Angry Face Central

Friday, December 15, 2006

Dissociative identity disorder

Dissociative identity disorder is a psychiatric diagnosis, most recently defined in the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). It is the existence in an individual of two or more distinct personalities or ego-states, each with its own pattern of perceiving and interacting with the environment. To qualify as dissociative identity disorder (multiple personality disorder), at least two personalities must routinely take alternate control of the individual's behavior, and there must be a loss of memory that goes beyond normal forgetfulness. This memory loss is often referred to as "switching". These symptoms must occur independently of substance abuse or a general medical condition.

Dissociative identity disorder is also known as multiple personality disorder (MPD) as described in the tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). In North America, the American Psychiatric Association changed the name to dissociative identity disorder for the DSM due to the degree of controversy in the psychiatric and psychological communities there regarding the concept of one (physical) individual having more than one personality, where personality may be defined as the sum total of that (physical) individual's mental states.

While dissociation is a demonstrable psychiatric condition that is tied to several different disorders, specifically those involving early childhood trauma and anxiety, multiple personality remains controversial (see multiple personality controversy). Despite the controversy, many mental health institutes, such as McLean Hospital, have wards specifically designated for dissociative identity disorder.

Symptoms of Dissociative Identity Disorder include a type of psychogenic amnesia (no medical cause, only psychological). Through this amnesia the person is able to repress memories of traumatic event/s or a period of time. This is a fragmentation of self and experience of the past. Through having several alters the host personality is living through healthy alters, aggressive alters, and often alters that are children. The therapy for this disorder is usually long-term.

Two characteristics of DID are depersonalization and derealization. Depersonalization is the distortion in the perception of self and one's reality. This person will often appear to be detached from reality. Patients often refer to this as "feeling outside of their body and being able to observe it from a distance". Derealization is the distortion in the perception of others. Through derealization, others will not seem to be real to the person. To these patients others may look the same and sound the same, but their real identity is absent or has differed in some way.

Research has shown that patients with Dissociative Identity Disorder often hide their symptoms around others. The average number of alters is 15 and the onset is usually in early childhood, which is why some of a patient's alters are often children. Many patients have co-morbidity, which means that they also have another disorder, for example, generalized anxiety disorder.

Tell Me Your Dreams

The central character of the book is Ashley. She is a workaholic. She suffers from a condition known as "Multiple Personality Disorder" or MPD due to the child abuse she faced when she was very young. Toni and Alette are her two "other" personalities. Toni is the dominant of the two.

Ashley is an introvert and a workaholic. Toni is very outgoing and dynamic. She can sing and dance. Alette is a very innocent and shy girl. She is an excellent painter.

Toni is angry with Ashley as they are completely contrasting characters. She always criticizes her in front of Alette. Alette keeps calming Toni down every time. Toni hates Ashley. Allete is neutral. But Toni and Alette are friends.

Ashley's fears that somebody is following her are confirmed when somebody breaks into her house and writes on her looking glass with a lipstick, "You will die." She wants the police to escort her that night. The next morning, the policeman who is her escort is found dead in her apartment. Two murders precede this, which are not to be mentioned here. The vaginal secretions obtained are found to be of the same woman in all these murders. The lovers of Toni as well as Alette are murdered. One common thing all the murders have is the victims had sex before the murder with the woman who murdered them. Who's behind the serial murders?

Sheldon takes care as usual to make the reader spellbound during the pages of the novel with unusual crimes happening in the cities of Quebec,Milan and Washington.The suspense is resolved sooner than expected. But it takes a long time to find out the reason for the murders ending with a turbulent climax that leaves the reader grasping for air!

This book delves into the much debated topic of multiple personality disorder or MPD.