Multiple personality controversy

The existence of multiple personalities within an individual personality is diagnosed as dissociative identity disorder (DID) in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM). Prior to the publication of the "DSM-IV", it was termed multiple personality disorder (MPD). Both the International Statistical Classification of Diseases and Related Health Problems (ICD) and Diagnostic and Statistical Manual of Mental Disorders list the condition in their taxonomies of mental disorders, as MPD and DID respectively.

The diagnosis of DID has been heavily debated in the last hundred years. Opinions vary greatly on the topic of DID. In recent years it has become discussed as to whether DID exists and is caused by repeated and severe abuse or whether patients have been simply copying symptoms either they've read about in fictional accounts or that a therapist asked them about while attempting to diagnose them for this condition. Among those who believe such a condition exists there is the additional controversy of whether it should be considered a mental illness or not.

Contemporary views

upporters of the therapy view

Reports of DID are often confirmed by objective evidence and people responsible for these acts might be prone to distort or deny their behavior. The DSM currently treats dissociative amnesia, dissociative fugue, and DID as mental disorders characterized by dissociation. Those who believe that multiple personality is a real phenomenon usually assume that it is a mental disorder, originating in children who are stressed or abused (especially sexually abused). It is presumed that such children may split into several independent personalities as a defense mechanism. Watkins Helen H. (1993). " [http://www.clinicalsocialwork.com/overview.html Ego-State Therapy: An Overview] ." American Journal of Clinical Hypnosis. Volume 35, Number 4, April 1993. p. 232 - 240.] DID is attributed to the interaction of overwhelming stress, insufficient childhood nurturing and an innate ability to dissociate memories or experiences from consciousness.cite web | url = http://www.merck.com/mmpe/sec15/ch197/ch197e.html | title = Dissociative identity disorder, doctor's reference | publisher = Merck.com | accessdate = 2008-02-03 | date = 2005-11-01 ] Prolonged childhood abuse is believed to be a factor in DID, with a very high percentage of patients reporting documented abuse.MerckManual|07|106|d|Dissociative Identity Disorder] DID has been described by Pearson as a severely lasting dissociative response to overwhelming and normally traumatic antecedents and results from childhood trauma.cite journal | author = Pearson, M.L. | year = 1997 |journal=Dissociation |volume=10 |issue=1 |pages=58–62 | title =Childhood trauma, adult trauma, and dissociation | url = https://scholarsbank.uoregon.edu/dspace/bitstream/1794/1837/1/Diss_10_1_9_OCR.pdf |accessdate = 2008-06-01] DID has also been found to have consistent diagnostic features.cite journal|last=Ross|first=C. |coauthors=Norton, G.& Fraser, G. |year=1989|month=|title=Evidence against the iatrogenesis of multiple personality disorder |journal=Dissociation|volume=2|issue=2|pages=61–5|url=https://scholarsbank.uoregon.edu/dspace/bitstream/1794/1424/1/Diss_2_2_2_OCR.pdf|accessdate=2008-02-10]

Some researchers assert that the present scientific evidence is inadequate to support that the suggestive influences in psychotherapy can cause DID and argue that there is little scientific support for hypnosis alone creating DID. One supporter of DID has argued that specialists do not influence their clients to make an increased number of personalities or to develop additional diagnostic criteria. D. Brown has argued that McHugh's publications questioning whether DID exists are "speculation" and claims that McHugh has insufficient clinical experience with DID patients to comment upon the diagnosis.cite journal |last= Brown |first=D|coauthors=Frischholz E, Scheflin A. |year= 1999 |title= Iatrogenic dissociative identity disorder - an evaluation of the scientific evidence |journal=The Journal of Psychiatry and Law |volume= XXVII No.3-4 |issue=Fall-Winter 1999 |pages= 549–637] Gleaves states that the research on DID does not support the ideas that DID is a construct of either psychotherapy or the media (the sociocognitive model), but that there is a connection between DID and childhood trauma and that treatment recommendations that follow from the sociocognitive model might be harmful due to the fact that they ignore the posttraumatic symptomology of people with DID.cite journal|last=Gleaves |first=D.|year=1996 |month=Jul |title=The sociocognitive model of dissociative identity disorder: a reexamination of the evidence|journal=Psychological Bulletin |volume=120 |issue=1|pages=42–59 |pmid=8711016 |doi=10.1037/0033-2909.120.1.42|url=http://content.apa.org/journals/bul/120/1/42]

There is insufficient understanding of consciousness to be able to explain how a novel split would occur in a previously undivided mind and how it would be maintained in the mind.Fact|date=August 2008 Psychoanalytic theorists believe a schizoid phase of development occurs in childhood, which may have encouraged this view of traumatic splitting. There has been nothing found to explain why children who are later diagnosed with multiple personalities would split from those who do not undergo comparable types of stress.Fact|date=August 2008

Dissociative identity disorder is diagnosed in 3 to 4% of people in hospitals for other mental health disorders and a large number of patients in treatment facilities for substance abuse.

