Dissociative identity disorder (also called multiple personality disorder or multiple personality disorder) is a mental disorder in which the consciousness does not have a single “I”, but is divided into 2 or more alter egos, which is why laymen often call it a split personality.
The presumable cause of the development of this disease is psychological trauma suffered in childhood . Before making an accurate diagnosis, a conversation is held with the patient and his behavior is observed. Anamnesis plays an important role in examining the patient. Information is collected about the subject's past life. The closest circle of close people is interviewed.
Features of split personality
To understand the characteristics of multiple personality disorder, you need to watch the films “Fight Club” and “Me, Myself and Irene.” They clearly reflect what such a disease is.
Despite the body of knowledge, experts were not able to make a definitive diagnosis, since there were doubts about the existence of such a disorder. Today, personality disorder is defined as a disease.
Jim Carrey movie Me, Myself and Irene
There are some statistics recording a greater manifestation of this disease in English-speaking countries. Over the last 20 years of the twentieth century, more than 30 thousand people were diagnosed.
Despite the available figures, the disease is considered rare. In some cases, the decisive role is played by doctors who carelessly use special techniques that affect the psyche. Such an effect is called iatrogenic in the scientific community.
Prevention
Because dissociative identity disorder is a mental illness, there are no preventive measures. But since the main cause is child abuse, it is important to avoid traumatic situations in childhood. International organizations and social services are working to identify and eliminate violence. If severe stress and psychological trauma have occurred in a child, it is important to contact a specialist in a timely manner, which will prevent the development of dissociative disorders in the future.
Factors in the development of the disease
Determining an exact list of reasons that contribute to the formation of multiple personalities is not easy, since the situation varies. A larger percentage of people suffering from the disease had the same causes.
Childhood shocks provide the necessary impetus for the development of the disorder. Such shocks are characterized by severe emotional stress. In some cases, the cause is violence. In addition to the above, deviations arise due to abundant mental stress caused by the environment. The presence of physical impact is not decisive.
Family violence
Experts characterize split personality as a defense of the human psyche. The result of this defense is isolation from traumatic memories. This leads to the formation of an alternative personality.
Primary school children are most vulnerable to developing the disease . At this stage, the development of the sensory components of the growing organism occurs. The disorder occurs as a result of a mental disorder. Adults are less susceptible to such effects.
According to unofficial information, in psychiatry departments there are 3% of patients diagnosed with multiple personality disorder. Studies have shown that the predisposition of women is higher than that of men. However, the statistics are not accurate, since it is more difficult to identify mental problems in men.
Treatment
There are no recommendations on how to treat DID. Doctors prescribe specific treatment in each specific case.
Treatment plans depend on the conditions that occur along with DID and may combine psychotherapy with necessary medications to help with symptoms.
Psychotherapy
Psychotherapy, or talk therapy, is the main treatment for people with DID. Methods such as cognitive behavioral therapy can help a person work through and learn to accept the triggers that cause personality changes. In DID, psychotherapy aims to help integrate a person's personality and learn to cope with post-traumatic experiences.
Other types of therapy
Art therapy, movement therapy, and relaxation techniques may all have a place in the treatment of DID. These techniques can help people connect aspects of their consciousness in a low-stress environment.
Symptoms of split personality
The main manifestation of split personality is the presence of several alter egos. At the initial stage, specialists identify up to 4 subpersonalities. The stage of full development of the disease involves up to 15 alter egos. Some rare cases revealed over 50 and even 100 individuals. Moreover, each character had individual characteristics.
The consciousness of a sick person, having multiple personalities, can combine a school-age girl with a dark-skinned African American at the same time. Emotionality and behavior of individuals are individual. Gestures, manner of communication and other parameters differ. There are even cases where the transition from one personality contributed to changes in heart rate and pressure.
James McAvoy movie Split
Subpersonalities are formed for situations, mainly of a traumatic type, in order to react appropriately. As a rule, people with this disease experience serious problems when interacting with their environment.
An alter ego is formed, a kind of protector, who becomes involved in difficult periods and situations that require such behavior. The main person who considers himself the “master” often uses real information, including place of residence, date of birth, parents, specialty and place of work.
One of the characteristics of the disease is the lack of understanding of the existence of multiple selves. Simply put, individuals do not know about each other. Switching alter egos happens unexpectedly. Influence is exerted by an external influence, physical or psychological in nature. As a result of such switchings, one personality temporarily dominates. Any memories are saved only for her.
Leonardo DiCaprio film Shutter Island
For this reason, memory lapses occur as information is stored individually. Important events may simply not be known to other individuals. The consequences of a sudden switch lead to the patient losing orientation in space, not being able to comprehend what is happening around him, and carrying things that are unknown to him. New acquaintances appear, behaving like friends, but the person does not recognize them. Sometimes, multiple alter egos are aware of their existence and conflict.
A person in a state of multiple personality often suffers from headaches, followed by periodic disturbances in sleep and mood. Sometimes somnambulism develops, in which the patient performs actions while asleep. As a result of the disease, anxiety and panic develop, caused by traumatic memories in certain situations. Neurotic conditions cannot be excluded.
Edward Norton movie Fight Club
The psyche loses its sense of self. Consciousness has difficulty perceiving the world around us, and a state of loss is experienced. The world around us is perceived from the perspective of everyday life, where there is nothing interesting.
Patients are not able to accurately name the date and time, which in general is not an important component for them. Hallucinations are a consequence of a psychological crisis. Constant depression leads to the formation of unwanted thoughts associated with suicide or dangerous behavior towards others.
