It's better known
under the name it helped for most of its lifetime in multiple personality
disorder. It's essentially a disorder in which the primary symptomatology is
individuals losing track of periods of time they have it's a very controversial
disorder category or the most controversial in the entire DSM but it
involves separate personality states taking charge in the individuals
behavior and cognition at different times and in different circumstances
that's the primary set of symptoms we see in DID there are a lot of things
that go along with that but that's basically it.
Yes there is a reason, the main reason is that it's it became apparent that these weren't
entire whole personalities alright so multiple personality it makes
sense so that's why they call it identity disorder the individual the
alters the the alternative pieces if you like of the individual's personality are
partial personalities if you like they tend to encapsulate certain kinds of
emotional reactions to certain supposed events in the individuals past but
they don't reflect the the entirety of the individuals personality or
experience so they're their identity fragments really which is why the name was changed.
Ah well how much time have we got? The short
answer to that is we don't know. The longer answer is the primary hypothesis
about it, well there are two actually primary hypotheses, one and this is the
dominant one that the governs treatment options in DID is that it's a
reaction to inappropriate traumatic events early in the individuals life
typically in childhood and the the specific kind of trauma that's usually
pointed to is childhood sexual abuse. A very high proportion of individuals who
have received the diagnostic label DID do report under varying
circumstances that they did experience or they recall having experienced some
sort of sexual trauma early in life incest, for example. A second hypothesis
which competes with the first is that it isn't a real disorder at all
that in fact the symptoms are if you like created some suggestive treatment
approaches by psychiatrists and clinical psychologists because in the majority
I'd say of cases the alters the various personality identity fragments that are
uncovered or uncovered in in therapy under hypnosis and of course the problem
with hypnosis as we know is the individual is by definition highly
suggestible you can get people to recall almost anything under hypnosis if you
suggest it strongly enough previous lives life in the womb doesn't really
seem to matter and so the alternative to the the trauma dissociation model which
is the the main treatment approach is that this is really not a disorder that
exists in the wild in nature at least not very very very frequently instead
it's something that's created by well-meaning but suggested therapeutic
techniques in the treatment situation and in fact there's there was a
study done published in 2015 looking at the all of the new cases of
DID that were reported between 2000 and 2010 so ten year period about 1200
brand new cases of DID were identified in that period of time 97% of
them are identified during therapy only 3% were identified outside. And we
have to understand also that most people who receive eventually the diagnostic
label DID don't come in complaining of the symptoms of DID they come in for
headache they come in for memory loss they come in for marital discord a whole
raft of different things and then for some reason or other it is suggested to
them that maybe they suffered childhood abuse and maybe they have memories that
have they have recovered and that may lead in some cases to a diagnosis of DID.
That's an interesting question
I guess the appropriate answer is not really
If you look at the early cases that is up to say 1975 or so
and between let's say 1800 and 1965 they're only
about 75 cases in the entire world that had been reported but then there were a
couple of publications a couple of books: Sybil, Three Faces of Eve just made into a
movie as a matter of fact, and suddenly we began to get a much more
frequent diagnosis of MPD than DID now and if you look at the early cases
they're typically two or three alters plus the host personality. Today the
average is something like ten or twelve and I recall reading a case where the
the eager therapists have managed to uncovered one thousand alters that was
after the five hundred he first diagnosed had split into two each of
them you know and so what does it make how does anybody have enough of a life
for a thousand personalities it simply doesn't make any sense at all so it's
it's hard to answer the question but something like ten or fifteen would be a
typical number these days.
There is a... cure is a tough
word there is a typical treatment—it varies in the way it's delivered
by different therapists but it's actually involves trying in various ways
to reintegrate all of the various fragments back into the host
personality in a significant fraction of the reported cases that that treatment
has been successful but they haven't really been tested adequately those
those models of treatment so we're hard to know really what is going on in
the treatment options there as I said the treatments are delivered differently
by different therapists, there may be different standards for diagnosis
they're holding out rafted reasons that we're not really sure whether that's the
best approach because there hasn't been any alternative really that's been
tested in the literature at all.
Socio cultural differences... well I can only say that that that study I
mentioned that looked at the that were roughly one thousand new cases between
2000-2010, something like 80% of them were in
Europe and North America and of those 50% were the United States. The
only significant area where there was a significant number of initial cases
diagnosed was actually turkey, of all places, virtually nowhere else in the
world do we get any significant number of cases diagnosed which leaves a lot of
critics to wonder about the diagnostic category itself.
DID patients often do lead normal lives as a matter of fact
even with the disorder because they're functioning it's just
the different aspects of their personality if you like, if you believe
in the disorder, come to the floor under certain life circumstances, if you're
having a conflict with a fellow worker one side of your personality may show up,
in an intimate relationship with the family an other side of the personality
or the host may be present, so by and large, yes, they do tend to lead
relatively normal lives. Some of the patients whose cases have been described
actually have very substantial professional jobs as a matter of fact
and were still functioning reasonably well.