Psychological diseases are among the most difficult, they are often difficult to treat and in some cases remain with the person forever. Split personality or dissociative syndrome belongs to this group of diseases; it has similar symptoms to schizophrenia; identity disturbances become signs of this pathology. The condition has its own characteristics that are not known to everyone, so this disease can be misinterpreted.

What is split personality

This is a mental phenomenon that is expressed in the presence of two or more personalities in the patient, which replace each other with a certain periodicity or exist simultaneously. For patients faced with this problem, doctors diagnose “personality dissociation,” which is as close as possible to split personality. This is a general description of the pathology; there are subtypes of this condition, which are characterized by certain features.

Dissociative disorder - concept and manifestation factors

This is a whole group of psychological disorders that have characteristic features violations of psychological functions that are characteristic of humans. Dissociative identity disorder affects memory, awareness of the personality factor, and behavior. All functions affected. As a rule, they are integrated and are part of the psyche, but when dissociated, some streams separate from consciousness, gaining a certain independence. This may appear in the following points:

• loss of identity;
• loss of access to some memories;
• the emergence of a new “I”.

Features of behavior

A patient with this diagnosis will have an extremely unbalanced character, will often lose touch with reality, and will not always be aware of what is happening around him. A dual personality is characterized by large and short memory lapses. Typical manifestations of pathology include following symptoms:

• frequent and severe sweating;
• insomnia;
• severe headaches;
• impaired ability to think logically;
• inability to recognize one's condition;
• mobility of mood, a person first enjoys life, laughs, and after a few minutes he will sit in the corner and cry;
• conflicting feelings towards everything around you and yourself.

Reasons

Mental disorders of this type can manifest themselves in several forms: mild, moderate, complex. Psychologists have developed a special test that helps identify the signs and causes that caused split personality. There are also common factors that provoke the disease:

• the influence of other family members who have their own dissociative disorders;
• hereditary predisposition;
• childhood memories of a mentally or sexually abusive relationship;
• absence of a strong person in the situation emotional stress support from loved ones.

Symptoms of the disease

Identity disorder in some cases has symptoms similar to other mental illnesses. You can suspect a split personality if there is a whole group of signs, which include the following options:

• the patient’s imbalance – sudden changes in mood, inadequate reaction to what is happening around;
• the appearance of one or several new hypostases within oneself - a person calls himself by different names, behavior is radically different (modest and aggressive personalities), does not remember what he did at the moment of dominance of the second “I”.
• loss of connection with the environment – ​​inadequate reaction to reality, hallucinations;
• speech disorder - stuttering, long pauses between words, slurred speech;
• memory impairment - short-term or extensive lapses;
• the ability to connect thoughts into a logical chain is lost;
• inconsistency, lack of coordination of actions;
• sudden, noticeable mood swings;
• insomnia;
• profuse sweating;
• severe headaches.

Auditory hallucinations

One of the common abnormalities in the disorder, which may be independent symptom or one of several. Disturbances in the functioning of the human brain create false auditory signals, which the patient perceives as speech that has no sound source, sounds inside his head. Often these voices tell you what needs to be done; they can only be drowned out with medications.

Depersonalization and derealization

This deviation is characterized by a constant or periodic feeling of alienation from own body, mental processes, as if a person is an outside observer of everything that is happening. These sensations can be compared with those that many people experience in a dream, when a distortion of the sensation of temporary, spatial barriers, and disproportion of limbs occurs. Derealization consists of a feeling of unreality of the world around, some patients say that they are a robot, often accompanied by depression, anxiety states.

Trance-like states

This form is characterized by a simultaneous disorder of consciousness and a decrease in the ability to adequately and modernly respond to stimuli from the outside world. The trance state can be observed in mediums who use it for spiritualistic seances and in pilots who perform long flights at high speed and with monotonous movements, monotonous impressions (the sky and clouds).

In children, this condition manifests itself as a result of physical trauma or violence. The peculiarity of this form is possession, which is found in some regions and cultures. For example, amok - among the Malays this state manifests itself sudden attack rage followed by amnesia. A man runs and destroys everything that gets in his way, he continues until he injures himself or dies. The Eskimos call the same condition piblokto: the patient tears off his clothes, screams, imitates animal sounds, after which amnesia sets in.

Changing your sense of self

The patient completely or partially experiences alienation from his own body; on the mental side, it can be expressed by a feeling of being watched from the outside. The condition is very similar to derealization, in which mental and time barriers are broken and a person loses the sense of the reality of what is happening around. A person may experience false feelings of hunger, anxiety, or the size of his own body.

In children

Children are also susceptible to personality splitting, and it occurs in a somewhat unique way. The child will still respond to the name given by the parents, but at the same time there will be signs of the presence of other “I”s, which partially take over his consciousness. The following manifestations of pathology are typical for children:

• different manner of speaking;
• amnesia;
• food preferences are constantly changing;
• amnesia;
• mood lability;
• self-talk;
• glassy gaze and aggressiveness;
• inability to explain one's actions.

How to Recognize Dissociative Identity Disorder

This condition can only be diagnosed by a specialist who evaluates the patient according to certain criteria. The main task is to exclude herpetic infection and tumor processes in the brain, epilepsy, schizophrenia, amnesia due to physical or psychological trauma, mental fatigue. A doctor can recognize mental illness by the following signs:

• the patient shows signs of two or more personalities that have an individual attitude towards the world as a whole and certain situations;
• the person is unable to remember important personal information;
• the disorder does not occur under the influence of drugs, alcohol, toxic substances.

Criteria for split consciousness

There are a number common symptoms, which indicate the development of this form of pathology. These symptoms include memory lapses, events that cannot be logically explained and indicate the development of another personality, alienation from one’s own body, derealization and depersonalization. All this happens when many personalities coexist in one person. The doctor must take an anamnesis, conduct conversations with the alter ego, and observe the patient’s behavior. The following factors are indicated in the reference book as criteria for determining split consciousness:

• in a person there are several alter egos that have their own attitude to the outside world, thinking, perception;
• capture of consciousness by another person, change in behavior;
• the patient cannot remember important information about himself, which is difficult to explain by simple forgetfulness;
• all of the above symptoms were not a consequence of drug use, alcohol intoxication, exposure to toxic substances, other diseases (complex seizures of epilepsy).

Differential analysis

This concept means the exclusion of others pathological conditions, which can cause symptoms similar to the manifestation of split consciousness. If studies show signs of the following pathologies, then the diagnosis cannot be confirmed:

• delirium;
• infectious diseases (herpes);
• brain tumors that affect the temporal lobe;
• schizophrenia;
• amnestic syndrome;
• disorders due to use psychoactive substances;
• mental fatigue;
• temporal lobe epilepsy;
• dementia;
• bipolar disorder;
• somatoform disorders;
• post-traumatic amnesia;
• simulation of the state under consideration.

How to exclude the diagnosis of “organic brain damage”

This is one of the mandatory stages of differential analysis, because the pathology has many similar symptoms. A person is sent for testing based on the medical history collected by the doctor. The examination is carried out by a neurologist who will give directions for the following tests:

• computed tomography - helps to obtain information about the functional state of the brain, allows you to detect structural changes;
• neurosonography - used to identify tumors in the brain, helps to examine the cerebrospinal fluid spaces;
• rheoencephalogram - examination of cerebral vessels;
• ultrasound examination brain cavities;
• MRI – is carried out to detect structural changes in brain tissue, nerve fibers, blood vessels, the stage of pathology, and the degree of damage.

How to treat split personality

The treatment process for patients is usually complex and lengthy. In most cases, observation is required for the rest of the person's life. You can get a positive and desired result from treatment only if you take the medications correctly. Drugs and dosages should be prescribed exclusively by a doctor based on the studies and tests performed. Modern schemes Treatments include these types of drugs:

• antidepressants;
• tranquilizers;
• neuroleptics.

In addition to medications, other methods of therapy are used that are aimed at solving the problems of split consciousness. Not all of them have quick effect, but are part of a comprehensive treatment:

• electroconvulsive therapy;
• psychotherapy, which can only be carried out by doctors who have completed specialized additional practice after graduating from medical school;
• the use of hypnosis is allowed;
• Part of the responsibility for treatment falls on the shoulders of others; they should not talk to a person as if they were sick.

Psychotherapeutic treatment

Dissociative disorder requires psychotherapy. It should be carried out by specialists who have experience in this field and have undergone additional training. This direction is used to achieve two main goals:

• relief of symptoms;
• the reintegration of all of a person's alter egos into one fully functioning identity.

To achieve these goals, two main methods are used:

1. Cognitive psychotherapy. The doctor’s work is aimed at correcting stereotypes of thinking, inappropriate thoughts through persuasion, structured training, behavioral training, mental state, and experiment.
2. Family psychotherapy. Consists of working with the family to optimize their interactions with the individual in order to reduce the dysfunctional impact on all members.

Electroconvulsive therapy

The treatment method was first used in the 30s of the 20th century, when the doctrine of schizophrenia was actively developing. The basis for the use of this treatment technique was the idea that the brain cannot produce localized flashes of electrical potentials, so they need to be created in artificial conditions, which will help achieve remission. The procedure is performed as follows:

1. 2 electrodes were attached to the patient's head.
2. A voltage of 70-120 V was supplied through them.
3. The device released current for a fraction of a second, which was enough to affect the human brain.
4. The manipulation was carried out 2-3 times a week for 2-3 months.

This method has not taken root as a treatment for schizophrenia, but it can be used in the field of therapy for multiple splits of consciousness. For the body, the degree of risk from the technique is reduced due to constant monitoring by doctors, anesthesia, and muscle relaxation. This helps to avoid all the unpleasant sensations that could arise when creating nerve impulses in the brain.

Application of hypnosis

People experiencing multiple splits of consciousness are not always aware of the presence of other alter egos. Clinical hypnosis helps the patient achieve integration in order to alleviate the manifestations of the disease, which helps to change the patient’s character. This approach is very different from conventional treatments because the hypnotic state itself can trigger the appearance of multiple personalities. The practice is aimed at achieving the following goals:

• ego strengthening;
• relief of symptoms;
• reduction of anxiety;
• creating rapport (contact with the conductor of hypnosis).

