In our weekly Psychological & Spiritual Therapy column, therapist Jack Surguy is offering professional advice to The Mindful Word readers for all those questions and problems you have wanted to discuss with someone qualified and caring.

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Based on a question raised by a reader about her ability to disappear into a different headspace when situations became “out of kilter,” as she put it—her ability to completely (mentally) remove herself from her physical situation, often making it necessary for her to jerk herself back into her immediate “now”—we’re going to go in a bit of a different direction this week.

In discussing a specific disorder, we’ll look at what possibilities this disorder may suggest when it comes to how we relate to our own physical bodies.

Dissociative Identity Disorder (DID)

In 1980, the American Psychiatric Association released the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). It was within the DSM-III that the diagnosis of Multiple Personality Disorder (MPD) made its first appearance. In 1994, the DSM-IV renamed MPD as Dissociative Identity Disorder (DID) and a publication entitled “Guidelines for Treating Dissociative Identity Disorder in Adults” was released by the International Society for the Study of Trauma and Dissociation.

The diagnosis of DID is extremely rare. Reports indicate that around 0.4 to 1 percent of people in community samples meet the criteria for this disorder.

Though there remains considerable debate regarding the validity of this disorder, researchers and clinicians do agree that the central issue in DID pertains to dissociation, which has been defined as “a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behaviour.

We’ve all experienced dissociation to some degree

Many of us have experienced a time when we were driving and then suddenly realized we either didn’t know where we were or had missed our exit miles ago. This is a form of dissociation. Our bodies seem to go into an auto-pilot mode in which we’re still responding to environmental cues (like keeping the car on the road), but are doing so in a way that lacks a full conscious awareness of exactly what we’re doing or where we’re going. Dissociation is highly correlated with trauma.

In her 2013 book, Restoring the Shattered Self: A Christian Counselor’s Guide to Complex Trauma, author Heather Davediuk Gingrich titled a section “Dissociation: God’s Gift to the Traumatized Child.”

When people are forced to endure extremely stressful situations, such as child abuse, the human mind has a way of protecting itself from those experiences. In ways not fully understood, the mind is capable of fully blocking out, from conscious memory, experiences that may be too emotionally charged for a person to acknowledge and process in a safe manner.

While a person is enduring a traumatic event, some people just “go away” in their mind to such a degree that the experience isn’t fully integrated into conscious biographical memory. Amazingly enough, however, a person may still respond to “triggers” or reminders of the traumatic event without knowing why. What’s even more amazing is that these people may also experience what’s referred to as “spontaneous” recovery of a traumatic memory, through which they’re able to remember the event in intense, vivid detail.

Taking on a life of its own

According to many theories, when a person (especially a child) is forced to endure particularly intense, repeated traumas, the dissociative experience accompanying the traumatic events may be powerful enough that a kind of “split” takes place in the person’s personality. The split-off or dissociated personality, typically the part that experienced the trauma, can then take on a life of its own—as astonishing as that sounds. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) lists the following as criteria for the disorder:

  • Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption of marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
  • Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.
  • The symptoms are not attributable to the physiological effects of a substance (e.g. blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g. complex partial seizures).

There’s some research that does appear to support the existence of DID, which can be read in more detail below in the “Research and Addendum Notes.”

I’ve witnessed this phenomenon only once

In the years I’ve practiced psychology and mental health, I’ve witnessed such a phenomenon on only one occasion.

I was working with a woman who’d been forced to watch her boyfriend’s execution at the hands of her own family. This person was highly traumatized and was barely functioning. While in session, she experienced a flashback, which is an extremely vivid memory that makes a person feel as if the trauma is occurring all over again. She just slumped down in her chair, sobbing, with her head resting on the nearby table.

This woman was darker-skinned, with very dark brown hair and dark brown eyes. I sat quietly as her crying subsided. She remained sitting quietly with her head down on the table. In a whisper, she asked me if she’d ever be able to function again. When I stated that I was very confident that she would, she turned her head and looked at me.

I sat in disbelief as she looked at me with very bright blue eyes. She just looked at me for maybe 10 seconds and then calmly said that she did have hope. She laid her head back down on the table and her body then seemed to slightly convulse. She exploded back into sobs, crying for a couple of minutes, and when she finally looked at me again, her eyes had returned to being dark brown.

What these studies suggest is that a person’s biological and physiological components can, in fact, be altered depending on the person’s state of mind and perception. In other words, changes at the genetic level can actually occur in relation to a person’s state of mind.

How does this apply to readers of The Mindful Word?

Mindfulness meditation is a practice in which our state of mind and perceptions are altered during practice. Research is now providing evidence supporting the belief that mindfulness meditation can literally change your body at a genetic level.

In a study by Rosenkranz et al. (2016)8 the researchers investigated the effects of a day of intensive mindfulness practice. Results from a group of experienced meditators were compared to those from a group of untrained control participants who engaged in quiet, non-meditative activities. After eight hours of mindfulness practice, the meditators showed a range of genetic and molecular differences, including altered levels of gene-regulating processes and reduced levels of pro-inflammatory genes, which in turn correlated with faster physical recovery from a stressful situation.

In another study, Carlson et al. (2014)9 found that mindfulness meditation altered the genetic processing of cancer patients in a manner that made the patients’ bodies more conducive to health and recovery.

