From James McAvoy’s 23 personalities in M Night Shyamalan’s Split (2016), to the split personality of Norman Bates, of the Bates’ Motel as portrayed in Alfred Hitchcock’s Psycho (1960), the cinema we consume has had a strange fascination with Dissociative Identity Disorder (DID), formerly called split personality or multiple personality disorder.
The frequency with which filmmakers decide to tackle DID, unfortunately, doesn’t have any bearing on the accuracy of such portrayals — “It is a disservice. This is a common plot device. The serial murderer turns out to have DID,” New York psychotherapist Elizabeth Howell tells Healthline, adding such half-baked portrayals of DID in conjunction with criminal behavior only seek to damage those living with the condition and increase stigma for them in society.
What is dissociative identity disorder?
A person with dissociative identity disorder develops one or more alternate personalities (termed ‘alters’) in addition to their main personality (called their ‘core’); they can either be aware of these additional personalities or not. DID is usually accompanied by disruptions in memory, consciousness, awareness, perception, and identity, or when the alters take over the core personality. The severity of these disruptions often determines the person’s standard of life — a person not aware of their alternate personalities and experiencing multiple gaps in memory and consciousness, for example, can have a lower quality of life than someone in whom these symptoms don’t manifest as strongly.
What are the symptoms of dissociative identity disorder?
Alternate personalities can exist completely outside of the person’s core behavioral traits; alters can be of a different gender, name and have a distinct set of personality traits and personal history. The alters can either be beneficial for the person like an outgoing alter and an introverted core, or disadvantageous, like an aggressive alter and a peace-loving core. Either way, DID can cause personal and professional problems, as people suffering from it could not exactly know what’s going on or what their alters have said or done.
According to the Cleveland Clinic, the mental health symptoms of having DID could include: headaches, feeling disconnected to one’s own self, thoughts and feelings, mood swings, anxiety and depression, and substance abuse issues. Hallucinations, amnesia, and self-injurious behavior such as cutting are also common. People with DID are also at risk of suicidal tendencies, with 70% having attempted it once.
What causes dissociative identity disorder?
90% of people with DID have a history of abuse. Severe trauma, arising from physical, emotional or sexual abuse, or from natural disasters or war, is one of the leading causes for an individual to develop DID.
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DID is part of a larger group of dissociative disorders, characterized by a tendency to dissociate from reality as a defense mechanism to deal with negative emotions associated with trauma. Aside from DID, others within the umbrella of dissociative disorders include dissociative amnesia, characterized by an inability to remember details of past traumatic incidents; and depersonalization-derealization disorder, characterized by detachment with oneself, periodic feelings of being outside one’s body, and feeling like the world is unreal. According to the Cleveland Clinic, “episodes of DID can be triggered by a variety of real and symbolic traumas, including mild events such as being involved in a minor traffic accident, adult illness, or stress. Or a reminder of childhood abuse for a parent may be when their child reaches the same age at which the parent was abused.”
How does one treat dissociative identity disorder?
Mental health professionals such as psychologists and psychiatrists can use standardized tests such as the Dissociative Experiences Scale (DES) and the Structured Clinical Interview for Dissociation (SCID-D) to determine a patient’s experience with DID. Once diagnosed, the goal of treating a person with DID is to get them to form connections between their core and alters, so as to decrease the amount of switching. The treatment, which can involve psychotherapy, cognitive behavioral therapy, family therapy or creative therapies, also seeks to minimize trauma triggers for the person with DID, and help them cope with supplementary issues such as anxiety and depression — sometimes, even with medication.
There is no medication to treat dissociative identity disorders.