Drug addiction and alcoholism characterize the neglect of the disease, since the patient does not find any other way out of the situation. An unstable psyche needs to be calmed by choosing the simple path. Often, patients become aware of their unhealthy behavior when they find themselves doing something dangerous. Unnecessary conflicts that develop into a fight are then condemned by the patient, citing unconscious behavior.
A case worthy of attention
The most significant person in the history of psychiatry, who harbored the serious illness of split personality, is considered to be a person who combines the existence of more than two dozen subpersonalities. Most often in scientific and fiction literature, this case is found under the name “The 24 Personalities of Billy Milligan.”
William Stanley Milligan, born in 1955 in the seventies of the last century, was subject to prosecution. This process took place in the USA, Ohio. At that time, Bill was charged with several rapes and robberies. However, a psychiatric specialist proved the following fact - all crimes were committed by a person who was not responsible for his actions. The poor guy had twenty-four alter egos! Moreover, each of them acted independently. He was not aware of Milligan's split personality. Traveling from one image to another, he had no idea about the terrible acts committed by his “second selves.”
One can compare the American mind to a certain dormitory in which many different souls lived. Each of them had their own separate “room”, and, at the same time, they never met each other. Subpersonalities manifested themselves one by one. Tommy (a mechanic and an artist) could appear in front of people in a dialogue, and a couple of moments later the little boy David would already participate in the conversation. To investigate and treat Billy's split personality, he was subjected to forced treatment in one of the state hospitals.
How is mental illness diagnosed?
A characteristic feature of multiple personality disorder is memory gaps. Depersonalization and derealization are inherent in a person suffering from split personality disorder. Such concepts characterize a low level of perception of the environment with loss of self-identification. The diagnosis is made through a conversation with the suspected patient and his immediate environment. This process in the scientific community is called anamnesis.
Criteria by which the disease is diagnosed:
- Definition of more than two personalities in the human mind, retaining individual thinking, worldview and attitude towards oneself;
- Replacing personalities with each other;
- Serious memory loss associated with important events in the patient’s life;
- The parameters indicated above are not characterized by the use of alcohol, drugs, or epilepsy.
Diagnostics
It takes time to make a diagnosis. Misdiagnosis is common, and doctors need to watch for symptoms and ignore other conditions. To make a proper diagnosis, doctors need to see different personalities and how they affect a person.
Time is also an important factor in seeing the full extent of symptoms. This is because people who seek help for DID usually have symptoms associated with other mental illnesses. In addition, the doctor must rule out symptoms of other conditions before making a diagnosis.
Forecast
In terms of prognosis, it can be noted: the earlier the disorder begins, the worse the prognosis for a person in social terms. Recovery is most often not complete. Impairments in dissociative identity disorder vary widely, from mild to severe. Treatment can reduce social, occupational, and relationship problems. Some patients respond slowly to treatment and require long-term treatment.
In this regard, patients are divided into groups:
- Patients whose symptoms are dissociative and post-traumatic in nature. Such patients retain their legal capacity and fully recover during treatment.
- Patients who, in addition to dissociative symptoms, also have other disorders: eating behavior, affective disorders, personality disorders, substance abuse disorders. Treatment in such patients is less effective, and improvement occurs slowly.
In both groups there are symptoms of mental disorders (emotional attachment to offenders). In this connection, it is necessary to carry out a longer course aimed not only at achieving personal integrity, but also at eliminating the symptoms of mental disorders. Dissociative identity disorder, compared to other personality disorders, is the most severe and has a chronic course. This is due to the fact that each alter personality may have its own mental disorders.
Manga
The problem of multiple personality syndrome has always interested not only psychiatrists, but also artists. Thus, a popular work, the main theme of which is the manga MPD Psycho. It represents Japanese comics. The history of their origin goes back at least one thousand years.
The manga MPD Psycho describes an amazing and interesting story from the mystical detective genre. It contains overtly cruel and bloody scenes, often straddling the border between madness and logic. The main character of the manga is a detective who works using intellectual methods to solve crimes. He suffers from multiple personality syndrome. He has to solve bloody crimes that are regularly committed. The main clue is the presence of a barcode under the killer's eye. But the detective himself has exactly the same mark. How can all these coincidences be connected?
Causes of DID
The pathogenesis of the disease is triggered by dissociation of consciousness - a protective mechanism of the psyche, manifested by a feeling of detachment from what is happening. Usually people say: everything happened as if it wasn’t happening to me. You get the feeling that you are looking at your own life as an outside observer. Sometimes the process is so strong that you feel like you are leaving your own body.
Normally, dissociation helps people evaluate current events with a sober look. It is a protective reaction of the psyche to traumatic circumstances. Helps an individual overcome excessive, intolerable emotions. This mechanism is especially characteristic of emotionally cold, cold-blooded individuals and manifests itself in situations that require emotional involvement.
It is worth repeating that dissociation is normally a quite useful protective mechanism of the psyche, allowing one to relieve strong emotional stress. Pathology begins as a result of increased activation of the process. The individual experiences such severe stress that it forces his own integral Ego to split. Therefore, dissociation is called “splitting”.
The integrity of the Ego, which forces a person to perceive external circumstances, experiences and respond to them in a fixed way, is disintegrated. That is, the unity and coherence of the activity of consciousness is lost. The psyche tries to deny the reality of what is happening, “says” that all this happened to someone else, blocks the memories of the frightening event, creates a new identity that can overcome the emotional typhoon. It is also called alter personality, identity, ego state.
