather that you are giving her a tool and guiding her in its use that will allow her to change the patterns in her own brain that relate to the anxiety and depression and whatever else she’s dealing with in the real world.