Multimodal Treatment With ECT for Identity Integration in a Patient With Dissociative Identity Disorder, Complex Post-traumatic Stress Disorder, and Major Depressive Disorder
A Rare Case Report
Bibliographic Data
| ID | 15519884 |
|---|---|
| Authors | Kyle D Webster (0000-0001-9765-5000, Michigan State University), Susan Michalowski (corresponding author), Thomas E Hranilovich (corresponding author) |
| Year | 2018 |
| Volume | 9 |
| Pages | 275-275 |
| Publication date | 2018-06-21 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Psychiatry (JOURNAL) |
| Journal identifiers | ISSN: 1664-0640 • E-ISSN: 1664-0640 |
| Publisher | Frontiers Media (PUBLISHER • CH) |
| DOI | 10.3389/fpsyt.2018.00275 |
| PMID | 29977211 |
| OpenAlex | W2807213171 |
| Language | EN |
| Citations received | 1 |
| References cited | 9 |
The legitimacy and etiology of Dissociative Identity Disorder (DID) remains a controversial topic within Psychiatry. The two schools of thought are the Post-Traumatic Model (PTM) and the Socio-Cognitive Model (SCM). This case highlights the validity of PTM in an individual who suffered severe and prolonged physical, psychological, and sexual abuse from 2 years old through adulthood. The reported abuse was corroborated and proven on two separate occasions via medical professionals/rape kit and the police. This resulted in the incarceration of one of her abusers. The only way for the patient to cope with the trauma she suffered was to dissociate, which resulted in the development of four full identity alters. In addition to being diagnosed with DID, the patient has been diagnosed with Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD), and chronic suicidality. Unable to manage the suicidal ideations and MDD after nearly 10 years of therapy and psychiatric medications, the patient was referred for Electroconvulsive Therapy (ECT). Upon receiving ECT weekly for 2 years, the patient reported having "lost the others." As ECT progressed she went from having four alters to no alters and at the time of this report only being able to vaguely hear alter #4. With the integration of these alters she had access to the memories and pain that the alters had protected her from. Prior to losing the alters, her long-term memory was impaired by dissociative processes. Her long-term memory was also impaired because when one of the alters was in control of consciousness only that alter remembered what had happened during that time, unless that alter shared what had happened with one or more of the others. It is unclear if frequent ECT was the catalyst that lead to the integration of her alters however, integration finally began following prolonged ECT. This case highlights the importance of the PTM as an etiological description for DID and the importance of mental health providers further studying and researching the effects of ECT on patients with chronic MDD, PTSD, and suicidal intent, especially if these are comorbid with DID
Cognition · Dissociative · Dissociative identity disorder · Electroconvulsive therapy · Major depressive disorder · Psychiatry · Schizophrenia (object-oriented programming · Traumatic stress · Clinical Psychology · Personality Disorders and Psychopathology · Psychology · Psychosomatic Disorders and Their Treatments · Psychotherapy Techniques and Applications
Identity through a Psychoanalytic Looking Glass
Linking the overwhelming with the unbearable
The trauma model of dissociation
The sociocognitive model of dissociative identity disorder
Dissociation in posttraumatic stress disorder part II
Self-Reported Sleep Disturbances in Patients with Dissociative Identity Disorder and Post-Traumatic Stress Disorder and How They Relate to Cognitive Failures and Fantasy Proneness
Dissociative identity disorder and the sociocognitive model
Multiple identity enactments and multiple personality disorder
Evaluation of the evidence for the trauma and fantasy models of dissociation
| Citations per year | 0.14 |
|---|---|
| Citation span | 2019 - 2019 (1) |
| Highly cited | No |