Patrick Purcell’s article “A Basic Introduction to Multiple Personality Disorder” (now known as Dissociative Identity Disorder) was published in the January/February 1994 issue of the journal THE CALIFORNIA THERAPIST.”
A Basic Introduction To Multiple Personality Disorder
Now also known as Dissociative Identity Disorder
The good news about Multiple Personality Disorder (MPD) is that more therapists are learning about it and asking their clients in their initial interviews the basic questions in regard to dissociation: “Do you ever experience lost periods of time or time lapses?” “Do you ever hear voices from inside your head that tell you to do things or comment on things that you do?” “Do you ever feel like you have personality shifts?” Therapists are realizing that children often go into a state of trance when they are abused so trance or hypnosis is needed in the assessment and treatment of child abuse. Increasing numbers of therapists are joining the International Society for The Study of Multiple Personality and Dissociation at (708) 966‑4322 and the American Society for Clinical Hypnosis at (708) 297‑3317.
Multiple Personality Disorder is the existence of more than one personality with unique behavior patterns. This subpersonality or alter can take control of the body at different times and make the client unconscious or amnesiac to what is happening during those times.
For the sake of clarity, I will use the pronoun “he” to refer to the therapist and “she” to refer to the client. There are many men with MPD, but they often end up in prison. Dissociation and amnesia is one explanation of why so many male sex offenders deny doing the abuse, because another subpersonality actually did the abuse and there is no conscious memory of it. More women have been abused, thus more women have MPD.
MPD typically originates in the client’s childhood when she suffers a traumatic experience that is too painful for her personality to handle. The client deals with the experience by spontaneously developing a subpersonality that takes over during the trauma and holds the feeling and the memory of the trauma. The client and often the subpersonality can repress the memory and go about her life as though it had never happened. The client can create several subpersonalities from any specific trauma or a number of traumas. Having MPD can help a client survive terrible traumas, but it obviously complicates a client’s life considerably and can put her life at risk with suicidal alters.
The therapist must be able to recognize this disorder so that he either treats the client appropriately or refers the client to a specialist for treatment. Failure of a therapist to recognize MPD or another dissociative disorder puts the client at a medical risk such as suicide, self‑mutilation, substance abuse or eating disorders. It also puts the therapist at the legal risk of a malpractice lawsuit for ignoring the condition of MPD. Also it delays the therapeutic healing process by not correctly diagnosing and providing subsequent treatment interventions that are appropriate to that diagnosis.
A therapist may want to treat clients with MPD or they may want to refer these clients to specialists. The important factor is that every therapist needs to know how to assess and diagnose MPD not only for the above mentioned reasons but because of the high prevalence of some type of dissociative disorder. Ross (1989, p. 130) says “I think that MPD, psychogenic amnesia, and atypical dissociative disorder together are as common in the general population as anxiety disorders.”
Putnam et al. (1986) found that 100 MPD patients had averaged 6.8 years between their first mental health evaluation for symptoms related to MPD and receiving an accurate diagnosis. Many clients suffer unnecessarily by losing their childbearing years before the completion of their therapy, as well as suffering with their symptoms longer than they should. They also often have unnecessary hospitalizations and deplete their insurance benefits. Richard Kluft (1989) says the average MPD client often needs six years of therapy while twelve years is normal for cult abused MPD clients.
A correct diagnosis can be a real comfort to the client in understanding what has been going on in her life, and the subpersonalities are often relieved to be acknowledged and accepted. Many maladaptive symptoms can be cleared up quickly if the therapist addresses the subpersonalities directly and contracts with them to stop the behavior. These acts are often used as a way to punish the original personality for not listening to their feelings and stories of their memories.