“Generally speaking, genetic loading, traumatic childhood events, physical illnesses, and other stress factors all tend to raise the incidence of psychiatric illnesses, including dissociative disorder. As for DID, it has been reported that childhood sexual/physical abuse has particularly been implicated in the development of the disorder. Also inborn dissociative tendency seems to play an important role in DID. Relative to these factors, childhood environmental factors, including the nature of parental care, have less impact as far as children’s psychopathology is concerned, except for the effect of overt childhood abuse or neglect”.
Needless to say, parental care has a significant effect on children’s current and future life. Parent’s personality trait, occupation and interest, religious belief and life style all have some impact on their children. However, as we know well, children end up being a person significantly different from their parents in many ways. Children identify themselves with some aspects of their parents while developing totally different or opposite tendency in other aspects. However, as far as psychopathology is concerned, parents’ characteristics and ways of raising their children have less impact in their incidence of particular mental illness, unless any grossly traumatic or neglectful influence is involved (Harris, 1999) . I hope that with this statement some parents might become less self-critical about their possible “failure” in their parental attitude.
Harris, JR (1999) The Nurture Assumption: Why Children Turn Out the Way They DO. Free Press.
However, some DID patients nonetheless harshly blame their parents for their inappropriate or inconsiderate attitude that they feel they experienced in their childhood, and some parents might become really apologetic toward their children. But repeated apology of the parents usually do not sooth their children’s anger and resentment about the way they raised, based on my observation of relevant cases.
⑤ to explain to the patients about how they would be cured, if possible, and what “integration” is about.
These are the most crucial questions for DID patients and their family members, but they are also very difficult and complicated to answer. Below is my best attempt to respond to them. First of all, dissociative conditions are different from psychotic state (i.e., schizophrenia, etc) in which the patients’ functional level is severely and often indefinitely impaired. Based on the data that I gathered from my follow-up study of DID cases, within a couple of years after the initiation of their treatment, many DID patients show loss of, or significantly less frequent switching of personalities. In most patients, there is at least some improvement of their symptoms. Therefore, long term prognosis of DID is fairly hopeful. However, in order to have favorable outcome, patients’ comorbid condition, especially depression, should be well under control. Patients should also be in a secure and supportive relationship and living environment so the chance of retraumatization is kept minimum.
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