As the name implies, Multiple Personality Disorder
(MPD) is a mental condition in
which two or more personalities appear to inhabit a single body. The
American Psychiatric Association Diagnostic and Statistical Manual, Fourth
Edition renamed MPD "Dissociative Identity Disorder" in 1994s.
There have been five main conflicting views about MPD. In this essay, we will describe MPD as viewed as:
Those therapists who accept MPD as a valid, common diagnosis believe that it is induced
by extreme, repeated, physical, sexual, and/or emotional abuse during early childhood.
Many MPD specialists consider MPD is the same class as "schizophrenia,
depression, and anxiety, as one of the four major mental health problems today."
1 Although it is diagnosed almost entirely among women,
therapists speculate that it may be equally common among men. However, men are less likely
to seek treatment. They often end up in jail because of the behavior induced by
MPD.
Research shows that the average person who is just diagnosed with MPD has spent
seven years in
the mental health system, and has usually been previously misdiagnosed with other many
disorders.
Treatment for MPD takes many years of painful, intensive therapy as childhood memories
of vicious abuse are slowly recovered. The condition of the patient invariable degenerates during
therapy. But therapists believe that they can be restored to health after all of the
abusive memories are uncovered and the many alters (alternative personalities) are reintegrated into a single
personality.
Therapists developed the concept of a hierarchy of alters, in which each fragmented
personality had a different degree of power and different function within the whole
system.
Dr. Bennett Braun was one of the former leaders in the MPD/DID field. (He has
since been expelled from the Illinois Psychiatric Society and the American
Psychiatric Association, apparently for ethics violations.) He recommended that the therapist study
each alter in depth in order to learn:
Its name, so that it can be directly addressed in the future
When and where the patient was at the time that it was created
What events caused the creation of the alter
"The duration of time that it has executive control of the
body"
How it fits into the hierarchy of alters
Its function; how it contributes to the system of alters
One alter that is frequently found has the specific responsibility of harming the
patient by slashing, engaging in other forms of mutilation and committing suicide. Those
proponents of MPD who believe in Satanic or government conspiracy theories generally feel
that this alter is programmed to trigger in the event that the patient is about to reveal
secrets about the cult or agency.
One source quotes an unspecified article in the Canadian Journal of Psychiatry,
which found that "Persons with [the diagnosis of] MPD are highly suicidal with 72% attempting and
2.1% successful." 2
E.B. Carlson and F. W. Putnam, developed a simple screening test to detect dissociation
levels in people. It is called the Dissociative Experiences Scale. 3
Two of the 28 questions are:
"Some people have the experience of finding new things among their belongings
that they do not remember buying. Mark the line to show what percentage of the time this
happens to you."
"Some people find evidence that they have done things that they do not remember
doing. Mark the line to show what percentage of the time this happens to you."
We must admit that we are at a total loss to know how to answer these questions. If
they had asked how many times a year each experience happens, we could answer immediately:
perhaps 2. But we don't have the foggiest idea how to convert that number into a
percentage. Percentage of what, we would ask.
Various researchers
who have used test have predicted that perhaps 1% of the general population and 5 to 20%
of patients in psychiatric hospitals suffer from this disorder. 3
Many memory researchers and a growing majority of therapists in North America have
reached a consensus that:
The recent 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 where
they felt different moods -- happy, sad; childlike, adult; etc. Then the
therapist gives 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 distinct personalitys, without either
of them being aware of the process.
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 is now in rapid decline in North America.
Some of the reasons for skepticism include:
A parallel hoax from the 1880's: Dr. P.R. McHugh of
Johns Hopkinsdescribed an event which 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 both 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 4
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 approximately two dozen MPD
clinics in North America have been closed.
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 be
happening.
Observations by Hot Line volunteers: Many listeners at crisis centers/
suicide prevention lines in North America are well aware that MPD is an artificial
phenomenon. 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 will typically start to present themselves as different alters, with
different names. When they break contact with the clinic, often because their insurance
runs out, the alters gradually disappear, and they become a single personality again
--
calling the hot line once more under a single name. 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. "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. 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; those who have seen their parents murdered; those who have been kidnapped during
childhood; children known to have been abused; 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.
But in fact, the number of therapists specializing in MPD is in decline. The International Society for the Study of Dissociation (ISSD) is currently losing
membership.
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: "MPD
experts contradict each other on the fundamental attributes of these
entities. As an example, 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
August Piper and Harold Merskey reviewed
the literature on DID and concluded that:
There is no proof for the claim that DID results from childhood
trauma.
The condition cannot be reliably diagnosed.
Contrary to theory, DID cases in children are almost never reported.
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
P.R. McHugh, "Multiple Personality Disorder,"
Harvard Mental Health Newsletter, (1993-Fall)
H. Merskey, "The Manufacture of Personalities,"
British Journal of Psychiatry, 160:327-340.
F.W. Putnam, "Diagnosis and Treatment of Multiple
Personality Disorder." Guilford, New York, NY (1989). Read
reviews or order this book.
A. Piper, "Multiple Personality Disorder: Witchcraft
Survives in the Twentieth Century," The Skeptical Inquirer, 1998-MAY/JUN, Pages
44 - 50
R. Ofshe & E. Watters, "Making Monsters: False
Memories, Psychotherapy and Sexual Hysteria," Schribners, New York, NY, (1994),
Chapter 10, Pages 205 to 224.
Piper August, Jr., "Multiple personality disorder: witchcraft
survives in the twentieth century," Skeptical Inquirer,
1998-MAN/JUN.
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.
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/