The”standard” definition of this is: Multiple personality disorder, or MPD, is a mental disturbance classified as one of the dissociative disorders. It is also known as dissociative identity disorder (DID).
MPD or DID is defined as a condition in which "two or more distinct identities or personality states" alternate in controlling the patient's consciousness and behaviour.
Note: It is not correct or accurate to use MPD or DID as synonyms for "Split personality" or to confuse it for schizophrenia.
Introduction (the “other” description/definition): We all have many (or multiple) “personalities: generally we call them “facets”, or “sides”. It is quite normal, for we act differently in different situations and around different people – and at different times.
In “normal” circumstances, those “aspects”, “sides” or “personalities” are connected and integrated, and we are generally aware of them.
It isn’t as if we are many totally “different” people. It is just that we adjust to the circumstances we find ourselves in.
But, and here’s the difference, there is a basic set of characteristic that reflect the “overall person” that remains consistent through the range of “sides”.
However, trauma and other contributing factors such as those described below can have such devastating impact, that the connection between each “facet” or “side” is broken or lost – and they become compartmentalized into separate compartments, or “personalities”.
Each “side” acts and operates independently from the other(s) – frequently unaware, or no longer aware, that they exist. It is then, that problems occur and that we refer to it as: Multiple Personality Disorder, or Dissociative Identity Disorder (due to the “identity” having been lost – for it becomes a question of, “which one is the “real” one”?).
In the strongest sense, they are NOT disorders – they are coping mechanisms.
The following gives a somewhat adequate explanation (it is adapted from other sources).
Description: The exact nature of DID (MPD) and its relationship to other mental disorders is not clear. Some researchers think that DID is a relatively recent development in western society.
It may be a culture-specific syndrome found in western society, caused primarily by both childhood abuse and unspecified long-term societal changes. Unlike depression or anxiety disorders, which have been recognized, in some form, for centuries, the earliest cases of persons reporting DID symptoms were not recorded until the 1790s.
Because childhood trauma is a factor in the development of DID, some doctors think it may be a variation of post-traumatic stress disorder (PTSD).
DID and PTSD are conditions where dissociation is a prominent mechanism. The female to male ratio for DID is about 9:1, but the reasons for the gender imbalance are unclear.
Some have attributed the imbalance in reported cases to higher rates of abuse (and-or rape/incest) of female children; and some to the possibility that males with DID are under- reported because they might be in prison for violent crimes (it can also be socio-cultural).
The most distinctive feature of DID is the formation and emergence of alternate personality states, or "alters (alter egos)."
People with DID experience their alters as distinctive individuals possessing different names, histories, and personality traits. It is not unusual for DID patients to have alters of different genders, sexual orientations, ages, or nationalities.
The average DID patient has between two and 10 alters. It is frequently associated with the Lost Child Syndrome (also see Dysfunctional Families Children’s ROLES page on this site: related articles are “Post Traumatic Stress” and “Dissociative Disorder”)
Causes and symptoms The severe dissociation that characterizes patients with DID is currently understood to result from a set of causes: • An innate ability to dissociate easily • Repeated episodes of severe physical or sexual abuse in childhood • The lack of a supportive or comforting person to counteract abusive relative(s) • The influence of other relatives with dissociative symptoms or disorders
The relationship of dissociative disorders to childhood abuse has led to intense controversy and lawsuits concerning the accuracy of childhood memories. The brain's storage, retrieval, and interpretation of childhood memories are still not fully understood.
The major dissociative symptoms experienced by DID patients are amnesia, depersonalization, derealization, and identity disturbances.
Amnesia: Amnesia in DID is marked by gaps in the patient's memory for long periods of their past, in some cases, their entire childhood. Most DID people have amnesia, or "lose time," for periods when another personality is "out." They frequently report finding items in their house that they can't remember having purchased, finding notes written in different handwriting, or other evidence of unexplained activity.
Depersonalization: Depersonalization is a dissociative symptom in which the person feels that his or her body is unreal, is changing, or is dissolving. Some DID individuals experience depersonalization as feeling to be outside of their body, or as watching a movie of themselves.
Derealization: Derealization is a dissociative symptom in which the person perceives the external environment as unreal. Some may see walls, buildings, or other objects as changing in shape, size, or color. DID patients may fail to recognize relatives or close friends.
