The truth about multiple personalities

A closer look at Dissociative Identity Disorder

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Dissociative Identity Disorder is often misunderstood and exaggerated, but is a real diagnosis.

The Three Faces of Eve, Sybil or more recently, The United States of Tara all come to mind as media depictions of Dissociative Identity Disorder (DID), former known as Multiple Personality Disorder. This disorder has been questioned as a "real" diagnosis since the early 1900s and has been controversial since.

Dissociation is a phenomenon that occurs naturally for many people in mild ways. For example, if you have ever been driving along a highway or riding on a subway and your mind wanders and goes somewhere else, you might lose sight of your immediate surroundings and miss your stop.

Others, however, experience dissociation and similar issues such as depersonalization in a more regular and severe way. 

This article specifically reveals what DID is and how it actually presents in people's lives.

DID: Definition

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which labels and defines mental health diagnoses, notes that one must meet the following criteria in order to qualify for a diagnosis of DID:

  • The person's identity is disturbed by two or more distinct personality states. One's sense of self is clearly altered in terms of their mood, behavior, thoughts, memory, perception and sensory-motor functioning.
  • The person experiences recurrent memory gaps in regular, every day life that cannot be explained by ordinary forgetfulness.
  • The symptoms interfere with one's functioning in life or cause remarkable distress.
  • None of the above can be explained by religion, fantasy play of a child or physiological effects of a substance.

    In other words: An alternative personality seems to take over one's "normal" identity at times, to such an extent that their whole human experience changes, and the "normal" identity has no recollection of times in which these switches seem to occur. 

    DID: Typical Structure

    The typical personality structure of someone with DID involves what is known as a "host" personality, which is basically the name you might know the person by, and a set of "alters," which are the alternate personalities.

    Unless the person is aware that they have DID (which many are not), the host is typically unaware of the alters and does not remember their activities. The alters, however, are aware of the host and most often monitor the host's feelings and situation.

    How does DID develop?

    While there is no crystal clear explanation that exists about the development of DID, it is widely recognized as a disorder that arises from childhood trauma. It is believed that DID does not result from the shattering of an already integrated adult personality, but that it begins in childhood as a failure of an integrative process of personality that occurs for most people.

    If something overwhelming occurs to a child, for example, abuse, or some other kind of trauma, the child's brain naturally may cope with this by pushing the event out of his or her consciousness into various compartments. Alternate personalities naturally take hold of such cut off memories and provide the child with ways to cope with the trauma. These "alters" then stay with the person until adulthood, and come out on an involuntary basis to help the host at times that may feel threatening or unsafe.

    How common is DID?

    Research published in the American Journal of Psychiatry shows that between one and six percent of psychiatric patients have DID. This disorder is not nearly as common as anxiety or depression, but it is certainly not mythical, as some may still believe it to be.

    It is a disorder that is often missed by mental health professionals in part because many are not properly trained to identify it. It is not often diagnosed until a person reaches his or her thirties or forties despite having it since childhood. Typically, people who are diagnosed have been in psychiatric treatment for a number of years prior to officially being diagnosed with DID, and are given a number of different diagnoses along the way.

    The media may exaggerate the presentation of DID, and it may be hard to believe that people can actually have multiple personalities that are unaware of each other, but DID is a real disorder that affects many people.

    Sources

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Putnam, F.W. (1989). Diagnosis and treatment of Multiple Personality Disorder. New York: The Guilford Press.

    Rifkin, A., Ghisalbert, D., Dimatou, S., Jin, C., Sethi, M. (1998). Dissociative Identity Disorder in psychiatric inpatients. American Journal of Psychiatry, 155, 844-5.

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