The Function of Alters

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Alters are the basis of multiple personality disorder and dissociative identity disorder.They emerge from the core personality, or the original identity, that is born within the body and brain. When the patient experiences more trauma than s/he can withstand but there is no chance of physical escape, the patient develops an alter ego, or an alter personality state. This personality is constructed to accept and deal with the trauma as it happens. The patient then retreats somewhere inside her or his head and doesn’t emerge until the crisis is over. In one rare case of MPD, the initial trauma was so extreme that the original patient regressed into an infantile state and never re-emerged for the rest of her life.

DID is rare or it isn’t rare depending upon who you ask. The circumstances that generally accompany this disorder are so extreme and repetitive as to be very unlikely. Dr. Richard Baer, the psychiatrist who treated Karen Overhill, stated, you have to be very, very careful about suggesting things to a patient. I think these [multiple personality] patients are very, very rare because of the circumstances required to create them. It takes a significant amount of trauma to cause a person to start to disassociate from it and that trauma has to take place over a sustained period of time, bringing with it multiple disassociations that become established as “alters.”

Types of Trauma Trauma doesn’t only refer to abuse. There are many types of trauma that a person can suffer and many reactions can result from any of them. Dissociation is one of many psychological defenses that protect people from harm although it doesn’t happen to everyone who experiences great trauma.

multiple-personalities-paulo-zerbatoRitual Child Abuse Extreme sexual, emotional and physical ritual abuse in childhood is a common trait among people with MPD or DID. It is believed that this is a cause of MPD but there is a problem with this theory. Not everyone who has MPD has been sexually, emotionally or physically abused. To be sure, repetitive, extreme abuse has to have a long-term effect on the patient. Developing multiple egos to distance oneself from pain and fear is a highly successful reaction to this type of abuse. The original personality leaves the situation and another emerges to tolerate the abuse, leaving the original, the “owner” of the body, unaware that abuse exists.

Extreme Duress
In the biography The Three Faces of Eve and later in her own autobiography I Am Eve, Christine Sizemore discussed how she began her experience as a multiple. At the age of two Sizemore witnessed a terrible accident at a sawmill where her father worked; a man was severed in half. As Sizemore’s mother held her and ran toward the accident, she mumbled to herself that the men were “careless” and she worried aloud whether it was Sizemore’s father who had died. Sizemore remembered being at the side of the pit where the worker’s body lay and, becoming overwhelmed with fear, she looked across the pit to see another little red-haired girl who looked calmly down into the pit. Of course, the little girl wasn’t real. This was Sizemore’s first “split”, as it is often called.

3facesofeveExtreme duress could also include the experience of war veterans, children suffering from long-term disease or illness, chaotic households, and many other situations, although these are not known to elicit MPD. Why it is that one type of stressor and not another results in a dissociation of the mind hasn’t been fully explored. There is the suggestion that some people are more “resilient” and do not need to retreat somewhere else into the mind.

What Alters Do An alter steps forward to take the place of a person who is overwhelmed during a severe traumatic episode and maintains control over the body until the trauma has passed. This alter experiences the trauma but the original person doesn’t. There may be several alters who fulfill this function. Some may develop at the same time during an extremely stressful incident. Others may develop later in life. Although it was once thought that alters only developed in childhood up to the age of 10, it is now believed that alters can begin in adulthood.

Types of Alters Alters are as unique as the individuals who possess them. No two people have the exact same alter, anymore than a person without MPD is exactly the same as another person. There are similarities however and most multiples possess a general form of personality states who fulfill specific functions. These include:

Pain There is usually an alter has no “choice” in experiencing physical abuse and is made from sheer picdesperation by the original person. This alter emerges when danger is nearby. The original person disappears into the mind and the new alter suffers the abuse or trauma.There may be more than one alter who suffers physical abuse.

Information  There is almost always one alter who possesses significant information that is relayed to the therapist This alter generally knows how many alters the patient possesses, who they are, their names, and their functions. If anyone was considered an eavesdropper, this alter would be it. The alter never suffers abuse and has no memory of it.

Child  There is usually a regressed alter who hasn’t had the chance to mature into adulthood due to the repression of the childhood environment. The child alter stays carefully hidden during the patient’s youth and tends to emerge under safe circumstances, usually when the patient is older and typically is in therapy,

Sexual Alter  This alter emerges when the patient engages in sexual activity of any sort. This alter is the one who suffers sexual abuse, and particularly pleasure that has been taught during abuse. In that way, the guilt and shame of sexuality is visited upon the sexual alter and not the patient.

