Why do Psychiatrists have to write books like this?

[GiantSteps]

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Why do Psychiatrists have to write books like this? Why does Newsweek have to run a story like this? And why does MSN have to feature the story? I suppose the answer to all three questions is $$$$.

http://www.newsweek.com/id/57343?GT1=10450

I am not saying that popularized writing on psychiatry/ psychology are a bad thing but sensationalized psychiatry/ psychology is.

P.S. Sorry if any of you hear some annoying clicking sound from this link.

 

[GiantSteps]

Sorry, I could no go back and edit the title. Obviously it shoudl read:

"Why do Psychiatrists have to write books like this?"

 

[Squarepants]

Of course it's all about the money. Our entire healthcare system and mass media were designed from the ground up with profit in mind. This isn't going to change until enough people realize how much of a disservice this does to the very people who rely on both (ie, regular people without huge bank accounts). In the meantime, lots of people will remain perfectly willing to cash in while they can.

 

[toby jones]

They don't have to, but some of them choose to do so to be sure. I expect they think they are doing the world a service. Heightening awareness of a condition that was once considered 'exceptionally rare'. In the same way that some people feel that there are many many other people with depression out there who desperately need our help (whether they will admit as much or not) other people feel that there are many many other people with dissociative identity disorder who desperately need our help (whether they know they are ill or not).

Severely misguided is the best I have to say to both...

 

[Therapist4Chnge]

It isn't limited to psychiatry, there are a TON of sham books out there on self-help, 'curing' various disorders, etc. Heck, even non-academics right books that never should have gotten out of editorial review.

As per the subject of the book, I am skeptical about DID, though I believe it can happen in some form, though not in the profound presentations that people often refer. I believe it can be in reaction to trauma and/or inability to cope, though I'm quite skeptical of COMPLETELY separate personalities, instead I believe there can be fractured personalities.

-t

 

[chaos]

I'm in no way qualified to render an opinion on the disorder one way or the other, but just from basic social psychology and my own experience, a lot of people, especially 'high self monitors', manifest very different behavior patterns, even thought patterns, depending on the context, or the expectation of the person they interact with. If someone has experienced severe trauma, as in most DID cases, usually chronic trauma from childhood, it makes sense that these discrete self-conceptions might not merge smoothly into one adaptable 'personality', but rather get 'stuck', with the person fearful and unable to regulate them...they have to compartmentalize what would normally be fluid variations in personality because they feel it is somehow not acceptable to 'own' all these aspects 'e.g. shy, rebellious, childlike' and integrate them into a unified self. Maybe indicative of the black/white/all/none thinking characteristic of the BPD that is often comorbid with the disorder. If some people have trouble with affect regulation, why not personality regulation? The 'injured child schema' might get randomly activated at a business meeting, therapy session, whatever. In fact I may have to check out some functional neuroimaging studies on this topic, because I'm sure there are biological correlates for this inability to suppress or activate appropriate parts of the self-concept on command. The point about labeling them with different names, separate entities entirely, in my opinion is just a function of the shame of experiencing these 'foreign' or 'forbidden' aspects of self.

Of course I am just rambling here...I know nothing about the disorder except like 10 minutes from abnormal psychology 🙄.

 

[GiantSteps]

In fact I may have to check out some functional neuroimaging studies on this topic, because I'm sure there are biological correlates for this inability to suppress or activate appropriate parts of the self-concept on command. The point about labeling them with different names, separate entities entirely, in my opinion is just a function of the shame of experiencing these 'foreign' or 'forbidden' aspects of self.

Of course I am just rambling here...I know nothing about the disorder except like 10 minutes from abnormal psychology 🙄.

Actually, I remember I once saw some neuroimages of what was supposed to be a person with DID. The images were fascinating. I was not in anyway trying to discreted the disorder which of course is a rather vague and misunderstood one (I remember learning that the individual personalities are not at all clear cut such as this book or a movie case would have one believe). I think the article is just an example of overdramatized psychological/ psychiatric disorders which presents little to no research. The article sounds as if this bizaare case is a typical one for DID and also that the psychiatrist miraculously cured the person.