How to treat multiple personality syndrome

The basis of therapy is medications that are aimed at alleviating symptoms and restoring the full functioning of a person as an individual. The course is selected, the dosage is only by the doctor, a severe form of bifurcation requires more strong drugs than easy. Three groups of medications are used for this:

• neuroleptics;
• antidepressants;
• tranquilizers.

Neuroleptics

This group of drugs is used for the treatment of schizophrenia, but with the development of split personality they can also be prescribed to eliminate a manic state and delusional disorders. The following options can be assigned:

1. Haloperedol. This is a pharmaceutical name, so this medicinal substance can be included in various medications. Used to suppress delusional and manic states. Contraindicated in patients with disorders of the central nervous system, angina pectoris, liver dysfunction, kidney dysfunction, epilepsy, active alcoholism.
2. Azaleptin. It has a powerful effect and belongs to the group of atypical neuroleptics. It is used more to suppress feelings of anxiety, strong arousal, has a strong hypnotic effect.
3. Sonapax. It is used for the same purposes as the means described above: suppressing feelings of anxiety, manic state, delusional ideas.

Antidepressant

Often, split personality occurs due to a psychogenic reaction to the loss of a loved one; in a child this often occurs against the backdrop of lack of parental attention and early childhood this does not manifest itself, but in adulthood it leads to psychiatry. Dissociative experience manifests itself as a result of a prolonged depressed state and severe stress. To treat such causes, the doctor prescribes a course of antidepressants to eliminate all symptoms of depression and apathy towards planning one’s future. The following medications are prescribed:

• Prozac;
• Porgal;
• Fluoxetine.

Tranquilizers

These drugs are strictly prohibited from being used independently without a doctor's prescription. These potent drugs can cause significant harm to health and worsen the patient’s situation. After a general examination, your doctor may prescribe these medications to achieve an anxiolytic effect. You should not take tranquilizers if you are suicidal or have prolonged depression. In medical practice, multiple personality disorder is usually treated with Clonazepam.

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– a mental disorder in which in one person there are two or more personalities with their own character, memories, temperament, and characteristics of interaction with the outside world. The age, nationality and gender of subpersonalities may vary. It is assumed that the cause of the development of multiple personality disorder is severe psychological trauma in childhood. The diagnosis is established on the basis of anamnesis, conversations and observations of the patient. Treatment – ​​psychotherapy, assistance in establishing cooperation between subpersonalities, pharmacotherapy of concomitant disorders (anxiety, depression).

General information

Multiple personality disorder (multiple personality, dissociative identity disorder) is a rare mental disorder in which several personalities coexist in one person. This disorder is well known to the general public from films and books (Sybil, Fight Club, Me, Myself and Irene, The Many Minds of Billy Milligan), but many experts until recently doubted the existence of multiple personality disorder. Dissociative identity disorder is now officially recognized and included in the latest edition International Classification Diseases (ICD-10).

It is believed that multiple personality disorder is more common in English-speaking countries, but the reasons for this phenomenon are not yet clear. From 1980 (from the moment the pathology was included in the directory of mental disorders) until the end of the twentieth century, according to various sources, this diagnosis was given to 20-40 thousand people. Some psychiatrists still consider multiple personality disorder extremely rare disease and consider multiple cases of this diagnosis as overdiagnosis or the result of iatrogenicity (the careless influence of the doctor’s words or actions on the patient’s psyche). Treatment for multiple personality disorder is carried out by specialists in the field of psychiatry.

Causes of Multiple Personality Disorder

The reasons for the development of multiple personality are not precisely understood, but research data show that this pathology arises as a result of the action of biological factors, which are superimposed by repeated severe psychological trauma. 98-99% of patients suffering from multiple personality disorder experience unbearable shocks in childhood, often life-threatening. The impetus for the emergence of multiple personality disorder can also be constant neglect, rejection and emotional pressure in the absence of direct sexual or physical violence.

Psychiatrists view multiple personality disorder as a defense mechanism that allows one to completely disassociate from traumatic events by splitting memories and then repressing them into an alternate personality or identities. The critical period is considered to be the age of development of feelings (up to 9 years). When severe psychological shocks occur in older age, split personality disorder develops very rarely.

Some experts claim that about 3% of patients undergoing inpatient treatment in psychiatry departments suffer from multiple personality disorder, but this information has not yet been officially confirmed. According to another unconfirmed opinion of some psychologists and psychiatrists, split personality disorder occurs 9 times more often in women than in men. At the same time, experts do not exclude that this ratio of sick men and women may be due to the difficulties of diagnosing the disorder in representatives of the stronger sex.

Manifestations of multiple personality disorder

The main manifestation of multiple personality disorder is the presence of several alter egos. Usually, at the initial stages of treatment, a psychiatrist is able to identify 2-4 subpersonalities in a patient. Subsequently, the number of detected alter egos can increase to 10-15 or more. Cases of multiple personality disorder have been recorded in which one patient had more than 100 alter egos. Each personality has its own character, views, attitudes, abilities, knowledge (for example, one personality may speak a language unknown to other alter egos), memories and life history.

Gender, age, nationality and origin of alter egos in multiple personality disorder may vary. A little white girl from Ohio, a young Texan, and a middle-aged black Hispanic can all coexist in the same patient. Each personality has its own gestures, its own manner of speaking, its own way of conducting dialogue and its own ways of expressing emotional reactions. Moreover, some researchers claim that even some physiological indicators (pulse and blood pressure) change during the transition from one personality to another.

Strictly speaking, with multiple personality disorder, it is not full-fledged alter egos that are formed, but fragments of personalities that have arisen to respond to a traumatic situation. One personality may perform primarily the function of a protector, the other may reflect the weak, childish, emotional part of the patient, unable to cope with external circumstances, etc. Usually, among the many alter egos of a patient suffering from multiple personality disorder, the host personality stands out, identifying himself with the present the name of the patient and most important facts his biography (place and time of birth, real parents, place of education, profession).

As a rule, the alter egos of patients with multiple personality disorder are unaware of each other's existence. The transition from one personality to another occurs suddenly, against the background of some external push (usually psychological or physical stress to varying degrees intensity). During the period of dominance of one alter ego, the others are “inactive” (as if they do not exist) and do not retain any memories of the events that occur.

Because of this, a patient suffering from multiple personality disorder cannot remember some events, including significant ones (for example, he does not know about the sale of an apartment or car). A patient with multiple personality disorder finds himself in some place without understanding how he got there, discovers other people’s things in his possession, finds documents and notes written in someone else’s handwriting, communicates with strangers who behave like acquaintances, etc. Sometimes individuals are aware of each other's existence and are in a state of conflict.

Headaches, mood swings and sleep disturbances are common in multiple personality disorder. Patients may suffer from nightmares or insomnia, and some develop somnambulism. Patients with multiple personality disorder experience increased anxiety, panic attacks are possible when immersed in traumatic memories or in similar situations. Signs of obsessive-compulsive neurosis (obsessions, compulsions, ritual behavior) are often identified.

Typical symptoms of multiple personality disorder are derealization and depersonalization - patients feel that they are observing their actions from the outside and cannot control their behavior. Trance states and a feeling of “curvature” of space and time are possible. Some patients with multiple personality disorder experience varying degrees of psychotic symptoms (eg, hallucinations). Against the background of constant psychological distress, depression develops and suicidal thoughts, intentions and actions arise.

In some cases, with multiple personality disorder, a tendency to self-persecution, self-destructive behavior, and direct violence towards oneself and others is revealed. Some patients suffering from multiple personality disorder, without a transition from one alter ego to another, “discover” themselves in dangerous or obviously harmful actions: gross violation of traffic rules, driving at high speed, stealing from friends or bosses, meaningless conflicts that turn into assault, etc. At the same time, patients with multiple personality disorder condemn such behavior and say that they would not have done this consciously (freely or even under pressure). There is an increased risk of developing alcoholism and drug addiction.

Diagnosis of multiple personality disorder

Symptoms that allow one to suspect a multiple personality disorder are lapses in memory, the presence of inexplicable events that make one assume the participation of another person (other people's notes, other people's stories about actions that the patient committed, but which he does not remember, “unfamiliar acquaintances”), depersonalization, derealization and alteration of identity (discovering oneself while committing unacceptable or disgusting acts). The diagnosis of multiple personality disorder is made on the basis of anamnesis, conversations with various alter egos and observations of the patient’s behavior.

The diagnostic criteria for multiple personality disorder in the DSM-4 reference book of mental disorders include:

• The presence in one person of two or more alter egos, having their own stable perception, thinking, attitude towards themselves and the outside world.
• “Transition” of patient behavior management from one personality to another.
• Inability to remember important information about oneself and one's life to a degree that cannot be explained by normal forgetfulness.
• The listed symptoms are not caused by alcohol, drugs, or are not the result of another disease (for example, complex partial seizures in epilepsy).

Treatment and prognosis for multiple personality disorder

The main goals of therapy for multiple personality disorder are the elimination or reduction of the intensity of “general” symptoms (anxiety, depersonalization, insomnia, etc.), ensuring the safety of the patient and the reunification of different alter egos. Psychiatrists consider psychotherapy as the main treatment method for multiple personality disorder. Various psychotherapeutic methods can be used: clinical hypnosis, family psychotherapy, cognitive therapy, psychodynamic therapy. in the correction of multiple personality disorder is ineffective, medicines are used only to treat co-occurring disorders and facilitate access to repressed memories.

The best result of treatment for multiple personality disorder is overcoming childhood trauma, eliminating internal conflicts that cause defensive splitting of personality, and forming a single, integral identity. However, even with prolonged work, the psychiatrist is not always able to achieve the reunification of different personalities. In such cases, the elimination of conflicts and the establishment of productive cooperation between various alter egos is considered as a satisfactory result. Long-term treatment average duration regular continuous therapy for multiple personality disorder is 6-8 years or more.