Suicidal Alter  Often there is a suicidal alter who simply cannot recover from the childhood and possibly teenage 640px-Dissociative_identity_disordertrauma. This personality state cannot cope and wishes to die however this alter has no concept of “killing” the others. S/he doesn’t understand that if s/he successfully commits suicide, all alters and the patient will die. Other alters rally around the suicidal alter when s/he/it emerges to prevent the suicide.

Opposite Gender Alter  Sometimes multiples have both men and women (or boys and girls) living within their minds. Sometimes these alters develop due to the admiration of a person of the opposite sex, or the erroneous belief that had s/he been born the opposite sex, the abuse would never have happened. Truddi Chase who wrote “When Rabbit Howls“, an autobiography of her life as a multiple, possessed a strong, black, male alter named Mean Joe Green. Green was a famous, professional football player when Chase was in her youth. She also saw him as a kind man. She personified him as an alter by his nickname and he functioned as a “protector” for the children.

Protector  This alter is always hovering in the wings in case danger emerges. This alter usually prevents danger by physically removing the patient from a situation before harm can happen. The protector may well be responsible for occasional fugue states when the patient travels a considerable distance under duress but has no idea how s/he arrived at the end destination. Strangely, the protector can function in a dual role and also commit self-harm against the patient.

abusedSelf-Abuse  This alter continues the punishment and hatred of the patient’s childhood abuser. The concept has been placed firmly in the patient’s mind that s/he was very “bad” as a child and deserved the abuse. Ergo, throughout adulthood the patient holds this same false belief and punishes him/herself by committing abusive acts against the body such as cutting and slashing with a razor, burning, attempting to “murder” the body. The self-abusing alter perpetuates the abuse cycle. The self-abuse alter often states that s/he hates the patient,

Mother  The patient mothers her own child but she may not be present during the birth due to the extreme pain of labour. The patient may regress inward and the alter who experiences pain births the infant. Ergo the patient has no memory of the birth or even parts of the pregnancy but is prepared to mother the child.Other alters emerge during child-rearing but usually they claim no “ownership” of the child, including the alter that has birthed it. There is usually a strong bond between the patient and child. Seldom does the patient abuse her own child.

The Abuser  This alter replaces the actual abuser, whether s/he is a parent, guardian, or another individual. The patient develops this alter as a sign of self-hatred. The abuser taunts and torments the alter. The cyclical abuse continues.

Pairs Sometimes two alters emerge as one. They fulfill the same purpose and even have separate names. They may not be the same race or gender. For whatever reason, these alters feel the need for their own alter in order to function.

Animal  It has been reported that some patients have an animal alter but I have never encountered such a case in my research and readings. Supposedly this alter replaces a childhood pet that was either abused to death by the abuser or ran away, or died of old age.

Relative Patients have alters who are representative of a relative in their family who has been kind to them, and has not been a threat. This alter tends to develop due to the death of this person. The death is too distressing for the patient and an alter develops who replaces the deceased loved one.

Employee – Someone has to work in order to earn a living. Sometimes an alter who can work with colleagues and if necessary the public fills this role. Sometimes it is the original personality. Sometimes there is a switching between the two or other alters may also materialize to maintain order and minimize stress during the course of the day.

Alters aren’t sketched in stone. Sometimes their functions may overlap. In one day, several alters may control the body, depending on the functions that are required. During this time, the patient seems to lose track of time. “Losing time” has long been thought to be a major characteristic of people with MPD or DID although this may not be true for everyone. MPD and DID have many different symptoms and not all of them can be listed in one blog, since many symptoms may not be public knowledge, or have even been discovered.

Characteristics of Alters Sometimes alters are unaware of each other. Sometimes some alters are aware of some alters but not others. These states are called amnesia, and there are different types.

Amnesia Barrier  Most patients claim they have no knowledge of their alters. Sometimes alters claim not to know about each other. This concept is being challenged in the psychiatric community. Lab experiments fail to locate an amnesia barrier.  The film The Three Faces of Eve demonstrated an alter named Eve Black who claimed “I know everything about her [the patient]”, but the knowledge wasn’t mutual.

