Chapter 10. To Begin With ―Psychoeducation (7)

③ Announcement of diagnosis would not usually worsen the condition
One of the biggest concerns that non-specialized clinicians tend to have is that diagnosing DID might worsen the condition. Some of them wonder if diagnosis of DID can become patients’ new identity. In fact, many clinicians seem to have this concerns, as before being sent to the specialists, majority of DID patients have been told “not to discuss” dissociative symptoms, let alone revealing other identities in their treatment settings. If the clinician has a radical attitude that denies even the condition of DID itself, the situation might be even more serious.
In sum, general or non-specialized clinicians’ concern can be expressed in the following single phrase: If clinicians acknowledge that the patient has DID, new identities would keep showing up and there is no limitation to it. If we follow this logic, therapeutic process such as mapping can really worsen the condition and it should never be done. For those who are almost phobic-like concern about treating dissociative symptoms, we can make a following statement.
“That concern might apply to only a fraction of patient with DID, while for most patients, it would not be a realistic problem. It is true that allowing expression of a dissociative part might sometimes lead to successive expression of other parts, as dissociative parts tend to have internal pressure to reveal themselves. This is what I would like to call dissociative chain reaction. If it occurs too fast to the detriment of the patient’s functional level, the clinicians should intervene and slow down the process. In most cases, however, dissociative parts settle down soon after having chances to express themselves as they tend to lose its internal after having a chance to express itself during the treatment sessions”.
In reality, dissociative chain reaction can be triggered by many factors other than therapeutic interventions. Typically when the patients get into a close relationship where they has a chance to freely express themselves, some dissociative parts would have an initial chance to reveal themselves. However in some unfortunate cases, retraumatization or excessive interpersonal or work-related stress can be a trigger.