Sybil

video recording Case Report PSY 281 deviant Psychology Guilford Technical Community College For Dr. Stephen ash Student Name(s) K solelyie Roberts, Porsha, and Jarvis Date 15, April 2013 1. Name of Video Sybil 2. Assigned Case parting a. Character Name Sybil Dorsett b. Played by Actor/Actress S altogethery line of merchandise 3. DSM-IV-TR Diagnoses Axis I Dissociative individuation Disorder (300. 14) Axis II N/A Axis IIIAxis IV (External Stressors) riot sounds, same(p) the one from the swing that triggered her flashback, and to a fault any woman with the alike hairstyle as her m different like the woman pushing the swing that ca employ her to flashback and stand her substitute teaching stance, Sounds of flaccid music, the sight of any hook like objects, feeling backed into a corner like when her father told her she didnt rich person a problem when she knew roundthing wasnt right. Any combative conduct toward her causes her to convert into Peggy, her younger extremely f earful self. Also if someone touched(p) her hands she would feel extremely threatened.And the color purple would cause counterchange ainities to surface. Axis V Current/Worst GAF _24_ Highest GAF in previous year _75_ 4. Diagnostic Documentation for Axis I or II diagnosis Dissociative Identity Disorder (300. 14) I. Primary Diagnostic Criteria for Dissociative Identity Disorder A. The presence of two or more distinct identities or temper states (each with its own relatively enduring pattern of perceiving, relating to, and thinking astir(predicate) the environment and self) Sybil including her regular disposition had approximately(predicate) thirteen more.Vanessa, Holds Sybils melodious abilities, plays the piano and dos Sybil pursue a romantic relationship with Richard. Shes a young girl, perhaps 12 days old. Vicky is a 13 year old who speaks French, a very strong, train and mature constitution who knows active and has insight into exclusively the early(a) person alities, though Sybil does not. Peggy is a 9 year old who dialogue like a unretentive child. She holds Sybils artistic abilities, and appears while crying hysterically because Sybils fears. She is confused like, she doesnt know that shes in New York and instead, thinks she is in the small town that Sybil grew up.Peggy feels the greatest trauma from her moms abuse, often feeling grim/depressed and unable to find happiness. Her biggest fears include the green kitchen, purple, Christmas, and explosions. Marcia, dresses in funeral garments and constantly has suicidal thoughts and attempts suicide. Its presumed she tried to kill Sybil in the Harlem hotel that was s exitped by Vicky. She thinks the end of the world is coming, but what she really fears in the end is Sybil. Mary, is Sybils remembering of her grandmother she speaks, walks and acts like a grandmother, and is anxious to realise Sybils grandmother.Nancy, kept waiting for the end of the world and was afraid of Armageddon. Shes a fund of Sybils dads religious fanaticism. Ruthie is one of Sybils less invented selves, a baby in fact. When Sybil thinks she hears her moms voice, she is so terrified that she regresses into Ruthie, an alter that parallels Sybil as a helpless, regressive, pre-verbal baby. Clara, Ellen, Margie, Sybil Ann is around 56 years old and is supposedly very shy. Sybil also had potent identities such as Mike who built the shelf in the top of Sybils closet to hide Vickies achetings, which she does at night.He and Sid want to know if they crowd out motionlessness give a baby to a girl like pa did nonetheless though they argon in Sybils (a females) body. Hes around 910 years old. Sid who wants to be just like his father, loves football. Hes around 78 years old B. At least(prenominal) two of these identities or constitution states recurrently take control of the persons behavior Vanessa, Holds Sybils musical abilities, plays the piano and helps Sybil pursue a romantic relations hip with Richard. Vicky has insight into all the other personalities, though Sybil does not, once Sybil lost control Vicky would step in and some ms even attend therapy sessions with Dr.Wilbur. Peggy, who talks like a little child, holds Sybils artistic abilities, and appears because Sybils fears. She is confused and doesnt even know that shes in New York. Marcia constantly has suicidal thoughts and attempts. Its presumed she tried to kill Sybil in the Harlem hotel but was stopped by Vicky. C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. Sybil told Dr. Wilbur that when she was a little girl she woke up one day and was two years older. When she was admitted to the hospital for cutting her hand she didnt know she gave Dr.Wilbur to do neurologic tests on her. She didnt even know when she got to the hospital or even how long she had been there, and when she felt smelt the fragrances Dr. Wilbur gave her she regressed into other personality, and woke up with other time lapse. D. The disturbance is not due to the direct physiological effects of a substance (e. g. , blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e. g. , complex partial seizures). Note In children, the symptoms are not attributable to imaginary playmates or other imagine play.Back to Overall Video Case Report Format 5. Etiology check to Nevid et al. Abnormal Psychology in a Changing World, 8th ed. (2011, hereinafter text), Dissociative Personality Disorder (DID) formerly known as double personality, is a display case of divisible disorder thats characterized by changes or disturbances in the functions of self, identicalness, memory, or consciousness, that make the personality whole(p209), or A divisible disorder in which a person has two or more distinct, or alter, personalities(p555). It is the emergence of two or more personalities.In dissociative disorders, the spacious use of repression resulting in the splitting off from consciousness of unaccepted impulses and painful memories(p. 221). Those with DID express the impulses through the development of alternate personalities. In some with dissociative individuality operator disorder their main or host personality does not know nigh the alternates, but the alternates do know about the main personality. Also the alternates sometimes wont know what other alternate personality-part has done, or even that they exist.There eject be at least two controllers of the of the person, and even the different personalities quite a little turn out different ages and knowledgeable preferences. The rate of DID is higher in women than men and females also tend to read more splits than males, averaging about 15 or more, than do men, who average about 8 alter personalities(p213). The psychodynamic approaching to the causes of DID, according to Nevid et al. , Dissociative disorders include massive repression, resul ting in the splitting off from consciousness of unacceptable impulses and painful memories(p221).They whitethorn portray these painful memories and impulses through the development of alternate personalities. From the social-cognitive theory standpoint, the role of mentally separating yourself from painful memories and unacceptable impulses, by splitting off, is beef up negatively by relief from anxiety or removal of feelings of offense or shame. The late social- cognitive theorist Nicholas Spanos, believe that dissociative identity disorder is a form of role-playing acquired through observational learning and funding(p222).They are so engulfed in the so called role-playing that they forget theyre enacting a role. From a biological perspective, research is still in its early spirit levels to take in whether brain function has anything to do with Dissociative identity disorder. solely late(a) studies have shown structural differences in brain areas twisting in memory and emoti on between patients with dissociative identity disorder and healthy controls(p222). But the relevance of the differences havent been throttled as of yet.Despite the massive amounts of severalise involving traumatic severe sexual and physical abuse during childhood in DID cases, those who experience severe trauma rarely develop dissociative identity disorder. In relation to the diathesis-stress model, certain personality traits, such as craving to fantasize, high ability to be hypnotized, and openness to altered states of consciousness, whitethorn dispose individuals to develop dissociative experiences in the face of traumatic abuse(p222).Not in particular that those with these types of personality traits will absolutely develop dissociative experiences, but arsehole help trigger a dissociative phenomena when paired with a traumatic event, just as a defense reaction mechanism. The most(prenominal) widely held great deal of dissociative identity disorder is that it represen ts a means of coping with and living severe, repetitive childhood abuse, generally beginning before the age of 5(Burton Lane, 2001 Foote, 2005). They will split into an alter personalities as a mental defense to unbearable abuse.When abuse of such severity and persistence continues, the alters become change and hard for the child to maintain a coordinated personality. The great volume of people with Dissociative identity disorder report being physically or sexually abused as children( lewis et al. , 1997 Scroppo et al. , 1998). In some tests 75-90% of all subjects tested were abused sexually or physically. Also according to go in 7. 1 on p224 in the Abnormal Psychology in A Changing World, social reinforcement can also lead to stabilization or even the creation of new personalities. Enactment of alter personalities is alter by positive degree reinforcement in the form of attention from therapists(p224). match to R. P. Kluft, Temple University, in the 1990s there were highly polarized debates about whether sixfold personality was iatrogenic, instigated and sustained by clinicians interest in motivating patients to designate the conditions phenomena, and whether the abuses alleged by patients, often recalled after years of apparent amnesia, were false, suggested by leading questions or subtle expressions of interest.It still is unclear whether multiple personality can be created by iatrogenic factors alone(Kluft). 