Some useful scales in assessing and diagnosing dissociative disorders are:
“The Dissociative Disorders Interview Schedule” in Multiple Personality Disorder Diagnosis, Clinical Features, and Treatment by Colin Ross (1989, p 314‑334),
“The Dissociative Experiences Scale” (DES) by Eve Bernstein Carlson and Frank Putnam (1990),
“The Child Dissociative Checklist” (CDC) by Frank Putnam (1990).
Some questions from these scales to ask adults are:
- Do you have a history of incest or other abuse?
- Do you have a history of injuring yourself or attempting suicide?
- How do you experience time?
- Do you ever experience lost periods of time or time lapses where you are amnesiac?
- Do you ever hear voices from inside your head that tell you to do things or comment on things that you do?
- Do you ever use the pronoun “we” instead of “I” to refer to yourself?
- Do you ever feel like you have personality shifts or different parts of yourself?
- Do others report seeing personality shifts or behavior that you cannot remember?
- Do you ever find artwork, writings or articles for which you cannot account?
- Do you ever have inexplicable skills like playing a musical instrument which you do not remember learning?
- Do you ever get severe headaches?
- Do you have inconsistent handwriting?
Some useful questions to ask children are:
- Do you daydream a lot or feel like you are in a different world?
- Do you ever use a different name?
- Do you forget things a lot?
- Do you get called a liar much?
- Do you ever feel like you are good at school, work, sports, music, or skills and then other times you are not?
- Do you ever feel like you have different parts of yourself?
- Do you have any imaginary friends?
- Do you ever want to injure yourself or kill yourself or wish you were dead?
- Has anyone ever hurt you seriously?
Unless the alters switch right out and say they are there or an alter actually initiates the therapy, the therapist needs to use hypnosis or guided imagery. Usually, dissociative clients are highly hypnotizable because they went into a trance to cope with the abuse. Sometimes they do not want to trust anyone or to let them know they exist and will not show themselves the first or second time the therapist asks for them. The therapist needs to explain that he understands they have different body images and ages in their internal world, but that in this world they share the same body. He must let them know he only sees the same body with each alter and they must let him know who is present in the body when they switch. Sometimes there are dramatic face and voice changes between alters and often there are not.
Once the therapist has developed rapport, trust, and a therapeutic alliance with the client by casually explaining some facts, the client can see that the therapist is not afraid yet can empathize with the client’s feelings of fear and threat. The therapist can use different kinds of inductions to get the client relaxed and then use ideomotor signals (a system of finger signals to communicate while in a trance) to decide whether to invite the alters out. The therapist can ask: “Which part of you is here now?”
Author Website – http://www.patrickpurcell.net
Thank, you Patrick Purcell for allowing And He Restoreth My Soul Project share your material. Thank you for the work you do to help survivors with DID.
Darlene J. Harris,
Serving at the pleasure of God