Dissociative Identity Disorder / Multiple Personality Disorder FAQ (frequently asked questions)

What is MPD?

MPD is a survival tactic. It is the creative attempt of highly traumatized children to protect themselves from the trauma and abuse (e.g.: "It isn't happening to me.") When these children dissociate (block) trauma, their "compartments" of trauma become "separate personalities/parts within their one self". Only children have sufficient flexibility (and vulnerability) to adapt to trauma by means of creating alter personalities.

I thought MPD and Schizophrenia were the same thing.

MPD is NOT schizophrenia! Most people thing that schizophrenia means "split personality." Actually, this is totally incorrect. "Split Personality" is MPD, not schizophrenia. Schizophrenia is a chronic form of psychosis due to a biochemical/genetic disorder of the brain. SCHIZOPHRENICS DO NOT HAVE OTHER PERSONALITIES. Schizophrenia is not caused by trauma, and does not involve amnesia and flashbacks.

When can a person get MPD?

MPD arises in childhood, mostly ages 3 to 9 years. There is juvenile diabetes and adult onset diabetes, but there is no adult onset MPD. Only children have sufficient flexibility (and vulnerability) to respond to trauma by breaking their "still-coalescing" self into different, dissociated parts. Adults do not have the capacity to adapt to trauma by forming alter personalities. (The exception is that adults who became "multiples" in childhood can continue to make more alters during adulthood.)

Isn't MPD really just a way for people to get attention?

It is often thought that MPD is a sham, a bizarre form of "play-acting" that is perpetrated by manipulative, attention-seeking individuals. It is not. MPD is a "disorder of hiddeness" wherein 80-90% of MPD patients do not have a clue that they are "multiple." Most know that there is something wrong with them; many fear that they are crazy-- but few know that they are multiple.

Isn't MPD just an exaggeration of the different parts of our personality; aren't we all really "multiple"?

This is an enticing question. "Yes," we all have different parts to our personalities. "No," MPD is not "just an exaggeration" of these parts.

Why?

At least 6 reasons:

1. Because we all don't have a dissociative disorder;
2. Because we all don't suffer from severe and chronic child abuse or trauma;
3. Because we all do not have amnesia for what we are doing when a different part of our personality comes to the fore;
4. Because the "raison d'être" of the different sides to our personality is not to hide from ourselves information or feelings about trauma;
5. Because we all do not posses the ability to be "highly" hypnotic; and,
6. Because we all do not develop POST TRAUMATIC STRESS DISORDER when we begin to pay attention to our parts.

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How many parts are there?

The typical female multiple has about 19 alter personalities; male multiples tend to have less than half of that. The number of alters is explained by 3 factors:

1. The severity of the trauma;
2. The chronicity of the trauma; and,
3. The degree of vulnerability of the child. Thus, the male multiple from ages 7 to 10 who was sexually abused a half-dozen times by a distant relative is going to have far fewer alters than a female multiple who was severely physically, sexually, and emotionally abused by both parents from infancy to age 16. The latter patient, in fact, could quite easily wind up with 30 to 50 (+) alters, even in the hundreds.

How could a person have so many different personalities and how would you tell the difference among them?

The answers to these questions require a clarification of several points:

• First, MPD is a misleading term-- DISSOCIATED SELF DISORDER would probably be better. There is but one self that is dissociated into multiple parts. MPD tends to be misunderstood to mean "multiple self disorder." In fact, there is only one self however divided, or dissociated, it may be.
• Secondly, there are usually only 3 to 6 alters who are particularly active (e.g.: assuming full executive control) on any given day. The rest of the alters are relatively quiet (even dormant for long periods of time).
• Finally, THERE IS NO REQUIREMENT THAT DIFFERENT PERSONALITIES BE VISIBLY DIFFERENT TO AN OBSERVER. It is only necessary that each alter fulfill the basic function of an alter personality-- that is, to protect the host personality from the knowledge and experience of the trauma. This task is accomplished by means of dissociative barriers or walls of amnesia. Thus a multiple could conceivably have dozens of alters that look just the same, but who, nevertheless, serve the function of walling off trauma from the host (and dispersing it among many alters). The answers to the above questions can now be more easily understood in light of the basic task of an alter personality. If the "raison d'être" of alters is to sequester trauma from the host so that he/she is able to continue to function without becoming overwhelmed, then additional alters may be produced to help contain the trauma. It is not required that these new alters look different, nor is it necessary that they all be active at one time; it is only necessary that they do their job (of containing the trauma of the abuse).

What types of alters are there?

The typical alters that are found in a person with MPD include: a depressed, depleted host; a strong, angry protector; a scared, hurt child; a helper; and, an embittered internal persecutor who blames (or persecutes) one or more alters for the abuse that has been suffered. While there may be other types of alters in any given MPD individual, most of them will be variations on the theme of these 5 alters.

