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The Wisdom of Psychopaths
In this engrossing journey into the lives of psychopaths and their infamously crafty behaviors, the renowned psychologist Kevin Dutton reveals that there is a...
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In the Showtime series United States of Tara, actress Toni Collette plays Tara Gregson, a Kansas mother who has dissociative identity disorder (DID), known formerly as multiple personality disorder. As with others with DID, Tara vacillates unpredictably between various personalities, often referred to as alters, over which she does not have control. One of these alters is a flirtatious and flamboyant teenager, another is a traditional 1950s housewife, and a third is a boisterous Vietnam War veteran.
Many films, such as The Three Faces of Eve (1957) and Me, Myself, and Irene (2000), similarly portray individuals as possessing more than one personality. Some of them even confuse DID with schizophrenia [see “Living with Schizophrenia,” by Scott O. Lilienfeld and Hal Arkowitz; Scientific American Mind, March/April 2010]. Even the revised fourth edition of the American Psychiatric Association’s diagnostic manual, published in 2000, specifies the core features of the disorder as the “presence of two or more distinct identities or personality states.” Yet despite the pervasive popular—and professional—portrayal of this disorder, research casts doubt on the idea that anyone truly harbors more than one personality.
Dramatic Differences
Plenty of evidence supports the idea that DID is not merely a matter of faking and that most people with the condition are convinced that they possess one or more alters. Although a few DID patients have only one alter—the so-called split personality—most report having several. In a survey conducted in 1989 by psychiatrist Colin Ross, then at Charter Hospital of Dallas, and his colleagues, the average number of alters was 16. Interestingly, that is the same number of alters purportedly possessed by Shirley Ardell Mason, the woman known as Sybil in the 1973 best-selling book and two made-for-television movies that popularized the diagnosis of multiple personality disorder. (Later evidence emerged suggesting that Sybil’s primary therapist encouraged her to display multiple personalities, creating a huge sensation.) In rare cases, the number of alters may reach into the hundreds or even thousands.
Differences among alters can be nothing short of astonishing. Alters within the same patient may be of different ages, genders, races and even species, including lobsters, ducks and gorillas. There have even been reported alters of unicorns, Mr. Spock of Star Trek, God, the bride of Satan, and Madonna. Moreover, some practitioners claim that alters can be identified by objective characteristics, including distinct handwriting, voice patterns, eyeglass prescriptions and allergies. Proponents of the idea of multiple personalities have also performed controlled studies of biological differences among alters, revealing that they may differ in respiration rate, brain-wave patterns and skin conductance, the last being an accepted measure of arousal.
The question of whether people can harbor more than one character has important legal and therapeutic implications. If they can, and if patients are often unaware of their alters’ actions, a legal defense of “not guilty by virtue of DID” may be justifiable. Other scholars have argued that each alter is entitled to separate legal representation. As professor of law Ralph Slovenko of Wayne State University noted in 1999 in an article, some judges have even required each alter to be sworn in separately prior to testifying.
In treating these patients, many therapists try to get them to integrate their discrete personalities into a coherent whole. In doing so, they may help patients contact “undiscovered” alters and forge lines of communication among alters. For example, Ross has advocated naming alters and holding “inner board meetings” in which they can converse, share opinions and provide information about missing alters. Psychiatrist Frank Putnam of Cincinnati Children’s Hospital has argued for the use of DID “bulletin boards” on which alters can post messages for one another in notebooks or other convenient venues.
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17 Comments
Add CommentThe leap of logic in this article which supposedly debunks "mental health fiction" is amazing. From the fact that the alter personalities of people with dissociative disorders are connected in some way, the authors jump to the conclusion that such people would therefore be better diagnosed with borderline or bipolar disorders, as though dissociative disorders do not exist! All diagnoses are, in a way, fiction - therapists' or researchers' conclusions based on their experience. Dissociative Identity Disorder has sound evidence for its existence, plus clear theory to explain it, unlike those other supposed disorders. Those of us who specialize in dissociative disorders have never argued that the different part-selves are separate people and should be judged separately in court. We regard them more as different circuits in the same brain, each circuit being activated separately. Severe developmental trauma prevented the direct connection of these circuits, resulting in relatively independent part-selves, each representing a particular emotional state or set of memories.
Reply | Report Abuse | Link to thisAlison Miller, Ph.D., Psychologist
I asked myself this question some time ago but did not get an answer until me spoke up.
Reply | Report Abuse | Link to thisIn dismissing DID based on possible partial memory overlap between alters, the authors have overlooked one important point - the alters have to share the same brain. Consequently, distinct alters should be expected to have some degree of access to the memories of their counterparts. And their "less direct" tests seem even more problematic than the methods they're criticizing. Take the queen/kin_ example - there are a very limited number of 4-letter words starting with kin to choose from and the only ones in common use are king and kind (according to the Oxford English Dictionary, kina, kine and kink are the only other ones) so it'd be nearly impossible to get a statistically significant response.