Repression  Rather than amnesia, it is possible that patients experience repression of their alternate selves. There may be no “amnesia barrier”, but rather alters are repressed when the patient feels threatened. The implication is that the patient is aware of interactions with other people but s/he chooses to allow alters to take control over the body during the situation.

 

 

 

 

 

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Multiple Personality Disorder (Hysterical Dissociative Disorder) and the DSM-II

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DSM I (Diagnostic & Statistical Manual of Mental Disorders, Version I) was created after WWI to provide a framework for labeling post-war psychiatric causalities. DSM II was written after WWII for the same purpose. Vibration-is-lifeThe texts were written in the USA by American psychiatrists. The International Code of Diseases (ICD) at that time through its present 9th edition has adopted these terms. MPD was listed as Hysterical Dissociative Disorder. As of the publication of the DSM-IV, psychiatric terminology distinguished two disorders that were once labelled ‘hysteria’: somatoform disorder and dissociative disorder.Patients with hysteria often experienced what has been termed as the Cassandra Effect. In Greek literature, Cassandra was a woman whom Apollo fell in love with and bestowed upon her the gift of prophecy. Cassandra1_jpegWhen she rebuffed his advances, he cursed her with the predicament of not being believed. Hysteria had been a favourite term with Victorian Era psychiatrists, especially that of Sigmund Freud. Hysteria was strictly a female phenomenon that included faintness, nervousness, sexual desire, insomnia, fluid retention, heaviness in the abdomen, and many other symptoms. One physician catalogued seventy-five pages of symptoms; by the time he was done, even a sneezing fit could fit the diagnosis. Doctors thought that stresses of modern life caused women to develop faulty reproductive tracts (a wandering uterus).

Josef Breuer – Anna O.
Anna O. (Berta Pappenheim) was a patient of Breuer’s in the early 20th century. He diagnosed Anna with hysteria due to symptoms that included “severe cough, Anna_Oparalysis of the extremities on the right side of her body, and disturbances of vision, hearing, and speech, as well as hallucination and loss of consciousness.” Breuer observed that she experienced ‘absences‘, a change of personality accompanied by confusion Breuer decided that Bertha Pappenheim‘s illness was caused by her father’s death. He died on 5 April 1881. At the time she became “rigid” and did not eat for days. Breuer’s treatment included force-feeding and chloral injections. .

He described Anna’s behaviour as follows:

She had two completely separate states of consciousness which alternated quite often and suddenly, and in the course of her illness became more and more distinct. In the one state she was sad and apprehensive, but relatively normal. In the other state she had hallucinations and “misbehaved”, that is, she swore, threw pillows at people.

Breuer thought she was deranged and hoped she would die to end her suffering. However, Anna disappointed him: she recovered and led a productive life. Anna’s symptoms fitted the definition of what was known at that time as “split personality.” 

In the DSM-II hysteria dissociative disorder was a minor condition in the manual. It lacked its own code number. The DSM-III gave “Dissociative Disorders” its own section. Experts decided which disorders should be listed in DSM-IV. Skeptics disagreed that MPD existed. Instead they concluded that patients believed they had more than one personality. The goal of therapy wasn’t integration but helping patients to overcome the belief that they had other personalities.Accordingly the name was changed to DID, dissociative identity disorder in the DSM-5.

What I don’t comprehend is how a patient would believe s/he had multiple personalities in the first flockplace, thereby needing to be cured of this delusion. Who puts the idea into the patient’s head? If anything, multiples typically argue against the notion that they possess alters and initially refuse to accept the diagnosis and integration since they believe it isn’t needed. Joan Francis Casey, in her text Flock: The Autobiography of a Multiple Personality” demonstrated great resistance in therapy about the diagnosis, to the point where she angered her doctor. Doctors who refute the diagnosis of MPD haven’t addressed this issue to the best of my knowledge.

 

Multiple Personality Disorder and the DSM-III

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3facesofeve1980 saw the revision of the DSM-II by the American Psychiatric Association. Several changes were made to the publication in the DSM-III concerning different disorders. One of the changes in the DSM-III was a separate category for the dissociative disorders. This gave considerable credence to the disorder. Of course it must be remembered that this was the time when Sybil was still fresh in people’s minds. Also around that time, Christine Sizemore, the “Eve” in “The Three Faces of Eve“, released a second publication about her experience with multiplicity. It had the unique perspective of being written in the first person by an integrated person who had suffered and been healed from the disorder.Sybil and The Minds of Billy Milligan soon followed, a “true” third person account, first as a text, then as a film, about a man who raped three women and used multiplicity as a legal defense during his trial.

