The Dissociative Identity Disorder (formerly known as Multiple Identity Disorder) is characterized by the control of two or multiple personalities over one single person. This mental disease conducts memory loss, such as personal information or traumatic/stressful events. This mental illness has been the object of many news sections or movies in the last decade. Yet, a notion of danger is very often associated with D.I.D. The portrait of a D.I.D patient will always be a dangerous individual who committed crimes without even knowing it because he claims that other people live inside his head. This misjudgment is due to a lack of knowledge and excessive media exposure.
In this paper, we will describe the D.I.D and illustrate that this complex personality disorder should not be seen as a threat. In 2016, the movie SPLIT came out bringing D.I.D into the spotlight; Kevin is an adult who suffers from Dissociative Identity Disorder and must live with 23 personalities. However, Kevin has not been in control over his body since 2014, and “the body” was shared between all of his other personalities. We will not get into the details of it because SPLIT is much more of an “American Horror Thriller” than an accurate documentary. Yet, some aspects of D.I.D presented, and the performance of actor James McAvoy is an adequate illustration of the disease.
First and foremost, we shall explain what is D.I.D. There are two forms of dissociation: with and without possession. Without possession does not involve any other personality per se; the patient might feel some sudden changes of consciousness and have the feeling of being an observer more than an actor to his action. But today we will focus on the possession form; that includes the apparition of multiple personalities.
Dissociative disorders involve breakdowns or disruption of memory, consciousness and identity after trauma. Frequently the trauma (implicating severe repetitive emotional, physical or sexual abuse) is so unbearable that it entails dissociation as a coping mechanism. This dissociation causes memory loss of the event but also of what happened or will happen while the other personality is in charge. Some personalities might even remember what causes the dissociation while others won’t. In SPLIT, for example, the personalities Patricia and Dennis claim that they keep “what happened” secrets from Kevin and the others because it could destroy them.
In addition to memory loss, DID patients can suffer from other symptoms such as depression and anxiety. It is not unlikely to have them fall into addiction, self-harming or suicidal behaviour. Those symptoms are caused by the trauma but also the constant hallucinations, memory flash-backs and impression that someone is using their body without their consent.
The uniqueness of Dissociative Identity Disorder remains in the fact that one personality can have a physical (or psychiatric) pathology while the others don’t. It has been illustrated in SPLIT, in which one of the personalities suffers from diabetes and must take insulin shots while none of the others has to. Plus, it is important to remember that each personality behaves as if they were all individuals. Their way of walking, talking, standing and acting is different because they are all from a different age, religion or ethnicity. This peculiarity is well shown is SPLIT, in which you can see how the different personalities stand, articulate and act differently, especially when one of them is a child whereas the others are teenagers or adults.
The medical and psychological care of DID patients starts with an evaluation of the situation’s emergency. Indeed, if the patient is stuck into the most severe phase, it is an absolute necessity to “wake him up” from dissociation. Afterwards, the main goal is to evaluate the risks of self-harming or harming others. Then, we will have to decrease the dissociative symptoms by helping the patient to get back in the right timeline. If ever the severe phase pursues, we might hospitalize the patient.
Unfortunately, to this day there are no pharmacological nor psychotherapeutic treatments. Therefore we can provide psychological care (if the patient is not in the most severe phase) but once more, the therapy will be different according to the symptoms and how far in the dissociation the patient is. As we said before, having a psychiatric or physical pathology in addition to D.I.D is probable, so this will be taken into consideration for the therapy decision.
Nowadays the most convenient therapies are cognitive behavioural therapy, dialectical behavioural therapy and hypnosis. Some psychologists are trying group therapy or family therapy as a means of treatment. Moreover, EMDR therapy (Eye Movement Desensitization and Reprocessing) has enlarged for the past few years. Furthermore, some pharmacological treatments are currently being used for D.I.D patients. Nevertheless, the treatments are intended for patients suffering from psychiatric pathology or symptoms associated with dissociation disorder (anxiety or depression).
Last but not least, we can postulate that even if there is a series of diagnostic criteria to evaluate this disorder in the DSM-V, we still have much to learn about D.I.D. The lack of knowledge explains the numerous stereotypes and misjudgments that are extremely widespread concerning this disorder. Therefore, we must keep in mind that behind the “frightening” representation of the disorder and the different pathologies the patient suffers from, there is somebody in pain. A human being that not only have to cope with trauma but also an exhausting disease. In that way, patient care and support appear to be primordial. Movies, such as SPLIT, could be a nice way to inform about the distinctiveness of the disease but, nowadays there is still a misconception and demonization of Personality Disorder.
Words we’ve learned : “foremost” : avant toute chose/ “unberable” : insupportable/ “enlarged” : agrandit/développer/ “Widespread” : répendu/ “frightening” : effrayant
Pauline Bolgert & Kenza Berrefane