 

[chaos]

Yeah I absolutely agree with you that books like that are annoying and probably detrimental-- it's one thing to report on a rare disorder, another to sort of...dramatize it, which it seems like this guy does. Actually there's another book about DID, I think it's called Stranger in the Mirror, actually by a local psychiatrist here, that completely distorts statistics about DID and makes it sound like anyone with any mental health problem or history of trauma has some kind of dissociative disorder 🙄

 

[toby jones]

Correlation doesn't show causation. If certain 'alters' don't access certain memories that tells us nothing about whether they choose not to or whether they can't or whatever.

I don't think that it is controversial that a number of people do meet diagnostic criteria for dissociative identity disorder. The main controversy is over the causal mechanisms that result in their meeting behavioural criteria, however.

On the one hand you have the post-traumatic theorists (Ross, Kluft, Putnam, Gleaves) saying that the disorder is a response to early childhood trauma. That alters exist as seperate states prior to therapy. That therapy is effective because it 'integrates' the memories etc.

On the other hand you have the socio-cognitive theorists (Spanos, Lilinfeld etc) saying that the disorder is a kind of 'strategic role enactment' where the persons behaviours are shaped by over zealous therapists and / or by the way that people come to see themselves. After Thigpen and Cleckly wrote the 'Three Faces of Eve' they were inundated by people who claimed to similarly have dissociative identity disorder, for example. According to the socio-cognitive model treatment consists in shaping behaviours back to reflect a more integrated self by not reinforcing dissociated behaviours (by calling different aspects by different names, by intentionally inducing switching and so forth).

What is a self? Most (theoretical) psychologists who work on the self now believe that selves simply are fragmented to a greater or lesser extent. There isn't much that is miraculous about an extremely fragmented self. If one understands a self as (something along the lines of) a complex of memories, thoughts, feelings etc then more than one self in one body is no more problematic than one self in one body. That being said the notion that a self has an immaterial 'soul' or similar prevails in the popular conception. That is the only sense in which the phenomenon seems really problematic (will all the alters go to heaven or just some?)

 

[socialcog]

Actually, I remember I once saw some neuroimages of what was supposed to be a person with DID. The images were fascinating. I was not in anyway trying to discreted the disorder which of course is a rather vague and misunderstood one (I remember learning that the individual personalities are not at all clear cut such as this book or a movie case would have one believe). I think the article is just an example of overdramatized psychological/ psychiatric disorders which presents little to no research. The article sounds as if this bizaare case is a typical one for DID and also that the psychiatrist miraculously cured the person.

Do you remember what ROI's stood out? Prefrontal cortex and limbic activity? Inhibitory control study? Or were the images only structurals and not fMRI images? Do you recall who authored the paper?

I could look for it myself but I'm fat and lazy. 🙂

 

[toby jones]

they did a write up for new scientist (unless there is more recent stuff that I'm missing)

Adler, R. (1999, December). Crowded Minds. New Scientist.

 

[socialcog]

they did a write up for new scientist (unless there is more recent stuff that I'm missing)

Adler, R. (1999, December). Crowded Minds. New Scientist.

I can't read this...arg. 😡 Is this paper relevant to the neuroscience reference?

 

[toby jones]

http://www.priory.com/psych/did.htm

I don't see how that helps matters at all. From memory the Apter paper was about how there were neurological changes when I person switched into different alters and those changes did not occur when the person 'acted' switching into different alters.

They got actors to similarly 'act' switching into different alters and they didn't find differential neurology for the actors.

I don't see what this shows, however.

I wonder how hypnotized subjects would perform if they were hypnotized into switching?

Get those actors to develop their own role... A role bound up with some of the most intense feelings (and painful feelings) that they have. Get them to routinely practice 'switching' into (ie acting out) the role. Maybe... Three times a week to mimic what happens in therapy, or maybe a bit more than that to reflect that people probably switch outside therapy to... Give them... How long? 6 years of that? How many years of treatment for DID did the person who had neuro changes have? About that many years. Do that in a kind of hypnotic environment and a fair few controls (some who are high in hypnotizability) and I don't expect you would find much in the way of difference between the actors and the patients.