Chapter 10. To Begin With ―Psychoeducation (6)

According to my own experience, if the patients’ profile generally matches that of DID and the patients are aware the presence of other identities to some extent, telling them about the diagnosis generally would not be shocking or cause a serious harm. That is quite different from informing schizophrenic patients about the diagnosis, as the patients would not have any insight or preparedness to understand its meaning, and the family members could be quite disappointed and feel helpless due to the seriousness of the prognosis of schizophrenia.
One of the benefits of learning about the diagnosis for DID patients, is that patients might be given an answer to a question that they might have been asking about themselves for a long time. The fact that DID might have a rather benign outcome might be of another help. For those who have been misdiagnosed with schizophrenia, learning that they have DID instead can be a sheer blessing. In that case, however, the clinicians should be experienced and skilled enough to be able to do so, as they cannot afford to repeat the misdiagnosis. I would propose that overriding the diagnosis of schizophrenia given by previous clinicians should be done with best care, and if there are questionable psychotic-like features in the patients’ clinical presentations which otherwise are generally compatible with DID, I would leave the diagnosis of DID provisional and let the patients know, if necessary, the reason why I am still open to other possible diagnosis.
I stated that announcing the patients’ diagnosis of DID can be generally beneficial, but for some patients, learning that they have DID can be a total surprise, as they might not have any readiness to accept that they have another parts of himself. In that situation, psychoeducation is even more necessary and explaining about the mechanism of dissociation step by step could be of help. They need to be told that DID has nothing to do with some possessions of evil spirit or incurable demonic illness that some of them believe DID means. One my patient asked, when I told her about her having DID, “So, am I normal? … I mean, am I a normal patient?” ” and quickly caught herself for the paradoxical nature of her question. When told that her experiences fit the profile of many DID patients, she appeared reassured nonetheless.