Dissociative identity disorder (DID), formerly known as multiple personality disorder, is often misunderstood and confused with schizophrenia. DID is caused by trauma and can result in the creation of “alters,” or separate personalities within the same person. Treatment involves therapy to integrate the alters and address underlying psychological conditions. The portrayal of DID in movies and TV shows is often exaggerated and not reflective of reality.
Multiple personality disorder is now more commonly referred to as dissociated identity disorder. It is one of the most misunderstood types of mental illness, often catching the interest of writers and directors, who tend to portray it in its most exaggerated form. The most important thing to understand is that multiple personality disorder is not schizophrenia. The two are often confused. However, in very rare cases, a personality, or alter as it is sometimes referred to, suffers from schizophrenia.
Multiple personality disorder is almost always caused by lingering trauma or past trauma such as early childhood sexual or physical abuse. When the trauma occurs over an extended period of time, the affected person may begin to cope by completely dissociating from the events causing the trauma. This can lead to “alters,” separate personalities within the same person who either know or are unaware of the abuse. Alters can be childish, forceful, male or female, and often emerge as a coping device.
Psychiatrists make the distinction between a person having multiple personalities and believing they have multiple personalities. In general, multiple personality disorder is the patient’s belief that several personalities appear to exist within the self.
One of the main characteristics of multiple personality disorder is that people seem to “waste” time. They seem unaware that time has passed; yet someone observing them can see them act in many different ways. The afflicted, however, tend to have no idea what happened. This generally central personality seems more likely to dissociate if the person is exposed to situations that may evoke early trauma or if the person is still enmeshed in a traumatic situation.
Other symptoms of multiple personality disorder include depression, confusion, suicidal thoughts, phobias, varying levels of ability to function “normally”, anxiety, and self-medication, such as alcoholism or drug abuse. Additionally, people with multiple personality disorder may self-harm, have a high degree of panic or panic attacks, have eating disorders, or be prone to headaches.
As portrayed in the movies, multiple personality disorder always seems to consist of a number of very distinct personalities, which isn’t always the case in reality. Rather, those with multiple personality disorder can transition from heightened to lower awareness, without assuming a different accent or assuming an entirely separate identity, although some experience distinct personalities. Multiple personality disorder resulting in crimes, as featured in several television series and to great effect in Richard Gere’s film Primal Fear rarely exists.
The primary treatment for multiple personality disorder is therapy, which may include play therapy, hypnosis, art therapy, and/or talk therapy. Drugs are not usually preferred due to the likelihood of overdose and because the dissociative state is not chemically induced. The goal is to put the alters in communication with each other, so that the person does not continue to dissociate from reality. A secondary goal is to ensure that the person is removed from any ongoing traumatic situations, such as removing a child from an abusive home.
When the person has reintegrated different personalities, treatment may still be needed, possibly drug therapy to treat underlying psychological conditions such as chronic depression or schizophrenia. However, while the person is still “running around,” drug treatment may be completely ineffective because the person may not remember to take the drug or may accidentally overdose.
Therapy is usually a long process, particularly when one has experienced repeated trauma. It may take several years before the patient begins to feel fully conscious at all times of his actions and thoughts of her. However, clinical research suggests that multiple personality disorder therapy is effective, if therapy is pursued continuously.
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