Multiple Personality Disorder (MPD) &
Dissociative Identity Disorder (DID):

MPD/DID considered as a
fad & hoax. #2 of 5 views

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Please read the overview to MPD / DID before tackling this essay.

Background:

As the name implies, Multiple Personality Disorder (MPD) -- since 1994 called Dissociative Identity Disorder -- is a mental condition in which two or more personalities appear to inhabit a single body. 

There have been five main conflicting views about MPD. This essay will describe the most popular belief system: that MPD is a psychological fad and hoax that does not appear naturally, but is artificially induced during therapy, perhaps with the client and therapist being unaware of the processes involved.

MPD/DID, seen as a psychological fad:

Many memory researchers and a growing majority of therapists in North America have reached a consensus that:

	The past epidemic of MPD is a psychological fad.
	MPD does not occur naturally.
	MPD is an iatrogenic (therapist induced) disorder, unknowingly created by the interaction of a therapist and patient.
	Belief in MPD is in decline.
	Persons who have been diagnosed with MPD are victims of bad therapy, but not of MPD itself.
	If true MPD exists, it is an extremely rare phenomenon, affecting perhaps fewer than a dozen people in North America.

They generally believe that a therapist who specializes in MPD/DID teaches their clients to identify different aspects of their life and perspectives when they felt different moods -- happy, sad; childlike, adult; etc. Then the therapist gives each of these feelings a name. Later, the therapist will have the client revisit those feelings by recalling them by name. "By naming them this way,...[the therapist was] reifying a memory of some kind and converting it into a 'personality'." ₈ The client's moods or feelings then appear to both the client and therapist as fragmented personalities, generally referred to as "alters." In most cases, neither the client nor the therapist is aware of the process by which the alters are created.

MPD/DID is closely linked to two other fads, namely Recovered Memory Therapy (RMT) and beliefs about Satanic Ritual Abuse (SRA). Since 1980, all three panics have appeared suddenly on the scene, risen quickly to prominence, been popularized on TV talk shows, been supported by little or no valid research. Belief of their existence suffered a rapid decline in North America during the mid 1990s.

Some of the reasons for skepticism:

	A parallel hoax from the 1880's: Dr. P.R. McHugh of Johns Hopkins described an event that occurred in France during the 1880's. 1 He feels that it closely parallels today's MPD hoax. Jean-Martin Charcot was the chief physician of Salpetriere Hospital in Paris. He announced the discovery of a new disease. He called it "hystero-epilepsy" because it appeared to combine symptoms of both hysteria and epilepsy. Symptoms included "convulsions, contortions, fainting, and transient impairment of consciousness." A student, Joseph Babinski, suspected that hystero-epilepsy did not occur naturally, but was unintentionally created by Charot and the hospital environment. He noted that the patients had presented vague concerns when they were admitted; Charcot believed that he detected symptoms of this new disease, and housed them in a single ward, together with patients suffering from epilepsy. The patients became convinced that they were all victims of this new disease and started to exhibit symptoms. The "cure" was simple: The hystero-epileptic patients were distributed throughout the hospital and isolated from one another. The physicians and staff intentionally ignored the patients' behavior and concentrated on helping them tackle the stressors and conflicts that had had originally brought them to the hospital. The symptoms gradually disappeared due to lack of staff reinforcement. Dr. McHugh draws a close parallel between hystero-epilepsy and MPD. He considers each to be: "an iatrogenic [physician created] behavioral syndrome, promoted by suggestion, social consequences, and group loyalties. It rests on ideas about the self that obscure reality, and it responds to standard treatments." He proposed a four-part cure: Close the dissociation clinics throughout North America; Spread the patients throughout the remaining psychiatric hospital wards; Ignore the alters whenever they seem to appear; Redirect therapy to focus on the patients' stressors that caused the original, pre-MPD, symptoms. Since he made these suggestions, the 28 MPD clinics in North America have been closed, and the number of MPD/DID cases has dropped precipitously.
	The misdiagnosis problem: MPD practitioners often note that the average person who has just been diagnosed with MPD has had a long history of involvement with the psychiatric system and had received many incorrect diagnoses in the past: e.g. schizophrenia, depression, anxiety, panic disorders, borderline personality disorder. Skeptics speculate that perhaps the MPD diagnosis is incorrect and that one of the earlier evaluations was correct. Some persons diagnosed with MPD may in fact be victims of schizophrenia who have been taught during therapy that their auditory hallucinations are different alters. Patients with borderline personality disorder might have been taught to look upon their mood swings as switches between alters.
	The lack of early symptoms: Skeptics point out that symptoms had never been observed by the friends, spouse or family of a person who has just been diagnosed with MPD. They only are detected only after therapy has begun. Clients who are diagnosed with MPD never seem to claim that they are suffering from MPD symptoms at their initial visit. Alters appear later in therapy, as the therapist trains the client to identify normal mood swings as individual personalities. Dr. P.R. McHugh has concluded that: "MPD is an iatrogenic behavior syndrome, promoted by suggestion and maintained by clinical attention, social consequences and group loyalties." 2 The implication is that if there were no therapists looking for MPD then the disorder would almost completely vanish, and we would quickly return to the pre-1980 environment in which MPD was seen as an extremely rare phenomenon. This appears to have largely happened.

