Perhaps one of the most controversial and potentially dangerous psychological diagnoses is the so-called "Multiple Personality Disorder" (MPD), which was reclassified as "Dissociative Identity Disorder" (DID) in the current version of the DSM (i.e., the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition; better known as the DSM-IV).
Briefly, MPD or DID involves several features, chief of which is the presence of two or more distinct identities or personality states, each with its own enduring pattern of thinking, perceiving and relating. In the vast majority of these cases, there is a reported history of extreme anxiety, usually stemming from traumatic abuse or neglect.
In suspected cases of MPD or DID, at least two of these identities or personality states (sometimes referred to as "alters") recurrently take control of the person's behavior who is then unable to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
The fact that the mental health establishment reclassified MPD as DID indicates that the very concept of the disorder is unstable, open to debate, and hard to pin down. Nevertheless, there are some mental health practitioners who seem almost married to the diagnosis and claim that dozens of their clients are suffering from the condition. Indeed, I know of one psychiatrist who dedicates her practice to DID cases and claims the number of people suffering from it in the general population is huge.
In truth, if MPD or DID even exists, it is amazingly rare. In fact, within my professional network, not a single competent therapist I know of has ever seen a legitimate case of DID. Thus never, in my experience, among dozens of clinicians who have provided treatment to literally thousands of clients spanning decades of clinical practice has a single person ever been identified as a bona fide DID sufferer.
Even the famous case of "Sybil," whose bizarre odyssey through the labyrinth of "MPD" sold millions of books and led to an Emmy winning TV miniseries, has been exposed as a total hoax and a complete fraud. (See Debbie Nathan's new book: "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case," which draws on a cache of letters at the John Jay College of Criminal Justice that reveals how three women (all now dead) created what they called "Sybil Inc." for fun, fame and profit. It worked pretty well, right?)
Hence, the danger for the consumer is that if a therapist unquestioningly buys into the label, the therapist will be likely to find, or worse yet, manufacture, evidence that supports the diagnosis. Even more alarming is that some clinicians actually encourage behaviors that seem consistent with the label, which increases the likelihood that the client will act more like the label and begin to "fit" into this diagnostic category. The net result is that the real, underlying psychological disturbance won't be properly addressed and the client will fail to derive any true therapeutic benefits from the "treatment". Even worse, he or she might be harmed due to the common emphasis that DID therapy places on "recovered memories" which in itself is a tremendously problematic issue.
Now I am not denying that people can have strange, disconnected, amnesic and fragmented experiences, nor am I totally decrying the diagnosis of DID. It is possible that some unfortunate people who suffered through horrendous abuse, neglect, or trauma may indeed suffer from some malady resembling this condition.
Still, before placing the label MPD or DID on someone, other more rational explanations for the behavior must be ruled out, such as serious medical or severe neurological conditions, drug intoxication, or perhaps more credible psychological disturbances such as Post-traumatic Stress Disorder, Factitious Disorder, Malingering, or extreme Personality Disorders. The bottom line:
• MPD or DID is not a widespread or common disorder despite the insistence of some practitioners and if it does actually exist it is most likely due to a profound neurological illness not a psychiatric condition.
Remember: Think well, act well, feel well, be well!
Copyright by Clifford N. Lazarus, Ph.D.