In my country, cases have been reported of abnormally eyeball movement and dissociative identity disorder patients in the timing of personality changes. And in my country, many psychiatrists have a common belief of that symptoms still.
However in some cases, patients with the knowledge of the timing of change of personality, (dissociative identity disorder patients turn over the whites of the eyes) can use this information to pretend a personality change. A female patient did so in front of a lover. Her lover reported to the chief physician at the examination the fear of such a state. And the chief physician acknowledged her symptom, saying," I thought this symptom would show ". ( However, he was not aware that she was pretending ).
However, the dissociative disorder patient says something different. She was alone, and during a recall state ( remembering the memories of the past, no one is near, and state not seen by anyone ), she reported subjective symptoms of eyeballs moving violently unconsciously. She says that the eyeballs were moving together with contents of memory ( recall ). And she says, of course, the symptoms do not absolutely show, when there is a relationship with others. And there is sometimes a timing that she can not be aware of at the movement of severe eyeball movement.
Have you ever seen the examination or counseling of a dissociative identity disorder patient ? Do their eyeballs reverses in the timing of personality change? If so, could you please elaborate the details of these symptoms. Also, if such cases of abnormal eyeball movement have been reported to occur together with recall of memory at the time of being alone.
Thanks.
You describe a phenomen wich has been named 'eye roll test' by Herberg Spiegel (1972) an american hypnotherapist. He found out that the ability to look upward while closing the eye-lids would be a useful clinical measure for hypnotazabilty.
Several research findings demonstrate that patients with dissociative disorders show a higher hypnotizability as compared to controls. However, the eye roll test is not a diagnostic sign or diagnostic criterion for dissociatie identity disorder and is not necessarily associated with psychopathology.
'Swiitching' personalities in the context of DID is a complex phenomenon with a range of potential markers that may or may not necessarily be representative of a specific presenting case.
Irrespective of surface markers that may or may not relate to the individual case, it is the long hard road of empathetic understanding for the therapist that is a vital, primary foundation to build any accurate assessment of switching when it occurs. Empathetic understanding is also an excellent foundation for being able to pick up on and shift the treatment towards any deliberate feigning.
As we know, switching is a trauma based response that is often employed as an attempt to protect the individual from potentially serious relational threats perceived to be in the environment. Because of this, premature exposure of switching by the therapist can have the client feel far too vulnerable, fearful and exposed in the therapeutic relationship before any confirmation of real and authentic trust has been built.
As the person becomes comfortable enough in congruent relating, whereby numerous aspects of their 'split' self feel predominately safe with the therapist, it is the client who will then share the complexities of their inner dissociated world with the therapist. This will occur irrespective of what their eyes may or may not be doing.
Frank Putnam, MD mapped switching in DID (Putnam, F.W. (1988). The switch process in multiple personality disorder and other state-change disorders. Dissociation, 1, 24-32. ) stating: "Secondly, most, but not all, patients exhibit either a burst of rapid blinking or one or more upward eye rolls at the beginning of the switch . This may be followed by a transient "blank" or vacant gaze ." p. 28. The eye-roll with switching may occur very rapidly or when the eyes are closed, so it is not observed directly. In some patients it is very noticeable. However, a savvy DID patient who was familiar with the literature - I also mention this in my article, Loewenstein, R.J. (1991). An office mental status examination for chronic complex dissociative symptoms and multiple personality disorder. Psychiatric Clinics of North America, 14, 567-604 (can be downloaded from this site). which has been disseminated widely, and I have described this while lecturing since the 1980s, and Dr. Putnam has described this in his talks and workshops about the switch process. Thus, a savvy patient could "fake" this symptom, i.e., create a factitious switch for some concscious purpose. In terms of memory, i document in my Mental Status article a patient who, when queried about his eye roll behavior, said, "that's the way I remember things". I have also seen spontaneous full Spiegel eye-rolls in individuals who do not have a clinical dissociative disorder, but are highly hypnotizable. This seems to occur at times of some shift in emotion or awareness. Also, since differential memory systems is one of the hallmarks of DID, it makes sense that switching, and associated switching behaviors, woule be associated with differential access to memory. Also, since one idea of the utility of hypnosis as an adjunctive treatment in DID, is that the hypnotic trance re-introduces a state similar to trauma-induced trance states that occur during traumatic experiences. Thus, self or auto-hypnotic trance states in DID could lead to memory access, and some DID patients even insist that they "need" PTSD flashbacks and nightares to make sense of their histories; they may resist learning or using symptom management skills that attenutate flashbacks and nightmares. If you would like a copy of Dr Putnam's paper, I can send it, or you can find it, and explore all the very interesting issues of the now defunct journal Dissociation at https://scholarsbank.uoregon.edu/xmlui/handle/1794/1129.
Dear Researchers.
Because I am working and student, I apologize that my reply was delayed.
Yasuko
Dear Mr.Martin
Thank you for the valuable information. However, in fact,I have a doubt to the hypnotherapist. I would not deny the effect of a therapy, but the high reactivity of patients with dissociative disorders are, I am considering the possibility of a suggestible state of them. And, I think that about patients with dissociative identity disorder is reproducible ability (acting) of high-level.
Thanks.
Dear Mr.Jones
'Switching' certainly is the reaction and escape-behavior from the subject of the threat of patients-side. The problem is whether patients with dissociative identity disorder the symptoms occurs factual reaction consciously. The in any event, the relationship of the therapist and the patient is difficult problem. I'm also going to research treatment of transition type, and the treatment of reverse transition type. Indeed, if we do not provide therapy environment of safety feeling to the patient, their symptoms will not improve.
I agree your opinion.
Thanks.
Dear Mr.Richard
Your comment has deep insight into my opinion. Thank you very much.
The switching of the line-of-sight has possibility leading to the memories of the past at the time of of recurrence of PTSD and trauma of the past is certainly high rate.
And certainly, if they are sure the memory, may be we can get the text of them. Become evidence if it is consistent with the facts. For not be fooled by fake action ( but i do not deny them), I hope that the doctors recognize seriously the treatment errors of the past. About Dr Putnam's paper, I would try to find on my own at first.
Your paper also reading little by little, I want to submit the report to you.
Thanks so much.
Yasuko
I'm just going throw a loose idea here: but wouldn't this link with the treating of trauma with rappid eye movement desensitisation therapy?
Dear Miss Hilda
I can not understand the gist of your question, but had discussed the relevance of rapid eye movement and recall of memory of trauma here.
Your question is meaning that relaxation therapy is effective to rappid eye movement ?
Yasuko
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