DID DID Treatment

[Kubash16]

Some unnecessary background info:

So I’ve been switched over to a new T. It’s been a really rough transition but she’s going slow with me and has been the nicest, most patient person, which is getting under my skin, which makes me hate her more (just on principle and only cause I’ve gots problems).

Anyway, unlike my previous T (who said he doesn’t see DID), she has extensive experience in CPTSD, borderline, and DID among other similar disorders. At first when I talked to her about me thinking I might have it she was like nah, you’re good, don’t see it.

But as we’ve gone through some more sessions and I’ve explained some more of my history, memory loss, and such. She’s starting to lean to it a bit. My score on the DES was 33 which pushes me into the right bracket. She said she could do an evaluation on me to give me a definitive yes or no but she said she doesn’t see much point since treatment really won’t change.

So the actual question:

Is that accurate that if you have DID, the treatment is pretty much the same as PTSD?

I’m fine with not adding yet another diagnosis cause I feel like I’ve got too much already. But, I also don’t want to short change myself if I should be doing something different.

 

[Muttly]

Well, DID treatment has changed a lot over the years and for that matter has PTSD treatment. Treatment for either should be focused on you, your symptom and what you need to recover and not on a diagnosis. The biggest difference, in my experience, in working with DID is there can be more work on internal communication and cooperation.

With my therapist, we don't focus on DID or specific parts except as it arises in dealing with specific issues. So, for example, when talking about SA, one part may come out insist that it was our fault and wasn't bad. And the rest of us tend to blame that specific part. And so our T has been working to help us sort that out. Self-blame and minimization are pretty common components of PTSD though.

 

[Reflections]

she said she doesn’t see much point since treatment really won’t change.

From what I've read, pretty much. It's a lot of the same treatment just some adjustments here and there. What's important I think is that your T isn't clueless and has training with DID so they can make those adjustments.

 

[Wendell_R]

What's important I think is that your T isn't clueless and has training with DID so they can make those adjustments.

Yes!

Is that accurate that if you have DID, the treatment is pretty much the same as PTSD?

Maybe a good way to put it for me is that even though I don't have DID, my alters are strong enough that my PTSD treatment focuses a lot on working with those alters, dissociation, etc. What matters isn't the diagnosis code, which is kind of murky about these things, but to figure out to what degree your personality is fractured. If you have parts, treatment that focuses on those parts really helps.

 

[whiteraven]

Is that accurate that if you have DID, the treatment is pretty much the same as PTSD?

I'm really interested in some of the answers here. I think it depends on how your therapist has been trained. The therapist I have now is strongly focused on treating the PTSD. We don't really talk about inside unless it comes up when discussing something else.

My former therapist, though, handled things much differently. We were heavily involved in mapping and meeting everyone, etc..., and he said the only way he would continue to work with me was if we worked on each individual alter/insider - memories, coping mechanisms, etc...He also said that in order to experience healing, we HAD to integrate and that that might involve his intervention.

I know he still treats this way, but I also know that these days the approach is often more integrative.

 

[Cypress]

With my therapist, we don't focus on DID or specific parts except as it arises in dealing with specific issues. So, for example, when talking about SA, one part may come out insist that it was our fault and wasn't bad. And the rest of us tend to blame that specific part. And so our T has been working to help us sort that out. Self-blame and minimization are pretty common components of PTSD though.

This is how it is with my therapist too. We don't focus on parts specifically but on the trauma and how I and all of my parts are affected. I realize that what I consider to be voices or inside entities also represent the same feelings and symptoms as PTSD. So while I may have an angry voice named Alisa, someone else with PTSD may describe having suppressed or repressed rage. The same thing but in a slightly different presentation. Acknowledging the anger is key in either person's experience.

I would feel very uncomfortable if I was asked to map them and introduce them to the therapist. I have this very strong feeling that I should keep them secret which I know is probably not very healthy.

 

[Sideways]

Trauma processing took a back seat while I learned internal communication and working together as a team. That didn’t mean that everyone had to turn up at therapy and be besties with my T. That’s never gonna happen!

When a person with PTSD (or any mental disorder) starts therapy, the focus is oftentimes on stabilisong before nutting down to the hard work. My T’s approach, since I have DID in the picture as well, was “we need to get everyone stable and communicating effectively” before nutting down to do processing work.

Any one part not coping can throw the whole process. So absolutely that was a big difference for me having DID.

 

[Mercy Joy]

My therapist started doing things a good bit differently after she diagnosed me with DID. (She had been treating me for PTSD) And things got so much easier and better when she did.

 

[Kubash16]

My therapist started doing things a good bit differently after she diagnosed me with DID. (She had been treating me for PTSD) And things got so much easier and better when she did.

Really? What changed?

 

[Mercy Joy]

We stopped the trauma work and started doing a lot of work on internal communication and building trust. Trust is key. Between ourselves and with our therapist. We’ve been focused on learning what each part needs for self care, what their triggers are, what each one needs to regulate, and lots of body stuff.

 

[theshadowoftheliving]

I think it depends on the modalities that are being used.

Have you read the ISDD treatment guidelines for adults with dissociative disorders? For OSDD and DID, the treatment is the same.

Component-based psychotherapy was formulated for survivors of CPTSD / Developmental Trauma Disorder, so there are overlaps there for both PTSD and DID. It's on of the modalities my therapist uses, which I find tremendously useful.

However, other modalities like DBT might work well for PTSD and not for DID, since skills learned by one part do not always translate to other parts.

 

[whiteraven]

We stopped the trauma work and started doing a lot of work on internal communication and building trust. Trust is key. Between ourselves and with our therapist. We’ve been focused on learning what each part needs for self care, what their triggers are, what each one needs to regulate, and lots of body stuff.

When we only focus on this and not on the intensity of the trauma, we do MUCH better.