A favourite of thriller writers and suspense filmmakers, Multiple Personality Disorder, now renamed Dissociative Identity Disorder, is supposed to be a fairly common result of severe trauma suffered in early childhood, most typically extreme, repeated physical, or emotional abuse,
writes Kuldip Dhiman

THE young girl was just reading a book in the meadows when, all of a sudden, she fainted. A few hours later, her parents were shocked to learn that she had gone blind and deaf. Hearing returned suddenly after about five weeks, and sight a few more weeks hence. Three months on, when the girl appeared to be completely normal, she continued to lie abed long after her usual time. Then she awoke at once and "as far as acquired knowledge was concerned, her condition was precisely that of a new-born infant". But she differed from an infant as her faculty of acquiring knowledge was that of a grownup. After five weeks in this condition, Mary Reynolds, the girl we are talking about, woke again in her former state, remembering nothing of her life in the intervening weeks. As the time passed, she continued to alternate between the two states of existence. In a similar case, Thomas Hanna, a young and respectable clergyman of good education, fell unconscious as the result of a heavy fall. He too started behaving like an infant, and later began to alternate between the two personalities.

In yet another mysterious case, Leonie, a dull-witted, melancholy, child, under hypnosis, revealed a secondary personality who called herself Leontine. "She knew Leonie and commanded all Leonie’s memories but she denied that she was the same person. Leontine, an extrovert full of life, was inclined to despise Leonie." When hypnotism was deepened, there emerged a third personality called Leonore, who had all the memories of Leonie and Leontine. She was a serious and intelligent girl who looked upon both Leonie and Leontine as inferior beings.

What we just encountered are cases of a psychological problem called multiple personalty disorder. Although these cases were first reported in the mid-nineteenth century, they were brought back to popular imagination by Corbett H. Thigpen’s famous book and later the film The Three Faces of Eve (1957) based on it. Interest in such cases was further enhanced by Sybil a book which portrays a true story of a woman, Dorsett Flora, who had 16 separate personalities most of whom did not know or remember any of the others. One of the personalities called Victoria Antoinette Scharleau was a very confident, sophisticated attractive blonde. Another named Mike Dorsett thought she was a male builder and carpenter.

A favourite of thriller writers and suspense film makers, Multiple Personality Disorder (MPD), now renamed Dissociative Identity Disorder (DID)), is supposed to be a fairly common result of a severe trauma suffered in early childhood, most typically extreme, repeated physical, sexual, or emotional abuse. Women suffer from the disorder between three and nine times more frequently than do men, probably because they are a lot more prone to abuse as children and adolescents. The woman in The Three Faces of Eve, was forced by her mother to kiss a dead body.

Dissociative disorder might develop with the victim experiencing depression, mood swings, suicidal tendencies, sleep disorders, such as insomnia, night terrors, and sleep walking, panic attacks and phobias like flashbacks, reactions to stimuli or "triggers". Others signs are alcohol and drug abuse, auditory and visual hallucinations, and eating disorders. In addition, those who suffer from dissociative disorder can experience headaches, amnesia, time loss, trances, and out-of-body experiences. Some might have a tendency toward self-persecution, self-sabotage, and might inflict violence upon themselves and even others.

The patient can have two or more identities, called sub-personalities or alters (alternative personality), one of which often appears more than the others and for this reason is called primary personality, or the host personality. The change from one personality to another is often sudden and dramatic.

Dissociation is a mental process that produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. At the time when a person is dissociating, certain information is not associated with other information as it normally would be. For example, during a traumatic experience, a person may dissociate the memory of the place and circumstances of the trauma from his ongoing memory, resulting in a temporary mental escape from the fear and pain of the trauma. This results in a memory gap surrounding the experience. Because of this, people who frequently dissociate often find their senses of personal history and identity affected.

Psychologists believe that dissociation could range from mild to the severe. Most of us do have mild dissociative experiences when we daydream, or get ourselves lost in an interesting book or film, and thus lose touch with a conscious awareness of our immediate surroundings. Extreme cases, may result in serious impairment or inability to function and yet some people may continue to hold responsible jobs and go about their lives appearing quite normal to their relations and friends.

It is difficult to diagnose Dissociative Disorder because its symptoms very closely resemble other disorders like ‘fugue’ and ‘somnambulance’. For example, in fugue, those who suffer from memory disorder, often become amnesiac to such an extent that they forget much of their past lives and take up a new name, occupation, and a way of living without an awareness about who they were previously. In somnambulism, on the other hand, a person may go through complex performances while asleep, without being aware of what he is doing or remembering about it after he awakens. A more severe form of dissociation could lead to a multiple personality, in which there are two or more personalties, each of which is so well developed and integrated as to have a relatively unified, and stable life of its own.

Various types of dissociations, psychologists say, might shade into each other by imperceptible degrees and it is quite possible that a case of somnambulism may, by improper handling, develop into a case of multiple personality, and conversely, by proper treatment may develop instead into a normal integrated individual.

According to psychologists Taylor and Martin, multiple personality, like ordinary personality, is a psychological product in which the individual’s native capacities and past and present circumstances have led to the development of at least one disparate, protective role that is fairly well integrated within itself. It is protective, in that within it the individual can escape from some of his stresses, and so can feel more comfortable than he does feel otherwise. This protective role is disparate, finally, in that it is more or less opposed to, and separate from the rest of the individual’s total mental makeup.