Critics

Some psychologists and psychiatrists regard DID as being iatrogenic or fictitious, or contend that true cases are extremely rare and that the majority of reported cases are iatrogenic.cite journal |author=Piper A, Merskey H |title=The persistence of folly: critical examination of dissociative identity disorder. Part II. The defence and decline of multiple personality or dissociative identity disorder |journal=Canadian journal of psychiatry. Revue canadienne de psychiatrie |volume=49 |issue=10 |pages=678–83 |year=2004 |pmid=15560314 |doi= | url = http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2004/october/piper.pdf | format = pdf] cite book |author=Spanos, Nicholas P. |title=Multiple Identities & False Memories: A Sociocognitive Perspective |publisher=American Psychological Association (APA) |location= |year=2001 |pages= |isbn=1-55798-893-5 |oclc= |doi= |accessdate=] Drs. Paul McHugh, Herbert Spiegel, A. Piper, H. Merskey 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 and that repression of memories is a common defense against childhood sexual abuse and linked to multiplicity.Fact|date=August 2008 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.cite book |author=Ketcham, Katherine; Loftus, Elizabeth F. |title=The myth of repressed memory: false memories and allegations of sexual abuse |publisher=St. Martin's Griffin |location=New York |year=1996 |pages= |isbn=0-312-14123-8 |oclc= |doi= |accessdate=] The work of psychologist Elizabeth Loftus, who specializes in human memory, is usually cited to support this conclusion. Some of Loftus's work, however, has been critiqued in terms of the applicability of its conclusions [cite journal |last=Crook|first=L. |year=1999 |title=Lost in a Shopping Mall--A Breach of Professional Ethics |journal=Ethics & Behavior. |volume=9 |issue=1|pages=39–50 |url=http://www.questia.com/PM.qst?a=o&d=95748793|accessdate= 2008-01-18 |doi=10.1207/s15327019eb0901_3 ] A more lengthy review of the normal fallacies of memory is given by Nicholas Spanos in his sociocognitive model.

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. Prior to the 1950s, cases of dual personality and multiple personality were occasionally reported and treated as curiosities in the Western world." [http://web.archive.org/web/20040216051717/http://www.fortea.us/english/psiquiatria/history.htm A History of Dissociative Identity Disorder] ." " [http://web.archive.org/web/20040215143349/www.fortea.us/english/psiquiatria/psiquiatria.htm Demonic Possession and Psychiatry] ".] 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.Adams, Cecil (2003). " [http://www.straightdope.com/columns/031003.html Does multiple personality disorder really exist?] ." " [http://www.straightdope.com The Straight Dope] ".] According to Joan Acocella, 40,000 cases were diagnosed from 1985 to 1995. The DID diagnosis is most common in North America, particularly the United States, and in English-speaking countries more generally. The majority of diagnoses are made by only a few practitioners.cite journal |author=Modestin J |title=Multiple personality disorder in Switzerland |journal=Am J Psychiatry |volume=149 |issue=1 |pages=88–92 |year=1992 |month=Jan |pmid=1728191 |doi= |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=1728191] There is a controversy around the accuracy of DID reports, as memories of childhood might be able to be distorted and DID patients are easy to hypnotize and are very vulnerable to suggestion in certain situations.

Healthy multiplicity

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 live as a group of selves who rejected integration and function in mutual cooperation.cite book |author=Phillips, Robert K.; Chase, Truddi |title=When Rabbit Howls |publisher=Berkley Pub. Co |location=New York |year=1990 |pages= |isbn=0-515-10329-2|oclc= |doi=] Groups which experience blackouts between personality switches can function by referring to jointly owned calendars, datebooks and lists.

Some take the position that multiplicity can arise in a variety of ways, from being born naturally multiple to dissociating due to trauma; but that regardless of origins, a group of selves can cooperate and function well in tasks of daily living. [Carter, Rita, "Fractured Minds". "New Scientist", 13 September 2003, [http://www.newscientist.com/channel/being-human/brain/mg17924125.100 web page found on 10 April 2007] .]

Recent history

Some of the criticisms of the diagnosis arose in the wake of the controversy over Satanic ritual abuse (SRA). Allegations of Satanic cults operating secretly, kidnapping children and using them in human sacrifices, was advanced in the early 1980s by evangelical Christian writers, among them Hal Lindsey and Johanna Michaelsen.cite book |author=Acocella, Joan Ross |title=Creating hysteria: women and multiple personality disorder |publisher=Jossey-Bass Publishers |location=San Francisco |year=1999 |pages= |isbn=0-7879-4794-6 |oclc= |doi= |accessdate= |url=http://www.nytimes.com/books/first/a/acocella-hysteria.html?_r=1&oref=slogin] Bennett Braun and others believed that abuse by such cults was widespread, and that some deliberately used mind control to induce multiple personalities in victims.cite book |author=Watters, Ethan; Ofshe, Richard |title=Making monsters: false memories, psychotherapy, and sexual hysteria |publisher=University of California Press |location=Berkeley |year=1996 |pages= |isbn=0-520-20583-9 |oclc= |doi= |accessdate=]

Some therapists have found that these allegations derive from a moral panic. [Jenkins, Philip, "Moral Panic, Changing Concepts of the Child Molester in Modern America". Yale, 1998.] As the memories described by some patients identifying with MPD/DID 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 skeptics and critics.Pendergrast, Mark (1996). "Victims of Memory: Sex Abuse Accusations and Shattered Lives" New York: Upper Access Books, 1996. ISBN 0942679180.]

