According to Boris Shusteff, the first medical study on Multiple Personality Disorder (MPD) (now referred to as Dissociative Identity Disorder or DID) began in the 1800s with the first complete account of a patient with MPD written in 1865 (“Multiple Personality Disorder”). According to Philip Coons of the Department of Psychiatry of the Indiana School of Medicine, the first MPD case was described in 1792 by Eberhardt Gmelin. Twenty-three years later after Gmelin reported the first case of MPD, the first MPD case in America was repored.
In 1840 Denise Pete reported the first case of MPD among children. In the succeeding years, the number of MPD cases among children aged 8 to 12 years has increased (Coons). In the 1900s, 76 cases of MPD (which was then considered by psychologists as an extremely rare medical condition) have been documented worldwide. It was during the 1980s that the American Psychiatric Association (APA) recognized MPD as an emotional illness and referred to it as a “hysterical neurosis” (“Multiple Personality Disorder”).
In 1984, approximately one thousand cases have been recorded; five years later the number of MPD cases has increased to about four thousand. Between 1985 and 1995, the number of MPD cases has reached 10,000. However, according to Shusteff, a decline in the number of MPD cases was observed during the mid-1990s. In 1869, four years after the first complete account on MPD was written, Pierre Janet, a French neurologist discovered that by hypnotism, “a system of ideas split” from the personality of his female patients.
It was William James, the father of American Psychology who coined the term “dissociation” to refer to MPD (“Multiple Personality Disorder”). Dissociative Identity Disorder (DID) was found to be a more appropriate term than MPD since a person is said to “dissociate” from his original personality and subsequently developing secondary personalities when faced with stress or traumatic situations. The publication of “Sybil” in 1973 established childhood physical and sexual abuse as strongly linked with the development of MPD.
In a study of Putnam wherein 100 persons with MPD were included, eighty-three percent were found to have been sexually abused; 75% of the total experienced physical trauma, and 61% had history of extreme neglect and abandonment (Coons). According to Spiegel, psychiatrists associate MPD with traumatic childhood experiences such as repeated physical, emotional or sexual abuse. Persons who have MPD tend to dissociate from their original personalities when confronted by stressful situations as a means of protecting themselves from experiencing either mental or physical pain.
Studies show a strong link between extreme and repeated physical and sexual abuse and the development of MPD. Mental health experts explain that multiple personalities arise in an individual who is unable to recover from repeated physical or sexual abuse or both. Researchers have also elucidated a biological basis for MPD. When confronted with an extremely stressful situation, the brain of a person with MPD releases a considerable amount of neurochemicals which subsequently cause “the area of the brain responsible for memory to pigeonhole what is remembered into separate compartments” (“Multiple Personality Disorder”).
Moreover, up to this day, there is no evidence showing that MPD is inherited. Cases of MPD before the present day were regarded as byproducts of “demonic possessions. ” Today, psychologists and psychiatrists are speculating that instances of demonic possessions were actual cases of MPD. Prior to the 1800s, when people behaved strangely and do not recall the actions they have taken, they were considered to be under the devil’s influence. Religious believers during this time who considered MPD as caused by possession of the devil thought that it can only be treated by exorcism (“Nature and History of the MPD/DID Controversy”).
Based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM II), MPD was regarded as a form of “hysterical neurosis. ” However, in the DSM (III), MPD was classified as one of the four dissociative disorders characterized by the following: first, the existence within an individual of different personalities with varying characteristics; second, the dominant personality at a particular time defines the behavior of the individual; lastly, each of the personalities possesses a complex characteristic, a unique behavior and social relationships (Coons).
Roediger further classifies Multiple Personality Disorder as a type of amnesia known as “functional amnesia. ” MPD or DID occurs in about 1% of the entire population. Studies revealed that this disorder occurs more frequently in females than in males with an incidence of 85% for the female population (Coons). Coons attributes this high incidence of MPD among women to sexual abuse and incest which have been found to be strongly associated with MPD.