Reply | Report Abuse | Link to thisI strongly suspect that the reason they're not persuaded by the evidence for DID is that they don't want to be persuaded.
Dr Alison - well said.
Reply | Report Abuse | Link to thisThis is, sadly, another low quality tabloid standard pseudo Science article. It contains no meaningful evidence, no insight and no valuable conclusion.
The truth is psychology is not a Science at all. It's a mish mash of subjective observational study and uncontrolled theorising with no mechanism of proving those theories one way or another. That's not to say it is useless. It is useful alright. But it's limitations are boundless.
Scott O. Lilienfeld and Hal Arkowitz claim that 'Plenty of evidence supports the idea that DID is not merely a matter of faking'. Yet there is also plenty of evidence to the contrary. What do they offer as a way of proving which is correct ? Nothing, of course, because they have no way of proving it either way. So all we get is a battle of 'we say yes and you say no' argument.
In other words no Science.
I really wish SciAm would stop their increasing foray into pseudo science and tabloidesque writing. The reputation of SciAm is suffering more and more as it chases the easy buck by appealing to this kind of market.
Instead of starting with unknowns, it is far better to start with the known. We know that severe changes to the brain (via head trauma, Alzheimer's, etc) can alter personality.
Reply | Report Abuse | Link to thisThis makes Dr Miller's contention that DID is real and a product of different circuits in the brain producing different personalities entirely plausible and also falsifiable (an important requirement for rigorous science).
(I'm not disputing or advocating Dr Miller's work here, I'm trying to stick to what is known and agreed-on, then seeing where that leads.)
We also know that not all neurological changes lead to changes in personality. Nobody, as far as I know, has contended that Scott Adams, author of Dilbert, changed personality by using singing to bypass a sudden loss in his ability to speak, although it is precisely because different circuits were in use that it is believed his technique worked at all.
Therefore, we also need to show that there are switches in mental circuits even after we filter out any circuits that do not appear to impact personality, that these switches correlate to switches in personality in people with DID, and that similar combinations of switches do NOT occur in people without DID.
Such experiments have presumably been carried out, but clearly have not gone far enough if the debate still centres around whether DID exists at all. Neurology has advanced in leaps and bounds over the years and is certainly quite capable of settling the issue of neural circuits once and for all - with the caveat that ultra high resolution scanners are hard to find, hard to book and very hard to pay for. Being possible is, sadly, not the same as being practical.
Regardless, this has long-since passed the point of philosophy. It is possible to draw up objective "hard science" experiments and predict what you'd see if a given hypothesis was correct, even if you'll never carry it out - a half-way point between the thought experiment and the physical one, but firmly outside of the social sciences.
I studied DID a bit in school 10 years ago. At the time, there was research that showed DID was basically a North American disorder. In other words, it wasn't being diagnosed in other countries. That doesn't necessarily mean it doesn't exist, but it could be a culturally based phenomenon. Another example is a local tribe in my area who's psychologist reports no incidence of schizophrenia in the tribe. This may be due to the fact that Native Americans frequently don't view symptoms of schizophrenia as a disorder to begin with.
Reply | Report Abuse | Link to thisBottom line for me: Is the diagnosis helpful to the patient? With weak ego strength a diagnosis can be destructive (an expectation predicts outcome scenario). In other cases, the diagnosis may provide tremendous relief from suffering and eventual healing.
This is way too generalized. But I'm inclined to think that multiple personalities are facets of a single personality. Unfortunately, each facet diverges on fundamental morality and therefore cannot sanely coexist or integrate in a single instance or moral view. For it's own survival, the super ego has got to choose between each facet at any particular time, especially when stressed, to navigate any particular sitiuation. But my view is that each facet is only a component of the whole, and that they are not truly separate personalities or completely dissasociated. How these facets come into being? Well, maybe a fractured and juxtuaposed social structure during developmental periods contribute.
Reply | Report Abuse | Link to thisThere are much odder things out there than DID and honestly a multi-disciplinary approach might bear a lot more fruit. I'd be very interested in knowing if nuerologists are even looking into this.
Reply | Report Abuse | Link to thisHaving said that, I am skeptical of claims that entirely separate minds can co-exist in one brain. Even in disorders of "self" they are primarily dealing with brain injuries that involve pretty specific brain areas involved with integrating the various aspects of function that result in the unity of self. In many cases there is no conscious access to the missing information, but it is still available to unconscious pathways (Blind sight would be an instructive analogy, damage to the conscious pathway deprives patience of the experience of vision entirely, but they can still react to visual cues with the secondary pathway they don't have conscious access to).
In short, both parties could be partially correct.
