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Abstract

第113巻第9号

Introducing Treatment for Dissociative Identity Disorder
Naoto KITAMURA
Tsutujigaoka Mental Clinic/Abe Clinic
Psychiatria et Neurologia Japonica 113: 918-926, 2011

 This paper is a case presentation and study of the introduction of treatment for Dissociative Identity Disorder(DID).
 Since one manifestation of the pathology of DID is that sufferers avoid relying on others, at the start of treatment we try to stabilise the relationship between clinicians and patients ; that is to say, we aim to build a treatment relationship which will be able to gradually overcome the patients’dread of relying on clinicians. In parallel with this we undertake a thorough psychiatric assessment of their condition. This is a standard treatment plan,which follows the general principles of clinical psychiatry.
 On the other hand, the specialist aspect of DID treatment calls for handling the unique behaviours of a group of mutually opposed alternating personalities appropriately, while always paying consistent attention to the traumatic memories which are connected to the formation and maintenance of the condition.
 This paper presents the first DID case which the author has taken charge of. There were some difficulties in the early stages of treatment,but after modifying some parts to acknowledge the alternating personalities as independent personalities in face-to-face interviews and psychological education for families, the stabilisation of the treatment structure progressed gradually and the stability of the relationship between clinicians and patients itself has become the focus.

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