Tomlinson Kendal, Baker Charley
School of Health Sciences, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, UK.
J Med Humanit. 2019 Sep;40(3):365-387. doi: 10.1007/s10912-017-9471-3.
Dissociative Identity Disorder (DID) is an uncommon disorder that has long been associated with exposure to traumatic stressors exceeding manageable levels commonly encompassing physical, psychological and sexual abuse in childhood that is prolonged and severe in nature. In DID, dissociation continues after the traumatic experience and produces a disruption in identity where distinct personality states develop. These personalities are accompanied by variations in behaviour, emotions, memory, perception and cognition. The use of literature in psychiatry can enrich comprehension over the subjective experience of a disorder, and the utilisation of 'illness narratives' in nursing research have been considered a way of improving knowledge about nursing care and theory development. This research explores experiences of DID through close textual reading and thematic analysis of five biographical and autobiographical texts, discussing the lived experience of the disorder. This narrative approach aims to inform empathetic understanding and support the facilitation of therapeutic alliances in mental healthcare for those experiencing the potentially debilitating and distressing symptoms of DID. Although controversies surrounding the biomedical diagnosis of DID are important to consider, the lived experiences of those who mental health nurses encounter should be priority.
分离性身份障碍(DID)是一种罕见的疾病,长期以来一直与暴露于超出可承受水平的创伤性应激源有关,这些应激源通常包括童年时期长期且严重的身体、心理和性虐待。在分离性身份障碍中,创伤经历后分离仍会持续,并导致身份中断,从而形成不同的人格状态。这些人格伴随着行为、情绪、记忆、感知和认知的变化。精神病学中使用文献可以丰富对一种疾病主观体验的理解,而在护理研究中使用“疾病叙事”被认为是一种增进对护理照顾和理论发展认识的方式。本研究通过对五篇传记和自传文本的仔细文本阅读和主题分析,探讨分离性身份障碍的经历,讨论该疾病的生活体验。这种叙事方法旨在促进同理心理解,并支持为那些经历分离性身份障碍潜在衰弱和痛苦症状的人在心理保健中建立治疗联盟。尽管围绕分离性身份障碍生物医学诊断的争议很重要,但心理健康护士所接触到的人的生活经历应是首要考虑的。