6. sermon The most common form of therapy in extending those with Dissociative identity disorder are psychodynamic paired with eclectic therapies, with psychodynamic being the base of therapy to get to the true answer of the problems, with efforts to unify the several different personalities into one cohesive unified personality. However, integration of personalities is not al styles assertable.In these situations, the goal is to master a harmonious fundamental interaction among the personalities that allows more normal functioning(Gluc k). Drug therapy can be used to subdue the coexisting issues like depression or anxiety, but doesnt affect the DID. Psychotherapy is the primary interference for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, which involves talking about your disorder and related issues with a psychodynamic therapists.Psychotherapy for dissociative disorders often involves techniques, such as hypnosis, that help you remember and work through the trauma that triggered your dissociative symptoms. The mannikin of the psychotherapy may be long and painful, but this treatment approach is very effective in treating dissociative disorders. According to the Mayo Clinic another form of therapy is creative art therapy. This type of therapy uses the creative process to help people who might have difficulty expressing their thoughts and feelings. Creative arts can increase elf-awareness, help cope with symptoms and traumatic experiences, and also produce positive changes. Creative art therapy includes art, dance and movement, drama, music and poetry. Cognitive therapy is a type of talk therapy that helps you identify unhealthy, negative behaviors and beliefs then replaces them with healthy, positive ones. Its based on the idea that your own thoughts, not other people or situations, determine how you behave. Even if an unwanted situation has not changed, they can change the way they think and behave in a positive more unified way.There arent medications that specifically treat dissociative disorders a psychiatrist can prescribe SSRIs, anti-anxiety medications or tranquilizers to help control the mental health symptoms associated with dissociative disorders. A case study is presented illustrating how traditional long-term therapy can be defined in renewable short-term stages. At mixed therapeutic intervals therapy may be discontinued or deferred based on the clients definition of personal wellness. Such a conceptualization ca n palliate client health while demonstrating accountability for the use of ongoing psychotherapy services (Applegate).The most common approach to thinking/feeling about the process of recovery from trauma or abuse is to conceptualize it as working through a series of stages. Herman summaries several such models in a table. In the three-stage model of modern trauma therapy outlined by Herman, a phase of safety, in which the patient receives sanctuary and support and is strengthened, is followed by a phase of remembrance and mourning, in which the minds representation of its traumatic experiences is explored, processed, and master and in which the losses and consequences associated with traumatization are grieved.The mind is reintegrated, and roles and functions are resumed in a phase of reconnection. In the nine-stage treatment of multiple personality (Kluft, 1999a and Kluft, 1999b) with multiple personality (1) the psychotherapy is established and (2) preliminary interventions are made to establish safety, develop a therapeutic alliance that includes the alters, and enhance the patients coping capacities. Then follows (3) record gathering and mapping to learn more about the alters, their concerns, and how the dust of alters functions.Then is it possible to begin (4) the metabolism of trauma within and across the alters. As the alters dole out more, work through more, communicate more effectively with one another, and achieve more mutual awareness, identification, and empathy, their conflicts are reduced, as is contemporary amnesia. They increasingly fall in and experience some reduction of their differences and senses of separateness. This is called (5) moving toward integration/resolution. More solidified stances toward ones self and the world are reached in (6) integration/resolution.Smooth and functional collaboration among the alters, usually including the blending of several personalities, is called a resolution. Blending all alters into a subjectiv e sense of smooth unity is an integration. Then the patient focuses on (7) learning new coping skills, working out alternatives to dissociative functioning, and resolution other previously unaddressed concerns. Issues continue to be processed, and mastery without repeat to dysfunctional dissociation is pursued in (8) solidification of gains and working through.Finally, treatment tapers, and the patient is seen at increasingly infrequent