People diagnosed with DID often report that they have experienced severe physical and sexual abuse, especially during their childhood.cite book | last = American Psychiatric Association | title = Diagnostic and Statistical Manual of Mental Disorders DSM-IV TR (Text Revision) | url = http://www.psychiatryonline.com/resourceTOC.aspx?resourceID=1 | date = 2000-06 | publisher = American Psychiatric Publishing, Inc. | location = Arlington, VA, USA | isbn = 978-0890420249 | doi = 10.1176/appi.books.9780890423349 | pages = 943]

A few accused criminals, especially murderers, have claimed one of their "alters" committed a crime and used the diagnosis as a defense. Hillside Strangler Kenneth Bianchi was among the most notable. Dr. Colin Ross was convinced Bianchi was a multiple: however, Chris Costner-Sizemore, brought in to observe Bianchi, stated that in her opinion he was not. [Chris Costner-Sizemore in a 1987 interview with Geraldo Rivera (when? what program?)]

The most recent case on record of an MPD criminal defense was the 1994 trial of Lori Scheirer, a Pennsylvania woman who confessed to a murder because one of her "alters" advised her to do so. She did not say that an "alter" had committed the murder. Scheirer had given enough details to police that she could reasonably be a suspect; but subsequently, she announced that she had made up the entire confession in order to gain attention. Scheirer and other family members related bizarre episodes of memory loss, stating that she looked and acted like totally different people at different times. Her disorder was speculated to have been caused by years of sexual, emotional, and physical abuse, as is usual with MPD claims. Two psychiatrists testified for her defense, one arguing that she had MPD, the other stating that she did not. The defense appeared to work to some extent; she was acquitted. [Katherine Ramsland and Rachel Kuter, [http://www.trutv.com/library/crime/criminal_mind/psychology/multiples/index.html Multiple Personality Disorder, Crime and Defense] , [http://www.trutv.com/library/crime/criminal_mind/psychology/multiples/10.html chapter 10] . Retrieved 2008-06-15.]

Chronology

* (1546) Paracelsus reportedly wrote an account of a woman who had amnesia about an alter personality who stole her moneycite book | last = Putnam | first = Frank W. | title = Diagnosis and Treatment of Multiple Personality Disorder | publisher = The Guilford Press | date = 1989 | location =New York | pages = 351 | url=http://books.google.com/books?id=vp6xseLqf-4C&dq=diagnosis+and+treatment+of+multiple+personality+disorder&pg=PP1&ots=0NSFfImmrN&sig=3Wh4ggUATJZgB9HtRfm7z-wrm_0&hl=en&prev=http://www.google.com/search?hl=en&ie=ISO-8859-1&q=+Diagnosis+and+Treatment+of+Multiple+Personality+Disorder++&btnG=Google+Search&sa=X&oi=print&ct=title&cad=one-book-with-thumbnail | isbn = 0-89862-177-1]
* (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. Carlson ET, (1989) Multiple personality and hypnosis: the first one hundred years. "J Hist Behav Sci", 25(4):315-22. PMID 2677129]
* (1838) Antoine Despine describes a case of dual personality in "Estelle," an 11-year-old girl. Fine CG, (1988) The work of Antoine Despine: the first scientific report on the diagnosis and treatment of a child with multiple personality disorder. "American Journal of Clinical Hypnotherapy", 31(1):33-9. PMID 3064579]
* (1887) to (1896) Eugene Azam, a professor of surgery interested in hypnotism, described the case of Felida X who exhibited three different personalities. [W. R. Gowers Mind, Vol. 1, No. 4 (Oct., 1876), pp. 552-554]
* (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" by autobiographical author Truddi Chase.
* (1989) Frank Putnam's "Diagnosis and Treatment of Multiple Personality Disorder", is published.
* (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.
* (2007) Richard Baer's "Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities", is published. [cite book |author=Baer, Richard A. |title=Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities |publisher=Crown |location= [New York] |year=2007 |pages= |isbn=0307382664 |oclc= |doi=] [cite news | last =Underwood | first =Anne | title =Identity Crisis What is it like to live with 17 alternate selves? A survivor of multiple personality disorder discusses the disease and the painful integration process that made her whole.| language =English | publisher =Newsweek | date =October 22, 2007 | url =http://www.newsweek.com/id/57861]

See also

* Dissociative identity disorder in fiction
* Repressed memory

References

Further reading

External links

* [http://www.skepdic.com/mpd.html Essay from the "Skeptic's Dictionary"]
* [http://www.issd.org International Society for the Study of Dissociation]

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