Multiple Personalities (Dissociative Identity Disorder)

Multiple personalities is a concept that is generally tied to what was once known as multiple personality disorder, but which is now referred to in medical terminology as dissociative identity disorder.  As such the past acronym MPD for multiple personality disorder has now been overtaken by DID for dissociative identity disorder.  This disorder is generally characterized by the recognition of more than one identity that manifestly controls the behavior of an individual.  In medical terminology, these multiple personalities or identities are known as “alter.”  There can be many diverse qualities of these alters that can radically alter when the sufferer of dissociative identity disorder switches between them.  These qualities can include mannerisms in speech or the hand with which they write, they may exhibit different allergies, have different thoughts, gender orientations or thoughts.  In addition, rarely does the individual share a memory between the different alters and as such is unaware of what they have said or done when their identity is associated with one of these alters.  As a result, it is not unexpected that a sufferer of dissociative identity disorder will experience large gaps of missing time, or amnesia, and in addition may be unable to recall facts or people who claim to be acquainted with them or even past actions of their own.

Coping with Dissociative Identity Disorder

Coping with dissociative identity disorder can be extremely difficult as the amnesia that is so often associated with this disorder may leave the person suffering from it initially unaware that they act under different personalities at various times.  In fact, according to the National Alliance on Mental Illness, a person suffering from dissociative identity disorder may have between two and one hundred distinct alters, though the average is approximately ten.  In addition, there is sometimes a type of crossover where those with dissociative identity disorder become suicidal and suffer from clinical depression at times because of an experience of hallucinations and hearing voices talking in their head.

The causes of dissociative identity disorder are not entirely understood, but it is hypothesized that the split of the individual’s psyche into a number of distinct identities may be a form of coping mechanism enacted as a result of some form of mental, physical or sexual abuse that occurs when the patient in question is still very young.  It is thought that they dissociate from themselves in order to not experience the abuse that is occurring and as such develop a number of different personalities or alters in order to deal with any number of different situations as they grow older.

The National Alliance on Mental Illness notes that there are a wide variety of symptoms in children who are suffering from dissociative identity disorder, which include a tendency toward depression, anxiety, behavioral issues, amnesia, anxiety, an inability to concentrate in school settings and the experience of visual and auditory hallucinations in some cases.  Given that the observation of these symptoms in children can be quite difficult as they are often uncommunicative, dissociative identity disorder is often misdiagnosed in its early stages as schizophrenia.

The way in which dissociative identity disorder is currently treated relies less on pharmaceutical options and more heavily on psychosocial ones such as psychotherapy including the use of hypnosis.  The goal of the psychotherapist is to engage in a communicative manner of some sort with each of the different identities in an attempt to engage with the trauma that those identities, or alters, were developed as a coping mechanism to deal with.  As a result, the desired outcome is twofold.  First, it is hoped that through this form of therapy that the patient will be able to reduce problematic behaviors associated with dissociative identity disorder.  Second, a more comprehensive goal is to engage with the childhood traumas in such a way that the individual identities cease to be required as a coping mechanism, with the ultimate outcome being the reunification of the sufferers psyche back into a single coherent identity.

Related Dissociative Disorders

Like dissociative identity disorder, there are a number of other related dissociative disorders that it might be useful to be aware of.  They are known as dissociative disorders because they are generally characterized by dissociation from some aspect of the individual’s waking consciousness.  Although the most well recognized dissociative disorder is dissociative identity disorder, there are a few others that are likewise characterized by what is generally considered to be a coping mechanism to some form of trauma that the individual has experienced. 

In dissociative amnesia, specific mental and not physical traumas are repressed in some way by the inability to remember certain important information of a personal nature.  There are four subtypes of dissociative amnesia that include a localized amnesia where a set amount of time cannot be remembered, selective amnesia, where only certain parts of an event or stretch of time can be recalled, generalized amnesia, where one cannot remember any past aspects of one’s life, and finally systematized amnesia where a set category of information cannot be remembered.  Dissociative fugue is much rarer and is characterized by an unexpected and rapid taking leave of one’s senses as one’s body goes off on a quest or journey of some sort.  The National Alliance on Mental Illness notes that these trips can last as little as a few hours and as long as several months, traveling at times vast distances, where they are either in a state of confusion or are acting through a new identity that they are otherwise unaware of.  Depersonalization disorder is characterized by a sense of distance, a detachment or dissociation from the individual’s experience of their body or sense of self.  This disorder is a more extreme form of depersonalization, an every day experience of occasionally feeling as though one is in a dream; however for sufferers of depersonalization disorder this experience is extremely frequent to the point of constant interruptions in one’s experience of reality to, on occasion, the sense that there is no real outside world.