Explaining Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified (DID/DDNOS) to a Therapist

Introduction

When explaining Dissociative Identity Disorder (DID) or Dissociative Disorder Not Otherwise Specified (DDNOS) to a therapist, it is important to understand the current diagnostic landscape and terminology. While DDNOS was a valid diagnostic label in the past, it is no longer used as a primary diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which was published in 2013. Instead, it has been integrated into the broader category of Other Specified Dissociative Disorder (OSDD). This article will provide a comprehensive guide on how best to explain these conditions to a therapist, including current diagnostic labels and their implications.

Dissociative Identity Disorder (DID)

Basic Definition

Dissociative Identity Disorder, also known as dissociative disorder type 2, is a condition in which a person exhibits two or more distinct identities, or personality states, that recurrently take control of the person’s behavior. Each personality or identity state has its own pattern of perceiving and interacting with the environment. DID is distinct from other dissociative disorders because it involves the presence of multiple distinct identities.

Diagnostic Criteria

For a diagnosis of DID, the patient must meet the following criteria as per the DSM-5:

The disturbance involves a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and thought. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The disturbance is not a normal part of a broadly accepted cultural or religious practice and is not attributable to the physiological effects of a substance or another medical condition. The diagnosis cannot be made if the pduct is better explained by another mental disorder, such as another dissociative disorder or a psychotic disorder.

Dissociative Disorder Not Otherwise Specified (DDNOS)

Historical Context

DDNOS, previously a diagnostic category in the DSM-IV, was used to describe individuals who met some, but not all of the criteria for DSM-IV-TR diagnoses of dissociative disorders, such as depersonalization, derealization, or dissociative amnesia. However, this label is now considered outdated and is not used in clinical practice.

Current Diagnostics

The DSM-5 has made significant changes to the diagnostic criteria for dissociative disorders. Instead of DDNOS, the current category is Other Specified Dissociative Disorder (OSDD). OSDD is used when a condition does not meet the criteria for any specific dissociative disorder due to a specific reason.

Explaining Dissociative Identity Disorder and DDNOS to a Therapist

Using Current Terminology

When discussing these disorders with a therapist, it is important to use the current diagnostic labels. You can start by explaining that you have been experiencing symptoms that align with a dissociative disorder. If you specifically have been diagnosed with DID or DDNOS, it is beneficial to bring your diagnostic report or relevant documentation to the appointment. However, if you suspect you might have these disorders, it is important to share your symptoms and experiences in detail.

Emphasizing the Symptoms

It is essential to outline the specific symptoms that you are experiencing. This can include:

Experiencing a loss of identity or memory that is not accounted for by normal facts of life, such as memory loss due to alcoholism. Gradual, progressive, or sudden changes in sense of self or identity. Violence or combat during which there is a dissociative alteration or loss of identity that is not caused by the direct physiological effects of a substance. A sense of derealization in which the external world is experienced as foggy, strange, unreal, or dreamlike, or a depersonalization in which the individual feels detached from his or her sense of self. Recurrent gaps in memory for everyday events, traumatic events, or both, without the usual social excuse for these gaps.

Explaining the Impact on Daily Life

Discuss how these symptoms have affected your daily life, relationships, and overall functioning. It is important to be honest about the challenges you face and how they impact your quality of life. This can help the therapist understand the severity of your condition and tailor the treatment plan accordingly.

Seeking a Multidisciplinary Approach

It is often beneficial to work with a multidisciplinary team that includes a therapist, psychiatrist, and potentially other healthcare professionals. A fellowship in dissociative disorders or a specialization in dissociative disorders can also be very helpful. This team can provide a comprehensive approach to treatment, including psychotherapy, medication management, and possibly other therapies such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or eye movement desensitization and reprocessing (EMDR).

Conclusion

Explaining Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified to a therapist requires a clear understanding of the current diagnostic landscape and terminology. By using the current diagnostic labels of DID and OSDD, and emphasizing your specific symptoms and their impact on your life, you can facilitate a more effective discussion with your therapist. Remember to seek a multidisciplinary team and explore various treatment options to address the complexities of these disorders effectively.