Multiple personality disorder, even in the 21st century, causes a division of specialists in psychiatry into two camps. Some are sure that such a “deviation from the norm” in the patient is far-fetched, while others are sure that the disease really exists. They provide a lot of evidence of this from real life, accompanying them with symptoms and causes of multiple personality syndrome, and also give a scientific explanation for this phenomenon in psychiatry. In the article we will talk about What is multiple personality syndrome?

What is it?

Dissociative (multiple personality syndrome) is the general name for a patient’s condition in which, in addition to the main personality, at least one more person coexists at the same time. This second one is called subpersonality. She is capable of taking away the right to control a person’s entire body, his feelings, mind, and will from the main (dominant) personality, which is given to a person from birth.

Some psychiatrists are confident that personalities arose under the influence of many fantastic stories, as a result of watching non-scientific programs, and operating with non-scientific terms and facts. Other experts are confident that people suffering from multiple personality syndrome really exist. And proof of this is the works of doctors who described such disorders long before the advent of psychiatry as a science (around the end of the 18th century).

Does this syndrome really exist?

It is often quite difficult to recognize that one person has several personalities at once. And the patient himself can often claim that his personalities know nothing about each other, they have absolutely different opinion, their behavior patterns are completely different. But there is no doubt that multiple personality syndrome really exists. Today, experts treat this phenomenon with minimal skepticism and do not try to immediately reject it, but try to explain and characterize it from a scientific point of view.

How to distinguish multiple personality syndrome from schizophrenia

The concepts of schizophrenia and multiple personality syndrome should not be confused, since this is absolutely various phenomena in psychiatry. Thus, people suffering from schizophrenia do not have multiple personalities. Their illness is characterized by the fact that, under the influence of chronic psychosis, they suffer from hallucinations that make them see or hear things that are not really happening. The main symptom of schizophrenia is the presence of a so-called delusional idea in the patient. Approximately 50% of patients hear voices that do not exist in reality.

Multiple personality disorder and schizophrenia have one thing in common: people suffering from these diseases are more likely to commit suicide than patients with other mental disorders.

Who is most susceptible to developing the syndrome?

The reasons for the appearance of dissociation have not yet been clearly identified, but there are general points. So the root cause of multiple personality syndrome begins in a person, usually before the age of 9. It can be associated with strong emotional experiences, extreme stress, psychological or physical abuse, improper upbringing and parental attitudes, especially when they behave unpredictably and frighteningly for the child.

Description of the disease by the patients themselves

Patients suffering from multiple personality disorder may describe their condition as follows:

1. The concept of depersonalization is when the patient says that he is “outside his body.”
2. Derealization, when the patient describes the world around him as unreal for him, as if he is looking at everything that is happening through a distance or a veil of fog.
3. Amnesia. The patient makes every effort, but cannot remember important personal information about himself. Often he forgets even those words that were spoken a few minutes ago.
4. Confusion in awareness of one's own identity. A person suffering from multiple personality syndrome is in a state of complete disorientation. He cannot clearly answer the question of who he considers or imagines himself to be. Often he catches himself thinking that he hates his personality at the moment, when she is engaged in some type of activity (violates traffic rules, drinks alcohol).
5. There is no clear understanding of where a person is, what time it is now, what situation he is in.

Human with multiple personality syndrome has one host personality that can provide basic real information about it. Other dissociative states (other personalities) are not mature, they can only talk about individual episodes and sensations from life, their memories are scarce and one-sided. It so happens that the host personality often does not even suspect the presence of other personalities.

Multiple Personality Syndrome: Causes

Among all the reasons that can become the impetus for the formation of dissociative identity syndrome in childhood, there is one main one - violence. It can be both emotional and physical. In any case, violence causes irreparable harm to the child’s psyche. The next reason is the incorrect upbringing of parents, when the child experiences severe fear around them or severe psychological discomfort.

Recently, drug addiction and alcoholism have become the cause of a person’s mental health crisis, provoking the emergence of a dissociative personality.

Signs (symptoms) of the disorder

How does the syndrome manifest? multiple personality? Signs of the disorder are as follows:

1. Amnesia, when the patient cannot tell basic information about himself as an individual.
2. The presence of two or more subpersonalities, each of which has its own model of behavior, character, habits, gestures, race, gender, conversation, accent, etc. A subpersonality can even be an animal.
3. Switching from one personality to another. This process takes from a few minutes to several days.
4. Depression.
5. Sudden mood swings.
6. Suicidal tendencies.
7. Sleep disorders (both insomnia and nightmares).
8. Feelings of anxiety on the verge of panic or phobias.
9. Often drug or alcohol use.
10. Rituals and compulsions.
11. Hallucinations (both visual and auditory).
12. Eating disorders.
13. Severe headaches.
14. State of trance.
15. Self-persecution and tendency to violence, including towards oneself.

Many patients say that, being under the guidance of one person or another, they cannot control either their body or their actions. In essence, they are third-party observers of everything that their personality does with their body and the world around them. They are often ashamed of such actions; they admit that their master personality would never do such a thing and would not even dare.

Multiple Personality Syndrome: Examples

According to the most conservative estimates, the world today knows about 40 thousand patients suffering from multiple personality syndrome. The most famous, both in psychiatry and in general society, are the case histories of people such as Louis Vive (one of the first officially recorded cases of dissociative personality), Judy Castelli, Robert Oxnam, Kim Noble, Truddy Chase, Shirley Mason, Chris Costner Sizemore, Billy Milligan, Juanita Maxwell. Most of these patients suffered from severe violence in childhood, which caused them to develop dissociative identity disorder.

Billy Milligan

Billy Milligan is a person with multiple personality disorder. He became known to the general public thanks to an absolutely incredible court decision against him. Thus, in the United States, a court found him not guilty of committing several serious crimes due to his multiple personality syndrome. Billy Miligan underwent a thorough psychiatric examination, the results of which not only did not constitute a medical secret, but were even published in newspapers, magazines, and were featured on television programs. At the trial, 4 psychiatrists confirmed the diagnosis of dissociative personality under oath.

Billy was repeatedly diagnosed with Billy Milligan Multiple Personality Syndrome was discussed very actively. Society is still divided into two camps and is arguing over who Milligan really was: a skilled swindler who managed large number psychiatrists, scientists, judges, juries and policemen, or he really suffered from the 24 personalities living in him and did not belong to himself.

Billy Milligan's Multiple Personalities

The cause of Billy Milligan's syndrome was the violence and humiliation he experienced as a child. Psychiatrists counted as many as 24 personalities in him. Each of them had its own name and received a detailed description.

After being declared insane by the court, Milligan is sent for treatment to the Athens State Hospital psychiatric clinic. Thanks to highly qualified personnel, as a result of the work done, Billy Milligan was discovered to have 10 personalities, and after a while - 14 more.

The personalities of this person were of different ages, genders, nationalities, different in character, inclinations, habits, and behavior. Some of them spoke with an accent. So who got along with the person who was diagnosed with ""? Kevin, a 20-year-old guy who takes turns with Phil - both hooligans capable of crimes - takes turns leading Milligan; 14-year-old boy Denny, who was terrified of men; David, 8, who was responsible for storing pain; Adalana is a 19-year-old lesbian who is accused of committing one of the serious crimes; boy Sean - a deaf disabled person with disabilities and many others.

After 10 years of intensive treatment, Billy Milligan was released from a psychiatric clinic. The result of the treatment was the doctors’ conclusion, which stated that the patient fully identifies himself, which means that he got rid of all subpersonalities. After leaving the clinic, Milligan disappeared to communicate with the press and society; it is not known for certain whether the treatment had a real result, whether he got rid of all 24 personalities and whether they returned to him over time.

Manga

The problem of multiple personality syndrome has always interested not only psychiatrists, but also artists. Thus, a popular work whose main theme is the manga MPD Psycho. It represents Japanese comics. The history of their origin goes back at least one thousand years.

The manga MPD Psycho describes an amazing and interesting story from the mystical detective genre. It contains overtly cruel and bloody scenes, often straddling the border between madness and logic. The main character of the manga is a detective who works using intellectual methods to solve crimes. He suffers from multiple personality syndrome. He has to solve bloody crimes that are regularly committed. The main clue is the presence of a barcode under the killer's eye. But the detective himself has exactly the same mark. How can all these coincidences be connected?

Scientific works that provide the most complete information about multiple personality syndrome

Dissociative identity syndrome has occupied a leading place in the works of many scientists for decades. One of the first descriptions dates back to 1791, when the Stuttgart doctor E. Gmelin described a German woman who, under the influence of the bloody events of the French Revolution, began to suffer from multiple personality syndrome. Her other “I” is a French woman who spoke perfect French.

A special place is occupied by books by Chinese specialists not only on the study of the syndrome, but also on methods of treating it.

In documents, until the mid-20th century, specialists officially registered and described in detail about 76 cases of dissociative personality.

Writers also paid close attention to the topic of multiple personality syndrome and dedicated their works to it. The general public was told about what multiple personality syndrome is in the books: “The Three Faces of Eve” and “Sybil.” The first was created by psychiatrists K. Thigpen and H. Cleckley in 1957. The book tells the story of the dissociative personality of their patient Eva White. The second famous book, Sybil, was published in 1973. Her character also suffered from this disorder.

Today there are no preventive measures that could prevent the development of multiple personality syndrome. Main reason the appearance of the disease is psychological or physical abuse of children. All efforts should be devoted to preventing such situations. If violence does occur, then it is necessary to take action and also refer the child for help to a psychologist who will help him survive the severe stress of the trauma.

Multiple personality disorder is a striking but rather controversial disease that still causes heated discussions among doctors and scientists. Some doubt whether it exists at all, others doubt whether this condition should be considered a deviation from the norm. “Theories and Practices” remembered how the research into this psychiatric phenomenon began and why one should not rush to evaluate it.

Background

Dissociative identity disorder is a condition in which the patient, in addition to the main personality, has at least one more (and often more) subpersonality that periodically “seizes control” of the body and acts in accordance with its own ideas about life. These ideas may be very different from the habits and philosophy of the real owner of the body.

