Originally posted here: https://hive.blog/hive-196387/@agmoore/split-personality-a-conversation-about-dissociative-identity-disorder
Thursday, February 11, 2021
Split Personality? A Conversation About Dissociative Identity Disorder
https://files.peakd.com/file/peakd-hive/agmoore/V5VgikXG-Dr.20Jekyll20and20Mr.20Hyde20192020Famous20Players-Lasky20Corporation202020Paramount20-20Artcraft20free.jpg
***Advertisement for 1920 Movie, Dr. Jekyll and Mr. Hyde***
*Dr. Jekyl and Mr. Hyde* ([1931](https://www.imdb.com/title/tt0022835/)). *The Three Faces of Eve* ([1957](https://www.imdb.com/title/tt0051077/?ref_=fn_al_tt_1)). *Split* ([2016](https://www.imdb.com/title/tt4972582/?ref_=fn_al_tt_1)). Each of these movies popularized the concept of multiple personality disorder for a different generation of viewers. Audiences are intrigued by the idea that one person can be 'beside' themself. That two distinct, or three distinct personalities may emerge in one person, and that these personalities may disavow knowledge of, or responsibility for, the other.
The notion of a split personality *is* intriguing. But is it persuasive? Let's turn to science and see if there is evidence to support the notion of split personality. #### Dissociative Identity Disorder As I turn to the literature, I find not the term split, or multiple personality. Instead there is a psychological condition called 'Dissociative Identity Disorder'. Chapter 24 in the [DSM-5,](https://psychiatryonline.org/doi/abs/10.1176/appi.books.9781585625048.gg24) (American Psychiatric Association 2013) current Bible of the U. S. psychiatric community, lists and describes this disorder: >**Dissociative Identity Disorder**: "a disruption of identity characterized by two or more distinct personality states or an experience of possession" ***Werewolf Image***
*Image credit: [LovableNinja on *Pixabay*]( https://pixabay.com/es/photos/animales-hombre-mapache-hombre-lobo-4754409/) The legend of the werewolf may be an expression of a cultural fascination with dissociative personalities.*
Much of the literature on this disorder describes the subjective experience of the individual. A patient reports *feeling*, or *perceiving* a specific psychological state. Is there objective validation of these subjective reports? Brain imaging, for example, that corresponds to the subjective experience? Apparently [there is.](https://www.psychologytoday.com/us/conditions/dissociative-identity-disorder-multiple-personality-disorder) I found a study in the journal [*Neuroscience*](https://www.researchgate.net/profile/Don_Condie/publication/12829283_Functional_Magnetic_Resonance_Imaging_of_Personality_Switches_in_a_Woman_with_Dissociative_Identity_Disorder/links/5508e29e0cf27e990e0d2907.pdf) which explains changes in the brain of a patient, observed with fMRI imaging (functional MRI). This kind of imaging is used often to observe dynamic states, which would be the case with a patient 'switching' personalities.
***Dynamic fMRI Brain Scan of the Picture's Author, Fastfission (Not Suffering from DID)***
As a basis to their dynamic study (before a personality 'switch' took place), the researchers describe a patient with a smaller than normal hippocampus. This, researchers explain, is often the case in patients diagnosed with post-traumatic stress syndrome--and in patients diagnosed with DID (dissociative identity disorder). When personality switching occurred in the patient, researchers [noted](https://www.researchgate.net/profile/Don_Condie/publication/12829283_Functional_Magnetic_Resonance_Imaging_of_Personality_Switches_in_a_Woman_with_Dissociative_Identity_Disorder/links/5508e29e0cf27e990e0d2907.pdf) reduced activity on both sides of the hippocampus. This inhibition was more evident on the right side. There was also inhibition in other parts of the brain: parahippocampal, medial temporal regions, substantia nigra regions and the globus pallidus. When this scan was repeated during a subsequent 'switch', the same results were observed.
