Dissociation writes Guest Blogger Alexandra Swartz, is the state in which a person becomes separated from reality. Dissociative Identity Disorder (DID), sometimes referred to as Multiple Personality Disorder (MPD), is a disorder involving a disturbance of identity in which two or more separate and distinct personality states (or identities) control the individual’s behaviour at different times. When under the control of one identity, the person is usually unable to remember some of the events that occurred while another personality was in control. The different identities are referred to as “alters”. (www.nami.com)
Alters may have experienced a distinct personal history, self-image and identity, including a separate name, as well as age. At least two of these personalities recurrently take control of the person’s behaviour.
Multiplicity simply put by the majority of multiples is about hiding, pain and survival no more no less. It is a desperate completely creative and wonderful survival mechanism for the child who endures repeated abuse mentally, emotionally and physically it may be their only escape. Dissociation is a common defence mechanism against childhood abuse, there is no adult onset of multiple personalities. Only children have the flexibility to fracture off from the “core” personality and escape the traumatic and painful memory. The common belief among most professionals is the personality splintered or fractured before the age of five.
Those with MPD have a dominant personality that determines the individual’s behavior. Each personality has a separate and consistent pattern of perceiving their environment, themselves and others. Each multiple has a specific way they see the inside of their mind, where the alters live when they are not in control of the body. Examples include stages, tunnels, houses and levels. These are their internal houses where they go when they are not out or when they are hiding. The mind of a multiple personality is like a roaming house in which two or more individuals co-exist. When one personality is in charge, the others remain hidden in the inner recesses of the brain. Each acts independently of the others and is totally different from them. (www.google.com/multiplepersonalities)
Virtually, every victim of multiple personality in time develops an ISH- an Inner Self Helper- described by Dr. Ralph Allison, a separate personality whose sole function seems to be to prevent the other personalities from tearing the physical body apart and therefore ending their own existences. (Hawksworth & Schwarz, The Five of Me. Page 14)
The person with DID may have as few as two alters, or as many as 100. The average number is about 10. Often alters are stable over time, continuing to play specific roles in the person’s life for years. Some alters may harbor aggressive tendencies, directed toward individuals in the person’s environment or towards other alters within the person. (www.nami.com)
The alter’s job is to protect the host personality from the memory of the trauma therefore, it is not necessary for all alters to look and act differently than the host.
Typical types of alters:
A depressed, exhausted host.
A strong, angry protector.
A scared, hurt child.
An internal persecutor who blames one or more of the alters for the abuse they have endured. (Sometimes named after the actual abuser)
Common Terminology of DID
An entity with a firm, persistent, and well-founded sense of self and of a characteristic and consistent pattern of behaviour and feelings in response to stimuli.
also known as the Original Personality This is the person that was present from birth, the one born into the body. For the majority of people, this is the person that began life before the multiplicity was created, though not for all.
The general belief is that this is the birth personality. The thought held by some in the psychological community is this person is often asleep or at least very distant from the system. Believed to be fragile, and one of the last personalities to be found. Although, this is not always the case.
For most multiples, this is the personality which most often is present and is in control of the body. This is the person who deals with daily functioning, and the system within, as a whole. Some multiples may have more several personalities that serve as their hosts.
A generic term for any personality useful because, in clinical situations, it often us unclear which personalities are original, host, and so forth, or whether an entity is sufficiently distinct and elaborate for a more precise label.
Inner Self Helper (ISH)_
Described first by Allison (1974), ISH’s are serene, rational and objective commentators and advisors.
The degree of knowledge and awareness that alters have with one another. They can communicate and work together as a group and have very little if any time loss.
This is the process of merging or joining alters so that the multiple becomes one person. (www.google.com/multiplepersonality, www.mdconsult.com)
Dissociative disorders are not common psychiatric illnesses but are not rare. Few good epidemiological studies have been performed some estimate 1 per 10,000 in the population but higher proportions are reported among psychiatric populations between
0.5% and 2%. A sharp rise in reported cases may be attributed to greater awareness of the diagnosis and misdiagnosis of DID as schizophrenia or borderline personality disorder. Some experts attribute possible under diagnosis to a family disavowal of sexual and physical abuse. However, there has been controversy about possible over diagnosis of the syndrome as well. Individuals who most commonly have the disorder are highly hypnotizable and therefore especially sensitive to suggestion or cultural influences.
