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Frankie & Alice

Mirna Gongora

Created on March 5, 2026

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Transcript

Frankie & Alice

By: Mirna Gongora

Dissociative Disorder

Is characterized by A) the presence of two or more distinct personality states or an experience of possession and B) recurrent episodes of dissociative amnesia.

Depersonalization- Experiences of unreality or detachment from one’s mind, self, or body. Derealization- experiences of unreality or detachment from one’s surroundings.

Formerly known as multiple personality disorder, DID is descriptive of an individual who has two or more separate personalities and episodic amnesia related to the personalities’ dominance at different times (APA, 2013; Pais, 2009).

Distinct Personalities (Refereed to as Alters)

  • switching between alters is indicated by “trancelike behavior, eye blinking, eye rolling, and changes in posture” (Gentile et al., 2013, p. 24).
  • Alters can differ depending on the purpose they serve, and each will often have its own “pattern of perceiving, relating to, and thinking about the environment and self” (Sadock et al., 2015, p. 459).

Trailer

Alters

Host 2 Genius

Frankie

Host 1 Alice

Self- A high-IQ Black woman working in a strip club.

A southern White woman with a racist character

A 7 year old who is very intelligent and acts as a protector.

Continued...

I CAN START

  • Alice is an African American female displaying a number of Alter identities that are protecting her from remenbering traumatic and stressful events, Showing signs of both depersonalization/derealization and reocurring episodes of selective dissociative amnesia. Alice switches her alter personalities to a white racist female and a 7 year old child who is highly intelligent. She suffers from heachaches, blackouts and non-epileptic seizures, when her alter personalities are in control she switches her name, accent, and wardrobe which she has no control of. She experiences flashbacks and has trouble remembering the birth of her deceased child and a accident that killed her husband. She has difficulty recalling these memories and owning them as personal and emotional, She engages in self-destructive behaviors and has a poor relationship with her mother and sister.

Assessment and Diagnosis

Dissociative Identity Disorder F44.81 Posttraumatic Stress Disorder (With Dissociative Symptoms) F43.10

  • Assessing for sucicide risk (Frankie's alters may have different levels of suicidal ideation)
  • The Dissociative Experiences Scale
  • The Peritraumatic Dissociative Experiences Questionnaire
  • The Multidimensional Inventory of Dissociation
  • Medical assessments to rule out any somatic symptom (headaches and non-epileptic seizures).

Necessary Level of Care

  • Inpatient, due to out of control dissociactive behavior and high risk of harming others
  • Individual sessions (1-2 times weekly)
  • Integration or recognition of alters (psychoeducation, Self-awareness).
  • Assessing for suicidality on a weekly basis

Strengths

  • Despite Frankie's traumatic events she chose to seek help and desires to acknowledge what is happening during blackouts. Frankie wants to have a relationship with her mother and sister despite past events. Frankie has a very high IQ and would thrive in her future jobs and relationships.

Treatment Approach

Mindfulness-Based Therapy (MBT) with attention to Acceptance and Commitment Therapy (ACT)

Aims and Objectives

  • Frankie will be encouraged to safely remember and process her emotional and physical experiences as they emerge without becoming overwhelmed.
  • Frankie will be able to reflect on her past, present and future experinces with increased self-awareness.
  • Frankie will increase her understanding of her dissociative symptoms through psychoeducation including the integration or recognition of her alter identities.
  • Frankie will journal between or during sessions for the natural return of memories and dissociative episodes.

Research Based Interventions

Therapeutic Support Services

Even though there isn’t strong, fully proven (“evidence-based”) treatment specifically designed for Dissociative Identity Disorder (DID), therapists are still advised to use a step-by-step (phase-oriented) approach when working with people who have DID. A phase-oriented approach usually means treatment happens in stages, such as: Stabilization – building safety, trust, and coping skills. Trauma processing – carefully working through traumatic memories. Integration and rehabilitation – helping the person build a more stable sense of self and daily functioning.

Referral to a psychiatrist Group Therapy

+ info

WHAT DO YOU THINK?

COUNSELORS

CULTURE/RELIGION

There are mental health professionals who believe DID exists, others who reject its presence, and still others who fall between the two opposing viewpoints.

There are cultures whose religious/spiritual ideas support “possession” and “nonepileptic seizures”; these are not only considered normal but are desired.

(APA, 2013, p. 295) https://www.isst-d.org/publications-resources/resources-for-professionals/

psychophysiological, neurobiological, and neuroimaging research, clinical trials treatment studies provide evidence that DID is a valid cross-cultural diagnosis that has validity comparable to or exceeding that of other accepted psychiatric diagnoses. However, they also note that pathological alterations of identity and/or consciousness may present in other cultures as spirit possession and other culture-bound syndromes (Cardeña, Van Duijl, Weiner, & Terhune, 2009).

Reference

  • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. (2022). American Psychiatric Association.
  • Treating Those with Mental Disorders: A Comprehensive Approach to Case Conceptualization and Treatment. (2018). Victoria E. Kress & Matthew J. Paylo. Pearson.

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