Chapter 13. Case “A” (1)

In this chapter I would like to discuss a case called “A” that I treated for her dissociative identity disorder for several years in the past. (In this book, I discuss several cases called “A”, but naturally every one of them is a different person.) Treatment course of DID patients varies greatly from case to case, and not all of them have very positive outcome. Fortunately, however, A’s treatment course was a quite favorable one and she achieved a good success in her private life as well as in her work. This case also is a fruit of a good working relationship between her psychiatrist (myself) and a psychologist, and can be a model for the treatment of DID on an outpatient setting. A is a single woman in her early twenties. After she graduated from a college, she took a job as an office secretary that she did not get adjusted well. Reportedly she had some “episodes” which made it difficult to stay in her workplace, but the details were unknown. Her mother took A to a nearby psychiatric department where I saw her for the first time. It was my impression that her mother took initiative in scheduling A’s visit to us and she reluctantly followed her mother’s advice.
A was a slender woman with a short haircut, who presented with complaints such as “People call me liar” and “I feel confused all the time.“ She further stated, “I cannot put up with living with my parents”. Also included among A’s complaints was “sometimes my memory slips” which certainly suggested dissociative disorder, but still DID was not one of my differential diagnosis upon the intake interview. A’s mother had a laundry list of complaints about A’s “life style” especially after she quit her job, such as her not doing house chores at all, her being always in bed or browsing and text-messaging in the cell-phone, her not seeking a job, etc. After her mother left the office, A slowly began to talk about her difficulty with her life, which was mainly focused on her difficulty dealing with her mother.