Multiple Personality

Details of DID

The genesis of Legion Theory was the notion that if the human mind can break down into separate personalities, then that tells us something fundamental about the structure and processes of the normal mind. So it then follows that the details of the characteristics of a mind broken down into separate personalities should then help provide details of the structures and processes of the normal mind. To study those details we made our own direct observations, studied many autobiographies of people with DID, and read case studies written by practitioners and articles written in academic journals. From these sources the following summary may be made.

The formation of multiple personalities

Multiple Personality Disorder (MPD), or as it is now known, Dissociative Identity Disorder (DID) is a situation in which more than one person appears to inhabit a single body.

Almost all people with DID report that they suffered severe psychological or physical trauma in childhood, and in the vast majority of cases the first alter will appear before the age of 12. The trauma is often in the form of sexual or physical abuse, extreme neglect, and the witnessing of a violent death of another person.

Three categories of alter

Each of the different ‘people’, or ‘personalities’, inhabiting a single body fall into one of three categories.

The first type is a single personality which is qualitatively different to all others. This personality is typically referred to as the original or core personality. Usually this personality becomes unconscious when any of the other personalities takes control of the body. So this personality may be completely unaware of the existence of other personalities within their body. They will often, however, be aware that they have lost time. That is, they will be aware of periods of time, when they were not asleep, for which they have no memories. People will often tell them what they have done during a period of lost time and they may be quite embarrassed as events described (flirting with men, stealing money, throwing something valuable away, etc.) will often be the opposite to the type of behaviour that they usually display. Periods of lost time may last for seconds, minutes, hours, days, months, or years. Some core personalities, for example, will report that they have absolutely no recollection of any event which may have occurred during several years of high school.

The second type of personality we refer to as active alters. These are alternative personalities which will, from time to time, take control of the body. The active alters are almost always aware of the events which happen when the core personality has control of the body (though they may choose not to attend). Active alters, however, may, or may not, be aware of the events which happen when another active alter has control of the body. Within an individual this will depend on which alter has control and which alter is attempting to watch.

Active alters vary considerably in terms of their ‘age’, ‘gender’, and ‘physical’ appearance.

Within an adult middle aged woman, for example, there may be several active alters who describe themselves to be children. Other active alters within the same system may describe themselves to be adult women (of varying ages). Alters also differ in their age in another way. Different alters will have been born, that is will come into existence, at different points in time. So an active alter describing themselves to be a six year old child may have been in existence much longer than an adolescent child alter or an adult alter within the same person. Some alters will begin as children and then grow older with the body, whilst others remain the same apparent age.

Over 50% of cases contain active alters who describe themselves to be of the opposite sex to the physical body.

Even those alters who describe themselves to be of the same age and gender as the physical body will not describe themselves to be of the same ‘physical’ appearance. They may, for example, describe themselves to be taller, shorter, fatter, thinner, paler, darker, more beautiful, less beautiful, etc. Overall the system is internally consistent. An active alter describing herself to be a small fair six year old child, for example, will be viewed by all of the other alters as a small fair six year old child.

Active alters within a single body will hold differing opinions, attitudes, and beliefs. One alter, for example, may like someone and others dislike them. One alter may be religious, and another atheist. One might love someone, and another (at least claim to) loathe them.

Alters are not necessarily awake when the core personality is awake or when another active alter has control of the body. This sleeping might be for only a period of hours, but it can also form a type of hibernation where the alter goes to sleep for months or years.

Each alter has its own set of memories – although these memories may overlap. An active alter’s memory of an event may differ from that of another alter. This occurs for several reasons. Firstly, if an active alter was in control of the body when an event happened, then that alter has a direct memory of the experience. Another alter, may have an indirect memory as they had merely observed the first alter when the event happened. A third alter might have an even more indirect memory of an event as they might not have been born at the time of the incident, or they may have been asleep when the incident happened. So their memory of the event might only be a memory of a story told to them as a story told to them. In other situations active alters appear to be able to consciously share their memories by choosing to pass them over to another alter.

Within an individual, the group of active alters will often form a complementary set which, taken together, can form a functioning whole. For example, one alter may take control when looking after children. Another may take control when studying at university. Another may only come out in times of danger to protect the group. Other alters may store the horrible memories of childhood abuse. Working together the group may be very capable and efficient, despite the burden of the memories of abuse from childhood, and in many cases DID is not discovered until the person has completed studies or started a family or career.

The third category of alter we describe as inactive alters. These alter personalities almost never take control of the body. They often describe themselves to be angels or spirit guides. Some therapists describe these alters as inner-self-helpers and their purpose appears to be one of an advisory role to the core personality and active alters. They will provide advice via inspirational images, voices, or messages transmitted within dreams. Some therapists contact the inactive alters (usually indirectly via one of the active alters) to gain advice and insight during therapy.