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How common is MPD?

Although the data is not all in, the best estimate of the prevalence of MPD is that it approximates that of about 1% of the population. This estimate would translate into at least 2,000,000 cases in the U.S. alone.

Why so many?

Because MPD is directly linked to the prevalence of child abuse. And, unfortunately, child abuse is all too common.

How impaired is the person with MPD?

The range of impairment across different persons with MPD is best analogized to that of alcoholism. Impairment due to alcoholism a) ranges from skid row bums to high functioning senators, congressmen, and corporate executives; and, b) varies in any given alcoholic from one period of time to another as a function of binges, patterns of drinking, life stresses, etc. It is much the same as MPD. There are some multiples who are chronic state mental patients, others who undergo recurrent hospitalization due to self-destructive behavior, and many more who raise children, hold jobs, and may even be high-functioning lawyers, physicians, or psychotherapists.

How Does Being A Multiple Help?

If you are a multiple alters have, for the most part, been your good friends. They have come to your rescue, endured pain for you, and they have hidden lots of your feelings when it wasn't safe to have those feelings and when you couldn't find a safe person with whom to share them.

Is It Bad To Be A Multiple?

Certainly not. Being a multiple helps some to stay alive. It allows them to protect themselves and remain sane in the face of severe abuse. It allows them to endure the bad times and to keep their heart and soul safe from their abusers.

Am I Crazy?

Being a multiple does not make you crazy, but being a multiple can make you feel like you're crazy. If you doubt yourself this way, you can become confused or uncertain. You can also feel ashamed, frightened, or want to spend time alone. This self-doubt and confusion can make you feel bad about yourself.

How long will it last? Does it go away on it's own?

A person who is "multiple" will REMAIN "multiple" until successfully treated. About 90% of "multiples" are totally unaware they are MPD. The symptoms of MPD wax and wane. A person who is "multiple" may appear to be fine for years and then suddenly begin to have strong symptoms- usually due to flashbacks of past trauma. MPD/DID IS treatable, but does not just go away on it's own.

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What signs should I look for if I think I and/or a friend/family member may have MPD?

Look for MPD if there is a pattern of:

• History of depression or suicidal behavior
• Childhood history of physical, sexual, emotional, or psychological abuse... reports one parent was very cold and critical; reports of "wonderful" parents by a person who is clearly emotionally troubled
• Abusive relationships in adulthood
• Strong attacks of shame; sees self as bad or undeserving sacrifices self for others feels does not deserve help; is a burden, reluctant to ask for help is sure you do not want to be troubled with seeing him or her
• Reports being able to turn off pain or "put it out of my mind"
• Self-mutilation or self-injuring behavior
• Hears voices
• Flashbacks (visual, auditory, somatic, affective, or behavioral)
• History of unsuccessful therapy
• Multiple past diagnoses (e.g.: major depression, schizophrenia, bipolar disorder, borderline personality disorder, substance abuse)
• Reports of odd changes or variations in physical skills or interests
• Described by significant other as having 2 personalities or being a "Dr. Jekyll Mr. Hyde"
• Family history of dissociation
• Phobia or panic attacks
• Substance abuse
• Daytime enuresis or encopresis
• History of psycho-physiological symptoms
• Seizure-like episodes
• History of nightmare and sleep disorders
• History of sleepwalking
• School problems
• Reports psychic experiences
• Anorexia or Bulimia
• Sexual difficulties
• History of shifting symptom picture (one day symptoms of this...next day symptoms of that)

Two positive items from among 1-15 mandates consideration of a diagnosis of a dissociative disorder (e.g.: Dissociative Disorder NOS=not otherwise specified or possible Post Traumatic Stress Disorder).

Four or more positive items (especially among 1-15) mandates serious consideration of a diagnosis of Multiple Personality Disorder now known as Dissociative Identity Disorder.

For many observers, MPD is a fascinating, exotic, and weird phenomenon. For the patient, it is confusing, unpleasant, sometimes terrifying, and always a source of the unexpected. The treatment of MPD is excruciatingly uncomfortable for the patient. The dissociated trauma and memory must be faced, experienced, metabolized, and integrated into the patient's view of him/herself. Similarly, the nature of one's parents, one's life, and the day-to-day world must be re-thought. As each alter metabolizes his/her trauma, then that alter can yield it's separateness and re-integrate (because that alter is no longer needed to contain undigested trauma).

Recovery from MPD and childhood trauma takes something on the order of five years. It is a long and arduous process of mourning. The important thing to remember is that recovery does and can happen.

Multiple Personality Disorder/Dissociative Identity Disorder IS TREATABLE.

next:  MPD/DID Key Findings Quick Facts