The Case of Anna O.

                                        The Case of Anna O.

     Dissociative Identity Disorder, or Multiple Personality Disorder, is the most severe dissociative disorder. Dissociative Identity Disorder (DID) involves two or more distinct personalities that exist in one person. Each of these personalities maintains its own pattern of behavior, thinking, and relationships (Meyer, Chapman, & Weaver, 2009). The relationship between personalities is often complex. Only one personality is dominant at a time and in most cases the core personality is unaware of the other personalities. However, some personalities may be away of the others. The individual maintains his or her own original identity (Hansell & Damour, 2008). The host personality is the one which usually retains the legal name, helps in maintaining employment, relationships, and responsibilities. 

     The etiology of Dissociative Identity Disorder can be explained through several components. These components include biological, psychodynamic, behavioral, cognitive, and social/sociocultural. Psychodynamic researchers believe that dissociative disorders are the result of the individual’s use of repression to block unpleasant or traumatic events (Sue, Sue, & Sue, 2010). The belief is that dissociation of mental processes occurs when complete repression does not occur. Dissociation may also explain the disruption of personal identity. Dissociative Identity Disorder also involves the mechanism of splitting (Hansell & Damour, 2008). In DID, splitting refers to the splitting of the good and bad of an individual. Thus, different personalities are developed. Dissociative Identity Disorder can occur after traumatic childhood events, such as abuse, as well as the inability to cope with them. Biological components involve the brain structure and processes. Some research has shown a link between DID and NMDA receptor antagonists, serotonergic hallucinogens, and cannabinoids (Hansell & Damour, 2008). Other research focuses more on the brain structures such as the hippocampus and amygdale. The hippocampus is associated with memories. Inhibition of this region is believed to be associated with the switching of personalities. It is also believed that a chronic activation of a stress response in childhood trauma can result in permanent structural changes in the brain (Sue, Sue, & Sue, 2010). This results in a reduction of volume of the hippocampus and amygdala and hampers the ability of the brain to integrate emotional memories. This explains why memories are not shared between personalities. Behavioral, cognitive, and social/sociocultural components have less prominence in etiology than psychodynamic and biological. Behavioral components are based on the role of operant conditioning. Behaviorists believe that a disruption of the reinforcements causes a split in personality. In the past, cognitive psychologists used the self – hypnosis theory to explain dissociative disorders. Modern cognitive psychologists believe dissociative disorders are the result of disruptions in memory and attention. The Sociocognitive Model of DID is the basis of the sociocultural perspective (Sue, Sue, & Sue, 2010). This model states that patients may learn about DID through the mass media and then enact the behaviors. In 1973 there was a publication released entitled Sybil where the main subject had sixteen personalities (Sue, Sue, & Sue, 2010). Thus, the mean number of personalities in DID patients grew from three to twelve.

     The Case of Anna O. tells the story of a woman with DID. Anna first sought treatment for a persistent cough (Meyer, Chapman, & Weaver, 2009). By using hypnosis, Anna’s physician Josef Breuer attempted to have her remember events leading up to the initial visit. Some researchers believe that this hypnosis was the cause of Anna’s DID. This assumption would fall in line with the psychodynamic perspective. Anna discussed events such as her childhood and the distress of caring for her ailing father. These events also could have contributed to Anna’s disorder. Some researchers believe that DID is a learned response within the family (Meyer, Chapman, & Weaver, 2009). Due to this, at least one parent is disturbed. Individuals most likely to develop DID include those abused as children, those under significant stress, and those that have experiences maternal rejection. Anan fit into all of these. It is the belief that Anna was generally emotionally abused in that her father and mother, among other factors, stifled her emotional need of independence (Meyer, Chapman, & Weaver, 2009). During the course of Anna’s treatment, two different personalities emerged. Personality 1 was a melancholy personality because of the gaps in consciousness, mood swings, and possible hallucinations (Meyer, Chapman, & Weaver, 2009). Personalities differ and sometimes even are complete opposites of one another. This was the case with Anna. Personality 2 had more antisocial qualities, including being abusive towards others, and displaying odd and rebellious behaviors; Anna called this personality “naughty” (Meyer, Chapman, & Weaver, 2009, p. 61). Breuer ended his treatment with Anna. She was later hospitalized for morphine addiction. However, she exhibited symptoms of DID: inability to speak her native language, absences of consciousness, and a feeling of missing time (Meyer, Chapman, & Weaver, 2009). Anna was able to make a recovery from her disorder and live a productive life.   

 

References

Hansell, J., & Damour, L. (2008). Abnormal Psychology (2nd ed.). Hoboken, NJ: Wiley.

Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case Studies in Abnormal Behavior (8th ed.). Boston, MA: Pearson/Allyn & Bacon.

Sue, D., Sue, D. W., & Sue, S. (2010). Ubderstanding Abnormal Behavior (9th ed.). Boston, MA: Wadsworth.

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