	Observations by crisis center volunteers: Many listeners at crisis centers/ suicide prevention lines in North America became well aware that MPD is an artificial phenomenon during the late 1980s and early 1990s. All hot lines have repeat, regular callers, and the volunteer listeners frequently build up a close emotional bond with many of them. If a caller starts to go to a MPD clinic, they would typically start to present themselves as different alters, with different names to the crisis line volunteers. When they broke contact with the clinic, often because their insurance runs out, the alters gradually disappear, and they become a single personality again -- once more calling the hot line under a single name and as a single personality. The disappearance of the alters may take only a few days, or may take years.
	Results of literature search: Dr. H. Merskey scanned 110 years of medical literature which predated the recent sudden rise in MPD diagnoses. None of the cases: "... excluded possibility of artificial production [of MPD symptoms]. ... No case has been found here in which MPD, as now conceived, is proven to have emerged through unconscious processes without any shaping or preparation by external factors...it is likely that MPD never occurs as a spontaneous persistent natural event in adults." 3
	Deterioration during therapy: Persons diagnosed with MPD/DID tend to start to deteriorate as soon as they are diagnosed. One leading MPD therapist commented that therapy "causes significant disruption in a patient's life outside the treatment setting". 4 He also notes that suicide attempts are common after diagnosis. It is an unusual mental health therapy that actually makes its clients worse. Mikkel Borch-Jacobsen stated: "As MPD psychotherapy progresses, patients may become more dissociative, more anxious, or more depressed...; the longer they remain in treatment, the more florid, elaborate, and unlikely their stories about their alleged childhood maltreatment tend to become....This worsening contributes to the lengthy hospitalizations - some costing millions of dollars... - that often occur when MPD patients who are well-insured are treated by the disorder's enthusiasts. Hospitalizations occur more frequently after the MPD diagnosis is made.... 7
	Lack of MPD among children: If MPD is created by intolerable levels of child abuse during childhood, then one would expect to find MPD symptoms among many children. But MPD seems to be found almost exclusively among adults. In the years prior to 1979, only one case of MPD in a child was reported. By 1988, only 8 new cases had been found. By 1990, 9 additional cases were reported. This represents a minuscule percentage of the total MPD diagnoses, which numbered in the tens of thousands. 5
	Lack of MPD among adults known to have been seriously abused in childhood: One would expect that adults who are known to have experienced truly horrific treatment during childhood would be found to be suffering from MPD. These would include people who: Survived terrible treatment in concentration camps, extermination camps, and Jewish ghettoes during World War II; Have seen their parents murdered; Have been kidnapped during childhood; Are known to have been heavily abused during childhood; etc. A variety of studies has revealed that "victims neither repressed the traumatic events, forgot about them, nor developed MPD." 5
	Lack of support for MPD Diagnoses: If 1% of the population suffers from MPD, as many proponents claim, then MPD is about as common as schizophrenia. One would expect that the number of MPD specialists would gradually increase to handle the approximately 3 million individuals in North America who are suffering from the disorder or will suffer from it in the future. But in fact, the number of therapists specializing in MPD is in decline. The International Society for the Study of Dissociation (ISSD), since renamed, lost membership during the 1980s and 1990s.  Psychological fads tend to have a lifetime of about 15 to 20 years. MPD diagnoses were essentially unknown prior to 1980, numbers of new cases per year rose quickly and reached a peak, probably in the early 1990's. They have been in decline since.
	Evidence of the creation of alters during therapy: Many skeptics believe that patients are actually coached in how to exhibit multiple personalities. For example, S.E. Buie, director of the Dissociative Disorders Treatment Program at a hospital in North Carolina offers the following advice for therapists who are digging for evidence of alters: "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 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'?" 6
	Lack of agreement over the nature of alters: Mikkel Borch-Jacobsen stated: "MPD experts contradict each other on the fundamental attributes of these entities. As an example, [Dr. Colin A.] Ross...says patients' minds are no more host to many distinct personalities than their bodies are to different people; another theorist believes that alter personalities are imaginary constructs... But in contradiction, DSM-IV and the writings of several MPD theorists repeatedly stress that alters are well-developed, distinct from one another, complex, and well-integrated.... Also, MPD-focused practitioners routinely report patients who have dozens or hundreds of personalities-yet Spiegel...has...claimed [in 1995] that because MPD patients cannot integrate various emotions and memories, such patients actually have less than one personality, not more than one." 7

