Introduction
Dissociative identity disorder (also known as multiple personality disorder) is one of the most distressing psychological conditions due to its persistent and extensive impacts to an affected individual. Studies reveal that it is a major cause of multiple mannerism, depersonalization, in-explainable phobia, amnesia, trauma, and anxiety attacks.
Rothschild (2009) posits that the controversies surrounding multiple personality disorder with reference to its origin and characteristics has led to its increasing publicity bearing in mind that it is coupled with high prevalence rates of about 8-10% in the United States.
It is from this consideration that this paper intrinsically explores this disorder from the perspective of an abnormal psychology movie Sybil, and evaluates its background and current prevalence, the cause and theoretical considerations that explain its occurrence. Besides, the paper also examines the high levels of comorbidity for the disorder and further explores treatment options employed to treat the disorder.
The movie Sybil
Sybil is a drama film that was produced in 1976 and remade in 2007 based on a book Sybil by Flora Schreiber (Schreiber, 2009). The title role of the film is played by Sally Field who stars as Sybil Dorsett. Other characters include Sybil’s psychiatrist Dr. Cornelia Wilbur, Sybil’s mother Hattie Dorsett, Sybil’s boyfriend Richard and doctor Quinones. Other characters include Tommy, Dr. Castle, Danny, Dr. Lazarus, Cam, Miss Penny and the Selve’s family among others (Schreiber, 2009).
Sybil is a graduate student suffering from multiple personality disorder which is believed to be a consequence of psychological trauma she had suffered right from her childhood due to abuse. As she grows, Sybil develops about 13 male and female distinct personalities each with a unique ability (Schreiber, 2009).
Those female personalities include Sybil Ann a shy 5-6 year old girl, Ruthie a pre-verbal baby, Nancy a religious fanatic afraid of Armageddon, Marcia a suicidal, Peggy a hysterical girl, Vicky a mature, sophisticated French speaking girl and Vanessa a romantic girl. Her male personalities include Sid and Mike (Schreiber, 2009).
c) Literature review and background of the disorder
According to American Psychiatric Association (2006), the occurrence of dissociative identity disorder (DID) symptoms can be traced back to periods before the onset of the 18th century when people with such conditions were considered to be possessed with some unknown evil spirits. As a matter of fact, the disorder was largely treated and understood in terms of various myths which had been put forward.
The American Psychiatric Association notes that the definition for DID has constantly changed from an association with amnesia, somnambulism, and fugue state in DSM-I to the current behavioral definition as provided for by DSM-IV which describes it as a disorder that makes a patient victim to develop multiple personalities (American Psychiatric Association, 2006).
According to Sar et al. (2009), DID is a psychiatric condition where an individual displays several distinct identities which have variant patterns of reference to the environment an individual is interacting with. Other psychiatric conditions such as schizophrenia and borderline personality disorder have also been found to be highly cormobid with DID.
Causes of the disorder
Controversies have persisted over the actual causes of DID in society for a considerably long period of time. However, as Rothschild (2009) point out, an overwhelming majority of psychologists including Dr. Lazarus in the movie Sybil have theoretically associated this psychological problem to intense and recurrent episodes of stresses, traumatic antecedents as well as reduced capacity of an individual to vividly coordinate between memory use and actual consciousness.
However, as the movie reflects, a large percentage of patients or individuals with DID indicate having been severely abused during their child ages. It is from this consideration that Rothschild (2009) argues that DID strongly correlates with childhood trauma as opposed to other psychological dysfunctions.
Most recent empirical researcher studies that have been conducted in this field of abnormal psychology indicate that if a child is nurtured by an abusive caretaker or parent, that child is confronted with a dilemma of getting the necessary attachment for survival which threatens his or her body’s integrity and physic.
In concurrence, Pihl (2010) explains that DID signify a response mechanism through which an individual seeks to establish an independent and specialized personality that can caution variant forms of abuse and difficult experiences. In addition, it acts as a factor of enhancing effective life functioning considerations.
From the movie, it is evident that human beings have specific memories and particular functioning styles that are highly compartmentalized. When a child is exposed to trauma, ego states present introjects that store up characteristics of abusers.
These characteristics are internalized and continuously recur in different instances in the future life of an abused. In the movie, Sybil has male personalities that reflect her father’s characteristics in spite of the fact that she is a girl. These memories appear grandiose as a system of invoking the individual from outside. An individual may feel threatened and may harm his or her body to silence the second party giving a command.
Theoretical considerations
Following great controversies that characterize DID, various theories have been put forward in an attempt to elaborate on the actual causes, development and possible treatment of the disorder in society. According to Rafieian and Hosier (2011), object relations and attachment theories indicate that one of the most important primary motivators in human development is an attachment or relation to other human beings.
