Dissociative Identity Disorder

You’ve probably heard stories about people who experienced such terrible traumas that they block out the experience and create alternate personalities to deal with the situation. This paradoxical disorder used to be called multiple personality disorder. It is now referred to as dissociative identity disorder (DID). Is this a real mental disorder? Can this happen to people?

Students often enter a psychology class with many preconceptions about psychology, behavior, and the mind. Much of what we know about psychology has been distilled to us through the popular press and the media. Many of my students assume that DID is real because they have heard about it in the media or other sources. The thing is that they do not have first hand experience with the disorder to know if it actually exists. The popular assumption is that when people experience trauma they either repress memories of that trauma or they dissociate from it. However, everything we know about memory indicates that we have trouble forgetting things with increased exposure. We also cannot differentiate between a real and a false memory unless we have corroborative evidence from another person. This makes the repression theory of trauma shaky.

The story of Sybil is cited often as evidence for DID. Many people are not aware that Sybil was highly prone to hypnotic suggestion. Her alternate personalities were suggested when she was under hypnosis. Sybil came up with sixteen personalities, or alters. Up until that time, most people who were diagnosed with DID showed two or three alters. A curious thing happened after Sybil’s case was reported – most people who were subsequently diagnosed with DID started manifesting ten, twelve, or more alters. Was this just a coincidence?

So, what causes DID? There are two major theories of DID. The first, called the posttraumatic model, has already been described. In this case, a person who experiences a terrible trauma dissociates, or compartmentalizes, the experience into alternate personalities as a means of coping with the intense emotional pain of the trauma. The second theory of DID is called the sociocognitive model. In this case, the diagnosis stems from decades of therapist-induced influences and increased media attention. DID then becomes a form of role playing in which the patient learns to assume different roles as a result of societal expectations and therapist encouragement. Subjective therapeutic practices such as hypnosis, guided imagery, and prompting of alters facilitate the development of DID.

We have to be careful here. Once we create a diagnosis, we begin to make it real. If a diagnosis is contained in the manual of mental disorders, then someone will be diagnosed with it. This is not to say that there are no cases of DID that were caused by posttraumatic stress. In some cases, this may certainly happen. However, we need to be aware of how social and culture factors influence our mental health. If we reduce the number of therapist-induced cases of DID, then we can begin to treat the real issues associated with traumatic experiences. DID masks the underlying problems people are struggling with that make them resort to anything to escape their pain, even fabricating false personalities as a way of escaping reality.