In spite of multiple personality disorder’s inclusion in the DSM-III psychiatrists worldwide argued against its validity. At that time, MPD was almost completely an American phenomenon. It was very seldom reported by European physicians. It was and remains, an almost strictly a female phenomenon, with women being diagnosed as multiples approximately 8 times more often than men. Is that due to gender prejudice in the psychiatric system? Consider there is a listing in the DSM-5 for Hysteria, a disorder that defines women who display abnormal behaviour due to various stressors.

Since the publication of the Eve, Sybil and Milligan books, sybilalong with the inclusion of multiplicity in the DSM-III, there was a virtual explosion in the publication of psychiatric journals, books, biographical accounts, of accounts about patients with MPD. In 1980 there were a number of landmark publications about the disorder including E. L. Bliss’ study of fourteen patients, P. M. Coons systematic information about making a diagnosis, G. B. Greaves review article, B, G. Braun’s treatment recommendations and S. S. Marmer psychoanalytic study.  In 1989, Frank W. Putnam of the National Institutes of Mental Health published “Diagnosis and Treatment of Multiple Personality Disorder”. In 1989 Colin A. Ross, a researcher, published “Multiple Personality Disorder: Diagnosis, Clinical Features, and Treatment”.

In 1994 the DSM-IV renamed MPD as Dissociative Identity Disorder (DID) and the publication of Guidelines for Treating Dissociative Identity Disorder In Adults” by the International Society for the Study of Dissociation. Screening instruments, diagnostic instruments, and a mental status exam were developed. There is increasing information to the general public. Yet the debate involving the existence of Dissociative Identity Disorder and Multiple Personality Disorder continues.
Fmo4FCdU5umEFakK2vaySzk2c5s (1)The evolving theory of thought about DID, that the patient needs to be cured of his or her belief that s/he possesses varying mental fragments, makes little sense to me personally. I wonder where the patient developed the idea that s/he was more than one person. If this diagnosis was given by a clinician who believes in MPD, but another clinician who does not insists the patient suffers from DID, who is right?

The History of Multiple Personality Disorder

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MPD has been diagnosed very early in history. Some professionals believe that it was first “described” in the images of “shamans changed into animal forms” on cave walls during the Paleolithic Era. Throughout recorded history cases of demonic possession have been reported that many experts now believe are cases of of multiple personality. At that time, people interpreted these odd behaviours as best as they were able for such a primitive era.

Eberhardt Gmelin
Millenia later, in the 1800s, American psychiatrists began diagnosing what appeared to be cases of multiplicity. Eberhardt Gmelin’s 1791 account of “exchanged personality” is erroneously credited as being the first documented case of multiple personality.

Paracelsus 1646
However, in 1646, Paracelsus wrote of a woman who had “amnesia about an alternate personality who stole her money.” The case involved a 20-year-old woman living in Stuttgart who began speaking perfect bifurFrench and speaking German with a French accent. Tellingly, this case took place the year the French Revolution began. During this time many French aristocrats left France and fled to Stuttgart for safety. When she was the “French Woman” she remembered everything she did while she was the “German Woman”, but while she was the “German Woman” she denied knowing anything of the “French Woman“. Gmelin could cause the personalities to switch with a movement of his hand. That sounds like therapist manipulation to me, and this is the grey area surrounding DID.

Benjamin Rush
Benjamin Rush, the “Father of American Psychiatry“, and chief surgeon of the Continental Army wrote the first text “Medical Inquiries and Observations Upon Diseases of the Mind.”  Rush included the concept of MPD and theorized the doubling of consciousness related to a disconnection between the two hemispheres of the brain.

