"The great French psychiatrist Pierre Janet coined the word dissaggregation about one hundred years ago to identify changes in consciousness which disturbed the normal, well-integrated functions of identity, memory and thought in several of his patients. This term was later translated from the French as dissociation
Janet's studies of patients with amnesias, fugues, and 'successive existences' (now known as other personalities), convinced him that their symptoms were the effect of split-off parts of the personality which were capable of independent thoughts, actions and identities. Further, he concluded that the dissociation which caused the symptoms was the result of past traumatic experiences, and that the symptoms could be alleviated by bringing the split-off memories and feelings into consciousness. Dr. Janet's contemporaries, both American and European, expanded upon his research and a model for the diagnosis and treatment of dissociation was soon built. During the 1930's, however, as Freud's theories were embraced by the psychiatric world, studies of dissociation declined. Renewal of interest among the professional community was not sparked again until the 1980's, following increased public and professional awareness of child abuse and the rise in treatment of Vietnam veterans' post-traumatic stress syndromes.
Most clinicians believe that dissociative processes exist on a continuum. At one end are mild dissociative experiences common to most people (such as daydreaming or highway hypnosis). At the other extreme is severe, chronic dissociation which may result in serious impairment or inability to function. There is a wide range of experiences in between. Some people with MPD can hold highly responsible jobs, contributing to society in a variety of professions, the arts, and public service. To co-workers, neighbors, and others with whom they interact daily, they apparently function normally.
The dissociative process may result in a series of discrete states which eventually may take on identities of their own. Often referred to as alternate personalities, these are the internal members of the MPD (DID) system. Changes between these personalities, or states of consciousness, are described as switching.
Dissociation and switching may become automatic responses to anxiety and anticipated anxiety, even in non-abusive situations. Even after the traumatic circumstance is long past, the vestigial pattern of defensive dissociation remains. Chronic defensive dissociation may lead to serious dysfunction in work, social and daily activities.
Individuals most likely to develop (DID) MPD present several factors in a common profile. They have endured repetitive, overwhelming, and often life-threatening trauma at a sensitive developmental stage of childhood (usually before the age of nine), and they amy possess a biological predisposition for auto-hypnotic phenomena (a high level of hypnotizablitiy). (DID) MPD is often referred to as a highly creative survival technique, because it allows individuals enduring 'hopeless' circumstances to preserve some areas of healthy functioning.
Fortunately, the problems caused by dissociation are highly reponsive to treatment, and people with (DID) MPD and other Dissociative Disorders can improve their lives through appropriate therapy.
Multiple Personality Disorder is one of four Dissociative Disorders indentified in the Diagnostic and Statistical Manual of Mental Disorders: Third Edition--Revised (DSM-III-R), published by the American Psychiatric Association. It is significant to note that the 1980 edition of the Manual was the first to include MPD and the other Dissociative Disorders, indicating the very recent 'legitimacy' of the diagnosis within the psychiatric community. However, many Mental Health Professionals remain skeptical about the existence of Dissociative Disorders, compounding difficulties of survivors in getting appropriate diagnosis and treatment.
(DID)MPD survivors often spend years living with misdiagnoses, consequently floundering within the mental health system. They change from therapist to therapist and from medication to medication, getting treatment for symptoms but making little or not actual progress. This is not surprising, since the list of presenting symptoms of MPD reads like the DSM-III-R itself: depression, mood swings (alter shifts), suicidality, sleep disorders (usually night terrors and sleep walking), panic attacks and phobias (reactions to stimuli or 'triggers'), alcohol and drug abuse, compulsions and rituals, psychotic-like symptoms (including auditory and visual hallucinations), and eating disorders. In addition, individuals with DID MPD experience headaches, amnesias, time loss, fugues, trancing, and out of body experiences. Some people with DID/MPD hae a tendency toward self-persecution, self-sabotage and even violence (both self-inflicted and outwardly directed).
There is a great deal of overlap of symptoms and experiences (such as time loss, amnesias, flashbacks, etc.) among the Dissociative Disorders".
"A group of psychiatric conditions which share certain common features and which are not due to an Organic Mental Disorder or any other disorder:
" The sudden inability to recall important personal information too extensive to be explained by ordinary forgetfulness."
"Sudden unexpected travel away from one's home or place of work, with the assumption of a new identity and the inability to remember one's past">
"Persistent or recurrent episodes of depersonalization (in which the usual sense of one's own reality is lost or changed) sufficiently severe to cause marked distress"
"The existence of two or more distinct personalities, each of which is dominant at a given time. The dominant personality determines the individual's behavior. Each personality has a consistent pattern of perceiving the environment and self".
"A category of disorders which predominantly features dissociative symptoms, but which does not meet the criteria for the specific Dissociative Disorders previously listed".
"The structure of relationships within the internal world of an individual who has DID. Although each person's system is unique, there are several recurring metaphors that DID/MPD clients use to describe how they function. Examples include stages, spotlights, tunnels, houses, and levels. It is often helpful for a person with DID/MPD to make a map or diagram of his/her internal personality system".
"An event, object, person, etc. that sets a series of thoughts in motion or reminds a person of some aspect of their traumatic past. The person may be unaware of what is 'triggering' the memory (ie, loud noises, a particular color, piece of music, odor, etc) Connected with brainwashing, a trigger may elicit a specific command message".
This information comes from the book:"Multiple Personality Disorder From The Inside Out" edited by Barry M. Cohen Esther Giller and Lynn W.
