Multiple personality controversy

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Dissociative identity disorder (DID) is the American Psychiatric Association's current name for a condition listed in earlier editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as multiple personality disorder (MPD). The International Statistical Classification of Diseases and Related Health Problems continues to list it as Multiple Personality Disorder. MPD and DID should not be confused with schizophrenia, even though the media often use the terms interchangeably.

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[edit] Recent history

Much of the controversy around the MPD and DID diagnoses came to revolve around the issue of whether memories can be repressed, rather than on the question of whether it is possible to have more than one personality or self. Many of the criticisms of the diagnosis arose in the wake of the controversy over Satanic ritual abuse. The idea of an international network of Satanic cults operating secretly, kidnapping children and using them in human sacrifices, was first advanced in the early 1980s by evangelical Christian writers,[citation needed] among them Hal Lindsey and Johanna Michaelsen. Some therapists such as Colin Ross and Bennet Braun believed that abuse by such cults was widespread, and that some deliberately used mind control to induce multiple personalities in subjects. [1]

Other therapists who did not necessarily agree with the idea that SRA was widespread did believe that psychological distress in adulthood was often due to repressed memories of childhood sexual abuse, and/or to other personalities formed by trauma.[citation needed] As the memories described by some MPD/DID patients in recovered memory therapy were bizarre and seemed to strain credibility, or described incidents that could not have happened, the debate over MPD and DID became indelibly linked to the debate over repression for some skeptics and critics. [2] [3]

Self-identified multiples who state they do not experience multiplicity as being connected to repression, abuse, or dissociation did not achieve any significant voice until after the controversy had died down and many psychologists had dismissed MPD/DID as a fad diagnosis and an artifact of therapy.[citation needed]

[edit] Contemporary views

[edit] Supporters of the therapy view

Those who believe MPD/DID is a real disorder generally contend that children who are stressed or abused (especially sexually abused) may split into several independent personalities or ego states as a defense mechanism.[4] According to this view, the primary function of these separate ego states is to hold traumatic memories and keep them out of the consciousness of the original self or "host," allowing the host to continue functioning in daily life as though nothing had happened. The alternate selves, or "alters," take turns controlling the body. Sometimes each alter reports remembering only the times when they controlled the body, and claims amnesia for all other periods. This model also holds that since alters represent dissociated parts of the original self, they are very limited in role, only capable of handling specific emotions or tasks.

Most doctors who believe in the diagnosis contend that the goal of treatment for a DID patient is to recover all the memories of trauma held by various selves, through hypnosis, guided visualization, dream analysis or other techniques, and then integrate the alters into the host's personality. Some believe that all reported details of recovered memories, even strange or unusual ones, should be taken seriously at least as narrative truth even if they are unlikely or impossible as historical truth.

[edit] Critics

Some psychologists and psychiatrists regard DID as being iatrogenic or factitious, or contend that true cases are extremely rare and that the majority of reported cases are iatrogenic. Drs. Paul McHugh and Herbert Spiegel are among the leading critics of the DID paradigm, and have made their views known in articles and television interviews.

Skeptics contend that those who exhibit the symptoms of MPD/DID have learned to behave as though they had different selves in return for social reinforcement and reward, either from therapists, from other DID patients, or from society at large. The modern DID model relies on the premises that multiplicity is a disorder of memory, that repression of memories is a common defense against childhood sexual abuse and linked to multiplicity, and that repressed memories can be accurately recovered through techniques such as hypnosis. As such, some critics have focused on studies citing the fallibility and flawed nature of human memory, the weaknesses of hypnosis as a tool for recall, and on disproving claims of the accuracy of recovered memories.[5] The work of psychologist Elizabeth Loftus, who specializes in human memory, is usually cited to support this conclusion.[5] A more lengthy review of the normal fallacies of memory is given by Nicholas Spanos in his sociocognitive model.[6]

Critics of the DID model point to the fact that the diagnosis of MPD and DID is a phenomenon largely unique to English-speaking countries.[6] Prior to the 1950s, cases of dual personality and multiple personality were occasionally reported and treated as curiosities in the Western world.[7] The 1957 publication of the book The Three Faces of Eve, and the popular movie which followed it, revived the American public's interest in multiple personality. The diagnosis of Multiple Personality Disorder, however, was not included in the DSM until 1980, following the publication in 1974 of the highly influential book Sybil. As media coverage spiked, diagnoses climbed. There were 200 reported cases of MPD from 1880 to 1979, and 20,000 from 1980 to 1990.[8] According to Joan Acocella, 40,000 cases were diagnosed from 1985 to 1995.[2] The DID diagnosis is largely centered in the United States, and in English-speaking countries more generally.[6] Some critics contend that a majority of diagnoses are made by only a few practitioners.[citation needed]

Some professionals are critical of a majority of DID diagnoses, and believe that many iatrogenic cases were induced during the height of its media popularity, but still argue that true cases of DID exist and must be treated.[citation needed] The DSM currently treats dissociative amnesia, dissociative fugue, and DID as mental disorders characterized by dissociation.

