A Systemic Approach to the Treatment of Dissociative Identity Disorder

Structural Family Therapy with a Client Diagnosed with Dissociative Disorder

“…Luxton 18 believed that inconsistency in parenting in terms of giving positive reinforcement and setting consequences of behavior could negatively affect a child’s sense of self-worth or self-esteem, which happened with the client as well. According to Pais, 19 in such cases, intervention with family should focus on helping the family understand the need to provide a safe and secure environment that can help persons with DID to re-experience trauma without feeling guilty and shameful. By doing so, a person with DID will be able to cope up with the splitting of personality without indulging in self-injurious and homicide behavior, which was the outcome of intervention with the family in this report.…”

“…Family therapy can bring intense discomfort in persons with DID by bringing back traumatic memories of the conflict with other family members, which can be counterproductive to the therapeutic progress. 19 Therefore, before starting the sessions, it is important to clinically prepare the client to handle the session and to prevent revictimization. 19 It is important to assess domestic violence in all clients who come for family therapy as it would affect the course and outcomes of the therapy.…”

“… 19 Therefore, before starting the sessions, it is important to clinically prepare the client to handle the session and to prevent revictimization. 19 It is important to assess domestic violence in all clients who come for family therapy as it would affect the course and outcomes of the therapy. Babcock et al 26 reported that severe domestic violence may be a contraindication for SFT as the focus would shift from changing the family functioning to addressing more immediate concerns like safety planning.…”

“…When educating the clients about dissociation, they may resist accepting altered identities as part of self, so it is important to build trust and a sense of safety within the therapeutic relationship and to discuss negative transference that may arise during those discussions. 19 The therapist should not side with or outrightly reject the viewpoint of any altered identity but should be emphatic, validating, and flexible and use language that is accepting of all the identities of the client. 11…”

“… 16 To bridge the gap in the research on the effectiveness of different models of family therapy, it is important to apply SFT techniques on more individual clients and compare the effectiveness with that of other systemic models such as Bowenian. 19 There is also a need to do a long-term follow-up study to see the effectiveness of SFT techniques on individual clients with different types of psychiatric illnesses. 5…”