The Strange Case of Mary Reynolds
Dr. Samuel Latham Mitchel
 in 1860, publiMary-Reynoldsshed an account entitled “The Strange Case of Mary Reynolds” in “Harper’s New Monthly Magazine“. Reynolds was born in England in 1785 and moved to Pennsylvania. The Reynolds household was strongly religious. During her childhood Reynolds was very melancholy and spent significant time in religious devotions. At 19, she became blind and deaf for six weeks, in what might have been a form of somatic disorder. Three months later she suddenly forgot things she had learned. Eventually she learned how to read and write although her penmanship was crude. Mitchel described new nature her as “buoyant, witty, fond of company and a lover of nature”. After five weeks, she suddenly returned to her prior self. The alter egos switched between each other for sixteen years Reynold reached her mid thirties, when she remained in her “buoyant, witty” ego until she died at 61.

Estelle 1840
Estelle was an 11-year-old Swiss girl in 1840 who seemed to have paralysis and was extremely sensitive brain-0to touch. It was believed that she developed a second personality who could walk and play. Tellingly, this alter could not tolerate her mother’s presence.  Her paralysis and sensitivity was probably a form of somatoform disorder and was embodied in an alter. It was quite probable that the mother was her abuser and the sensitivity to touch was a result of painful abuse from her parent. The child was supposedly cured the through various treatment methods, some of which are currently utilized in the psychiatric community.

Eugene Azam 1843
In the late 19th century, Eugene Azam, a surgeon and hypnotist, published reports of Felida X, an alleged case of multiple personality. Born in 1843, Felida X’s father died in her infancy. Felida X experienced a difficult childhood, meaning she was very abused. She exhibited three different personalities, The second personality manifested when Felida was 13 years old. Switching happened every day after a strong pain in the temple and a solid sleep for three minutes. The switching happened every 25 to 30 days and lasted a few hours. The third personality exhibited anxiety attacks and hallucinations. Eventually the first personality became pregnant and the second personality took responsibility for it.

Pierre Janet early 20th century
In the late19th century and early 20th century, Pierre Janet described the five cases of Leonie, Lucie, Rose, Marie and Marceline. Leonie had three or more personality states including a child named Nichette. Lucie, had three personality states with an alter named Adrienne who experienced flashbacks of a traumatic childhood event. Rose suffered from somnambulistic states. Sometimes she was paralyzed and sometimes she could walk. Often these symptoms are clustered under somatoform disorder, making this DID diagnosis a case of co-morbidity.

Mortin Prince 1906
Mortin Prince published the Christine Beauchamp case in “The Dissociation of a Personality“. Beauchamp allegedly had three personality states including one calling herself Sally who was childlike. 3facesofeveSally differed greatly from an alter called a very regressed alter called Idiot. Eventually MPD was declared “extinct” by E. Stengel in 1943. Months later Prince released a landmark paper of “The Journal of Abnormal Psychology” which “was the most quoted reference in the history of the illness“. After this documentation however no mentioned was made of MPD in the journal until Prince’s published famous account of Christine Costner Sizemore. In 1957 the case was made into a film starring Joanne Woodward playing the title role in The Three Faces of Eve. It was presented as extremely rare and bizarre although since then psychiatric communities who accept the DID diagnosis state it is not as rare as once thought.

Dr. Cornelia Wilbur 1978
Most people are familiar with the famous case of “Sybil an alias for Shirley Ardell Mason, a woman Wilbur claimed possessed 16 personalities as a result of a traumatic and highly abusive childhood.Mason’s story Sybilfirst arrived as a best-selling book that was” ghost-written” by author Flora Shcreiber who told the story in the third person(s). It sold in the millions. Not long after the book’s release, Hollywood actress Sally Fields starred in the movie Sybil, along with Joanne Woodward as her psychiatrist.

The text has come under fire in recent years, significantly weakening the argument for MPD/DID. An author named Debbie Natham, released “Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case,” an account that disputes much of the information. She claims that Wilbur was a fraud and intentionally invented several of Mason’s so-called personalities using the hypnotic drug sodium pentothal. Wilbur’s method was to suggest abusive trauma to Mason, who agreed with Wilbur’s account. Medical records do not support Sally_Field_1971Wilbur’s claims about Mason’s physical and sexual abuse at her mother’s hands. Mason herself once asked a different psychiatrist who temporarily treated while Wilbur was away, which alter he would like her to portray, stating the name of an alter Wilbur especially preferred. Mason also admitted that if she didn’t agree she had multiplicity Wilbur wouldn’t treat her. Wilbur herself admitted that if she didn’t use the term multiple personality disorder in the account, her publisher would not publish the text.

