What’s “Dissociative Identity Disorder?”
Dissociative Identity Disorder is the current label for the psychiatric diagnosis of Multiple Personalities. It’s a controversial diagnosis, and concept — many physicians, even psychiatrists, in the United States don’t believe that Multiple Personality is possible under any circumstances. Others believe it to be a highly over-diagnosed, exceedingly rare, or iatrogenic condition. Since little mention is made of DID in medical schools these days, it’s hard to know upon what fact or theory doctors (and other mental health professionals) base their out-of-hand dismissal of Multiplicity. Perhaps it’s simply out of fashion.
The diagnostic criteria for Dissociative Identity Disorder are:
- A. The presence of two or more distinct identities or personality states, each with its (sic) own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self
- B. At least two of these identities or personality states recurrently take control of the person’s behavior
- C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness
- D. The disturbance is not due to the direct physiological effects of a substance or a general medical condition. In children, the symptoms are not attributable to imaginary playmates or other fantasy play.
The phenomenon of Multiple Personality is even more subjective than experiences that lead to psychiatric diagnoses like clinical depression or schizophrenia. Barring some kind of emergency or major loss of control, and even with the “patient’s” full cooperation, outsiders can’t necessarily tell if the body they are looking at has more than one “personality” in there, or not. Each person’s and each system’s experience of Multiplicity is unique, with much possible variation in organization and expression. Few Multiples present as dramatically and impressively as those portrayed in movies, complete with seizure-like transformations and lisping, cooing child alters.
It has been our sad experience that many mental health professionals assume that ‘clients’ in general are unreliable or deceitful in reporting their subjective experiences and symptoms. What this means in practical terms for a person with DID is that, the more honest she is about herself and her experience, the more likely she will be regarded with suspicion and hostility by those who might, theoretically, be able to help her — and can certainly, and easily, do her harm. This is known as the “liar liar pants on fire” effect.
The root cause of Multiplicity is generally overwhelming, often repeated and extreme, stress in early childhood (physical and sexual abuse, torture, war, terrorism), coupled with a particular child’s innate capacity for dissociation, and exacerbated by a lack of supportive attention, protection, and soothing.
Most experts in the field agree that the ideal treatment for Dissociative Identity Disorder is intensive, long-term psychotherapy, with the ultimate goal of “integration” of the disparate personalities into a single identity. Unfortunately, very few people in the real world can afford that kind of treatment, even if they could find a willing AND able therapist or psychiatrist. A number of quick and dirty approaches are used, instead, in the few dedicated wards and clinics that deal with Multiplicity, to raise the level of day-to-day functioning somewhat before tossing the patient back out into the world.
Multiples are not schizophrenic, nor are we personality-disordered.
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