by Carolyn Kaufman, PsyD
This article was born of a discussion on another writer's forum, where misconceptions about "split personalities" were flying fast and hard. So here we'll look at a few common misconceptions about Dissociative Identity Disorder (multiple personality disorder).
Reality: many experts question the existance of DID, typically for political and historical reasons.
Freud did a lot of work with hypnosis (which is an induced dissociative state) early on, and when he decided he didn't want to anymore, he started bad-mouthing dissociation altogether. (Ironically, many people believe his most famous client, Anna O., had DID.) Many if not most people who question whether DID exists have never worked with the disorder, or worked with it at any length. In other words, it's easy to say you don't believe in something from afar.
But to be fair, there are more reasons people question DID.
When people hear about the atrocities necessary to create DID--skinning children alive, using electric shocks, forcing them to kill animals or other people--they don't want to believe one human can treat another so poorly. Unfortunately war, if nothing else, has shown us that human beings are capable of just such horrifying deeds. And when these sorts of things are done in peacetimes, especially to children, they are referred to as sadistic or ritual abuse (RA).
You can read more about the kinds of torture endured in ritual abuse . (Please be aware that the information is graphic and may be triggering or upsetting to sensitive readers.)
There's also a political group called the False Memory Syndrome Foundation that attempts to discredit DID and dissociative amnesia. It was started as part of a mother/daughter battle over whether the mother and father abused the daughter so badly she dissociated some of her memories. (For more info, you can read Jennifer (the daughter) Freyd's material on Betrayal Trauma and Recovered Memories. )
Dissociation is a split in consciousness; in DID, the dissociation acts like walls ("amnestic barriers") between different personalities. Many if not most of the personalities were created in response to a particular, overwhelming, sadistic trauma (so the more personalities, the worse the person was abused). The experience was so awful it was walled off into its own little part of the brain. Whenever a similar trauma is experienced, it triggers that part of the person's experience, and so the personality begins to develop independent of the core (the birth personality) and the other personalities.
Before co-consciousness, or cooperation between the personalities, each personality usually has amnesia for what happened when any other personality was out. Even after co-consciousness, those alters who were not sharing consciousness are going to have amnesia for what happened. They may "hear" about incidents from other alters, but they weren't "there."
So regardless of whether you want to buy the term "Dissociative Identity Disorder" or not, there's a definite series of dissociative walls in the person's personality. Even EEG readings are different when the personalities switch, and "multiples'" brains are physically organized differently than those of "singletons." And the bottom line is that currently DID is recognized by the DSM-IV, and that's the gold standard for whether a disorder "exists." Stay tuned for the next edition of the DSM!
Many people with DID, schizophrenia, and bipolar disorder show none of these "symptoms," or do not show them consistently. Worse, all of these "symptoms" are likely in anyone who's having a Very Bad Day! Think about it -- strep throat and throat cancer share some symptoms, but to the doctor, who knows what to look for, there's a huge difference between them. So you've got to be careful about saying two things "look alike" when the looking alike is superficial.
DID is caused by horrific, sadistic, downright evil trauma that is so overwhelming that the brain is forced to partition each trauma from the rest of the brain to keep the person alive and sane. One of the hallmark symptoms of DID is amnesia. Before therapy (in most cases), when Personality A is "out," all of the other personalities have no idea what's going on. Therefore, when Personality B (or C, or D, etc.) comes out, she has amnesia for what happened while A (and C, and D, etc.) did. This can be, as you might imagine, very confusing and upsetting!
Schizophrenia is a biological disease caused by, among other things, an excess of a neurotransmitter (brain chemical) called dopamine. People with schizophrenia do not feel like more than one identity lives in their body, and they do not have problems with amnesia, as those with DID do. Symptoms of schizophrenia include:
The reason people mistake DID and schizophrenia is that "schizophrenia" literally means "split personality." Eugen Bleuler, the person who first came up with the name, noticed a "split" in what we now call positive (disorganized, strange, psychotic) symptoms and negative (catatonic, apathetic, a-motivational) symptoms. In other words, the same person may have way too much of a brain chemical that makes them psychotic (dopamine) and other times not enough of chemicals that help them keep moving and caring about life (serotonin and norepinephrine).
They never lose the sense of who they are, or move into another "personality," and they never have big blocks of amnesia, but they act very differently on the outside, making it look like there's a "split" in personality.
Bipolar disorder, like schizophrenia, is extremely genetic and chemical in nature. Bipolar disorder is caused by the brain's inability to regulate neurotransmitters properly, leading to highs (mania) and lows (depression) that also can make the person behave very differently from one week or month to the next. But again, like people with schizophrenia, they have a very consistent sense of "I" and no amnesia.
Schizophrenia and bipolar mania can sometimes look similar, particularly because both are caused by an excess of brain chemicals like dopamine. Still, there are differences you can look for. For example, people with bipolar disorder tend to have a good sense of humor and "get" jokes easily; people who have schizophrenia are very "concrete" and take everything literally, which makes humor not funny. People with DID don't have a biochemical imbalance (aside from any PTSD or comorbid disorders, which are diagnosed on their own) -- they have splits in their experience of "I."
In fiction, DID is massively overused as a defense; in reality, Billy Milligan used it as a defense successfully, and then everyone else started trying (starting with Ted Bundy) -- and failing. As Kathrine Ramsland puts it,
The public...mistakenly believes that many criminals successfully use it to get away with crimes and that criminals are set free immediately after being acquitted.... In general, not guilty by reason of insanity is a high risk defense that succeeds only a fraction of the time. It is used in less than 3 percent of criminal scases, and it fails more often than it succeeds. Most of the successes (85 percent) result from plea bargains...thus, few juries are 'fooled.'"
And a not guilty by reason of insanity plea is not an "off the hook" plea. In fact, a criminal is better off going to jail -- his sentence will be shorter and he'll have more freedoms. The average not guilty by reason of insanity sentence (in a psychiatric institution) is approximately twice the length of a guilty (and sane) sentence.
Ramsland, K. (2002). The Criminal Mind: A Writer's Guide to Forensic Psychology