Intermittent Explosive Disorder (IED)
Because of recent developments in Diane’s behavior, we have modified Diane’s diagnosis to include IED, which is characterized by uncontrollable bouts of rage with no proportional anger initiator. We observe Diane collapse into extreme fits of anger and violence on a daily basis. These rages often erupt out of long periods of extreme boredom and/or heightened feelings of depersonalization. In her episodes, Diane sometimes appears to focus her violent behaviors on items she associates with her grandmother. It is our speculation that these tantrums derive from Diane’s internal frustration with her avoidant disposition and her need to escape from her depersonalized state (see DPD ). In crude terms, they can be viewed as explosions of latent inner conflict between two selves: Diane the prison and Diane the prisoner.