Multiple worlds

DID is not only a disorder of multiple personalities, it is also a disorder of multiple worlds. When active alters are not in control of the body they usually inhabit another inner world. The form of this world is varied. It might, for example, be a world of valley’s hills and waterfalls, or it might be a room with stone pillars. Active alters not in control of the body will often sit in this world and watch the events in the outside ‘real’ world. At least some alters have the capacity to imagine other inner worlds which they, and other active alters, may visit. Entry and exit from the inner world into the ‘real’ world is usually described to take place via a door or a gate.

Inactive alters are usually described to inhabit yet another world, which they will describe in terms such as the spirit world or the other side.

Changes to the brain and its activity

Several studies have shown that childhood trauma leading to the development of DID leads to changes in the brain and the way the brain operates.

Changes have been found in the structure of the brain of people with DID. Studies have shown, in both animals and humans, that early stress causes changes in the development of at least one part of the brain – the hippocampus [1]. Consistent with this, a magnetic resonance imaging (MRI) study has found both hippocampal volume and amygdalar volume to be significantly smaller (by 19.2% and 31.6%, respectively) in DID patients when compared to a healthy control group [2].

A group of researchers compared DID patients to a control group of professional actors [3]. The researchers measured the EEG of DID patients when the core personality was in control of the body and when alter personalities were in control of the body. They also measured EEG of professional actors who were asked to act as different personalities. Significant change occurred in the DID group between core and alter personality conditions. No differences in EEG were found between personalities for the actors.

Examination of the cerebral blood flow of individuals with DID has provided results consistent with this EEG study. A study comparing cerebral blood flow of core personalities compared with alter personalities found that when the core personality is in control of the body a broad range of brain areas were activated, but when an alter personality was in control fewer brain areas were active [4].

  1. Meaney et al., 1988
  2. Vermetten et al., 2006
  3. Hopper et al., 2002
  4. Reinders et al., 2006

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Selected Readings

Allison, R. (1980). Minds in many pieces: The making of a very special doctor. New York: Rawson, Wade Publishers.

Allport, G. W. (1938). The Journal of Abnormal and Social Psychology: An editorial. Journal of Abnormal and Social Psychology, 33, 3-13.

American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Binet, A. (1890/1977). On double consciousness. Washington, DC: University Publications of America.

Binet, A. (1896/1977). Alterations of personality. Washington, DC: University Publications of America.

Breuer, L., & Freud, S. (1983). Studies on hysteria. New York: Pelican Books. (Original work published, 1895).

Casey, J. F., & Wilson, L. (1991). The Flock. New York: Fawcett Columbine/Balantine books.

Chase, T. (1987). When rabbit howls. New York: Jove Books.

Cohen, B. M., Giller, E., & Lynn, W. (Eds). (1991). Multiple personality disorder from the inside out. Lutherville, MD: The Sidran Press.

Creno, C. (1992). Sarah’s story. The Quill, 80(4), 22-26.

Ellenberger, H. F. (1970). The Discovery of the Unconscious: The history and evolution of dynamic psychiatry. New York: Basic Books, Inc.

Elzinga, B. M., Phaf, R. H., Ardon, A. M., & van Dyck, R. (2003) Directed forgetting between, but not within, dissociative personality states. Journal of Abnormal Psychology, 112(2), 237-243.

Freud, S. (1995). The Freud reader. P. Gay (Ed.). London: Vintage. (Original work published 1915).

Hopper, A., Ciorciari, J., Johnson, G., Spensley, J., Serejew, A., & Stough, C. (2002). EEG coherence and dissociative identity disorder: Comparing EEG coherence in DID hosts, alters, controls and acted alters. Journal of Trauma & Dissociation, 3(1), 75-88.

International Society for Study of Dissociation. (2005). Guidelines for treating dissociative identity disorder in adults (2005). Journal of Trauma & Dissociation, 6(4), 69-149.

James, W. (1890a). The Hidden Self. Scribner's magazine, 7(3), 361-374.

James, W. (1890b). The Principles of Psychology. New York: Holt.

Janet, P. & Prince, M. (1907). A symposium on the subconscious. Journal of Abnormal Psychology, 2(2), 58-92.

Lancaster E., & Poling, J. (1958). Strangers in my body: The final face of Eve. London: Secker & Warburg.

Mayer, R. (1988). Through divided minds; Probing the mysteries of multiple personalities – a doctor’s story. New York: Doubleday.

Meaney, M.J., Aitken, D.H., van Berkel, C., Bhatnagar, S., & Sapolsky, R.M. (1988). Effect of neonatal handling on age-related impairmants associated with the hippocampus. Science, 239, 766-768.

Murray, H. A. (1956). Morton Prince: Sketch of his life and work. The Journal of Abnormal and Social Psychology, 52, 291-295.

Nemiah, J. C. (1989). Janet redivivus: The centenary of L'automatisme psychologique. American Journal of Psychiatry, 146, 1527-1529.