Despite the fact that some experts consider this disease to be iatrogenic - that is, provoked by the careless words of doctors or by watching a “scientific” TV show - there is a number of evidence indicating the opposite. One of the most impressive is the history of the disease. Cases of dissociative disorder were recorded even when there were no traces of either psychotherapists or television shows. However, psychiatry itself did not exist.

One of the first described cases of dissociative identity disorder occurred at the end of the 18th century in the German city of Stuttgart. A revolution had just occurred in France, and aristocrats, saving their lives, fled from their native country to neighboring states, including Germany. A young resident of Stuttgart took their misfortunes too seriously. She suddenly had a second personality - a French woman. She not only spoke her “native language” perfectly, but also coped noticeably worse with German, and she developed a noticeable accent. The Frenchwoman who appeared was of aristocratic blood, and her manners and habits were fully consistent with her status. It is noteworthy that the German girl did not remember what the “French girl” did, and she knew nothing about the rightful owner of the body.

The young German woman was not the only person with such a disease in her century, but, nevertheless, her illness turned out to be extremely rare - in total, until the middle of the 20th century, 76 cases of dissociative identity disorder were documented. Interestingly, in recent decades, much more of them have been described - today there are more than 40 thousand people living in the world with this diagnosis. However, this does not mean the beginning of an “epidemic” - psychiatry, with all its arsenal of medications, appeared only in the middle of the last century, and, accordingly, control over the incidence of such disorders began not much earlier.

Separation of functions

Today, quite a lot of books and articles have been written about multiple personality disorder, both popular and academic. The most interesting thing about it is, perhaps, the moment of the onset of the disease in childhood. No one is born a “ready-made”, whole person. Growing up, a child experiences many emotions and experiences that are loosely related to each other. Over time, they integrate together, forming one common identity. However, child development does not always go smoothly. In cases where children are early age(around 2 years of age) are separated from their mother when they experience violence or some kind of traumatic experience, childhood experiences can remain segregated and lead to the formation of two or more personalities. Almost all patients with multiple personality disorder (97–98% to be exact) mention a difficult childhood with traumatic experiences.

Dissociative identity disorder often begins in childhood, but can appear later in life. Over the years, patients tend to have an increasing number of “tenants.” Since individuals, as a rule, perform certain functions, help to cope with certain life situations, with the emergence of new tasks and problems, new residents appear who are able to cope with them. Each of the subpersonalities has its own worldview, its own habits, gestures and facial expressions, even age and intelligence. At certain moments, either by the free will of the “owner” or in spite of it, one of the personalities gains control over the body, and everything done by it during use, as a rule, is not controlled and is not remembered by the patient himself.

The key issue in the life of patients with dissociative identity disorder is the relationships that have developed in the “team”. Subpersonalities may or may not know about each other's existence, act aggressively or quietly wander through museums on their own time, negotiate a rental schedule with the owner of the body, or regularly organize power grabs. The treatment strategy also depends on these factors - it is based on psychotherapy, and although its ultimate goal is to achieve the integration of personalities into one, an important task in the process is the “neutralization” of dangerous residents, and the organization of harmonious relationships between all subpersonalities.

Having more than one identity in one body is unfortunately not the only symptom of dissociative identity disorder. It is often accompanied by depression, anxiety disorders, phobias, sleep and eating disorders, even hallucinations. Dissociative disorder is sometimes confused with schizophrenia, but the two diseases can be differentiated—with schizophrenia, symptoms tend to be perceived as enemy actions by aliens, the KGB, or members of the Masonic Lodge, which is not the case with dissociative disorder. In addition, splitting identities in schizophrenia is a simple separation of mental functions due to a general breakdown of the personality, but in DID (Dissociative identity disorder - another name for multiple personality disorder) everything is much more complicated. The functions are not only divided, but also become full-fledged individuals: each of them has her own style of clothing, supports her football team and has her own ideas about how to spend time.

Deviation or norm?

Treatment for patients diagnosed with multiple personality disorder is usually long, difficult, and emotionally taxing. However, not everyone agrees that it should be treated at all. American psychologist James Hillman, founder of the school of archetypal psychology, is convinced that the position according to which multiple personality syndrome is considered a disorder is nothing more than a stereotype that can and should be fought, advocating for the right of people with this diagnosis to be considered no less normal than others. The goal of therapy, according to Hillman, is simply the creation of harmonious relationships among all subpersonalities. His position is supported by many patients. The ideologist of such a movement was Truddy Chase, who refused to integrate subpersonalities into a single whole and instead established mutually beneficial cooperation with them. She wrote about her experience in the book When the Rabbit Howls. Today, Truddi is far from the only one who refuses integration. No wonder: kill good friends with your own hands and useful assistants, albeit symbolically, is still not easy.

Have you ever thought that you might not know someone very well? That sometimes he seems completely different, alien, unfamiliar, as if he had been replaced? As if several completely different people live in his body?

Dissociative identity disorder (DID), also known as multiple personality disorder (MPD), multi-personality, split personality...what is it?In this article, psychologist Yulia Koneva will tell you everything about multiple personality disorder, what are its causes, signs, symptoms and manifestations, and you will also learn real stories from the lives of people with this disorder.

Split personality: 23 souls in one body

“Personalities” may differ in mental abilities, nationality, temperament, worldview, gender and age

Reasons for the development of DID

How does multiple personality occur? The etiology of split personality is currently not fully understood, but the available data speaks in favor of the psychological nature of the disease.

arises due to the mechanism of dissociation, under the influence of which thoughts or specific memories of ordinary human consciousness are divided into parts. Divided thoughts expelled into the subconscious spontaneously emerge in consciousness thanks to triggers, which can be events and objects present in the environment during a traumatic event.

Split personality disorder, like other dissociative disorders, is psychogenic in nature. Its occurrence is associated with a whole complex of factors. The trigger can sometimes be an acute stressful situation that a person is unable to cope with on his own. For him, multiple personality serves as a defense against traumatic experiences. Many dissociative disorders develop in people who are, in principle, able to dissociate, to separate their perceptions and memories from the stream of consciousness. This ability, coupled with the ability to enter a trance state, is a factor in the development of dissociative identity disorder.

The causes of split personality often lie in childhood and are associated with traumatic events, the inability to defend against negative experience and lack of love and care towards the child on the part of his parents. Research by North American scientists has found that 98% of people with multiple personality disorder were victims of violence as children(85% have documentary evidence this fact). Thus, these studies have proven that the key factor provoking split personality is childhood violence. In other situations, it plays a large role in the development of dissociative identity disorder. early loss loved one, complex disease or other acute stressful situation. In some cultures, a key factor may be war or a global catastrophe.

For multiple personality disorder to occur, a combination of:

• Intolerable or severe and frequent stress.
• Dissociation abilities (a person must be able to separate his own perceptions, memories or identity from consciousness).
• Manifestations in progress individual development defense mechanisms of the psyche.
• Traumatic experiences in childhood with a lack of care and attention towards the injured child. A similar picture arises when the child is insufficiently protected from subsequent negative experiences.

A unified identity (the integrity of the self-concept) does not arise at birth; it develops in children through many experiences. Critical situations create an obstacle to the child's development, and as a result, many parts that should be integrated into a relatively unified identity remain separate.

A longitudinal study by Ogawa et al suggests that lack of access to the mother at age 2 is also a predisposing factor for dissociation.

The ability to generate multiple personalities does not appear in all children who have experienced violence, loss, or other serious trauma. Patients suffering from dissociative identity disorder are characterized by the ability to easily enter a trance state. It is the combination of this ability with the ability to dissociate that is considered a factor contributing to the development of the disorder.

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Symptoms and signs

Dissociative identity disorder (DID) is the modern name for a disorder that is known to the general public as multiple personality disorder or split personality disorder. This is the most severe disorder from the group of dissociative mental disorders, which manifests itself with most of the known dissociative symptoms.

TO main dissociative symptoms include:

1. Dissociative (psychogenic) amnesia, in which sudden memory loss is caused by a traumatic situation or stress, and the assimilation of new information and consciousness is not impaired (often observed in people who have survived military operations or a natural disaster). Memory loss is recognized by the patient. Psychogenic amnesia is more common in young women.
2. Dissociative fugue or dissociative (psychogenic) flight reaction. Manifests itself in the sudden departure of the patient from the workplace or home. In many cases, the fugue is accompanied by an affectively narrowed consciousness and subsequent partial or total loss memory without awareness of the presence of this amnesia (a person may consider himself a different person, as a result of having a stressful experience, behave differently than before the fugue, or may not be aware of what is happening around him).
3. Dissociative identity disorder, as a result of which a person identifies himself with several personalities, each of which dominates him at a different time interval. The dominant personality determines a person's views, behavior, etc. as if this personality is the only one, and the patient himself, during the period of dominance of one of the personalities, does not know about the existence of other personalities and does not remember the original personality. The switch usually happens suddenly.
4. Depersonalization disorder, in which a person periodically or constantly experiences alienation from his own body or mental processes, observing himself as if from the outside. There may be distorted sensations of space and time, the unreality of the surrounding world, and disproportionality of the limbs.
5. Ganser syndrome(“prison psychosis”), which is expressed in the deliberate demonstration of somatic or mental disorders. Appears as a consequence of the internal need to look sick without the goal of gaining benefit. The behavior that is observed with this syndrome resembles the behavior of patients with schizophrenia. The syndrome includes passing speech (a simple question is answered out of place, but within the topic of the question), episodes of extravagant behavior, inadequacy of emotions, decreased temperature and pain sensitivity, amnesia regarding episodes of the syndrome.
6. Dissociative disorder, which manifests itself in the form of trance. Manifests itself in a reduced response to external stimuli. Split personality is not the only condition in which trance is observed. A trance state is observed during monotony of movement (pilots, drivers), among mediums, etc., but in children this state usually occurs after injury or physical violence.

Dissociation can also be observed as a result of long-term and intense violent suggestion (processing of the consciousness of hostages, various sects).

