Multiple personality disorder is now more usually
termed dissociated identity disorder. It is one of the more
misunderstood types of mental illness, frequently capturing the
interest of writers and filmmakers, who tend to portray it in its
most exaggerated form. What is most important to understand is the
multiple personality disorder is not schizophrenia. The two are
often confused. However, in very rare cases, a personality, or
alter, as it is sometimes termed, suffers from schizophrenia.
persistent trauma, or past trauma such as early childhood sexual
or physical abuse. When trauma occurs over a long period of time,
the affected person may begin to cope by completely disassociating
from the events that cause the trauma. This can lead to “alters,”
separate personalities within the same person who either are aware
of, or are unaware of the abuse. Alters can be childlike, strong,
male, or female, and often emerge as a coping device.
Psychiatrists make the distinction between a person having several
personalities, and believing they have several personalities. In
general, multiple personality disorder is the belief on the part
of the patient that several personalities seem to exist within the
self.
One of the main characteristics of multiple personality disorder
is that people seem to “lose” time. They seem unaware that time
has passed; yet someone observing them may see them acting in many
different ways. The afflicted however, tends to have no idea what
has occurred. This generally central personality seems most likely
to dissociate if the person is exposed to situations which can
evoke earlier traumas, or if the person is still enmeshed in a
traumatic situation.
Other symptoms of multiple personality disorder include
depression, confusion, suicidal thoughts, phobias, differing
levels of ability to function “normally,” anxiety, and
self-medication, such as alcoholism or drug abuse. Additionally,
those with multiple personality disorder may hurt themselves such
as in cutting the skin, may have a high degree of panic or panic
attacks, may have eating disorders or be prone to headaches.
As portrayed in films, multiple personality disorder seems to
consist of a number of very distinct personalities, which is
usually not the case in reality. Rather, those with multiple
personality disorder may pass from greater awareness to less,
without putting on a different accent or assuming a completely
separate identity. Multiple personality disorder that results in
crimes, as presented in several television series and with great
effect in the Richard Gere film Primal Fear rarely exists.
The primary treatment for multiple personality disorder is
therapy, which may include play therapy, hypnosis, art therapy,
and/or talk therapy. Medication is usually not preferred because
of the likelihood of overdose, and because the dissociative state
is not chemically induced. The goal is to get alters in
communication with each other, so that the person does not
continue to dissociate from reality. A secondary goal is to be
sure the person is removed from any ongoing traumatic situations,
such as removing a child from an abusive home.
When the person has reintegrated different personalities, there
may still be need for treatment, possibly drug therapy to treat
underlying psychological conditions like chronic depression or
schizophrenia. However, while the person is still “losing time,”
drug treatment may be completely ineffective because the person
may not remember to take the medication or may accidentally
overdose.
Therapy is usually a long process, particularly when one has
suffered repeated trauma. It can take several years for the
patient to begin to feel fully conscious at all times of his/her
actions and thoughts. However, clinical research suggests that
therapy for multiple personality disorder is effective, if the
therapy is continuously pursued
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