From the foregoing arguments, therapeutic interventions for persons displaying the behaviors labeled as DID must consist of extinguishing a reasonable share of the behavioral variability in the personality repertoire and reinforcing behavioral stability and generalization; literally, to shape one personality. In an ABA research design, Kohlenberg (1973) reported increasing the frequency of specific behaviors composing one personality of an individual who exhibited DID-like behaviors by differential reinforcement of that personality repertoire. Upon returning to baseline and extinction, these behaviors returned to baseline levels.
Other techniques would involve the client role-playing and rehearsing social interactions and experiencing some situations expected to elicit and occasion "normal" emotional behaviors. Price and Hess (1979) reported success at "reintegrating" the personalities in a dual personality individual by teaching assertiveness skills via role-playing. Caddy (1985) also used assertiveness training and shaping in “reintegration” of a varied personality repertoire. The therapist might videotape the client as they behave, to use for feedback and in shaping and instructing more "cohesive" behavior. Therapy could also dictate a means of teaching the client to engage in more "social-referencing," or seeking public feedback in more instances of what is acceptable behavior. Whereas you or I might ask, "Did you see (or hear) something?" when we are unsure of seeing or hearing, individuals whose behaviors are consistent with the label of DID may have to learn to ask, "Am I still behaving as me?" The therapist could not completely answer this question but family members and significant others could. This process would have to continue until the person reports being the same individual with the same experiences, and has less observable variability in their personal repertoire.
Even if a therapist were to try to pursue such an intervention (most would probably not), this process could be drawn-out and arduous, due to the multiple sources of control that would require intervention. This could possibly sabotage the efforts by those who, with the best of intentions, attend to and reinforce the personality variability. Based on this account, control of the behaviors in this pattern would be difficult for anyone to establish. Even the therapist who occasions and reinforces the variance is not exerting control unless unpredictable behavior is the target behavior. As a result, these individuals likely have been in therapy for years and will continue to seek and need therapy for years to come (American Psychiatric Association, 1994).
Answers to all your Biology Questions