I also have to add I am very skeptical when they make the comparison with borderline personality disorder. In the military that's a catch all diagnosis that can be and is used to get rid of troublesome hard to treat individuals (Early Traumatic Brain Injury patients were gotten rid of this way, as well as others with various anxiety disorders and other perfectly treatable issues). In fairness, the military uses a rather truncated definition of borderline personality disorder rather than the full DSM-IV definition. Just the same, there is a rather large amount of symptom overlap from one diagnosis to another. So, my skepticism of their comparison remains.
The human brain, is the most complicated structure known to human kind, and we have a long way to go before we can claim to have more than a rudimentary understanding of it. Skepticism is a good thing, providing it leads to more research and study. In this case the writers seem interested in additional study, and I see no harm in that (Even if I don't agree with their ideas).
P.S. I must add here that I am not an expert of any kind. I read a lot about the subject matter in question largely because I have suffered from mental illness most of my life (primarily anxiety and depressive disorders). My comments regarding military practice are based on personal experience as well a first hand gripes from military mental health care providers.
Reply | Report Abuse | Link to thisWhat all this comes down to in the end is this: We simply do not yet know enough about either the human brain or the mind to be able to formulate definitive answers about DID or, for that matter, just about anything concerning the brain/mind---yet. So we keep on researching, speculating, trying to understand enough to help those in distress, and hoping for more answers. They will come eventually, maybe.
Reply | Report Abuse | Link to thisStill, would it not be ironic if it turns out that the human brain/mind turns out to be too complex for it to understand itself?
Some claim Napoleon was able to watch 6 conversations simultaneously. Does this require on personality for each talk ?. When considering the enormous disasters this man caused, his insanity would have meant not only six, but many more personalities.
Reply | Report Abuse | Link to thisI had truly hoped we were past this. The false memory people were more than enough.
Reply | Report Abuse | Link to thisYes, folks, it exists. It's not bipolar (but can be comorbid), schizophrenia, or borderline. The painful experiences were indeed not created by their alters: they were created by their abusers. Good therapy will allow them to understand that the alters *are* them.
How do I know? I've spent about fifteen years in the trenches, as it were, married to a multiple. I had to drag her through many misdiagnoses and health system failures to arrive at an accurate diagnosis. Her original shrink didn't believe in DID, as if it were a religion. He had to admit, however, that the problems started to get better once she got the diagnosis and therapy.
It's not just me. I know several multiples in my immediate area. I help run an online support group for significant others of people with DID and there are literally hundreds of us subscribed at any given time.
[SOSUPPORT at Yahoogroups]
We need to stop the disbelief and denial, concentrating our efforts instead on proper diagnosis and treatment.
Colin Ross is quoted. He's the expert; pay attention. Dr. Ross also put together some very enlightening and sad facts about how our own government was helping to create multiples. [Project Paperclip, MKULTRA, 1975 Congressional Hearings - the Church Committee]
P.S. Fibromyalgia didn't `exist' until there was a pill for it.
I was a therapist for over 30 years. DID is a misnomer; you obviously miss the implications of mind body integration and the switch between true personalities.
Reply | Report Abuse | Link to thisRead about the Huichol Indians In Mexico.
I have great disdain for the recent “PROS” of MPD or DID.
C'mon. Go back and read FW Putnam, Colin Ross, etc and Robert Allison.
Is Jennie Jennifer or what is the relationship? Often there is no relationship at all.
YOU DO REALIZE THE DISCREDIT YOU DO TO TRUE Multiples or plurals.
You take away their truths which have been with them forever. Then you lie to them and tell them they are not real. How insulting.
MPD was never a disorder. It was/is the highest level mechanism that can be developed or adhered to. Bye the way, I have never met an MP that was not ultimately smarter than me. I graduated UC Berkeley with a graduate degree in psychotherapy.
Have you ( THE "PROS" ) figured out yet how an okie adolescent who steals cars as a male in a female physical body can then be replaced by a classical concert violinist who was never trained and makes music like and angel. When you figure that out please let me know. Life and personality is far beyond your x's and o's.
How do the pros of DID and MPD explain the physiological changes that happen in the “body” when different people move into the body.
The reason I am here after all these years is that there was a true multiple, NOT DID, in my house two days ago as a function of a friend of my son inviting his friend over. I noticed radical changes in eye color which tipped me off. How do you explain changes in eye color? Any portrayal of a shift between personalities as is portrayed in cinema is far too drastic and not subtle enough. How do you explain that voice recognition software can recognize the voices of trained actors trying to fool the software and they cannot fool the software? Put a different (“alter”) person in the body and it registers as a different person to the same software.