The power of our minds

In writing about these exciting findings, I decided to first discuss the profound biological, neurological and psychological changes that can ensue when severe trauma occurs. I did this to help the reader understand that our minds are extremely powerful and can alter our biology in profound ways we previously thought impossible.

Current research is now demonstrating that mindfulness practice can also alter our biology, even if this happens in less dramatic ways when compared to the effects of trauma. However, you must consider the fact that trauma is often a life-changing event. The person prior to the traumatic event is different from the person after the event. Life has been radically changed.

But what if we approached our mindfulness practice in a radical manner? What if we allowed the insights we often gain in meditation to truly transform the way we perceive the world and act within it? According to research, if we did just that, we could literally change our biological and neurological processing in such a way that our genetics would be altered. In other words, in a very real sense, we could truly become new people who’d be able to view the world differently.

RESEARCH AND ADDENDUM NOTES

Research by Shepard and Braun monitored refraction, visual acuity, ocular tension, keratometry, colour vision, and visual fields in DID patients and found changes in these measures among each patient’s varying identities or personalities1.

In another study by Ludwig et al2, the visual evoked potentials (VERs) were studied with a patient diagnosed with DID. The visual evoked potential (VEP), or visual evoked response (VER) is a measurement of the electrical signal recorded at the scalp over the occipital cortex, in response to light stimulus. The light-evoked signal, small in amplitude and hidden within the normal electroencephalographic (EEG) signal, is amplified by repetitive stimulation and time-locked, signal-averaging techniques, separating it from the background EEG readings. The results indicated that two dissociated personalities had prominent and similar VERs, a third personality had none and a fourth personality had only a small potential2. In similar studies, Larmore3 and Pitblado and Densen-Gerber4 reported differences in VERs in their DID patients.

In a very interesting study, Braun (1983a)5 found differences in VERs in the personalities of two DID patients. However, after successful treatment, the patients’ post-integration VERs were different from any of their pre-integration VERs.

Densen-Gerber (1986)6 reported on two patients who exhibited unusual dermatological variations. The first patient would develop symbolic needle track marks when she’d switch to a drug-addicted personality. The second would develop welts and marks on his back and legs when undergoing flashbacks of physical beatings.

Clinicians have also described anecdotal evidence in which DID patients had variations in allergic reactions and differential responses to medications across dissociated identities, as well as reports indicating that eye colour even changes across varying dissociated personalities. In a more recent study, Reinders et al. (2006)7 found that patients with DID neurologically processed information in different ways. In other words, a person’s brain reacted differently to stimuli across different dissociated identities.

FOOTNOTES

1 Shepard, K.R & Braun, B.G. (1985). Visual changes in multiple personality. In B.G. Braun (Ed), PROCEEDINGS OF THE SECOND INTERNATIONAL CONFERENCE ON MULTIPLE PERSONALITY/DISSOCIATIVE STATES, (p. 85). Chicago: Rush-Presbyterian-St Luke’s Medical Center.
2 Ludwig, AM., Brandsma, J.M., Wilbur, C.B., Benfeldt, F., & Jameson, D.H. (1972). The objective study of a multiple persanality, or, are four heads better than one? ARCHIVES OF GENERAL PSYCHIATRY. 26, 298-310
3 Larmore,K,Ludwig, A.M., & Cain, RL. (1977).Multiple personality: an objective case study. BRITISH JOURNAL OF PSYCHIATRY, 131,35-40.
4 Pitblado, D., & Densen-Gerber, J. (1986). Pattern-evoked potential differences among the personalities of a multiple: some new phenomena. PROCEEDINGS OF THE THIRD INTERNATIONAL CONFERENCE ON MULTIPLE PERSONALITY/DISSOCIATIVE STATES,In B.G. Braun (ed.), (p. 123). Chicago: Rush-Presbyterian-St. Lukes Medical Center.
5 Braun, B.G. (1983a). Neurophysiologic changes in multiple personality. AMERICAN JOURNAL OF CLINICAL HYPNOSIS, 26,84-92.
6 Densen-Gerber, J. (1986). The occurrence of stigmata in multiple personality/dissociative states. In B. G. Braun (Ed), PROCEEDINGS OF THE THIRD INTERNATIONAL CONFERENCE ON MULTIPLE PERSONALITY/DISSOCIATIVE STATES. (p. 74). Chicago: Rush-Presbyterian-St Luke’s Medical Center.
7 Psychobiological Characteristics of Dissociative Identity Disorder: A Symptom Provocation Study Reinders, A.A.T. Simone et al. Biological Psychiatry , Volume 60 , Issue 7 , 730 – 740
8 Rosenkranz, M. A., Lutz, A., Perlman, D. M., Bachhuber, D. R. W., Schuyler, B. S., MacCoon, D. G., & Davidson, R. J. (2016). Reduced stress and inflammatory responsiveness in experienced meditators compared to a matched healthy control group. Psychoneuroendocrinology, 68, 117-25. doi: 10.1016/j.psyneuen.2016.02.013. PMCID: PMC4851883
9 Carlson, L. E., Beattie, T. L., Giese-Davis, J., Faris, P., Tamagawa, R., Fick, L. J., Degelman, E. S. and Speca, M. (2015), Mindfulness-based cancer recovery and supportive-expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors. Cancer, 121: 476–484. doi:10.1002/cncr.29063

image: Multiple Personality Disorder by SymphoneySymphoney via Flickr 2.0 Generic (CC BY 2.0)