The study cited above was performed on one patient, in 1999. A more recent [study,](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3233754/) published in 2006, reports results of magnetic resonance imaging performed on fifteen patients, all women who had been diagnosed with DID. In each case, the scan revealed that, "Hippocampal volume was 19.2% smaller and amygdalar volume was 31.6% smaller in the patients with dissociative identity disorder, compared to the healthy subjects." ***Artist's Impression of Dissociative Identity Disorder***
###
Diagnosis
According to the DSM-5 (as reported by [*Psychiatry online*](https://psychiatryonline.org/doi/abs/10.1176/appi.books.9781585625048.gg24)), the following symptoms may be either observed by a physician or reported by a patient:
Causes
***Child Abuse Pyramid***
###
Treatment
***Basic Tenets of Cognitive Behavioral Therapy***
[According to](https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders/Treatment) the National Alliance on Mental Illness--NAMI, though drugs are often prescribed for those who suffer from dissociative identity disorder, the drugs are not considered efficacious in treating DID. Rather, they are prescribed to treat symptoms that may accompany DID (comorbidities), such as anxiety. Psychotherapy remains the treatment of choice for DID. NAMI lists the three most commonly used:
*Illustration from a brochure issued by the U.S. Naval Center for Combat and Operational Stress Control (NCCOSC). License: Public domain.pdf)*
#
Conclusion
I began this post with a light tone. But there is nothing light-hearted in the struggle for mental health. Although certitude among some critics is lacking in the diagnosis and treatment of this disorder (indeed, even in the existence of this disorder), the fact remains that people suffer. Jean-Martin Charcot was the physician first [credited](https://www.psycom.net/mchugh.html) with identifying 'multiple personality disorder'. He called it 'Hystero-Epilepsy'. There were skeptics at the time. That skepticism continues, even today. ***Jean-Martin Charcot Treating Patients (at [Salpetriere Asylum?](https://www.atlasobscura.com/places/pitie-salpetriere-hospital))***
A recent article published in the book, [*Evidence-Based Psychotherapy*](https://www.researchgate.net/publication/322097708_The_Treatment_of_Dissociation_The_State_of_the_Science_and_Practice) explains: > *Given the controversial nature of dissociative disorders, we will proceed with the understanding that although patients may present with dissociative symptoms, questions linger regarding the trauma-based genesis of these symptoms and the validity of the diagnoses of DID and dissociative amnesia, in particular.* I'll end my post with the hope that questions surrounding the diagnosis and treatment of this syndrome will be answered. Because, those questions represent people in need. Whatever name is assigned to their distress, their distress is real. It must be addressed. That is, after all, the role and mission of medicine.
## Selected Sources Used in Writing This Blog 1.https://link.springer.com/chapter/10.1007/978-1-4899-0310-5_16 2.https://psychiatryonline.org/doi/abs/10.1176/appi.books.9781585625048.gg24 3.https://www.psychologytoday.com/us/conditions/dissociative-identity-disorder-multiple-personality-disorder 4.https://www.researchgate.net/profile/Don_Condie/publication/12829283_Functional_Magnetic_Resonance_Imaging_of_Personality_Switches_in_a_Woman_with_Dissociative_Identity_Disorder/links/5508e29e0cf27e990e0d2907.pdf 5.https://www.denofgeek.com/movies/15-split-personality-movies-that-went-to-the-big-screen-together/ 6.https://www.psychiatry.org/patients-families/dissociative-disorders/patient-story 7.https://www.researchgate.net/profile/Philip_Coons/publication/12476745_The_differential_diagnosis_of_epilepsy_pseudoseizures_dissociative_identity_disorder_and_dissociative_disorder_not_otherwise_specified/links/5440f1850cf228087b69ab05.pdf 8.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3233754/ 9.https://www.cdc.gov/violenceprevention/aces/index.html 10.https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder 11.https://journals.sagepub.com/doi/full/10.1177/1755738012471029 12.https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders/Treatment 13.https://www.psycom.net/mchugh.html 14.https://www.atlasobscura.com/places/pitie-salpetriere-hospital 15.https://www.researchgate.net/publication/322097708_The_Treatment_of_Dissociation_The_State_of_the_Science_and_Practice 16.https://www.imdb.com/title/tt0022835/ 17.https://www.imdb.com/title/tt0051077/?ref_=fn_al_tt_1 18.https://www.imdb.com/title/tt4972582/?ref_=fn_al_tt_1 19.https://www.livescience.com/44875-werewolves-in-psychiatry.html Illustration credit not otherwise noted: Masks from which accent GIF was made: [Vector free, Pixabay](https://pixabay.com/es/vectors/teatro-comedia-tragedia-m%C3%A1scaras-311730/)
*Thank you for reading my blog*
*Hive on!*

Originally posted here: https://hive.blog/hive-196387/@agmoore/split-personality-a-conversation-about-dissociative-identity-disorder
Originally posted here: https://hive.blog/hive-196387/@agmoore/split-personality-a-conversation-about-dissociative-identity-disorder
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