Dissociative identity disorder

In psychiatry, dissociative identity disorder (DID) is the current name of the condition formerly listed in the Diagnostic and Statistical Manual of Mental Disorders as multiple personality disorder (MPD) and multiple personality syndrome. The International Statistical Classification of Diseases and Related Health Problems continues to list it as Multiple Personality Disorder. Multiple Personality Disorder should not be confused with schizophrenia. more...

Those who recognize dissociative identity disorder as a psychological condition believe that it is characterized by the use of dissociation as a primary defense mechanism. A chronic reliance on dissociation as a means of defending against stressors in the environment causes the individual to experience their psyche/identity as disconnected (from their senses, for example) or split into distinct parts.

Some psychologists and psychiatrists dissent from the manuals and regard the disorder as possibly iatrogenic or factitious. Some will accept it as a disorder, but prefer not to use terms like "defense mechanism", which they regard as an unscientific borrowing from Freudianism. See the article Defense mechanism for further discussion.

It is not clear what percentages of the psychological community accept, accept with reservations, or disagree with the previously noted positions.

Controversy

This diagnosis is controversial. The main points of disagreement are:

1. Whether MPD/DID is a real disorder, or just a fad.
2. If it is real, is the appearance of multiple personalities real or delusional?
3. If it is real, should it be defined in psychoanalytic terms?
4. Whether it can be cured.
5. Whether it should be cured.
6. Who should primarily define the experience -- therapists, or those who believe that they are "multiple" (have multiple personalities)?
7. Whether it is invariably a disorder or simply a way of being.

In rough terms, believers in DID or MPD argue that children who are stressed or abused (especially sexually abused), split into several independent personalities or ego states as a defense mechanism. How people with DID/MPD perceive their actions varies, but often only one personality (or "alter") can control the body at any given time. Sometimes alters are co-conscious and share all memories. Sometimes each alter reports remembering only the times when he/she/it controlled the body, and claims amnesia for all other periods. People diagnosed with DID may exhibit erratic alterations of personality and may claim to "lose time".

Skeptics claim that people who act as if they have MPD/DID have learned to exhibit the symptoms in return for social reinforcement, either from therapists, from others with DID, from society at large or from any combination thereof.

A third view is that it is normal to experience oneself as multiple and that "multiplicity" is not necessarily a disorder, so that it is possible to be multiple without having MPD or DID. Proponents of this view may generally hold the perhaps controversial belief that mental illness itself generally tends to be a culture-specific syndrome, and that many cultures throughout history have had different models for integrating alternative mentalities into their social fabric, for example, as shamans. Proponents of the "healthy multiple" position are common in online communities.

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