Signs of split personality also include:

• Derealization, in which the world seems unreal or distant, but there is no depersonalization (no violation of self-perception).
• Dissociative coma, which is characterized by loss of consciousness, a sharp weakening or lack of response to external stimuli, extinction of reflexes, changes in vascular tone, disturbances in pulse and thermoregulation. Stupor (complete immobility and lack of speech (mutism), weakened reactions to irritation) or loss of consciousness not associated with a somatoneurological disease is also possible.
• Emotional lability(sharp mood swings).

Possible anxiety or depression, suicide attempts, panic attacks, phobias, or eating disorders. Sometimes patients experience hallucinations. These symptoms are not directly associated with multiple personality disorder, as they may be a consequence of psychological trauma that caused the disorder.

Diagnostics

Dissociative identity disorder is diagnosed when the following criteria are met:

• Absence of alcohol, drug intoxication, influence of other toxic substances and diseases. No obvious simulation or fantasy.
• The person has obvious memory problems that have nothing to do with simple forgetfulness.
• The presence of several distinguishable “I” states with stable models of perception of the world, different attitudes to the surrounding reality and worldview.
• The presence of at least two of the distinguishable identities capable of influencing the patient's behavior. Dissociative identity disorder (multiple personality disorder, multiple personality disorder, organic dissociative identity disorder) is a rare mental disorder in which there is a loss of personal identity and the impression that several different personalities (ego states) exist in one body. .

Dissociative identity disorder is diagnosed based on four criteria:

1. The patient must have minimum two(possibly more) personal states. Each of these individuals must have individual characteristics, character, their own worldview and thinking; they perceive reality differently and differ in behavior in critical situations.
2. These personalities control a person's behavior in turn.
3. The patient has memory lapses; he does not remember important episodes of his life (a wedding, the birth of a child, a course he took at the university, etc.). They appear in the form of phrases “I can’t remember,” but usually the patient attributes this phenomenon to memory problems.
4. The resulting dissociative identity disorder is not associated with acute or chronic alcohol, drug or infectious intoxication.

Split personality needs to be distinguished from role-playing games and fantasies.

Since dissociative symptoms also develop with extremely pronounced manifestations of post-traumatic stress disorder, as well as with disorders associated with the appearance of pain in the area of ​​some organs as a result of an actual mental conflict, split personality must be distinguished from these disorders.

The patient has a “basic” main personality, who has a real name, and who usually unaware of the presence of other personalities in his body Therefore, if a patient is suspected of having a chronic dissociative disorder, the psychotherapist needs to explore:

• certain aspects of the patient's past;
• current mental status of the patient.

How is the disorder diagnosed? Interview questions are grouped by topic:

• Amnesia. It is advisable that the patient give examples of “time gaps”, since microdissociative episodes under certain conditions also occur in absolutely healthy people. In patients who suffer from chronic dissociation, situations with gaps in time are often observed, the circumstances of amnesia are not associated with monotonous activity or extreme concentration of attention, and there is no secondary benefit (it is present, for example, when reading fascinating literature).

At the initial stage of communication with a psychiatrist, patients do not always admit that they are experiencing such episodes, although every patient has at least one personality who has experienced such failures. If the patient has given convincing examples of the presence of amnesia, it is important to exclude the possible connection of these situations with drug or alcohol use (the presence of a connection does not exclude split personality, but complicates the diagnosis).

Questions about the presence of things in the patient’s wardrobe (or on herself) that she did not choose help to clarify the situation with time gaps. For men, such “unexpected” objects can be vehicles, tools, weapons. Such experiences may involve people (strangers claiming to know the patient) and relationships (actions and words that the patient knows about from loved ones). If strangers, addressing the patient, used other names, they need to be clarified, since they may belong to other personalities of the patient.

• Depersonalization/derealization. This symptom is most often found in dissociative identity disorder, but it is also characteristic of schizophrenia, psychotic episodes, depression or temporal lobe epilepsy. Transient depersonalization is also observed in adolescence and in moments of near-death experience in a situation of severe trauma, so you need to remember the differential diagnosis.

It is necessary to clarify with the patient whether he is familiar with the condition in which he observes himself as by a stranger, watching a “movie” about himself. Such experiences are common to half of patients with multiple personality disorder, and usually the observer is the patient's main, base personality. When describing these experiences, patients note that at these moments they feel a loss of control over their actions, look at themselves from some external, located on the side or above, fixed point in space, and see what is happening as if from the depths. These experiences are accompanied by severe fear, and in people who do not suffer from multiple personality disorder and have received similar experience As a result of near-death experiences, this state is accompanied by a feeling of detachment and peace.

There may also be a feeling of the unreality of someone or something in the surrounding reality, a perception of oneself as dead or mechanical, etc. Since such perceptions manifest themselves in psychotic depression, schizophrenia, phobias, etc., a broader differential diagnosis is necessary.

• Life experience. Clinical practice shows that in people suffering from split personality, certain life situations are repeated much more often than in people without of this disorder.

Violence suffered in childhood - key factor development of DID

Typically, patients with multiple personality disorder are accused of pathological lying (especially in childhood and adolescence), denial of actions or behavior that other people have observed. The patients themselves are convinced that they are telling the truth. Recording such examples will be useful at the therapy stage, as it will help explain incidents that are incomprehensible to the main personality.

Patients with multiple personality disorder are very sensitive to insincerity and suffer from extensive amnesia, covering certain periods of childhood (the chronological sequence of school years helps to establish this). Normally, a person is able to consistently talk about his life, recalling year after year. People with multiple personality disorder often experience sharp fluctuations school performance indicators, as well as significant gaps in the chain of memories.

Often, in response to external stimuli, a flashback state occurs, in which memories and images, nightmares and dream-like memories involuntarily invade the consciousness. A flashback causes severe anxiety and denial (a defensive reaction of the main personality).

There are also intrusive images associated with the primary trauma, and uncertainty about the reality of some memories.

It is also typical to manifest certain knowledge or skills that surprise the patient, since he does not remember when he acquired them (sudden loss is also possible).

• The main symptoms of K. Schneider. Patients with multiple personality disorder may “hear” aggressive or supportive voices arguing in their head, commenting on the patient's thoughts and actions. Phenomena may be observed passive influence(often this is an automatic letter). By the time of diagnosis, the main personality often has experience communicating with his alternating personalities, but interprets this communication as a conversation with himself.

When assessing the current mental status, attention is paid to:

• appearance (can change radically from session to session, up to sudden changes in habits);
• speech (timbre, vocabulary changes, etc.);
• motor skills (tics, convulsions, trembling of the eyelids, grimaces and reactions of the orientation reflex often accompany a change in personalities);
• thinking processes that are often characterized by illogicality, inconsistency and the presence of strange associations;
• the presence or absence of hallucinations;
• intelligence, which generally remains intact (only long-term memory shows mosaic deficiency);
• prudence (the degree of adequacy of judgments and behavior can change dramatically from adult behavior to child behavior).

Mental status assessment for multiple personality disorder
Sphere	Characteristics
Appearance	From session to session, dramatic changes can occur in the style of clothing, methods of personal care, general appearance, and demeanor of the patient. During the session, noticeable changes in facial features, posture, and manners are possible. Habits and addictions, such as smoking, can change within a short period of time
Speech	Changes in speech rate, voice pitch, accent, volume, vocabulary, and use of idiomatic or vernacular expressions may occur over a short period of time
Motor skills	Rapid blinking, eyelid trembling, noticeable eye rolling, tics, convulsions, orientation reflex reactions, facial tremors or grimaces often accompany switching alter personalities
Thinking processes	Sometimes thinking can be characterized by inconsistency and illogicality. Strange associations are possible; patients may experience blocking of thoughts or breaks in the sequence of thoughts. This is especially true in fast transitions or revolving door crises. However, thinking disorder does not go beyond the crisis
Hallucinations	Auditory and/or visual hallucinations may occur, including derogatory voices, voices commenting or arguing about the patient, or imperative voices. Usually the voices sound inside the patient's head. There may be voices whose messages are positive or have secondary process features.
Intelligence	Short-term memory, orientation, arithmetic operations and the main store of knowledge generally remain intact. Long-term memory may demonstrate mosaic deficiency
Discretion	The degree of adequacy of the patient's behavior and judgment may fluctuate rapidly. These shifts often occur along the dimension of age (that is, shifts from adult to childish behavior)
Insight	Typically, the personality introduced at the beginning of treatment (in 80% of cases) is not aware of the existence of other alter personalities. Patients demonstrate a marked learning disability based on past experiences

Putnam F. “Diagnosis and treatment of multiple personality disorder”

Patients typically present with a marked learning disability based on past experiences. EEG and MRI are also performed to exclude the presence of organic brain damage.

There are also other symptoms of multiple personality disorder:

• mood swings, depression;
• suicidal ideas and attempts;
• increased level of anxiety up to anxiety disorder;
• sometimes dissociative disorders of a different nature are present;
• disturbance of appetite, diet;
• poor sleep, insomnia, ;
• the presence of various phobias, panic disorders;
• a feeling of loss, confusion, sometimes derealization and depersonalization appear;
• Children may experience changeable tastes, conversations with themselves, and conversation in different manners.

Since schizophrenia and dissociative identity disorder have many similar symptoms, even hallucinations sometimes appear with a split personality, a person is sometimes mistakenly diagnosed with schizophrenia, although dissociative identity disorder is of a completely different nature.

Psychological testing

MMPI test

The MMPI test (Minnesota Multiphasic Personality Inventory, MMPI) is a personality questionnaire created at the University of Minnesota (USA) by psychiatrist Stark Hathaway and clinical psychologist John McKinley in 1947. This test is used in personality diagnostics.

