Oct 26

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.

Oct 25

“Sybil Exposed”: Not An Argument Against Multiplicity Itself

A newly released book by journalist Debbie Nathan, Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case, is currently getting a lot of attention in the press, as well it should if it is accurate in its depiction of highly fraudulent practices on the part of three individuals—the therapist, the author of the original book about Sybil (1973), and the patient herself—who allegedly conspired to make this woman’s condition and treatment into something that it wasn’t, turning her into “Sybil Inc.,” an immensely popular and lucrative enterprise.

On the positive side of this mess, the products generated by Sybil Inc. have served to popularize multiple personality disorder, now known as dissociative identity disorder (DID), and have given many people hope that their complex conditions could become better understood and treated.

On the negative side, the doubters—including some mental health professionals who don’t believe the condition actually exists in anyone—may now seize the chance to use Sybil Exposed to add fuel to that particular fire. See? Dissociative identity disorder is a crock, some are likely (illogically) to maintain.

I have neither read Nathan’s book nor can I weigh in on whether our Sybil of yore does represent one big fat lie, but I have witnessed and do strongly believe that there are those who do live with DID and that they represent one major truth: it is possible, it is indeed highly creative, when faced with severe childhood trauma, for one’s personality to become divided in order to withstand the torturous pain.

Do an online search for DID and you’ll find many up-to-date books that can serve to offset any indications, however shocking and upsetting, that this one particular patient/therapist/writer team may have fabricated multiplicity. (Clarification/ update, 6/10/12: In other words, there are still many experts who cite other case examples and histories; there are still many who believe that DID exists.) Two highly recommended books are The Dissociative Identity Disorder Sourcebook by Deborah Haddock and Multiple Personality Disorder From the Inside Out, edited by Cohen, Giller, and Lynn W.

With so many written and oral testimonies by those who’ve experienced DID firsthand, I confess that it’s beyond my ability to comprehend how anyone in my field could be a disbeliever. I contend that the therapists who disbelieve are either uninformed or unexposed or that they are so closed off to the possibility that they are unable or unwilling to see or accept it in their clients.

Moreover, clients may be unable or unwilling to reveal themselves fully in therapy if they sense any of the above characteristics in their shrinks.

For anyone who counters with, If they can hide it, it must not be so, consider your own personality. Do you routinely, for various reasons, keep parts of yourself in check? Please don’t say no. Because if you don’t, the rest of society may ask you to get some help learning how.