Dissociative identity disorder

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An artist's depiction of DID

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Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) is a mental illness in which a person has two or more notably different personalities that may independently control their body; the personalities coming to the fore at different times. Its status as a real, identifiable mental illness is disputed by many psychotherapists, although recent research suggests it is a real disorder, albeit an uncommon one. A number of cases have been recorded in both the US and the UK. Most psychiatrists agree that the condition is not psychosis.

In popular perception, dissociative identity disorder is often confused with schizophrenia. Many analogies to conflicting personalities or styles are often called "schizophrenic" but this is wrong. Schizophrenia is characterized by hallucinations, paranoid delusions, and disorganized thought, but not by multiple personalities. There is a degree of consensus that DID is real but rare.

How it works

People with DID have different "alters," or personalities. These alters may have their own names.

Cause

Serious and repeated childhood abuse is believed to be the most common cause of DID. It has been reported that "About 90% of the cases of DID involve some history of abuse. The trauma often involves severe emotional, physical, and/or sexual abuse."

It's believed that this extreme trauma disrupts a child's ability to consolidate a core identity, resulting in the child developing multiple "states" or identities.

Official diagnosis

The Diagnostic and Statistical Manual of Mental Disorders diagnoses someone with Dissociative Identity Disorder if they exhibit:

• Two or more distinctly separate personalities emerging in one person frequently for more than one month,
• Memory loss between these personalities that goes beyond normal forgetfulness,
• The change in personality is not triggered, affected, or manipulated in any way by external stimuli such as drugs or alcohol.

Treatment

People with DID can benefit from treatment.

Myths

Movies like Split, Psycho, and Identity portray people with DID as violent, further stigmatizing a group of people who may be in great need of help.

But people with DID are not necessarily more violent than others. They're more likely to hurt themselves than to pose a threat to other people.

Controversies

Brain imaging

Whether it's real

Some skeptics (including doctors) have argued that DID is not real and should not be diagnosed. They believe that patients may be faking it, may have false memories, or may be highly suggestible (thus believing they have multiple personalities when they don't.

However, research suggests that DID is a real condition. Researchers have found that:

• People with DID have physical differences in their brains, with some areas being smaller and an increase of white matter in other areas.
• Brain activity in DID is different than in people without it, including those prone to fantasies.
• People with DID aren't inherently more suggestible or prone to false memories.
• It occurs in many countries.

Sybil and DID epidemic

Controversy over the diagnosis stems from the explosion of DID cases in the wake of the publication of the book Sybil and its subsequent film spin-off in the 1970s. Sybil was the pseudonym of Shirley Mason, a woman who claimed to have sixteen personalities. The release of further documentation, such as tapes of the therapy sessions, demonstrated that Mason's therapist had encouraged her to manufacture multiple personalities and engaged in questionable practices such as hypnosis and barbiturate injection.

The DID epidemic later played into the recovered memory therapy craze and Satanic Panic of the 1980s. Since the 1990s, many DID specialists have been sued for malpractice and specialist clinics have been closed down.

From their own perspective

Herschel Walker, a sports player with DID

It is notable that some "plurals" do not consider their condition to be a mental disorder so much as a natural state of being, much like the autism rights movement. This subcommunity, known as the endogenic or parogenic community, rejects the idea that DID must be the result of either childhood abuse or the induction of false memories, and argues that their condition is considered a mental illness only because society has branded it as one. Thus they reserve the term "DID" for dysfunctional systems. Plurals by and large prefer the term "headmates" or "systemmates" for entities sharing a body, on grounds that "alter" is derogatory toward personalities other than the one who happens to be "in front" the most.

External links

• Dissociative Identity Disorder/Multiple Personality Disorder, WebMD
• Entry in The Skeptic's Dictionary
• ABC report on Sybil