In three studies, the MMPI was administered to a sample of 15 or more patients with DID (Coons & Sterne, 1986; Solomon, 1983; Bliss, 1984b). All of these independent studies produced a number of consistent results. The MMPI profile of patients with DID is characterized by an increase in the F validity scale and in the Sc scale or the “schizophrenia” scale (Coons and Sterne, 1986; Solomon, 1983; Bliss, 1984b). Among the critical items on the schizophrenia scale that patients with DID often responded positively to were item 156: “I have had periods when I did something and then didn’t know what I was doing,” and item 251 : “I have had periods when my actions were interrupted and I did not understand what was happening around me” (Coons, Sterne, 1986; Solomon, 1983). Coons and Sterne (1986) found in their study that item 156 was answered positively by 64% of patients on first testing and 86% on retesting, with an average interval of 39 months between two tests. They also found that 64% of patients gave a positive answer to item 251. In addition, it was noted that these patients were much less likely to give positive answers to critical psychotic disorders items of the questionnaire, with the exception of the item describing auditory hallucinations.

An increase in the F score, which is often a formal basis for considering an entire MMPI profile invalid, was found in all three studies (Coons & Sterne, 1986; Solomon, 1983; Bliss, 1984b). Solomon (1983) interpreted high scores on this scale as a “cry for help” and noted that it was associated with suicidal tendencies in his sample. In all three studies, the results of applying the MMPI to patients with DID indicate that the latter are polysymptomatic, in addition, it was suggested that many of the resulting profiles indicate the presence of borderline personality disorder.

Rorschach test

An even smaller number of patients with DID have been tested using the Rorschach test. Wagner and Heis (1974), in a study of the responses of patients with DID to the Rorschach test, noted two common features: (1) a large number of varied movement responses and (2) labile and conflicting color responses. Wagner and colleagues (Wagner et al., 1983) supplemented these data with four DID patients. Danesino et al. (1979) and Piotrowsky (1977) confirmed the first results of the Rorschach test by Wagner and Heis (1974), based on interpretations of the responses of two patients with DID. However, Lovitt and Lefkov (1985) objected to following the rules of interpretation followed by Wagner et al. (1983), who used a different protocol for recording responses to the Rorschach test in a study of three patients with DID. and Exner's system for interpreting responses. Although the number of cases that were examined using these protocols was too small to allow generalizations, the authors offered their conclusions about the specificity of the Rorschach test in identifying DID and other underlying dissociative pathology (Wagner et al., 1983; Wagner, 1978).

Physical examination

Psychiatrists in their practice, especially during outpatient visits, as a rule, do not systematically assess the patient’s physical status. There are many reasons for this, and the decision to carry out a physical status study is the prerogative of general practitioners. However, there are several considerations regarding the importance of examining a patient's physical status, or at least their neurological status, when diagnosing DID.

The single most characteristic pathophysiological feature of DID is amnesia, which manifests itself as difficulty remembering. Differential diagnosis Memory functioning requires the exclusion of organic disorders, such as concussion, tumor, cerebral hemorrhage, and organic dementia (for example, Alzheimer's disease, Huntington's chorea, or Parkinson's disease). In order to exclude the possibility of these diseases, a full neurological examination is necessary.

Physical examination may also help identify signs of self-inflicted physical injury, i.e. . Common body parts that are targets of self-harm in DID, often hidden from superficial observation, include the upper arms (hidden under long sleeves), the back, inner thighs, breasts, and buttocks. As a rule, marks from self-inflicted wounds take the form of neat cuts made with a razor blade or broken glass. In this case, thin scars are visible, similar to lines from a pen or pencil. Often, scars from repeated cuts form a shape on the skin, similar to Chinese characters or traces of chicken feet. Another common form of self-harm is burns caused by cigarettes or matches that are put out on the skin. These burns leave circular or dotted scars. If physical status assessment reveals signs of repeated self-harm, then there is good reason to suspect that the patient has a dissociative disorder, similar to DID or depersonalization syndrome.

Scars in patients with DID may also be related to childhood abuse. Sometimes patients with multiple personalities cannot explain the appearance of scars associated with a surgical operation - this gives us another fact that gives reason to assume that the patient has amnesia for important events his personal life.

Meeting alters

How to behave if you are dealing with a person suffering from multiple personality disorder? The diagnosis of DID (or RML) can only be made if the clinician himself directly records the emergence of one or more alter personalities and his observational data confirms that at least one alter personality has characteristic distinctive features and from time to time takes control of the individual's behavior (American Psychiatric Association, 1980, 1987). A discussion of the individuality and independence inherent in alters, which distinguishes them from shifting moods and ego states, is provided later in this chapter. How should a specialist behave upon first contact with the alter personality of his patient? F. Putnam talks about this in his book “Diagnostics and Treatment of Multiple Personality Disorder.” Let's take a closer look.

From a review of NIMH publications and research data, the initiators of first contact in approximately half of all cases are one or more alters who “come to the surface” and assert themselves as individuals whose identity is different from the main identity of the patient (Putnam et al ., 1986). Quite often, the alter personality begins contact with the therapist with a phone call or letter, introducing himself as a friend of the patient. As a rule, until this incident, the therapist does not suspect that his patient suffers from DID. Spontaneous manifestation of this symptom is possible immediately after the first meeting with the patient, either if he is in a state of crisis, or if the diagnosis of DID is confirmed.

Let's say that the patient acknowledges some dissociative symptoms and says that at times he feels like he is a different person or that there is another personality in him, and the other personality is generally characterized as hostile, angry or depressed and having suicidal tendencies. The clinician may then ask whether it is possible for him to meet this part of the patient: “Could this part come up and talk to me?” After asking this question, patients with multiple personality may experience signs of distress. The dominant personalities of some patients know that they can prevent the emergence of personalities they do not want and do not want the therapist to try to establish contact with them. Quite often it happens that the main personality, aware of the existence of other alters, competes with them for the therapist's attention and is not interested in facilitating their introduction to the therapist. In different ways the therapist may be made to understand that the emergence of a particular alter personality is impossible or undesirable.

Therapists who are not experienced with DID may experience great anxiety when alter personalities first appear. “How should I behave if some alter personality really suddenly appears in front of me?” “What can happen with this, are they dangerous?” “What if I'm wrong and there really aren't any alter personalities? Will my questions lead to the artificial emergence of such a personality? Typically, these and other questions arise with particular urgency for therapists who suspect their patient has multiple personalities, but who have not yet had experience of a clear change of alter personalities in their patient.

Alter personalities

The best way to establish contact with potential alters is to approach them directly. In many cases it makes sense to ask the patient directly about their existence and try to establish direct contact with them.

However, in some circumstances it is possible to use hypnosis or special drugs to facilitate the establishment of contact with alter personalities.

Addressing Suspected Alter Personalities

If the therapist has serious reasons to believe that his patient has DID, but contact with the alter has not yet occurred, then sooner or later there will come a time when the therapist will have to contact the suspected alters directly to establish this. This step may be more difficult for the therapist than for the patient. The therapist may feel stupid in this situation, but it is necessary to work through it. First of all, you need to determine “to whom” exactly to address your question. If the patient is truly a multiple personality, then in most cases the personality with which the therapist identifies the patient is probably the main personality. The main person, as a rule, is the person who is represented in the treatment. Usually this person is depressed and oppressed by the circumstances of his life (this may be less true for men), this person actively avoids or denies evidence of the existence of other personalities. If the patient is represented in sessions by a person who is not the main one, then this person is most likely aware of the plurality of the patient’s personality and strives to reveal it.

Typically, the therapist will address the alter personality he or she knows best about. The therapist, asking about situations that may be associated with manifestations of dissociative symptoms in a given patient, can, along with positive answers, receive a description specific situations who can help him. Let's say that a patient talks about how he lost his job several times due to outbursts of anger about which he could not remember anything. Based on this information, the therapist can assume that if the episodes of which the patient cannot remember anything were the appearance of DID, then most likely there is a person who became active during these moments and acted while experiencing the affect of anger. The therapist can use a description of this person's actions and, based on them, address her something like this: “I would like to speak directly to that part [aspect, point of view, side, etc.] of you that was active last Wednesday at your workplace and said all sorts of things to the boss.” The more direct the appeal to the supposed alter personality, the higher the chances of causing its appearance. Typically, calling by a specific name is most effective; however, establishing contact will also be facilitated by using the attributes or functions of the person being addressed (for example, “something dark,” “someone angry,” “little girl,” “administrator”). . The tone in which a request for a meeting with another part of the personality is made should be inviting, but not demanding.

Typically, the appearance of an alter personality does not occur immediately after the therapist first contacts it. Typically, this request must be repeated several times. If nothing happens, the therapist should pause to assess how his actions affected the patient. The therapist should carefully observe the appearance of signs of behavior indicating a possible change in the patient's alter personalities. If there are no visible signs of switching, then the therapist should determine whether his questions have caused the patient a feeling of discomfort. For most patients who do not have DID, questions directed at a hypothetical personality system structure do not cause significant distress. They simply pause or say something like, “I don’t think there’s anyone else here with us, Doctor.” On the other hand, in response to the therapist's persistent attempts to communicate with the alter personality, patients with multiple personality tend to show signs of great discomfort. This can be regarded as evidence of the existence of alter personalities. Most likely, at such moments they experience very strong distress. Some patients may experience a trance-like state where they become unresponsive to their surroundings.

If the patient shows signs of severe discomfort, the therapist may be tempted to refuse the request. In this state, the patient may squeeze his head with his hands, he may have grimaces of suffering, he begins to complain of headaches or pain in other parts of the body, and there may be some other signs of somatic suffering caused by the therapist’s request. This discomfort is due to the fact that some kind of struggle is unfolding inside the patient. Perhaps the main or some other alter personality belonging to the personality system is trying to prevent the emergence of one or another personality to which the request was sent; or two or more alters attempt to appear simultaneously; or the personality system is trying to push to the surface the alter personality to which the request was addressed, but this personality resists, it does not want to “come to the surface” and meet with the therapist. However, each therapist in each specific case must determine the degree of his persistence. Not all alter personalities appear when first approached, and, of course, the patient may not have DID.