Prince, M. (1905/1978). The dissociation of a personality. New York: Oxford University Press.

Prince, M. (1906). Hysteria from the point of view of dissociated personality. Journal of Abnormal Psychology, 1(4), 170-187.

Prince, M. (1908a). Experiments to determine co-conscious (subconscious) ideation. Journal of Abnormal Psychology, 3(1), 33-42.

Prince, M. (1908b). The unconscious. Journal of Abnormal Psychology, 3(4), 261-297.

Prince, M. (1908c). The unconscious. Journal of Abnormal Psychology, 3(5), 335-353.

Prince, M. (1909a). The unconscious. Journal of Abnormal Psychology, 3(6), 391-426.

Prince, M. (1909b). The unconscious. Journal of Abnormal Psychology, 4(1), 36-56.

Prince, M., & Peterson, F. (1908). Experiments in psycho-galvanic reactions from co-conscious(subconscious) ideas in a case of multiple personality. Journal of Abnormal Psychology, 3(2), 114-131.

Pope, H. G., Oliva, P. S., Hudson, J. I., Bodkin, J. A., & Gruber, A. J. (1999). Attitudes toward DSM-IV-TR dissociative disorder diagnosis among board-certified American psychiatrists. American Journal of Psychiatry, 156, 321-332.

Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press.

Putnam, F. W., Guroff, J. J., Silberman, E. K., Barban, L., & Post, R. M. (1986). The clinical phenomenology of multiple personality disorder: Review of 100 recent cases. Journal of Clinical Psychiatry, 47(6), 285-293.

Reinders, A. A. T. S., Nijenhuis, E. R. S., Quak, J., Korf, J., Haaksma, J., Paans, A. M. J., Willemsen, A. T. M., & den Boer, J. A. (2006). Psychobiological characteristics of dissociative identity disorder: A symptom provocation study. Biological Psychiatry, 60, 730-740.

Ross, C. A. (1989). Effects of hypnosis on the features of multiple personality disorder. American Journal of Clinical Hypnosis, 32, 99-106.

Ross, C. A. (1997). Dissociative identity disorder: Diagnosis, clinical features, and treatment of multiple personality. New York: John Wiley & Sons, Inc.

Ross, C. A., Norton, G. R., & Wozney, K. (1989). Multiple personality disorder: An analysis of 236 cases. Canadian Journal of Psychiatry, 34(5), 413-418.

Schreiber, F. R. (1973). Sybil. New York: Penguin Putnam Inc.

Sidis, B., & Goodhart, S. P. (1905). Multiple personality. New York: Appleton-Century Crofts.

Sizemore, C. C. (1989). A mind of my own. New York: William Morrow and Company Inc.

Sizemore, C. C., & Pitillo, E. S. (1977). I’m Eve. New York: Doubleday.

Spiegel, D., & Cardeña, E. (1991). Disintegrated experience: The dissociative disorders revisited. Journal of Abnormal Psychology, 100(3), 366-378.

Spitzer, R. L., Skodol, A. E., Gibbon, M., & Williams, J. B. W. (1981). Diagnostic and statistical manual of mental disorders case book. Washington, DC: American Psychiatric Association.

Stone, G. (1994). Little girl fly away. NewYork: Simon & Schuster.

Taylor, E. (1982). William James on Exceptional Mental States. The 1896 Lowell Lectures. New York: Scribner's.

Thigpen, C. H., & Cleckley, H. (1954). A Case of Multiple Personality, Journal of Abnormal and Social Psychology, 49, 135 151.

Thigpen, C. H., & Cleckley, H. M. (1957). The Three Faces of Eve. New York: McGraw-Hill.
van der Hart, O., Bolt, H., & Kolk, B. A. (2005). Memory fragmentation in Dissociative Identity Disorder. Journal of Trauma & Dissociation, 6(1), 55-70.

Vermetten, E., Schmahl, C., Linder, S., Loewenstein, R. J., & Bremner, J. D. (2006). Hippocampal and amygdalar volumes in dissociative identity disorder. The American Journal of Psychiatry, 163, 630-636.

West L. J. (1967). Dissociative reaction. In Freeman A. M., & Kaplan H. I. (Eds.) Comprehensive Textbook of Psychiatry (pp. 268-288). Baltimore: Williams & Wilkins.

Wilbur, C. B. (1984). Multiple personality and child abuse. Psychiatric Clinics of North America, 7, 3-7.

Williams, D. (1994). Somebody somewhere. Moorebank, N.S.W.: Corgi Books/Transworld Publishers.

Xiao, Z., Yan, H., Wang, Z., Zou, Z., Xu, Y., Chen, J., Zhang, H., Ross, C. A., & Keyes, B. B. (2006). Trauma and dissociation in China. The American Journal of Psychiatry, 163, 1388-1391.

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What is DID?

Early history

Freud and DID

Details of DID

 

     
         
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