H. Ellenberger published a paper entitled “The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry” that focused on multiple-personalities-paulo-zerbatomultiple personality disorder. Throughout the 1970s, a number of clinicians worked toward defining and establishing the legitimacy of the condition. Margareta Bowers along with six other contributors published “Therapy of Multiple Personality” in 1971. “Therapy of Multiple Personality” outlines rules for treating multiple personalities. Several psychiatrists in the 1970s and 1980s have written notable accounts of case studies and treatment methodology.

Cecil Adams 2003  The Straight Dope
Adams writes for an online publications called The Straight Dope, a site that is self-described as “fighting ignorance since 1973.” Adams answered a writer about the phenomenon of multiple personality disorder. In his view, the disorder resulted from nothing more than media influences, misguided clinical practices and mass hysteriaAdams emphasized that the disorder was manufactured  “under the influence of hypnosis and other techniques,” whereby patients were coaxed into “uncovering bloodcurdling stories of child abuse” or satanic cults. The whole satanic cult-thing has never appealed to me as especially legitimate. If so many of these abusive cults exist why aren’t more people being charged, arrested and thrown in prison for their abuse of children and youth?

The disagreement over the definition of personality also complicates the diagnosis of DID. Supposedly in DID is open-uri20120817-11927-1fr97jaalters are independent of one another, but this is difficult to prove. Speech and behavior can be faked. In support of DID brain-wave patterns may vary although some doctors insist this is not due to a genuine personality switch.  In a study of DID, patients and their alters, different sets of words. When different personality states were asked whether a word was recognized, if it supposedly belonged to a different alter, patients hesitated. The implication was —I’m not supposed to know this. Were those alters truly independent? Obviously not.

My personal feeling is that it may be possible for a single ego not to form due to repetitive, extreme trauma but this is extremely rare. I believe the many currently diagnosed cases are false. DID is just one of those “disorders” that is nigh impossible to prove. It appears to be extremely difficult for therapists to produce legitimate, longitudinal studies about DID, unlike almost all other disorders and illnesses listed in the DSM-5. I doubt that any current clinicians go so far as to use sodium pentothal with their patients but I do believe there is room for error and the use of false memory syndrome. I don’t believe most patients or clinicians do this on purpose. Very few people gain “fame and fortune from this disorder anymore, ergo the extrinsic rewards are nil. There may be intrinsic rewards for the patient but none thus far have been documented. Unlike Wilbur’s deliberate, false account of Mason, I believe it is misguided belief in an interesting, unique phenomenon.

Problems with Assessment of DID/MPD

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DSM-V defines DID/MPD as the presence of two or more distinct identities or personality states” that alternate control of the individual’s behavior, accompanied by the inability to recall personal 640px-Dissociative_identity_disorderinformation beyond what is expected through normal forgetfulness. In each individual, the behaviour varies and the level of functioning can change from severely impaired to adequate. Individuals with DID may experience distress from both the symptoms of DID (intrusive thoughts or emotions) as well as the consequences of the accompanying symptoms (dissociation rendering them unable to remember specific information).   Identities may be unaware of each other and compartmentalize knowledge and memories, resulting in chaotic personal lives. 

The primary identity, which usually has the patient’s birth name, is the original core, or the first personality the individual possesses. It is hypothesized that the person is dalia faceborn whole then “splits” into several alters due to ongoing, extreme trauma. The core personality is “passive, dependent, guilty and depressed“. The alters are “out” or active more often than the primary or core personality. They are usually more aggressive and tend to hold complete memories, something the core lacks. DID is a major change in the DSM-5. Heretofore, DID was listed as MPD (Multiple Personality Disorder). MPD itself was fraught with controversy. Across continents there has been considerable debate as to whether MPD/DID even exists. There are a number of valid reasons for this:

