凯西·罗斯说话时声音没有变化。 She doesn't suddenly bear a different expression or posture. 她的巴尔的摩郡口音从未离开过她； no Southern belle or gruff motorcyclist emerges. She is, in short, nothing like what you would see on TV or in a movie. 但在她心中，凯茜拥有20个不同部分的身份。

The 1994 稳定的十大彩票网站 graduate has Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. It's the result of years of sexual abuse by her mother and stepfather. 当她还是个学生的时候，她不知道自己有DID。 All she knew was that she felt nothing—not even the will to live.

“人们喜欢感觉自己是人类的一部分，”凯茜说。 "That's how they get joy or pleasure out of life. 我完全没有那种感觉。”

然而多年来，凯茜拒绝接受她的诊断。 She feared it would make her life much more complicated. She resisted targeted DID therapy until one of several breakdowns left her hospitalized in 2006.

"I realized that until I admitted that I had DID and I addressed my parts, they were going to keep making my life unmanageable."

解开答案

稳定的十大彩票网站 psychology professor Bethany Brand is currently leading the world's largest and longest study of treatments for dissociative disorders — an umbrella category of mental illnesses, including Dissociative Identity Disorder.

Movies and television have largely misrepresented DID and rarely explained why it exists. The reality is that "parts" are like gatekeepers—compartments that lock away various memories and feelings connected to childhood trauma so the child doesn't have to feel the psychological damage. For people with DID, mental illness develops when that protection starts to wear down. A dissociative disorder is, by definition, a side effect of abuse—a double-edged sword inflicted on those who should never have suffered the first pains.

"People who have been severely abused in childhood tend to think they are 'bad' or 'weak,'" says Brand. "Several participants in our first study found it downright shocking to fill out our surveys because it made them realize, 'These are symptoms, not signs that I'm just a bad person.'"

That first worldwide study determined that targeted treatment of dissociative disorders (DD) is effective: patients and their therapists reported fewer signs of the condition, including fewer suicide attempts and psychiatric hospitalizations. For years, researchers from Johns Hopkins insisted these disorders weren't valid and treatment was actually harmful. 陶森教授和她的团队刚刚证明他们错了。

换句话说，他们点燃了希望。

"I think there are therapists who still don't believe in the diagnosis," says Rachel Elise '10, who also has Dissociative Identity Disorder. "It's one of the few serious mental illnesses that's entirely curable through psychotherapy, so it's particularly important to understand how to treat it."

这是正确的。 它是可以治愈的。 Movies don't tell you that, either, maybe because a cure takes so long. 一般的心理治疗研究只持续13周。 但没有一个患有分离性障碍的人能在三个月内好转。 这需要几年的时间。

"People don't split unless they absolutely cannot handle something, so therapy involves facing that which completely broke you," explains Rachel, who was severely abused as a child. "It can take a long time to get into a place that is stable and grounded enough to do the core work."

创造历史

By current data, the worst manifestations of dissociative disorders affect one percent of the world's population. The same is true for schizophrenia, a condition belonging to a different psychological category. But when Brand started researching DD in 2009, there were 103,000 scholarly articles on schizophrenia and only eight on DD. (Her team has since doubled that number.)

The reason for the disparity is that very few mental health professionals even know how to identify dissociative disorders, let alone how to treat it well. People with DD are often misdiagnosed, leading to years of damaging drug treatments or therapy that never touches the core issue. 更糟糕的是，一些患有DD的人被认为是骗子。 Brand's goal is to change all that, and help an underserved, under-identified, worldwide population get better.

And if improving or saving lives isn't a strong enough argument, here's another: the results of Brand's study could also cut health care costs. Undiagnosed, misdiagnosed or ineffectively treated patients with dissociative disorders deal with repeated emergency room visits, hospitalizations, prescriptions and other care needs.

"Think about the cost savings and reduction in suffering that could come from figuring out how to provide cost-effective interventions," Brand says.

布兰德和她的研究团队正在为治疗师和患者开发网络视频。 Used weekly, the videos, along with journaling and behavioral exercises, are designed to help patients diminish their symptoms, regulate their reactions and control unsafe behaviors. Brand's team includes web designers who will disseminate the videos on servers worldwide—accessible for free. Built-in analytics will assess efficiency, using participant feedback to determine the helpfulness of the exercises.

模仿生活的艺术

瑞秋是一名艺术家，她在工作中处理自己的紊乱。 Unlike a lot of artists, her creations use different media, different styles and different approaches. Those differences, Rachel says, are the products of the parts that create the art.

“这就是为什么艺术对我来说如此令人满足，”她解释道。 "It's a way to integrate different pieces of my experience tangibly. Several parts can be saying something different, but it all comes together into one image."

Rachel points out that "normal" people take certain things for granted, like having a linear sense of time or a consistent way of looking at the world. Patients with Dissociative Identity Disorder don't have those things. 她的艺术有助于解释这一点。 But she says it also conveys a common bond, an understanding that everyone struggles with who they are. "It's more exaggerated for someone with DID, but I think it's a universal experience to feel pulled by different sides of oneself, or to question one's true identity."

For Brand and her research team, the art lies in finding the most effective ways to help people who have suffered unspeakable trauma as children. It's work Cathy finds heroic.

“这些研究人员不需要进入这一行。 To me, those people are crusaders for us."

资助研究

Brand's study, TOP DD (Treatment of Patients with Dissociative Disorders) Network, requires funding—the most challenging part of the process so far. The recession and other cutbacks have made financial support hard to find. 稳定的十大彩票网站, Sheppard Pratt, therapists, patients and the researchers themselves have contributed. 给了。