Conclusions:

August Piper and Harold Merskey reviewed the literature on DID and concluded that:

1. There is no proof for the claim that DID results from childhood trauma.
2. The condition cannot be reliably diagnosed.
3. Contrary to theory, DID cases in children are almost never reported.
4. Consistent evidence of blatant iatrogenesis appears in the practices of some of the disorder's proponents.

They concluded that "DID is best understood as a culture-bound and often iatrogenic condition." Their paper was published in the Canadian Journal of Psychiatry, 2004-SEP. ₉

References:

1. P. R. McHugh, "Multiple Personality Disorder," an essay at: http://www.psycom.net/mchugh.html
2. P.R. McHugh, "Multiple Personality Disorder," Harvard Mental Health Newsletter, (1993-Fall)
3. H. Merskey, "The Manufacture of Personalities," British Journal of Psychiatry, 160:327-340.
4. F.W. Putnam, "Diagnosis and Treatment of Multiple Personality Disorder." Guilford, New York, NY (1989). Read reviews or order this book.
5. A. Piper, "Multiple Personality Disorder: Witchcraft Survives in the Twentieth Century," The Skeptical Inquirer, 1998-MAY/JUN, Pages 44 - 50 
6. R. Ofshe & E. Watters, "Making Monsters: False Memories, Psychotherapy and Sexual Hysteria," Schribners, New York, NY, (1994), Chapter 10, Pages 205 to 224.
7. Piper August, Jr., "Multiple personality disorder: witchcraft survives in the twentieth century," Skeptical Inquirer, 1998-MAN/JUN.
8. Mikkel Borch-Jacobsen, "Sybil -- The making of a disease," New York Review of Books, 1997-APR-24, Pages 61 & 62. This is an interview of Dr. Spiegel, who exposed Sybil's MPD misdiagnosis. See: http://www.astraeasweb.net/ Cited in Reinder Van Til, "Lost Daughters: Recovered Memory Therapy and the people it hurts," Eerdmand (1997), P. 180 & 181.
9. August Piper & Harold Merskey, "The Persistence of Folly: A Critical Examination of Dissociative Identity Disorder. Part I. The Excesses of an Improbable Concept," Canadian Journal of Psychiatry, 2004-SEP; 49; Pages 592 to 6000. See: CJP archives at: http://www.cpa-apc.org/
10. "The Three Faces of Eve," Science in the Cinema transcript, 1998-AUG-20, at: http://science-education.nih.gov/

Related essays on this Website:

	Mind control / programming by Satanic cults
	Demon possession and exorcism
	Recovered memory therapy
	Satanic ritual abuse

Copyright © 1998 to 2009, by Ontario Consultants on Religious Tolerance
Originally written: 1998-JAN-11
Last updated and reviewed on 2009-SEP-13
Author: B.A. Robinson

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