If the patient undergoes a dramatic transformation and then says, “Hello, my name is Marcy,” then the therapist has overcome the first obstacle. If the patient reacts differently, then the therapist should stop and, together with the patient, explore what happened to the latter when the therapist tried to establish contact with the alter personality. Patients with multiple personalities may report that after contacting a putative alter personality, they seemed to "fade out", withdraw and withdraw, feel suffocated, feel very intense internal pressure, or feel as if a veil of fog had descended upon them. Such patient testimony strongly suggests dissociative pathology and indicates that the therapist should continue, perhaps in the next session, his attempts to contact the alter personality. In addition to trying to appeal to those alter personalities, the existence of which the therapist guesses from the examples given by the patient during the interview, one can try to establish contact with “some other” personality who may wish to enter into communication with the therapist.

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If the patient does not show obvious signs of strong feelings and denies any internal reaction to the therapist's request, then he may not have DID. However, there is a possibility that some strong alter personality or group of alter personalities is making efforts to hide the patient's multiple personality, and they may be able to do this for quite a long period of time. Most therapists who have experience treating DID have encountered similar cases more than once. Therefore, the therapist should not completely exclude the diagnosis based on only one unsuccessful attempt make contact with an alter personality. Either way, the therapist should not feel bad about making this request to his patient. Patients who don't have DID tend to treat such questions as one of those routine procedures that doctors usually do, like tapping patients on the knee with their little rubber hammers. Whereas patients with DID, after such questions, realize that the therapist is aware of the plurality of their personality and even wants to work with it. In general, the result of this intervention will be positive and it is quite possible that in response to it there will be a “spontaneous” emergence of an alter personality over the course of several subsequent sessions. Sometimes the personal system simply needs some time to get used to what was, perhaps, the first experience of being addressed as a kind of integrity and to decide on its response.

If the therapist is unable to induce the emergence of an alter personality through direct treatment and the patient continues to show clear signs of frequent dissociative episodes, then the use of hypnosis or drug-assisted interviewing should be considered.

Ways to communicate with alters

The simplest communication options include the appearance of an alter personality, which introduces itself and calls itself by a specific name, after which it enters into a conversation with the therapist. Most likely, this development of relationships is the most common; most patients with DID come to this sooner or later in therapy. However, at the very first stages of therapy, other ways of communication between alter personalities and the therapist are possible. They may approach the therapist indirectly, as if they were not “on the surface” (that is, they do not have direct control over the body). F. Putnam says that when he first came into contact with the alter personality of one patient, she introduced herself as "Dead Mary" and communicated with him using the voice of the shocked and frightened main personality. First of all, Dead Mary spoke about the hatred she felt towards the patient, and said that she wanted to “roast her so that she would turn into a firebrand”; Later, when her immediate appearance occurred, she turned out to be much less evil than her first remarks might have suggested. The reaction of the main personality to her first appearance was intense horror. The therapist's usual practiced response was to accept the emerging alter's statements as an objective fact and to maintain a polite and interested conversation with Dead Mary. This approach bore fruit and a dialogue was started. Of course, the main goal for which contact is established with the patient’s alter parts is a productive dialogue.

Contact can also be made through internal dialogue. The patient may “hear” the alter personality as an inner voice, which, as a rule, belongs to the “voices” that have been heard in the patient’s head for many years. In this case, the patient conveys to the therapist the answers he receives from the inner voice. Since the alter personality's responses in this situation are controlled by another personality (usually the main personality), distortions in the transmitted messages are possible. Dialogues based on the transmission of answers from internal voices are, one way or another, rather uninformative. Perhaps this situation is caused by insufficient degree trust between patient and therapist to achieve more or less direct contact.

Another means of communication with an alter personality is automatic writing, that is, the patient’s recording in writing of the alter personality’s responses in the obvious absence of volitional control on his part over this process. Milton Erickson published a case in which treatment was carried out using the method of automatic writing (Erickson, Kubie, 1939). If a patient reports new entries in a diary that he keeps regularly, but states that he cannot remember how he made them, then the therapist may try to use automatic writing to establish a channel of communication with the author of these entries, provided that previous attempts establishing direct contact with this alter personality remained unsuccessful. Automatic writing takes a lot of time and creates many problems, in addition, this method is not very effective for long-term therapy. However, in the early stages, with this method the therapist can gain access to the personality system, which may prove important in the later stages of treatment. Another way to establish contact with alter personalities with whom direct contact is impossible at this stage of therapy is the ideomotor signaling technique. Greatest effect achieved by combining this technique with hypnosis. The ideomotor signaling technique involves an agreement between the therapist and the patient to assign a certain meaning (for example, “yes”, “no” or “stop”) to a certain signal (for example, raising the index finger of the right hand).

How to talk to alters

Diagnosis confirmation

The therapist's contact with an entity whose identity is fundamentally different from the personal identity of the given patient, which has become familiar to the therapist, is not a sufficient basis for confirming the diagnosis of DID. Further confirmation is needed that the alter personality and other personalities that may appear in its wake are truly independent, unique, relatively stable, and distinct from intermittent ego states. The therapist is faced with the task of determining as accurately as possible the degree to which the patient's alter personalities are present in the outside world and, in particular, in therapy, as well as the role they played in the patient's life in the past. The therapist should also assess the level of temporary stability of the alters. True alters are amazingly stable and enduring entities whose “character” is independent of time and circumstances.

All currently known evidence suggests that the onset of DID is associated with the child experiencing states of extreme helplessness in childhood or early adolescence. Over time, efforts must be made to determine the history of the emergence of certain alter personalities of the patient that first appeared under similar or different circumstances or earlier. In other dissociative disorders, such as psychogenic fugue, the secondary identity typically has no memory of independent activity before the fugue episode, since the emergence of a new personal identity is strictly conditioned by the onset of the fugue.

Confirming the diagnosis of DID at the first stage of therapy may require some time, while acceptance of the diagnosis by both the patient and the therapist may be followed by its rejection, etc. You need to be prepared for this. Not currently developed special techniques for diagnosing DID. As a rule, to definitively confirm the diagnosis, data on the patient's response to the proposed treatment is required. If there is a significant improvement in the condition of a given patient as a result of the use in his treatment of methods specifically designed for the treatment of multiple personality, while other therapeutic approaches have proven to be less effective, then the criterion of truth, so to speak, is practice.

Treatment for Multiple Personality Disorder

Dissociative identity disorder is a disorder that requires the help of a psychotherapist experienced in treating dissociative disorders.

Main areas of treatment are:

• relief of symptoms;
• the reintegration of the various personalities that exist within a person into one well-functioning identity.

For treatment use:

• Cognitive psychotherapy, which is aimed at changing thinking patterns and inappropriate thoughts and beliefs using structured training, experimentation, and mental and behavioral training.
• Family psychotherapy, aimed at teaching families how to interact in order to reduce the dysfunctional impact of the disorder on all family members.
• Clinical hypnosis, helping patients achieve integration, alleviating symptoms and promoting change in the patient's character. Multiple personality disorder should be treated with hypnosis with caution because hypnosis can trigger multiple personalities. Works by multiple personality disorder treatment specialists Ellison, Caul, Brown, and Kluft describe cases of hypnosis being used to relieve symptoms, strengthen the ego, reduce anxiety, and create rapport (contact with the hypnotist).

Insight-oriented psychodynamic therapy is used relatively successfully, helping to overcome trauma received in childhood, revealing internal conflicts, identifying a person’s need for individuals and correcting certain defense mechanisms.

The treating therapist must treat all of the patient's personalities with equal respect and not take any one side in the patient's internal conflict.

Drug treatment is aimed solely at eliminating symptoms (anxiety, depression, etc.), since there are no medications to eliminate split personality.

With the help of a psychotherapist, patients quickly get rid of dissociative escape and dissociative amnesia, but sometimes amnesia becomes chronic. Depersonalization and other symptoms of the disorder are usually chronic.

Generally all patients can be divided into groups:

• The first group is characterized by the presence of predominantly dissociative symptoms and post-traumatic signs, general functionality is not impaired, and thanks to treatment they fully recover.
• The second group is characterized by a combination of dissociative symptoms and mood disorders, eating behavior etc. Treatment is more difficult for patients to tolerate, it is less successful and takes longer.
• The third group, in addition to the presence of dissociative symptoms, is distinguished by pronounced signs of other mental disorders, so long-term treatment is aimed not so much at achieving integration, but at establishing control over symptoms.

First of all, a person who has noticed alarming signs of a violation of self-identity should definitely contact a psychotherapist for help. If the patient truly has multiple personality disorder, rather than schizophrenia, intoxication, or another conversion disorder, then the primary goal of treatment will be the integration of the individual, distinguishable identities into one stable, well-adjusted personality. And this can only be done under the supervision of a specialist using psychotherapy methods. This disease responds well to treatment with cognitive techniques, family therapy methods, and hypnosis. Medicines are used exclusively to relieve accompanying symptoms, such as anxiety or depression. It is important in the treatment process to help the patient overcome the consequences of psychological trauma, identify conflicts that provoked the separation of several identities and correct protective mental mechanisms. Treatment for dual personality disorder is not always able to help integrate different identities into one. However, ensuring the peaceful coexistence of different personalities is also quite a big success. In any case, you should trust the specialists and tune in to a positive result.

Prevention of DID

Dissociative identity disorder is a mental illness, so there are no standard preventive measures for this disorder.

Since child abuse is considered the main cause of this disorder, many international organizations are currently working to identify and eliminate such abuse.

To prevent dissociative disorder, it is necessary to promptly contact a specialist if a child is diagnosed with psychological trauma or experienced severe stress.

Very little scientific literature provides information about dissociative identity disorder, but modern human culture constantly touches on this issue in its works and fully shows the symptoms of this disease.

