Developmental devastation: dissociative identity disorder

Abstract

Two detailed clinical vignettes of dissociative identity disorder are presented that illustrate the sequelae of abnormal development resulting from childhood abuse. They focus on the patients’ internal world, an elaborate landscape exhibiting extreme developmental deficits. Its significance is considered both as a means of understanding the patient and as an aid to therapy. I highlight aspects of my own therapeutic approach and give clinical examples that are illustrative.