Schizophrenia and Dissociative Identity Disorder: Not the Same

FACT: Schizophrenia and Dissociative Identity Disorder are not the same.

QUESTION:

What’s wrong with the following popular jokes? (Besides their general offensiveness, I mean.)

1. What’s the worst thing about schizophrenia?      

Paying more than once for everything.

2. Roses are red/Violets are blue/I’m schizophrenic/And I am too.

3. A psychiatrist asked her multiple personality patient, “So do you feel like you’re cured?”      

He replied, “Absolutely. We’ve never felt better.”

 ANSWER:

The first two jokes confuse the definitions of the distinctly different conditions of schizophrenia and dissociative identity disorder (formerly known as multiple personality disorder). A diagnosis of schizophrenia does not include having more than one personality but may include having delusions or hallucinations, neither of which are likely to cause a sense of internal division.

The third one implies that integration of personalities has to be the only or ultimate goal of therapy for those with dissociative identity disorder (DID), a common myth that might have something to do with the popularization of “Sybil” and her supposed treatment, a topic that was addressed in yesterday’s post.

In fact, some individuals with DID do wish to achieve the merging of their different alters, but many do not. My own approach with clients with DID has been to find out what they want. (Note: This should not be a novel thought among therapists.) The upshot is that my experience has been to work with clients’ alters or “parts” to help them learn to co-exist, not to integrate.

Identifying as a dissociative with a system of different parts—and not identifying as a one-name/one-personality-only type of person—does often lead, when feeling safe enough, to using “we” versus “I” in self-reference. Thus, if a client with DID were to say to me, as in the above joke, “We’ve never felt better,” I’d be very happy for them.

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