As a matter of fact, the theory tends to put more importance to human relation across the society. Rafieian and Hosier explain that according to the theory, a child develops strong internal stability system that explicit itself in form of internalized representations.
The latter growth and developmental pattern may not be possible without relating it to human relations across the board. Bowby further highlights in his development theory that the dominant attachment pattern between a child and a caretaker becomes a long term template evident in all other relationships with other people in the family and community (Sar et al., 2009).
Hence, the sequential and well being of a child in terms of growth and development is largely dependent on the immediate family members and how he or she relates with them.
When a caretaker or a parent becomes abusive, the child seeks alternative mechanisms on how best to survive the unwelcoming or tough environment. Forzano et al. (2011) indicate that splitting occurs and forms a perfect mechanism upon which an abused child establishes a caretaker or parent to be either good or bad. Unfortunately, there is sufficient empirical evidence that such forms of abuses often recur later in life as DID.
In the movie, the memories depicting traumatic expression occur as the dissociated personality holds on to memories of previous experiences. This theory has been employed by majority of the psychologists who indicate its efficacy in explaining the system following the strong correlation between the prevalence of DID and child abuses in the society.
While there may be lapses in this theory even as it tries to relate child abuse and the associated development of DID, it is quite imperative to note that the growth and development of a child is usually depicted by the nature of immediate environment. Hence, we may not refute fully the theoretical approach that has been put forward by this school of thought.
Diagnosis
Diagnostic and Statistical Manual of mental Disorder scale was developed to generate the correct means of providing valid measure of diagnosing mental disorders of different individuals. This method provides diagnosis that essentially consists of mental disorder symptoms as provided by the DSM-IV. It is imperative to note that DSM-IV has a five multi axial system that forms part of its effectiveness.
In its first axis (Axis I), it deals with diagnosing major mental, learning, substance use and clinical disorders. Besides, it has been revised to include Autism, a developmental disorder. Intellectual disabilities and personality disorders like mental retardations are in the second axis (Axis II) while physical and acute medical disorders fall under the third axis (Axis III). Environmental and psychosocial contributing factors fall in the fourth axis (Axis IV) while global scale for functioning of children under the age of eighteen is in the fifth (Axis V).
Pihl (2010) indicates that while there is no known cure for the disorder, treatment of the condition is mainly focused towards reducing symptoms on DID persons. Hence, early diagnosis is necessary so that the affected patient may start symptomatic treatment.
Treatment plans may include relieving the particular distressing aspects to guarantee affected persons the necessary security, weekly visits to talk therapies, adjunctive therapies and use of medication. Traditionally, behavioral therapists sought to address the problem by addressing individual identities that traumatized the individuals with DID. However, psychotherapy and medications have increasingly become common in addressing the problem in recent times.
Rafieian and Hosier (2011) are quite categorical that the best method to address the problem in society is offering the correct and guided upbringing of a child especially at the early years of development. This approach has also been suggested by other scholars in abnormal psychology.
Conclusion
To sum up, it is evident from the discussion that dissociative identity disorder is a serious problem that continues to negatively affect many people in the society.
The movie Sybil has been very insightful in providing an understanding on mental issues that can affect an individual and which can be avoided. Since the origin of DID has been associated with the abusive mode of child upbringing during their early ages, it is essential to offer children a conducive, correct and loving environment for growth and development so as to reduce chances of DID development.
From the movie, it is worth noting that parents and guardians should seek early childhood development education as a factor of inferring the necessary understanding for effective child growth. There should also be effective cooperation between the communities and psychologist researchers to initiate studies that can help in further understanding of the problem in the society.
References
American Psychiatric Association (2006). Diagnostic and Statistical Manual of Mental Disorders DSM-IV TR (Text Revision). Arlington, VA: American Psychiatric Publishing, Inc.
Forzano, L., Michels, J., Carapella, R., Conway, P. & Chelonis, J. (2011). Self-control and impulsivity in children: multiple behavioral measures. The Psychological Record, 61(3), 425-448.
Pihl, R. (2010). Mental disorders are brain disorders: you think? Canadian Psychology, 51(1), 40-49.
Rafieian, S., & Hosier, S. (2011). Dissociative experiences in health and disease. Human Architecture, 9(1), 89-109.
Rothschild, D. (2009). On becoming one-self: reflections on the concept of integration as seen through a case of dissociative identity disorder. Psychoanalytic Dialogues, 19(2), 175-187.
Sar, V., Taycan, O., Bolat, N., Özmen, M., Duran, A., Öztürk, E. & Ertemvehid, H. (200). Childhood trauma and dissociation in schizophrenia. Psychopathology, 43(1), 33- 40.
Schreiber, F. R. (2009). Sybil. New York, USA: Grand Central Publishing.