Chapter 14. Treatment of DID with a Use of Email (3)

Present Illness, and Past Psychiatric History)
A experiences hearing voices from her childhood, but she was thinking that it may be happening to anyone. Her first psychiatric visit occurred when she was in her college at the age 20. When she dated for the first time in her life, she suddenly became verbally aggressive with a male voice toward her boyfriend. Although she does not remember the episode, he left her because of this event. A very similar thing happened with her second boyfriend. She then began to think that there is something wrong with her and visited a local psychiatric clinic, where no definite diagnosis was made. After A finished high school, she entered a vocational school for fashion design, where she experienced a great difficulty catching up with the study. She often “daydreamed” during the classes and could not remember what was lectured. She often felt extremely sleepy and dosed off often during practical training classes.
In the year 20XX-1, she started to notice that there are different handwritings in her journal and she has belongings that she does not remember having bought or been given. One person that she befriended in the internet game during this period pointed out that a male character named B often logs in instead of A late at night. A figured out that same B often wakes up at night and goes to a local game center where he spends a couple of hours, which explains A’s extreme sleepiness at school during the day time.
Treatment course)
Her first visit to us was in August, 20XX. Her diagnosis of DID was rather clear upon intake, although I could not contact B initially. As she is located in a very remote town which requires several hours’ train ride to come to the clinic, her visit is inevitably scheduled every two to three months. It was in these circumstances that communication with A during the sessions was designed by email. I also recommended that she use a journal for internal communication. As I could not contact B during the initial session, I asked A to write in the journal my message to B that I would like to meet with her.