Nursing Care for Dissociative Indentity Disorder

Dissociative indistinguishability disorder is a common genial disorder. American Psychiatric Association (2000) defines DID as, presence of two or more distinct identities or individualisedity states that recurrently take control of the singulars behaviour, accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness (as cited in Ringrose, 2011, p. 294).Coons (1998) states that an individual deplorable from DID shows different personalities who may maintain different ages, names, and functions (as cited in Gentile, Dillon & Gillig, 2013, p. 24). The original personality is host and developed personalities are alters who may have different level of conciousness and knowledge (Persin, 2011, p. 58). It is complex type of disorder, Briere & Elliott (2003) and Spitzer et al. (2006) estimate that 1 to 3 percentage of total population are suffering from DID in North America (as cited in Gleadhill & Ferris, 2010, p. 3). The complexities in personality of the DID unhurried fake difficulty in give-and-take however, Chlebowski and Gregory (2012) argue that sychotherapy, cognitive behavioral therapy, hypnosis, chemical assort and family therapy are common for the treatment methods for DID (p. 165). By developing effective foresightful term treat care plan, and implementing it through the individual, family or group therapy, nursing intervention can play important role for the treatment of DID enduring having different symptoms.DID patients may show several symptoms including amnesia, identity confusion, identity alteration, picture of loss of time and space, flashbacks, nightmares, headache, and emotional unstableness. Steinbergs (2004) structured clinical interview for the diagnosis of DID identifies the five core symptoms as amnesia, depersonalisation, derealisation, identity confusion and identity alteration (as cited in Gleadhill & Ferris, 2010, p. 43).DID patient may besides have the symptoms such as fear of others, loneliness, deep insecurity and lack of a long sense of self, loss of time and space, flashbacks, nightmares, fragmented and missing memories, headaches, emotional instability ranging from extremes of rage and fear through to numbing and inability to feel (McAllister, 2000, p. 26). Coons (1998) identifies some(prenominal) somatic symptoms such as pseudoseizures, conversion, and gastrointestinal and genitourinary disturbances (as cited in Gentile, Dillon & Gillig, 2013, p. 24).Coons pull ahead agrues that DID patients usually show the signs such as eye rolling, eye blinking, trancelike behaviour, and changes in posture during changing of personality from host to alter. almost of the DID patients also report dissociative symptoms of extrasensory experiences such as hallucinations (Gillig, 2009, p. 26). Whatever the symptoms the DID patient shows, there are underlying several traumatic causes for the patient suffering on his/her childhood. DID is acquired in the childhood due to severe ongoing neglect, physical, emotional, psychological and sexual abuse.Lev-Weisel (2008) states that when child gets maltreated, mostly sexually abused, he/she thinks the body no longer be a safe home, and thinks to get rid from the abused situation (as cited in Gleadhill & Ferris, 2010, p. 43). This situation develops dissociative behaviours in an individual as a coping mechanism. Curtis (1988), and Ross and Fraser (1987) argue that repeatition of abuse strengthens the defense mechnism of dissociation which allows scurrilous memories to be stored in different retention banks so that alter is create with different personalities to handle the abuse (as cited in Precin, 2011, p. 8). Gold, Hill, Swingle and Elphant (1999) and Volkman (1993) state that the severity of the DID depends on childs age at the time of abuse, duration and severity of abuse, emotional appendix to the abuser, and psychological factors (as cited in Gleadhill & Ferris, 2010, p. 43). In addition to severe child abuse, Armstrong (1991), and briny and Solomon (1986) identify that a disorganized attachment style, and the absence of social as wellspring as familial support also develop DID (as cited in Gillig, 2009, p. 24).Several therapies are in practice for the treatment of the DID such as sychotherapy, cognitive behavioral therapy, art therapy, hypnosis, group and family therapy. Among them common treatments for DID identified by Pais (2009) include individual, family, or group therapy, creative arts therapies, pharmacotherapy and clinical hypnosis (as cited in Gleadhill & Ferris, 2010, p. 44). Due to complexity of disorder and multiple personalities to treat within an individual, weber (2007) reports that its treatment is often long as well as challenge with possibility of remission scarce (as cited in Gleadhill & Ferris, 2010, p. 3). Chlebowski and Gregory (2012) argue that the treatment stupefy with the largest empirical basis has been Klufts (1999) individualized and multistaged treatment (p. 167). They state, It involves making contact and placement among alters to work towards integration, accessing and processing trauma with occasional use of hypnosis, learning unfermented coping skills, and eventually fusion among the alters and the self (p. 167).OReilly in1996 develops a nursing therapy specimen for the treatment of DID patient that focuses basically on three stages reassuring collapse safety, associating important merories by ensuring patient confidence, and listening, applying and sharing the interpretation (as cited in McAllister, 2000, p. 31). McAllister et al. after an action research in 2001 find that nurse can reassociate the memory of DID patient by developing effective individualized as well as group therapeutic relationship with the patient (P. 31).Association of dissociative memory is quite challenging work among the psychotherapist however, longitudanal individual and group therapies are still cons idered as effective methods for the treatment of DID. With patients support on treatment, nursing intervention may be effective method for the treatment of DID patient by developing longitudanal, individualized and multistaged effective care plan. Some studies on nursing therapy for DID patient show its potentiality for the treatment however, gain research is necessary to identify its effectiveness.