Multiple Personality (DID): A Controversial Diagnosis

Consider what two major editors of the American Psychiatric Association's Diagnostic and Statistical Manual-IV say about MPD (also known as Dissociative Identity Disorder or DID):

"A good rule of thumb is that any condition that has become a favorite with Hollywood, Oprah, and checkout-counter newspapers and magazines stands a great chance of being wildly overdiagnosed" (p. 288).

"Many therapists feel that the popularity of Dissociative Identity Disorder represents a kind of social contagion. It is not so much that there are suddenly lots of people with lots of personalities as there are lots of people and lots of therapists who are very suggestible and willing to climb onto the bandwagon of this new fad diagnosis" p. 286.

"[W]e are worried that the current overdiagnosis of multiple personality is an illusory fad that leads to misdiagnosis and mistreatment and does a disservice to the vast majority of patients who fall under its sway" p. 287.

"If you are wondering whether you qualify for this diagnosis it is a very good bet that you almost surely do not" p. 289.

"For any of you who suspect that you have Dissociative Identity Disorder, or are now in treatment for it, our suggestion is to focus your energies on the here-and-now problems in your everyday life. We would recommend avoiding any treatment that seeks to discover new personalities or to uncover past traumas" p. 290.

Frances, A. and First, M.B., Your Mental Health: A Layman's Guide to the Psychiatrist's Bible. New York: Scribner, 1998

The controversies surrounding the diagnosis of Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) as it is now called, focus on two areas: The cause of the disorder (Is it iatrogenic, i.e. caused by the therapeutic experience?) and The treatment for the disorder (Does one pay attention to the alters or ignore them, for example?).

See "The Pros and Cons of Dissociative Identity (Multiple Personality) Disorder" by David Spiegel and Paul McHugh in Journal of Practical Psychiatry and Behavioral Health, September 1995, p. 158-166, and "Resolved: Multiple personality Disorder is an individually and socially created artifact," Affirmative: Paul McHugh and Negative, Frank Putnam in Journal of American Academy of Child and Adolescent Psychiatry, 34 (4) July, 1995 p. 957-963.

An article by psychiatrist Martin Orne, M.D., Ph.D., and Nancy Bauer-Manley provides an insightful perspective of issues involved with the diagnosis and treatment of MPD. Although the article is written primarily for professionals, all should find it interesting, particularly the sections starting with "The Use and Misuse of Myths, Metaphors, and Memories." Disorders of Self: Myths, Metaphors, and the Demand Characteristics of Treatment by Martin T. Orne and Nancy K. Bauer-Manley. In J. Strauss and G.R. Goethals (Eds.) The Self: Interdisciplinary Approaches. New York: Springer-Verlag, (1991). 93-106.

Evidence of unjustified diagnoses in four cases of supposed MPD is presented in a paper published in the Canadian Journal of Psychiatry, 38 (4), 245-247.

Some therapists and some media workers continue to perpetuate the idea of multiple personality as a common disease:

Switching Time -- a skeptical review (also available as PDF)

SYBIL!

The articles and books mentioned here present a skeptical view, i.e. MPD can be created in therapy and that treatment should involve ignoring alters and focusing on the here and now. There are many websites that present alternate perspectives.

But It's in the DSM-IV (Part 1), FMSF Newsletter October 1998

But It's in the DSM-IV (Part 2), FMSF Newsletter October 1998

Review of Creating Hysteria: Women and Multiple Personality Disorder, a book by Joan Acocella; some Excerpts are also provided. FMSF Newsletter, September 1999

MPD in the Courts, FMSF Newsletter April/May 1999 Vol. 8 No. 3

Overview of First Person Plural: My Life as A Multiple, a book by Cameron West, Ph.D. FMSF Newsletter April/May 1999 Vol 8 No. 3

Comments by August Piper, MD, on First Person Plural: My Life as a Multiple, FMSF Newsletter April/May 1999 Vol. 8 No. 3

Piper, Jr., A. (1998, May) Multiple Personality Disorder: Witchcraft survives in the Twentieth Century, Skeptical Inquirer, p. 44-50.

Pendergrast, M. (1996) Multiple personalities and satanic cults, Excerpts from Victims of Memory, Upper Access.

Some Additional Readings with a skeptical perspective:

Borch-Jacobsen, M. (1997) "Sybil, The making of a disease: An interview with Dr. Herbert Spiegel," The New York Review, April 24, p. 60-64.

Dinwiddie. S.H., North C.S. & Yutzy, S.H. (1993) "Multiple Personality Disorder: Scientific and medicolegal issues," Bulletin of the American Academy of Psychiatry & law, 21 (1) p 69-79.

Frankel, F.H. (1993) "Adult reconstruction of childhood events in the multiple personality literature," American Journal of Psychiatry, 150, pp. 954-958.

Freeland, A., Manchanda, R., Chiu, S., Sharma, V. & Merskey, H. (1993) "Four cases of supposed multiple personality disorder: Evidence of unjustified diagnoses," Canadian Journal of Psychiatry, 38, p 245-247

Merskey, H. (1992) "The manufacture of personalities: The production of Multiple Personality disorder," British Journal of Psychiatry, 160, p. 327-340.

Miller, M. & Kantrowitz, B. (1999) "Unmasking Sybil: A re-examination of the most famous psychiatric patient in history," Newsweek, January 25, pp. 66-68.

Orne, M.T. & Bauer-Manley, N.K. (1991) "disorders of self: Myths, metaphors, and the demand characteristics of treatment," In J. Strauss and G.R. Goethals (Eds.) The Self: Interdisciplinary Approaches, New York: Springer-Verlag p. 93-106.

Piper. Jr., A. ( Hoax and Reality: The Bizarre World of Multiple Personality Disorder (Northvale, New Jersey: Jason Aronson).

Pope, H. G., Oliva, P.S., Hudson, J.I., Bodkin, J.A. and Gruber, A.J. (1999). "Attitudes toward DSM-IV Dissociative Disorders Diagnoses among Board-Certified American Psychiatrists." American Journal of Psychiatry, 156:2, Feb. 1999. 321-323.

Sarbin, T.R. (1995) "On the belief that one body may be host to two or more personalities," "International Journal of Clinical and Experimental Hypnosis, XLIII (2) p. 163-183.

Seltzer, A. (1994) "Multiple Personality: A psychiatric misadventure," Canadian Journal of Psychiatry, 39 p 442-445.

Spanos, N.P. (1996) Multiple Identities & False Memories: A sociocognitive perspective, Washington, DC: American Psychological Association