For the rest of you, the more you even care about the DSM the more you are its slave. The people who write it are arrogant and have no understanding of what they write. The DSM is not even close to good fiction. How do they understand you/us/ many people if they have never walked the talk? Forget the DSM; throw it in the trash where it belongs. In indigenous cultures, there are NO KRAZZEESS.
God Love you and bless you.
Lilienfeld and Arkowitz offer us here yet another abuse of their credentials, presenting themselves as authorities on a subject of which they have conspicuous ignorance. Legitimate and respectable scholars they may be, but not in the field of dissociative disorders. (Do a Google Scholar search for their names...)
Reply | Report Abuse | Link to thisWe understand that scholarly citations and literature reviews are not to be expected here, but this is not a license to cherry-pick one's references. We expect a visibly informed and balanced review of the literature, but find this piece grievously deficient.
The dissociative disorders diagnoses listed in the DSM-IV (1994) the professional consensus understanding of at least the previous decade that "multiple personalities" was a misleading and essentially incorrect label; hence the change of "MPD" to "DID". Ah, but to recognize this change in the consensus psychopathology classifications would have robbed the authors of their subject, would it not? So, let's write, in 2011, as if we're in 1990. Another round of dead horse flogging, anyone?
That they are in over their head on this topic is suggested immediately - in the third sentence of the second paragraph, where the DSM-IV-TR's specification of DID's essential feature is given as "...the presence of two or more distinct identities or personality states.” They then demonstrate that they do not grasp that an "identity" is a subjective entity residing in consciousness, and that as such they can indeed be quite distinct when multiple. However, identities are not personalities. A "personality state" is by definition a condition or state of a single personality. But understanding at this level usually requires substantial clinical experience with these disorders, as well as in-depth reading of the theoretical and empirical literature, all of which clearly validates the construct and the reality of "personality states" both in people with DID and in "normals" without DID. (I would love to hold forth on this at length, and could, but then I'd be writing my own article here...)
The initial 1994 edition of the DSM-IV uses the same wording as the revised 2000 edition. The 1987 DSM-III-R uses the language "...two or more distinct personalities or personality states." (p. 269). Even prior to the DSM-IV, it was recognized that distinct personalities was not a necessary condition for MPD. It amazing what a brief literature review will uncover! Too bad the authors didn't do one.
Some additional thoughts:
Reply | Report Abuse | Link to thisThe subtitle of the article is pure fiction: "Can People Have Multiple Personalities? Although many therapists think it is possible, research raises doubts"
No support whatsoever is offered for the assertion that "...many therapists think it is possible". That's understandable. There is none in the literature, and since I'm a psychotherapist specializing in trauma and dissociative disorders, this is my literature, which is more than can be said for the authors. They have simply constructed a classic "straw man", so they can attempt to demolish it.
They also disrespect the process by which the DSM is arrived at. Surely there IS contention in the clinical psych./psychiatric community, and in all scientific/professional communities. This is a GOOD thing, for in challenging each other we improve our thinking and the quality of our assertions. But if there is contention, there is also consensus, arrived at after lengthy review of the literature, discussion, multiple re-writes, and extensive field trials. Does this silence the contention? Of course not. We're human, we argue. But that fact is not license to ignore the consensus, nor the process by which it is arrived at. Yet the authors do just that. They cite sources that support positions contrary to the consensus, and consider their work done. Whether you grasp it or not, your intelligence as a reader has just been insulted. If they thought they would NOT get away with this, they would not do it.
Respect for the process by which the DSM is arrived at is a reasonable expectation, even if Lilienfeld and Arkowitz appear to have none at all. As the "Introduction" to the DSM-IV (1994, p. xvi) states, "...the major innovation of DMS-IV lies not in any of its specific content changes but rather in the systematic and explicit process by which and constructed and documented." If Lilienfeld and Arkowitz were more than mere off-balance polemicists, if they were actually committed to psychological science, they would evidence such respect. If Scientific American were a peer-reviewed journal, where the "peers" were informed participants in the field of dissociative disorder, this piece would never have seen the light of day, as we would be the better for it.
Abuse of credentials AND venue. I rest my case.
DID is real. I work with trauma victims, and I have seen it. Some clients change there names and personas when they need to be "tough". Many street prostitutes have it from being abused so much.
Reply | Report Abuse | Link to thisHowardB has struck a resonant cord in my psyche when he says, "I really wish SciAm would stop their increasing foray into pseudo science and tabloidesque writing. The reputation of SciAm is suffering more and more as it chases the easy buck by appealing to this kind of market." Since Science Magazine acquired Scientific American, the quality has suffered. I had great hopes for Mind, but depth is lacking.
Reply | Report Abuse | Link to thisAs for multiple personalities, simple exercises in self-hypnosis employing finger levitation for introspective interrogation puts the exclamation point on the potential for them to exist. When the unconscious takes over control of an appendage in response to an a conscious question, you become a believer.