Dissociative Identity Disorder, often called multiple personality disorder, mental illness

in which a person has two or more distinct identities or personality states, which
recurrently take control of the person’s consciousness and behavior. The person often
gives the alternate identities their own personal names, and these identities may have
characteristics that differ sharply from the person’s primary identity. In addition, a person
with this disorder experiences some degree of amnesia, in that one personality usually
will not recall what occurred when another personality controlled the person.

People often act and feel differently in various settings. For example, teenagers may act
differently at a party than they do at school. However, people in good mental health
maintain continuous awareness of themselves no matter what the situation. Individuals
with dissociative identity disorder do not. They experience sudden shifts in
consciousness, identity, and memory. They may find themselves in a strange apartment
and not remember how they got there, or discover new clothing in their closet without
knowing how it was purchased. Their identity is fragmented into pieces with different
emotions, memories, and styles of interacting with people. They may shift from being
passive and accepting of advice from others to being hostile and uncooperative. They are
often at war with themselves, with certain personalities being quite critical of other
personalities. At times one personality may go so far as inflicting physical harm on one of
the other personalities. In one case, a woman with dissociative identity disorder carved
the words “I hate Joan” on her forearm while in a different personality state.

In 1994 the American Psychiatric Association (APA) changed the name of the disorder
from multiple personality disorder to dissociative identity disorder. Psychiatrists wanted
to emphasize the fact that the disorder does not really consist of many personalities living
in one body, but rather of a failure to integrate various aspects of identity into a unified
personality. In a sense, people with this disorder suffer not from having more than one
personality but rather from having less than one personality.

Typically the disorder begins in childhood or adolescence, although the symptoms may
not become evident to others for many years. In childhood, individuals with dissociative
identity disorder often appear moody or irresponsible because they may switch
personalities suddenly or deny having done something they no longer remember. Doctors
often misdiagnose people with this disorder as having other mental illnesses. Although
critics claim the disorder is an invention of therapists, most experts agree it is a real but
rare condition.

Most individuals with dissociative identity disorder report histories of severe and
repeated physical, sexual, or emotional abuse in childhood (see Child Abuse). This does
not mean that everyone with the disorder was necessarily mistreated. However, most
psychiatrists now understand the disorder as a reaction to chronic trauma and stress.
People frequently enter altered states of consciousness during traumatic events such as
physical or sexual assault, natural disasters, motor vehicle accidents, or combat. They
detach or dissociate themselves from their immediate circumstances as a means of
protecting themselves from overwhelming mental or physical pain (see Post-Traumatic
Stress Disorder). In dissociative identity disorder this useful ability may become
conditioned by repeated trauma, leading to separate personality states that may be
triggered by any anxiety or stress.

The best treatment for the disorder is long-term psychotherapy aimed at helping patients
to gain insight into each of their personality states, work through the aftermath of
traumatic memories, achieve greater self-acceptance, and reduce self-damaging behavior.
Hypnosis may help a person control spontaneous switching of personality states. Many
people with this disorder suffer from depression and may benefit from antidepressant
medication as well.

Contributed By:
David Spiegel

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Microsoft Encyclopedia Standard 2004
April 17, 2009