Identity disturbances: Identity disturbances in DID result from the individual's having split off entire personality traits or characteristics as well as memories.
When a stressful or traumatic experience triggers the re-emergence of these dissociated parts, the person switches -- usually within seconds -- into an alternate personality. Some have histories of erratic performance in school or in their jobs caused by the emergence of alternate personalities during examinations or other stressful situations.
People vary with regard to their alters' awareness of one another.
Diagnosis: The diagnosis of DID is complex and some physicians believe it is often missed, while others feel it is over-diagnosed. People have been known to have been treated under a variety of other psychiatric diagnoses for a long time before being re-diagnosed with DID. The average DID individual is in the mental health care system for six to seven years before being diagnosed as a person with DID.
Many DID people are misdiagnosed as depressed because the primary or "core" personality is subdued and withdrawn, particularly in females. However, some core personalities, or alters, may genuinely be depressed, and may benefit from antidepressant medications. One reason misdiagnoses are common is because DID individuals may truly meet the criteria for panic disorder or somatization disorder.
DID people are often frightened by their dissociative experiences, which can include losing awareness of hours or even days of time, meeting people who claim to know them by another name, or feeling "out of body." Persons with the disorder may go to emergency rooms or clinics because they fear they are going insane.
Treatment Treatment of DID may last for five to seven years in adults and usually requires several different treatment methods.
Psychotherapy: Ideally, individuals with DID should be treated by a therapist specializing in dissociation. Most therapists who treat multiples, or DID people, recommend further treatment after personality integration, on the grounds that the individual has not learned the social skills that most people acquire in adolescence and early adult life. In addition, family therapy is often recommended to help the person's family understand DID and the changes that occur during personality reintegration. Many DID people are helped by group as well as individual treatment.
Medications: Some doctors will prescribe tranquilizers or antidepressants for DID people, other therapists prefer to keep medications to a minimum because these patients can easily become psychologically dependent on drugs. In addition, many DID patients have at least one alter who abuses drugs or alcohol, substances which are dangerous in combination with most tranquilizers.
Hypnosis: While not always necessary, hypnosis is a standard method of treatment for DID patients. Hypnosis may help patients recover repressed ideas and memories. Further, hypnosis can also be used to control problematic behaviours that many DID patients exhibit, such as self- mutilation, or eating disorders like bulimia nervosa. In the later stages of treatment, the therapist may use hypnosis to "fuse" the alters as part of the patient's personality integration process.
Prognosis: Some therapists believe that the prognosis for recovery is excellent for children and good for most adults. Although treatment takes several years, it is often ultimately effective. As a general rule, the earlier the patient is diagnosed and properly treated, the better the prognosis.
Prevention: Prevention of DID requires intervention in abusive families and treating children with dissociative symptoms as early as possible.
Key Terms Alter: An alternate or secondary personality in a patient with DID.
Amnesia: A general medical term for loss of memory that is not due to ordinary forgetfulness. Amnesia can be caused by head injuries, brain disease, or epilepsy as well as by dissociation.
Depersonalization: A dissociative symptom in which the patient feels that his or her body is unreal, is changing, or is dissolving.
Derealization: A dissociative symptom in which the external environment is perceived as unreal.
Dissociation: A psychological mechanism that allows the mind to split off traumatic memories or disturbing ideas from conscious awareness.
Dissociative identity disorder (DID): Term that replaced Multiple Personality Disorder (MPD). A condition in which two or more distinctive identities or personality states alternate in controlling a person's consciousness and behavior.
Hypnosis: An induced trance state used to treat the amnesia and identity disturbances that occur in dissociative identity disorder (DID).
Multiple personality disorder (MPD): The former, though often still used, term for dissociative identity disorder (DID).
Primary personality: The core personality of an DID patient. In women, the primary personality is often timid and passive, and may be diagnosed as depressed.
Trauma: A disastrous or life- threatening event that can cause severe emotional distress. DID is associated with trauma in a person's early life or adult experience.
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_________________________________________ Klaas Tuinman M.A. Life Self-Empowerment Facilitation at Dawn Cove Abbey Comments and Questions are welcomed