Through the Lens of a DID Specialist

Abstract

The case of Daniel, a patient with distinct dissociated self-states, is discussed from the perspective of a psychoanalyst with expertise in the treatment of Dissociative Identity Disorder. Early assessment of the patient’s dissociative mental structure is emphasized to inform and guide the treatment of profound early childhood trauma. Also discussed is developing and maintaining interpersonal relatedness not only between the patient and analyst but—importantly—between the dissociated internal self-states as well.

Keywords:

• dissociation
• Dissociative Identity Disorder
• enactments
• self-states
• trauma

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Notes

¹ For the purpose of simplicity, I will use the term self-state to refer to alter personality as well.

² These guidelines are in the process of being revised and updated as of this writing.

³ The average number of dissociated self-states in DID patients is about 15.

Additional information

Notes on contributors

Sheldon Itzkowitz

Dr. Shelly Itzkowitz is an adjunct clinical associate professor of psychology and clinical consultant at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis, and Guest Faculty, the Eating Disorders, Compulsions, and Addictions Program at the William Alanson White Institute. He is on the teaching and supervisory faculty of the National Institute for the Psychotherapies and the Trauma Studies Program of the Manhattan Institute for Psychoanalysis. He is an honorary member of the William Alanson White Society, and a Fellow and member of the Board of Directors of the International Society for the Study of Trauma & Dissociation (ISSTD). Dr. Itzkowitz has published several articles on the topics of trauma, dissociation and DID and has presented his work on dissociation and dissociative identity disorder both nationally and internationally. He and Elizabeth Howell are co-editors of their recently published book, Psychoanalysts, Psychologists and Psychiatrists Discuss Psychopathy & Human Evil, which received the 2021 Media Award-Written and the Sandor Ferenczi Award by ISSTD. They have also co-edited, The Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma, which received the 2016 Media Award-Written by ISSTD and was nominated for the 2017 Gradiva Award. Dr. Itzkowitz received the “Lifetime Achievement Award” from the International Society for the Study of Trauma & Dissociation. He is in full time private practice in Manhattan working with individuals and couples and offers clinical consultation individually and in groups.