Furthermore, studies show that during dissociation from the original personality, men tend to act more violently than women thus more men are jailed. Lastly, women assume more personalities than men, with a record of as many as fifteen personalities for females whereas males assume eight personalities (“Multiple Personality Disorder”). When a person who has MPD experiences dissociation from his original personality, he experiences temporary amnesia. According to Coons, the original personality does not recall any of the secondary personalities.
However, the secondary personalities may be aware of the existence of other personalities and even the original personality. Moreover, the original personality is usually “reserved and depleted of affect,” according to Coons. Contrary to the original personality who is “depleted of affect,” the secondary personalities possess emotions such as anger, depression, or anxiety. It has been documented that a person with MPD may assume different personalities with varying gender, age, and race.
Different personalities may also possess varying biological characteristics such as blood pressure, pain tolerance, and heart rates. These personalities may even exhibit varying response to medication such as penicillin and insulin. “Switching” is defined as a process by which the different personalities of an individual is revealed. It may last for a duration of a few seconds although some may last for several hours to days. Based on studies, the stronger personality governs and takes control of the other personalities (“Multiple Personality Disorder).
Kluft and Putnam have identified MPD as characterized by “a history of repeated childhood abuse, subtle alternating personality changes such as a shy child with depressed, angry, seductive, and/or regressive episodes, amnesia of abuse and/or other recent events such as schoolwork, angry outbursts, and regressive behavior, marked variations in abilities such as schoolwork, games, and music, trance-like states, hallucinated voices, intermittent depression and lastly, disavowed behaviors leading to being called a liar” (Coons). Up to this day, mental health experts still encounter difficulty in diagnosing the disorder.
Some patients are reluctant in divulging information about experiences of hallucinations and the existence of multiple personalities within them because of stigma. These patients feel afraid of being tagged as “insane” by the public. There are also instances when a change of personality is mistaken for mood changes. Next, because MPD is an extremely rare disorder, mental health experts assume that will not encounter cases of MPD in their practice thus causing them to miss MPD when making a diagnosis of dissociative disorders (Coons).
Today, MPD is treated through psychotherapy, hypnosis, or administration of anti-depressants. According to David Spiegel, psychotherapy is “aimed at helping patients to gain insight into each of their personality states, work through the aftermath of traumatic memories, achieve greater self-acceptance, and reduce self-damaging behavior. ” During hypnosis, personality switching is controlled. Lastly, those patients with MPD who experience depression may be given anti-depressants to alleviate the condition. According to Coombs, the treatment of MPD has three phases.
During the initial phase of therapy, communication with the different personalities is done so as to make their names, origins, and functions known. This phase may be very brief or may last for several months. Coombs stressed that during this phase of therapy, trust is a vital element. The amount of trust developed by the patient determines the length of this phase. The middle phase of therapy involves helping the original and secondary personalities deal with their problems. The therapist traces possible traumatic experiences which could have led to the development of MPD. The final phase involves an integration of all the personalities.
Integration can be done through including play therapy, hypnotherapy, and abreaction according to Kluft, Fagan, and MacMahon During this phase, the person with MPD should learn to cope with dissociation. In cases where there are attempts for self-destruction, hospitalization may be an option. It is important to note that the duration of treatment of children with MPD is often shorter than that of adults. Antipsychotic medications as well as anti-depressants may be administered although the effects are only temporary.
Works Cited
Coons, P. “Child Abuse and Multiple Personality Disorder. ” 23 November 2007. , <http://www. healthyplace.com/Communities/personality_disorders/wermany/reading_room/abuse. htm. > Roediger, H. “Memory (Psychology). ” Microsoft Encarta Encyclopedia. 2006. Shusteff, B. “Multiple Personality Disorder. ” 22 November 2007. <http://www. gamla. org. il/english/article/2005/feb/b1. htm>. 2005. Spiegel, D. “Dissociative Identity Disorder. ” Microsoft Encarta Encyclopedia. 2006. “Multiple Personality Disorder. ” 21 November 2007. Net Industries, <http://www. science. jrank. org/pages/4499/Multiple-Personality-Disorder. htm>. “Nature and History of the MPD/DID Controversy. ” 22 November 2007. , <www. religioustolerance. org. mpd. did2. htm>