Known cases of dissociative identity disorder

At the first sign of a violation of self-identity, you should consult a psychotherapist

Louis Vive

One of the first recorded cases of split personality belonged to the Frenchman Louis Viva. Born to a prostitute on February 12, 1863, Vive was deprived of parental care. When he was eight years old, he took the criminal path. He was arrested and lived in a correctional facility. When he was 17 years old, he was working in a vineyard and a viper wrapped itself around his left arm. Although the viper did not bite him, he was so terrified that he suffered convulsions and was paralyzed from the waist down. After becoming paralyzed, he was placed in a psychiatric hospital, but within a year he began walking again. Vive now seemed like a completely different person. He didn't recognize any of the people in the hospital, he became more gloomy, and even his appetite changed. When he was 18 years old, he was released from the hospital, but not for long. Over the next few years, Vive was constantly hospitalized. During his time there, between 1880 and 1881, he was diagnosed with multiple personality disorder. Using hypnosis and metal therapy (the application of magnets and other metals to the body), the doctor discovered up to 10 different personalities, all with their own personality traits and stories. However, after reviewing the case in recent years, some experts have concluded that he may have had only three personalities.

Judy Castelli

Growing up in New York State, Judy Castelli suffered physical and sexual abuse and subsequently struggled with depression. A month after she entered college in 1967, she was sent home by the school psychiatrist. Over the next few years, Castelli struggled with voices in her head that told her to burn and cut herself. She practically mutilated her face, almost lost sight in one eye, and lost one arm. She was also hospitalized several times for suicide attempts. Each time she was diagnosed with chronic undifferentiated schizophrenia.

But suddenly, in the 1980s, she began to travel to clubs and cafes and sing. She almost signed a contract with one label, but failed. However, she was able to find work and was the main act in a successful non-profit show. She also began sculpting and making stained glass. Then, during a therapy session in 1994 with a therapist she had been seeing for over a decade, she began to develop multiple personalities; at first there were seven of them. As the treatment continued, 44 personalities appeared. After learning she had a personality disorder, Castelli became an active supporter of movements related to the disorder. She was a member of the New York Society for the Study of Multiple Personalities and Dissociation. She continues to work as an artist and teaches art to people with mental illness.

Robert Oxnam

Robert Oxnam is a distinguished American scholar who spent his entire life studying Chinese culture. He is a former college professor, former president of the Asia Society, and currently a private consultant on issues related to China. And although he has achieved a lot, Oxnam has to struggle with his mental illness. In 1989, a psychiatrist diagnosed him with alcoholism. Everything changed after the sessions in March 1990, when Oxnam planned to stop therapy. One of his personalities, an angry young guy named Tommy, who lived in the castle, approached the doctor on behalf of Oxnam. After this session, Oxnam and his psychiatrist continued therapy and discovered that Oxnam actually had 11 separate personalities. After years of treatment, Oxnam and his psychiatrist reduced the number of personalities to just three. There is Robert, who is the main personality. Then there's Bobby, who was younger, a fun-loving, carefree guy who loves roller skating in Central Park. Another "Buddhist"-like personality is known as Wanda. Wanda used to be part of another personality known as the Witch. Oxnam wrote a memoir about his life called Split Mind: My Life with a Split Personality. The book was published in 2005.

Kim Noble

Born in the United Kingdom in 1960, Kim Noble said her parents were unhappily married workers. She was physically abused from a young age, and then she suffered from many mental problems when she was a teenager. She tried to swallow pills several times and was admitted to a psychiatric hospital. After twenty years, her other personalities emerged and they were incredibly destructive. Kim was a van driver, and one of her personalities, named Julia, took over her body and crashed the van into a bunch of parked cars. She also somehow stumbled upon a pedophile ring. She went to the police with this information, and after she did so, she began receiving anonymous threats. Then someone poured acid on her face and set her house on fire. She could not remember anything about these incidents. In 1995, Noble was diagnosed with dissociative identity disorder and continues to receive mental health care. She currently works as an artist, and although she doesn't know the exact number of personalities she has, she thinks there are somewhere around 100. She goes through four or five different personalities every day, but Patricia is the dominant one. Patricia is a calm, confident woman. Another notable figure is Hayley, the one who was involved with the pedophiles that led to that acid attack and arson. Noble (for Patricia) and her daughter appeared on The Oprah Winfrey Show in 2010. She published a book about her life, All My Selves: How I Learned to Live with the Many Personalities in My Body, in 2012.

Truddy Chase

Trudy Chase claims that when she was two years old in 1937, her stepfather physically and sexually abused her, while her mother emotionally abused her for 12 years. As an adult, Chase experienced enormous stress working as a real estate broker. She went to a psychiatrist and discovered that she had 92 different personalities that were significantly different from each other. The youngest was a girl about five or six years old, referred to as Lamb Chop. Another was In, an Irish poet and philosopher who was about 1000 years old. Neither personality acted against the other, and they all seemed to be aware of each other. She didn't want to integrate all the personalities into one because they had been through a lot together. She called her personalities "Troops". Chase, along with her therapist, wrote the book When the Rabbit Howls, which was published in 1987. It was made into a television mini-series in 1990. Chase also appeared on a very emotional episode of The Oprah Winfrey Show in 1990. She died on March 10, 2010.

Mark Peterson trial

On June 11, 1990, 29-year-old Mark Peterson took an unknown 26-year-old woman out for coffee in Oshkosh, Wisconsin. They met two days later in a park, and while they were walking, the woman said, she began showing Peterson some of her 21 personalities. After they left the restaurant, Peterson asked her to have sex in his car, and she agreed. However, a few days after this date, Peterson was arrested for sexual assault. Apparently the two individuals disagreed. One of them was 20 years old and appeared during sex, while the other person, a six-year-old girl, simply watched it. Peterson was charged and convicted of second-degree sexual assault because it is illegal to knowingly have sex with someone who is mentally ill and unable to consent. The conviction was overturned a month later, and prosecutors did not want the woman to suffer the stress of another trial. Her number of identities increased to 46 between the incident in June and the trial in November. Peterson's case was never heard again in court.

Shirley Mason

Born on January 25, 1923, in Dodge Center, Minnesota, Shirley Mason apparently had a difficult childhood. Her mother, according to Mason, was practically a barbarian. During numerous acts of violence, she gave Shirley enemas and then filled her stomach with cold water. Beginning in 1965, Mason sought help for her mental problems, and in 1954, she began dating Dr. Cornelia Wilbur in Omaha. In 1955, Mason told Wilbur about strange episodes in which she found herself in hotels in different cities, having no idea how she ended up there. She would also go shopping and find herself standing in front of scattered groceries with no idea what she had done. Soon after this confession, different personalities began to emerge during therapy. Mason's story of her horrific childhood and her split personality became a best-selling book, Sybil, and was made into a hugely popular television series of the same name starring Sally Fields. Although Sybil/Shirley Mason is one of the most famous cases of dissociative identity disorder, the public response has been mixed. Many people believe that Mason was a mentally ill woman who adored her psychiatrist, who instilled in her the idea of ​​a split personality. Mason even seemed to admit that she made it all up in a letter she wrote to Dr. Wilbur in May 1958, but Wilbur told her that it was just her mind trying to convince her that she wasn't sick. So Mason continued therapy. Over the years, 16 personalities have emerged. In the television version of her life, Sybil lives happily ever after, but the real Mason was addicted to barbiturates and dependent on her therapist to pay her bills and give her money. Mason died on February 26, 1998 from breast cancer.

Chris Costner Sizemore

Chris Costner Sizemore remembers that her first personality disorder occurred when she was about two years old. She saw a man being pulled from a ditch and she thought he was dead. During this shocking incident, she saw another little girl watching. Unlike many other people diagnosed with multiple personality disorder, Sizemore did not suffer from ill-treatment with children and grew up in a loving family. However, after seeing that tragic event (and another bloody work injury later), Sizemore claims that she began to behave strangely, and her family members also often noticed this. She often got into trouble for things she did and didn't remember. Sizemore sought help after the birth of her first daughter, Taffy, when she was in her early twenties. One day, one of her personalities, known as "Eve Black", tried to strangle a child, but "Eve White" was able to stop her. In the early 1950s, she began seeing a therapist named Corbett H. Siegpen, who diagnosed her with multiple personality disorder. While she was being treated by Siegpen, she developed a third personality named Jane. Over the next 25 years, she worked with eight different psychiatrists, and during this time she developed a total of 22 personalities. All these individuals were completely different in behavior, and they were different in age, gender, and even weight. In July 1974, after four years of therapy with Dr. Tony Tsitos, all the personalities merged and she was left with only one. Sizemore's first doctor, Siegpen, and another doctor named Harvey M. Cleckley wrote a book about Sizemore's case called "The Three Faces of Eve." It was made into a film in 1957, and Joanne Woodward won the Academy Award for Best female role, playing three of Sizemore's personalities.

Juanita Maxwell

In 1979, 23-year-old Juanita Maxwell was working as a hotel maid in Fort Myers, Florida. In March of that year, 72-year-old hotel guest Inez Kelly was brutally murdered; she was beaten, bitten and strangled. Maxwell was arrested because she had blood on her shoes and scratches on her face. She claimed that she had no idea what happened. While awaiting trial, Maxwell was examined by a psychiatrist, and when she went to trial, she pleaded not guilty because she had multiple personalities. In addition to her own personality, she had six others, and one of the dominant personalities, Wanda Weston, committed this murder. During the trial, the defense team, with the help of a social worker, were able to get Wanda to appear in court to testify. The judge considered the change to be quite remarkable. Juanita was a quiet woman, while Wanda was loud, flirtatious, and fond of violence. She laughed as she admitted to beating a pensioner with a lamp over a disagreement. The judge was convinced that either she really had multiple personalities, or she deserved an Academy Award for such a brilliant transformation. Maxwell was sent to a psychiatric hospital, where she says she did not receive proper treatment and was simply given tranquilizers. She was released, but in 1988 she was arrested again, this time for robbing two banks. She again claimed that Wanda did it; internal resistance was too strong and Wanda had the upper hand again. She pleaded no contest to the charge and was released from prison after serving her sentence.

Thank you for reading us! We will be grateful for your questions and comments on the article.

Certified psychologist, candidate economic sciences, accredited coach ICF (International Coach Federation). He has been engaged in psychological practice since 2002, including as a child psychologist and crisis psychologist. Specialization: victimology. Teaching experience since 2000.