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dissociative identity disorder
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Journal Articles
The American Journal of Occupational Therapy, 1993, Vol. 47(10), 872–876.
Published: 01 October 1993
Abstract
Adult persons with multiple personality disorder have survived a traumatic past. After diagnosis and the initiation of psychotherapy, they frequently face a long and arduous treatment process. During this time, intense emotions and memories are retrieved that can disrupt functional life skills in an already disjointed life. The stresses of life combine with therapeutic issues to perpetuate the dissociation that interrupts functional performance. The original traumas occurred when the child was functioning primarily at a sensorimotor level. Occupational therapy can identify sensorimotor activities that provide a focal point of control to reduce stress during the therapeutic process and to develop new life skills.
Journal Articles
The American Journal of Occupational Therapy, 1992, Vol. 46(7), 634–638.
Published: 01 July 1992
Abstract
This article identifies mental health rehabilitation services for patients with multiple personality disorder. Through the use of a literature review and a retrospective examination of 20 patients’ records, the frequency of discipline-specific services is noted in occupational therapy, art therapy, movement therapy, vocational counseling, and recreational therapy. Recommendations for practice and program development include ongoing education about multiple personality disorder and continual assessment of the patient’s functional level to identify subsequent treatment needs and services.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 1048–1050.
Published: 01 November 1990
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 991–993.
Published: 01 November 1990
Abstract
This article examines the prevalence and complexity of multiple personality disorder as well as the contributions that psychiatry and occupational therapy make in its treatment. The value of activity is that it serves as a nonverbal mediator of communication. Activities are also useful in helping the therapist to obtain a patient’s history, which is necessary for abreaction (i.e., the patient’s reliving and recalling of the original abuse). Abreaction is a precursor to the integration of the abusive memories into the patient’s current life.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 1013–1022.
Published: 01 November 1990
Abstract
Patients with multiple personality and dissociative disorders have learned to create an alternate identity system, originally designed to protect them from experiencing the pain of inescapable, unrelieved trauma and abuse. The resulting amnesia and identity confusion cause significant dysfunction in daily living. Issues of trust and control are paramount, and occupational therapists are challenged with the task of engaging these patients in meaningful activity. Although these patients often avoid structured groups, they have generally been responsive to expressive art opportunities as an initial activity. This paper outlines an expressive framework by which occupational therapists can therapeutically manage the artwork behaviors of the patient with dissociative or multiple personality disorder. The material presented is based on clinical observation of more than a dozen patients with multiple personality disorder in various stages of recovery and of many persons with dissociative trauma who may have multiple personality disorder. These observations took place within an acute care, inpatient occupational therapy setting. Guidelines for the creation of a positive working alliance and therapeutic climate for self-expression are outlined, and a progressive model for the viewing of patients’ art products is described.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 1037–1043.
Published: 01 November 1990
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 994–997.
Published: 01 November 1990
Abstract
There is little occupational therapy literature that addresses the profession’s efficacy in the treatment of persons with multiple personality disorder, yet the characteristics and complexity of this disorder render it one that can gain much from occupational therapy intervention. This paper examines the ways in which the occupational therapist can help in the treatment of patients with multiple personality disorder by introducing the alter personalities to each other, encouraging rapport among the personalities, and providing tasks that allow the alter personalities and the host to work together for mutual benefit.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 967–969.
Published: 01 November 1990
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 1008–1012.
Published: 01 November 1990
Abstract
A paucity of occupational therapy evaluation tools exists for use with patients with multiple personality disorder. The Model of Human Occupation (Kielhofner & Burke, 1980), particularly the volition and habituation subsystems within this model, proved useful for the identification of the many facets of patients with multiple personality disorder on a short-term treatment unit. The Role Checklist (Oakley, Kielhofner, Barris, & Reichler, 1986), a tool derived from the Model of Human Occupation, was adapted for use with this population and was found to be beneficial in the identification of common goals held by most of the personalities of each patient with multiple personality disorder. The use of the Role Checklist is illustrated with a case example.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 971–976.
Published: 01 November 1990
Abstract
Multiple personality disorder is understood today as chronic dissociative psychopathology that most often develops in response to severe abuse in childhood. The dissociative component is a manifestation of a defense mechanism out of control: The person with a biopsychological capacity to dissociate flees inward from overwhelming abuse or feared abuse. When continuing abuse perpetuates dissociations and they are chained by common affective themes, the foundations of multiple personality disorder are laid. Although the disorder has its roots in childhood, most patients are not diagnosed with this condition until 20 to 50 years of age. Many have received several prior, erroneous diagnoses of mental or physical disorders or both over a period of 7 or more years. Failure of diagnosis is an indication of the multiple factors that contribute to making this a covert disorder. Diagnosis and management begin at the same place: the establishment of trust and therapeutic alliance between patient and therapist.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 1024–1027.
Published: 01 November 1990
Abstract
Patients with multiple personality disorder are being admitted to acute care psychiatric units with increasing frequency. Occupational therapists have been confronted with setting treatment goals and designing interventions for this population with little information available in the occupational therapy literature. This paper describes how one therapist, the author, reviewed psychiatric and psychological literature on multiple personality disorder to delineate a role for occupational therapists who are working with this special population on an acute care psychiatric unit within the context of existing programs.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 978–983.
Published: 01 November 1990
Abstract
Until recently, few cases of multiple personality disorder were diagnosed in children. Today, the number of cases is increasing at an alarming rate and appears to be most closely associated with repeated sexual and physical abuse. This paper focuses on reports of childhood multiple personality disorder in the literature, the etiology of this disorder, family dynamics, the differences between childhood and adult multiple personality disorder, credibility problems in children, reasons for failure to diagnose multiple personality disorder in children, treatment, and signs and symptoms to look for in the clinical setting.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 1045–1047.
Published: 01 November 1990
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 999–1007.
Published: 01 November 1990
Abstract
Occupational therapy intervention with the patient with multiple personality disorder requires an understanding of the complex psychotherapeutic goals for the patient and of the process involved in resolution of the trauma that led to the development of multiple personality. The psychotherapeutic techniques of hypnosis and abreaction affect the provision of occupational therapy services. Hypnotic communication, particularly the use of ideomotor hand signals, often facilitates work with various alter personalities. Occupational therapists may use a developmental approach with both child and adult alter personalities and may also use projective techniques, self-care training, and role and task management techniques. Occupational therapy can act as a stabilizing force for the person with multiple personality disorder through the enhancement of function and competency during the psychotherapeutic process.
Journal Articles
The American Journal of Occupational Therapy, 1990, Vol. 44(11), 984–990.
Published: 01 November 1990
Abstract
Occupational therapists are becoming more involved in the treatment of persons with multiple personality disorder. Occupational therapy literature concerning treatment of this group of patients, however, is sparse. Clinical manifestations of multiple personality disorder include common alter personalities with distinct roles and functions, age-related behavioral patterns, and physiological differences. By recognizing and understanding these differences and characteristics and their relationship to treatment goals, occupational therapists can better use their background in life roles and occupations to increase the functional daily living skills of patients with multiple personality disorder.