An exploration of the experience of conflict in psychiatric patients diagnosed with Dissociative Identity Disorder : a collective case study

Abstract

Background: The role and nature of conflict in DID is underexplored beyond theoretical deduction. The present study sought to explore the subjective experience of conflict and the nature of conflict in psychiatric patients diagnosed with DID. Methodology: Qualitative methods were used for this study. First-hand accounts in the form of secondary data were explored – i.e. typed transcriptions of previously recorded in-depth interviews. A collective case study design was used, and the data analysed using thematic analysis alongside the constant comparison analysis method as formulated by Boeije (2002) Findings: Three main themes emerged from the data, viz.: 1) participants’ levels of separateness and unity of the self, 2) participants’ experience of having one or more incompatible and conflicting worldviews about their DID, and 3) the type and nature of conflict that arises between dissociative identities, i.e., conflict of information in awareness, conflicting actions or behaviours, conflicting ways of feelings, conflicting goals, conflicting values, and battle of wills. Conclusion: DID patients experienced distinct and separate parts or identities and these identities were experienced as separate to a lesser or greater extent. The participants’ understanding of the origin of their DID is contextually situated and variable. The conflict between one’s various belief systems may contribute to further dissociation. The study also revealed the nature of the different types of conflict that may be present between participants’ dissociative identities. Conflict between dissociative identities was found to be pervasive and multifaceted. The study provides insight into the complexities of conflict between dissociative identities as well as the role of awareness in DID.