intervals in a stage of (9) follow-up. Treatment may be challenging to patient and therapist alike. body of work with traumatic real can be upsetting and destabilizing. Worse than that is the pain of tying into what patients learn to their own perceptions of their relationships, with significant others who may appear to have been guilty of mistreatment that wasnt remembered before.. Patients should be informed about the possibility that material that emerges and may be useful for treatment may not put forward to be accurate. Processing traumatic memories has been controversial because the accuracy of initially inaccessible memories has been challenged(Kluft), and the affects experienced with this process can cause upset and trigger self-destructive actions. virtuallytimes decompensating occurs or an inability to maintain defense mechanisms in answer to stress, resulting in personality disturbance or a psychological imbalance. Some multiple personalities cant handle this kind of work. But so far reported successful recoveries to the point of integration have involved processing traumatic memories(Kluft).Studies also have demonstrated that many acquire memories of DID patients have been confirmed, and some have not even been tasten accurate. picture imply that deliberate processing of traumatic memories should not be performed unless patients have demonstrated the proper strength and stability for the work. All others should be set supportively, addressing traumatic memories only when they are intrusive, are disruptiv e, and cant be put aside. Patients sometimes have periods of anting say everything said in therapy was a joke as Sybil did when confronted more about the green room, trying to drive out painful memories of trauma, betrayal, and loss associated with important people in their lives to maintain relationships and a sense of safety within those valued relationships. Tact, hold onment, and circumspection are need from therapist and patient alike(Kluft). The patient should be cheered from fitting overwhelmed by and lost in the traumatic situation, and treatment should be paced to protect the patients safety and stability. There should be no forcing or rushing. The alter system is designed to facilitate escape from pain and difficulty or, failing that, to reframe or disguise it. Alters often reenact scenarios that (in their perceptions) are tried and true methods of charge pain at bay, even if they disrupt the patients treatment, life, and relationships(Kluft). Sybil displayed this wh en she was confronted by her father and another time when she was in therapy. In therapy, working directly with alters often may make them more prominent, but the more theyre worked, empathized, and helped to communicate with other alters, their separateness is worn down, making the personality more cohesive.The therapist should treat all of the personalities with respect, and also appreciate the immediacy, and defensive aspects of their separateness, and that they all express separate of a single personality, whose personality structure is to have multiple personalities. Interventions to contain alters dysfunctional behaviors, aggressiveness toward other personalities, self-destructiveness, and irresponsible autonomy (e. g. , failing to caution for children, who may be seen as belonging to another personality) may prove necessary(Kluft).The therapist may call on personalities to work on their particular issues in the treatment and to facilitate their cooperation with the treatment and one another. Treatment must respect the entirety of the patients concerns. Certain DIDs treatment may be put off repeatedly to address other rising slope concerns and other mental health issues. For example, a woman with dissociative identity disorder whose child develops cancer is not in a position to pursue trauma work. 7. Personal Application N/A 8. References * Nevid, J. S. , Rathus, S. A. & Greene, B. (2011). Abnormal psychology in a changing world. (8th ed ed. ). Upper commove River Prentice Hall. * Gluck, Samantha Treatment of Dissociative Identity Disorder, 2008 Hhttp//www. healthyplace. com/abuse/dissociative-identity-disorder/treatment-of-dissociative-identity-disorder-did/ealthy Place, Americas Mental health Channel, web, 01/2013 13, April 2013. * Treatment and Drugs, The Mayo Clinic http//www. mayoclinic. com/health/dissociative-disorders/DS00574/DSECTION=treatments-and-drugs 3, March 2011web, 13 April 2013 * Judith L.Herman, Trauma and Recovery, BasicBooks, 1991, p 156 * Applegate, Maureen Multiphasic Short-term Therapy for Dissociative Identity Disorder Journal of the American psychiatrical Nurses Association February 1997 vol. 3 no. 1 1-9 * Kluft, R. P. , Encyclopedia of Stress(2nd Edition),2007,p783-790 * Kluft, R. P. ,Current issues in dissociative identity disorderJournal of Practical Psychiatry and Behavioral Health, 5 (1999), pp. 319 Sybils Friends * Peggy- an aggressive nine-year old * Vicky- a sophisticated young lady * Mary- grandmother * Mike- * Sid- * Martha-