Some studies show that women make up the majority of these cases 90% or more. Both in the United States and in non-Western Countries the most common dissociative disorder diagnosis falls into the “not otherwise specified” category. Dissociative disorders are the world, although the structure of the symptoms varies across cultures. (www.medconsult.com)
Even after extensive studies were begun on the phenomenon of the multiple personality in about the year 1919, most psychiatrists insisted that men did not suffer from it, only women. Today we know that approximately 20% of the recorded cases are male. But the disorder itself is still shrouded in mystery the subject of a good deal of controversy. Perhaps 50% of all psychiatrists deny that it even exists. Research has shown that the average age for the initial development of alters is 5.9 years. (Hawskworth & Schwarz. The Five of Me. Page 11)
Approximately one-third of patients complain of auditory or visual hallucinations, it is common for these patients to complain that they hear voices in their heads but are merely the personalities within, communicating with one another. Often times, the MOD is misdiagnosed as a schizophrenic due to “hearing voices”, but the multiple personality hears the voices inside their head in contrast to the schizophrenic which hears from the outside of themselves. Often a multiple before diagnosis will speak of noise or clatter inside making it difficult for them to concentrate. It is possible for the multiple to hear many distinct and separate voices, of all ages talking at the same time.
Each alter within a multiple has their own history, personalities that are unique to them, body movements, facial expressions, the way they express verbal communication, voice tone and pitch. You might encounter a small child who hides her face and speaks in a childlike voice. Another child within the same system of personalities might be gregarious and charming. The description above would hold true for any age alter and are just two examples of the variance you might find within the same age group of any of the alters.
In diagnosing DID another indicator is the difference in handwriting styles.
Time loss is quite common in the non-conscious multiple. For the non-conscious multiple the time losses can be devastating. Time loss can occur when something triggers an alter that the host is unaware of. These individuals might find themselves in a place or talking to someone they don’t even know. The length and duration of the time loss depends on how the multiple’s system works and if a more dominant personality can remain in control.
Suicidal and self-mutilation is a common in this group, body memories and nightmares.
Children with DID have a great variety of symptoms including some of the ones mentioned above, depressive tendencies, anxiety, conduct problems, episodes of amnesia, difficulty paying attention in school and hallucinations. Often these children are misdiagnosed as having schizophrenia. By the time the child reaches adolescence, it is less difficult for a mental health professional to recognize the symptoms and make a diagnosis of DID. (www.google.com/multiplepersonality)
Some two hundred cases have been reliably recorded in medical literature and several recent ones have proved similar in a variety of respects. For example: Chris Sizemore (10), Sybil Dorsett (16), Billy Milligan (10). (Ian Wilson. All in the Mind. Pages 128-135)
Treatment for DID consists primarily of psychotherapy with hypnosis. The therapist seeks to make contact with as many alters as possible and to understand their roles and functions in the patient’s life. In particular, the therapist seeks to form an effective relationship with any personalities that are responsible for violent or self-destructive behaviour and to curb this behaviour. The therapist seeks to establish communication among the personality states and to find ones that have memories of traumatic events in the patients past. The gold of the therapist is to enable the patient to achieve the breakdown of the patients separate identities and their unification into a single identity. (www.nami.com)
Pharmacological approaches involve balancing therapeutic benefit and risk. Antianxiety medications are most commonly used and may be helpful in reducing the amplification of depersonalization and derealization are also side effects of antianxiety drugs, so their therapeutic response, may also increase symptoms, leading to a spiral of increasing symptoms and drug dosage but without therapeutic benefit. (www.mdconsult.com/dissociativedissorder)
We have seen, then, that multiple personality is a psychiatric condition underdiagnosed. The personalities do not have an extraterrestrial origin, but can be traced back to the characteristics of real-life persons who have formed a strong impression upon the sufferer, who has then personalized them and unconsciously developed them into a character of his own. In short, each personality is nothing more than a satellite, a superficial fragment split off from the parent individual as a result of extreme stress-yet from our point of view the equally important aspect is that each is extraordinarily convincing. (Wilson, Ian. All in the Mind. P.136)
MPD has always fascinated me, from the phenomenon of being different personalities to the amazing survival that these people have because that’s how they learn how to survive by slipping into a state of mind to the point that they think that all this abuse is not happening to them but to someone else. But it is sad though that many doctors do not detect the problem until after is too late in some cases and misdiagnose to be something else. I did notice that as it was said by Ian Wilson in his book, every personality has his own job as we can say the reason why they are there. The child who was innocent when all this abuse started happening, for example, we have the aggressive protector, we have the helper, etc.
I have always admired these people their defence mechanism against all this abuse is extraordinary and for those of us who do not understand about this illness, it would be great to read about it and even watch videos about it. For me, it has made me understand more about it and comprehend the pain they go thru especially since children are the ones who are able to split into these states.
Hawksworth & Schwarz. The five of me. 1977 Published by Henry Regnery Company.
Online Sites. www.nami.com
Nobitt & Randall. Cult and Ritual Abuse. 2000 revised edition. Published by Praeger Publishers.
Wilson, Ian. All in the Mind. 1981, 1982. Originally published in Great Britain by Victor Gollancz, Ltd.