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Cited by 80Psychosomatic Disorders and Their TreatmentsPsychoanalysis and Psychopathology ResearchPsychotherapy Techniques and Applications

An Overview of the Psychotherapy of Dissociative Identity Disorder

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Kluft, Richard P.·1999·American Journal of Psychotherapy
DOI 10.1176/appi.psychotherapy.1999.53.3.289
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Abstract

Dissociative Identity Disorder (DID) is identified and studied with increasing frequency. However, the controversy that often surrounds DID can make it difficult to approach its treatment in a circumspect manner. This paper will provide an overview of DID treatment as it is practiced by those experienced and skilled in the treatment of this group of patients. The treatment of DID resembles the treatment of other traumatized populations in that it is stage-oriented, beginning with supportive and strengthening work. Various stances toward the treatment of DID are reviewed, and specific issues that arise in the psychotherapy of DID are addressed, such as pragmatic arrangements, informed consent, work with alters, and the use of specific techniques, such as hypnosis. The employment of therapeutic modalities and ancillary therapies is discussed. The heterogeneity of DID patients is reviewed, and the characteristics of three general groups of DID patients, high, intermediate, and low in both function and prognosis, are explored. Considerations in the matching of DID patients to either exploratory or supportive treatments are discussed, and observations are made about both trauma work and the supportive psychotherapy of DID.

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  • A foundational body of theoretical and clinical work, and a small but growing body of empirical research, supports the effectiveness of a phase-oriented psychotherapeutic approach for the treatment of DID.

    “A foundational body of theoretical and clinical work, and a small but growing body of empirical research supports the effectiveness of a phase-oriented psychotherapeutic approach for the treatment of DID [5–9].”

    From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [7]

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Research works printed but not linked: 23

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  3. Merskey H (1992). The manufacture of personalities: The production of multiple personality disorders. British Journal of Psychiatry,160,327-340.
  4. Hornstein N, & Putnam FW (1992). Clinical phenomenology of child and adolescent multiple personality disorder. Journal of the Academy of Child and Adolescent Psychiatry, 31, 1055-1077.
  5. Braun BG (1986). Issues in the Psychotherapy of Multiple Personality Disorder. In B.G. Braun (Ed.) Treatment of Multiple Personality Disorder (pp. 1-28). Washington, DC: American Psychiatric Press.
  6. Fine CG (1993). A tactical integrationalist perspective on the treatment of multiple personality disorder. In R.P. Kluft& C.G. Fine (Eds.), Clinical perspectives on multiple personality disorder (pp. 135-153). Washington, DC: American Psychiatric Press.
  7. Kluft RP (1997). Overview of the treatment of patients alleging that they have suffered ritualized or sadistic abuse. In G.A. Fraser (Ed.), The dilemma of ritual abuse: cautions and guides for therapists (pp. 31-64). Washington, DC: American Psychiatric Press.
  8. Kluft RP (1990). The fractionated abreaction technique. In D.C. Hammond (Ed.), Handbook of hypnotic suggestions and metaphors (pp. 527-528). New York: Norton.
  9. Kluft RP (1986). Personality unification in multiple personality disorder: A follow-up study. In B.G. Braun (Ed.), Treatment of multiple personality disorder (pp. 29-60). Washington, DC: American Psychiatric Press.
  10. In R.P. Kluft & C.G. Fine (Eds.), Clinical perspectives on multiple personality disorder (pp. 19-50). Washington, DC: American Psychiatric Press.
  11. Putnam FW (1984). The study of multiple personality disorder: General principles and practical considerations. Psychiatric Annals, 14,58-61.
  12. Kluft RP (1995). Psychodynamic psychotherapy of multiple personality disorder and allied forms of dissociative disorder not otherwise specified. In J.P. Barber & P. Crits-Cristoph (Eds.), Dynamic therapies for psychiatric disorders (axis I) (pp. 332-385). New York: Basic Books.
  13. Hammond DC (Ed.). (1990). Handbookofhypnotic suggestions and metaphors. New York: Norton.
  14. Loewenstein RJ, Hornstein N, & Färber B (1988). Open trial of clonazepam in the treatment of posttraumatic stress symptoms in multiple personality disorder. Dissociation, 2(3), 3-12.
  15. Torem MS (1996). Psychopharmacology. In L.K. Michelson & W.J. Ray (Eds.), Handbook of dissociation: Theoretical, empirical, and clinicalperspectivesipp. 545-566). New York: Plenum Press.
  16. Fine CG, & Madden NE (in press). The role of group psychotherapy in the treatment of dissociative identity disorder and allied dissociative disorders. In R. Klein & V.L. Schermer (Eds.), The healing circle: Group psychotherapy for psychological trauma. New York: Guilford.
  17. Kluft RP, Braun BG, & Sachs R (1985). Multiple personality, intrafamilial abuse, and family psychiatry. International Journal of Family Psychiatry, 5,283-301.
  18. Fraser GA, & Raine D (1992). Cost analysis of the treatment of MPD. In B.G. Braun (Ed.), Proceedings of the Ninth International Conference on Multiple Personality/Dissociative States (p. 10). Chicago, IL: Rush.
  19. Kluft RP (in press). The difficult to treat dissociative disordered patient. In M. Dewan & R. Pies (Eds.), The difficult to treat psychiatric patient. Washington, DC: American Psychiatric Press.
  20. Braun, BG (1988). The BASK (behavior, affect, sensation, knowledge) model of dissociation. Dissociation, 1(1), 4-23.
  21. Boon, S, & van der Hart, O (1994). Supportive psychotherapy for MPD patients. In B.G. Braun & K.L. Robins (Eds.), Proceedings of the 11th International Congress on Dissociative States. Chicago: Rush.
  22. Boon, S, & van der Hart, O (1995). De behandleing van de multiple persoonlijkheidsstoornis [Treatment of multiple personality disorder]. In O. van der Hart (Ed.), Trauma, dissociatie en hypnose (pp. 165-186). Lisse: Swets & Zeitlinger.
  23. Fine, C.G. (1992). The cognitive therapy of multiple personality disorder. In A. Freeman & F.M. D'Attilio (Eds.), Comprehensive textbook of cognitive-behavior therapy (pp. 347-360). New York: Plenum.

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Authors
Kluft, R. P.
Affiliations
Temple University (US)
Corresponding author
Kluft, Richard P.
Venue
American Journal of Psychotherapy
Publisher
American Psychiatric Association Publishing
Published
1999-07
Volume
53
Issue
3
Pages
289-319
ISSN
  • 0002-9564 (ISSN-L)
  • 2575-6559
DOI
10.1176/appi.psychotherapy.1999.53.3.289
OpenAlex
W1556407949
Cited by
80
References
54
Citations by year
2025: 2 · 2024: 6 · 2023: 7 · 2022: 1 · 2021: 2 · 2018: 1 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 5 · 2013: 6 · 2012: 6
FWCI
0.32
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
dissociative identity disorder, trauma treatment, informed consent, hypnosis, supportive therapy, prognosis, patient heterogeneity, therapeutic modalities, ancillary therapy
MeSH terms
Adaptation, Psychological, Humans, Dissociative Identity Disorder, Psychotherapy

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