  1. It is almost strictly a North American phenomenon – MPD is diagnosed more frequently in NA than anywhere else in the world.
  2. Females are diagnosed 3 times more often than males.
  3. It became extremely popular in psychiatry after the sybilrelease of the boo Sybil, written by Flora Schreiber, and the release of the movie by the same name, Sybil, starring Sally Fields The story featured the supposed biography of Shirley Ardell Mason, although there has been much skepticism in the following decades about the validity of her account.
  4. Diagnosis dropped considerably into the 1980s when the disorder was called into question for inclusion in the DSM-IV-TR.
  5. MPD was linked with extreme sexual abuse but no scientific research has proven conclusively that this is true, particularly since a number of people who claim to have MPD have never been sexually or physically abused.
  6. There is no scientific methodology to prove the existence of MPD/DID.
  7. It is a disorder that many people have tried to fake for attention-seeking purposes and in some cases, for financial gain. This is co-morbid with a factitious disorder called malingering.
  8. MPD can be co-morbid with another disorder and therefore be difficult to assess.
  9. Psychiatrists have manufactured the existence of alternate personalities in patients.This is known as iatrogonesis.
  10. There is no such thing as several people within one body and one brain.
  11. No longitudinal studies have been conducted.
  12. No epidemiological studies have been conducted.
  13. Patients claim to have varying numbers of alters, yet there is no proof for these claims. The number of alters varies widely, with most patients identifying fewer than ten, 640px-Dissociative_identity_disorderthough as many as 4,500 have been reported.The average number of alters has increased over the past few decades, from two or three to now an average of approximately 16.
  14. DID/MPD has been diagnosed based on memory, a poor assessment tool.
  15. Only a small cluster of clinicians accept and use the diagnosis.

 

 

 

 

 

PowerPoint Presentation on MPD/DID

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I have to toot my own horn on this one. I put together a PP years ago on multiplicity.Recently I did another one. I got a picvery good response to them. Alas, many of the links in the old presentation are now broken (clearly they weren’t at the time). I cannot repair them since I no longer have the original work. Stupidly, I deleted it (definitely not with malice aforethought).

If you do decide to view them, forgive the many broken links. **Also there are warnings in each presentation that the presentation or certain videos could be triggering. ** Please keep this in mind regardless of the mental disorder you may possess. Now, pop open a microwaved bag of popcorn and enjoy!

Dissociative Identity Disorder – an examination of a controversial mental health phenomenon

Dissociative Identity Disorder and Multiple Personality Disorder – quite frankly this a more updated and sophisticated presentation. There is more information and hopefully it makes the phenomenon of DID a little easier to understand.

 

 

 

Causes

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Identifying causes is a major problem with diagnosing DID and this is one of many reasons why the inclusion and categorization of MPD/DID is an ongoing issue in the DSM-V. One reason is that there is no general consensus as picto what causes the disorder. There are debates but no scientific proof. There are no longitudinal studies. There are no epidemiological studies. There is no in-depth research on case studies. Diagnosis is dependent upon:

  1. Memory – a poor methodology at best
  2. Comparison of symptoms between case studies.
  3. Suspicion exists as to whether doctors themselves create alters through hypnotherapy and other methods (Iatrogenesis  or  brought forth by the healer).
  4. New discovery that DID development is possible after childhood
  5. prevalence rates across cultures and populations
  6. DID in children may partly result from a strong imagination used in coping skills. In adults however, DID may present as PTSD (post-traumatic stress disorder).


Possible causes:

  1. Trauma – sexual and physical abuse appear to occur frequently in these individuals The accuracy of these reports are disputed by professionals, witnessesParentsDaughterAug1931 and families.
  2. Other causes – early loss, serious medical illness or other traumatic event
  3. Lack of comfort by at least one parent or guardian during ongoing abuse. Individuals who have a chance to process the abuse and turn to a “safe” adult after
    abusive episodes seldom develop DID. Those who do not have this option frequently develop DID. However this too is called into question. How does the therapist know whether a traumatized individual would have potentially
    developed DID when this disorder doesn’t occur?
  4. Possible genetic connection. However, the gene theory hasn’t and cannot be proven. It is possible that forms of dissociation, such as dissociative fugue or amnesia, may be present in immediate or extended family members although this isn’t always the case.

Dr. Susan Taylor, a psychiatrist and expert in MPD (is there such a thing as an expert?) offers the explanation
that the higher self recognizes when a situation occurs that shouldn’t. That self acknowledges that “this is not right. I really shouldn’t do open-uri20120817-11927-1fr97jait. Just this once.” (She is referring to the splitting into another alter). Over time, the splitting becomes a kind of “belief system” and therefore ingrained. When that happens “we don’t remember the wisdom of the body and the wisdom of nature that told us, hey, don’t go down that road.” Inevitably, this leads to a “full-blown disease state.” Frankly this is one of the most comprehensive, if incomplete, explanations of the causes of multiplicity that I’ve ever heard.