For instance, when faced with overwhelmingly traumatic situations from which there is no physical escape, a child may resort to "going away" in his or her head. This ability is typically used by children as an extremely effective defence mechanism against acute physical and emotional pain. By this dissociative process, thoughts, feelings, memories, and perceptions of the traumatic experiences can be separated off psychologically, allowing the child to function as if the trauma had not occurred.

In adopting new personalities, an individual might take on one or more roles moulded by experience. This might happen either passively or actively, consciously or unconsciously. Passively, a role may come from out of the past, or from a living example, or from verbal or other suggestion. Actively, the sufferer may select or synthesise a role from his various observations and thoughts. Although it is usually so, it is not necessary that the new role be in total contrast to usual personality.

Often, even after the traumatic circumstances are long past, the left-over pattern of defensive dissociation remains. Chronic defensive dissociation may lead to serious dysfunction in work, social, and daily activities. Repeated dissociation may result in a series of separate entities, or mental states, which may eventually take on identities of their own. These entities may become the internal "personality states," of a dissociative person. Alternating between these states of consciousness is described as "switching."

Generally, different alters may relate to each other in one of three different ways:

• Mutually amnesiac - when the sub-personalities have no awareness of the others.

• Mutually cognisant - when each personality is aware of the others.

• One-way cognisant- when one personality knows of the second, or the third or the fourth, but the second will have no awareness of the first.

The most common of the three is the one-way amnesiac. The way in which the sub-personalities relate to each other can be varied. They may hear each other, talk to each other, get along well or argue non-stop.

Being a very rare disorder, the very existence of dissociation is in doubt. But those who have done work on the subject say that dissociative disorders are highly responsive to individual psychotherapy, as well as to a range of other treatment modalities, including medication, hypnotherapy, and adjunctive therapies such as art or movement therapy. The course of treatment is long-term, intensive, and invariably painful, as it generally involves remembering and reclaiming the dissociated traumatic experiences. Nevertheless, individuals with this disorder have been successfully treated by therapists of all professional backgrounds.

What the sceptics say

There are many who ask whether multiple personality disorder really exists. Researchers tell us that the symptoms attributed to it are as genuine as hysterical paralysis and seizures. But the sceptics say that: multiple dissociation, like hystero-epilepsy, is actually created by therapists themselves. Dissociation became popular after the appearance of several best-selling books and movies. It is often based on the crudest form of suggestion. How this could be done is shown in An introduction to MPD by Stephen E. Buie, who says that:

"It may happen that an alter personality will reveal itself to you during this (assessment) process, but more likely it will not. So you may have to elicit an alter... You can begin by indirect (sic) questioning such as, ‘Have you ever felt like another part of you does things that you can’t control?’ If she gives positive or ambiguous responses ask for specific examples. You are trying to develop a picture of what the alter personality is like. . . . At this point you may ask the host personality, "Does this set of feelings have a name?". . . . Often the host personality will not know. You can then focus upon a particular event or set of behaviors. ‘Can I talk to the part of you that is taking those long drives in the country?’"

Once patients have permitted a psychiatrist to "talk to the part. . . that is taking these long drives," they are committed to the idea that they have MPD and must act in ways consistent with this self-image.

Leave alone understanding multiple personality, we do not even understand what is called a ‘normal’ personality in the first place. The question of personality, or self is a hotly debated one and although the concept seems simple enough, the issue is a very complicated one indeed. The matter cannot be discussed in detail here, but most of us take it for granted, that a normal person is actually a single unified and consistent self, and that self usually is our body.

"We just assume" says psychologist Charles Tart, "that a given person is relatively consistent with himself, that he constitutes one person with various characteristics, traits, and so on. Thus you call yourself by one name, with the implication that you are indeed one person even though you have a range of moods and feelings. . . we actually have many quite discrete subpersonalities, each of which calls itself "I" when it happens to be activated by appropriate environmental stimuli, but we have no unity of personality at all except in the sense that all the various sub-personalities are associated with the same physical body and name."

If we looked at our own lives, we would realise that there is precious little continuity between our different states of consciousness. Let’s say when we are an employee one moment, we have usually forgotten that we were a completely different person, a friend, a student or a parent, a few moments before, and will be yet another person later. We are usually consumed by the personality of the moment. The personalities are isolated from each other by invisible walls of ‘unawareness.’ Between the many "I’s" there are defences or buffers and there is no stage director who remembers and coordinates all of the roles.

It is not surprising, that people from theatre, cinema and politics—who don so many roles and have a split in their public and private images—are likely to be more predisposed to some form of dissociation. A famous heroine of yesteryear who, because of the kinds of tragic roles that she played, had unwittingly created a very traditional image of herself among her fans, although in her real life she was very outgoing. One day, she was at home, smoking and drinking, when someone announced that a reporter was at the door. There was a sudden transformation in her personality, and by the time she was in front of the reporter, she was a very shy traditional Indian woman.

Stars and public personalities aside, almost every one of us suffers from weakly-connected consciousness, and mild dissociation appears to be natural and normal. We only recognise it as a problem in its most extreme forms, where there is total and complete disconnection of the different parts of the self. These are the cases where the different people inhabiting the body are complete strangers to each other.

Having read so far, if you suspect that you yourself or someone you know might be suffering from some form of dissociation, you need not be unduly alarmed, for as social psychologist George H. Mead (1863-1931) put it, "A multiple personality is in a certain sense normal."