[edit] Healthy multiplicity

Some people who self-identify themselves as having multiple personalities contend that it is not a disorder, but a natural variation of human consciousness. They believe that so long as communication and (especially) cooperation between selves are present, multiples can lead happy and productive lives, and that it is not necessary for healthy persons to have only a single self. Groups which experience blackouts between personality switches can function by referring to jointly owned calendars, datebooks and lists.

Some people who hold this view believe that the unity of the self is an illusion and that everyone is fundamentally multiple, an opinion some claim is similar to the beliefs of William James [9] and other modernist writers. Others take the position that multiplicity can arise in a variety of ways, from being born naturally multiple to splitting from abuse, but that regardless of origins, a group of selves can cooperate and function well in tasks of daily living.

Truddi Chase, author of the best-selling book When Rabbit Howls, is one believer in healthy multiplicity. Although she described the multiplicity as originating from abuse, she claims to have a group of selves rejected integration and live as a collective. [10]

[edit] Chronology of multiple personality and MPD/DID in the Western world

  • (1791) Eberhard Gmelin describes a case of "exchanged personality" in a 21-year-old German woman who manifested a second self, speaking French and claiming to be a French aristocrat. Gmelin believed that cases such as hers could aid in understanding the formation of personality.[11]
  • (1838) Charles Despine describes a case of dual personality in "Estelle," an 11-year-old girl.[12]
  • (1906) Morton Prince's book The Dissociation of a Personality describes his work with multiple personality patient Clara Norton Fowler, alias Christine Beauchamp.
  • (1954) Shirley Jackson's book The Bird's Nest, a fictional story of multiple personality, is published.
  • (1954) Thigpen & Cleckley's book The Three Faces of Eve, loosely based on the therapy of Chris Costner-Sizemore, is published, reviving the American public's interest in the subject of multiple personality.
  • (1957) A movie version of The Three Faces of Eve, starring Joanne Woodward, is released.
  • (1973) Flora R. Schreiber's bestselling book Sybil, a novelized treatment of the life and therapy of Shirley Ardell Mason, alias 'Sybil Dorsett' in the book.
  • (1976) A made-for-TV film version of Sybil is produced, starring Sally Field in the title role.
  • (1977) Chris Costner-Sizemore publishes an autobiography, I'm Eve, alleging that Thigpen and Cleckley's book was a misrepresentation of her life.
  • (1980) Publication of Michelle Remembers.
  • (1981) Daniel Keyes' book The Minds of Billy Milligan is published, based on interviews with Billy Milligan, some of his therapists, lawyers and family members.
  • (1986) Publication of When Rabbit Howls.
  • (1995) Astraea's Web, the first Internet website to describe non-disordered and self-recognized multiplicity, goes online in September.
  • (1996) Publication of Rewriting the Soul by Ian Hacking.
  • (1998) Joan Acocella's New Yorker article detailing the excesses of MPD therapy, Creating Hysteria, is published.
  • (1999) Cameron West's book, First Person Plural: My Life as a Multiple is published.
  • (2005) Robert Oxnam's autobiography, A Fractured Mind, is published.

[edit] References

  1. ^ Ofshe, Richard. Making Monsters: False Memories, Psychotherapy, And Sexual Hysteria. San Francisco: University of California, 1996. ISBN 0520205839.
  2. ^ a b Acocella, Joan (1999). Creating Hysteria: Women and Multiple Personality Disorder. San Francisco: Jossey-Bass Publishers, 1999. ISBN 0-7879-4794-6
  3. ^ Pendergrast, Mark (1996). Victims of Memory: Sex Abuse Accusations and Shattered Lives New York: Upper Access Books, 1996. ISBN 0942679180.
  4. ^ Watkins Helen H. (1993). "Ego-State Therapy: An Overview." American Journal of Clinical Hypnosis. Volume 35, Number 4, April 1993. Pp. 232 - 240.
  5. ^ a b Loftus, Elizabeth & Katherine Ketcham (1996). The Myth of Repressed Memory: False Memories and Allegations of Sexual Abuse. St. Martin's Griffin; 1st St. Martin's Griffin Ed edition. ISBN 0-312-14123-8 Amazon.com
  6. ^ a b c Spanos, Nicholas P. (2001). Multiple Identities & False Memories: A Sociocognitive Perspective. American Psychological Association (APA). ISBN 1-55798-893-5 Amazon.com
  7. ^ "A History of Dissociative Identity Disorder." Demonic Possession and Psychiatry.
  8. ^ Adams, Cecil (2003). "Does multiple personality disorder really exist?." The Straight Dope.
  9. ^ William James, Exceptional Mental States. New York: Scribner, 1983. ISBN 0684179385.
  10. ^ Truddi Chase, When Rabbit Howls. New York: Dutton, 1987. ISBN 0515103292.
  11. ^ NIH.gov
  12. ^ NIH.gov

[edit] See also

[edit] External links

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