Category: Dissociative Identity Disorder

It is quite unfortunate that a majority of persons living in the world have encountered childhood traumas which often led to this long term mental health situation known as the “Dissociative Identity Disorder”. Formerly known as the multiple personality disorder, this mental health situation has been known to cause an alteration in the accurate recalling of events and certain personal information (Johnson JG, Cohen P, Kasen S, Brook JS, 2006). There are several reasons which usually orchestrate this mental health issue. They include trauma disorders while growing up, exposure to the real life situations which trigger the trauma (Fear), repetition of actions as a result of the past traumatic experience and finally, dissociation.

The Predisposing causes of dissociative identity disorder are natural born tendency to dissociate and child exposure growing up in a toxic family environment. The first reason for this is the kind of environment a child was exposed to and the nature and character of people a child stayed with while growing up. In line with Ross (2011), children who grow up in a very toxic environment where the parents tend to subdue and maltreat them usually grow up with likely tendency of fear. This fear makes it possible for the child to easily suffer a traumatic disorder. The next reason for this is the lack of proper family planning by most families before giving birth to children. When they finally give birth, they let things slide because they have not properly educated themselves on the best way to actually train up the children (As analyzed by Tohid, 2016). An example can be considered in the case of a child who grew up in a home where the father constantly abuses and beats the mother a lot. In this situation if the child is a girl, she will grow up with an impression that men are violent and constantly try to avoid them or even hate them. In conglomeration, the experiences which a lot of people suffer as kids while growing up in various families, has hugely impacted in the way they react and respond to various things around them. This has chiefly led to the dissociative identity disorder which most people suffer during their lifetime.

The Principal causes of dissociative identity disorder are fear and traumatic experience about an event. One of the reasons for this cause is sexual child abuse. According to Manton (2016), the direct exposure and encounter someone was exposed to while growing up occupies up to 80% of the way he or she reacts and treats people. This seems to be true in most cases and this is the reason why a lot of people have been urged to mind the way they treat their kids at home. At the developmental stage in a kid’s life, their brain gets to assimilate more than when they are adults. When a child is abused at a very young age, they tend to dissociate themselves more from people. Another reason for this cause is the maltreatment of a child. This often brings about a great amount of fear which a child would possess. This fear triggers the memories of the past or a certain event which was mind-disturbing and painful to bear (Reviewed by Ross, 2011). Ross went on to state in his work that there cannot be a clear and cut pattern of bringing up a child as various persons who are now referred to as parents tend to follow the same trend they were brought up in raising their kids. This can really be an awful experience for the child especially if the parents or one of the parents grew up in a very harsh environment and allowed the treatments gotten as a kid to overwhelm him or her. An example can be seen in a family where the father sexually abuses his daughter which led to his death as a result of the self defence used by the daughter. When she grows up, such trauma would keep hunting her and thus make her develop the dissociative identity disorder. In brief, these past experiences which a child suffered while growing up will always lead to an adaptation of a particular lifestyle in order to get over the trauma.

The Precipitating cause of dissociative identity disorder is repetition of thoughts and actions. This occurs as a result of a constant thought or reoccurrence of certain actions which reminds a person about an ugly experience in the past. Tohid (2016) attempted to give a lucid explanation of how constant and repeated thought of something can trigger the dissociative identity disorder. He stated that the human brain is a great tool which can be used for good or bad but reports have shown that bad thoughts and experiences easily get to weigh the brain down. This line of reasoning has also been supported in the work of Johnson JG, Cohen P, Kasen S, Brook JS, (2006). An example is seen when a child who often hid inside the closet any time his parents are fighting develops the habit of locking himself or herself indoors. In summation, when people get to think more of the negative aspect of a past experience which is overwhelming, they are easily triggered into a shock or instant panic which will lead to mental identity disorder. This makes them seek out other ways to get over this fear or shock. One of these ways involves adapting a defence mechanism known as dissociation.

The Perpetuating cause of dissociative identity disorder is dissociation. One of the reasons why patients suffering from dissociative identity disorder often choose to dissociate themselves from people and certain events is to get relieve from anxiety and the stress that comes with the past trauma. Tohid (2016) in his work stated people who often suffer this mental disorder are often introverts who restrict themselves from much encounter with other people. They tend to appear a little bit constrained to just themselves. They feel that much communication with others have a high tendency to spark up the ugly experiences of the past which will create an unwanted feeling. They are often anxious and stressed mentality when they are in company of others. An example can be seen with someone who was always locked up in the house by their parents and never allowed to have any friends coming to visit them. They have just lived their lives with the idea that they ought to stay away from people. So, when these people are in a group with other people, they feel very anxious because they do not know the next step to take or what to say. In brief, people with this mental disorder often try as much as possible to restrict their amount of communication with the outside world.

In conclusion, dissociative identity disorder has greatly affected the way people act in the society. In order to tackle this problem, there should be adequate child care and advocacy programs in the high schools scattered across various countries. This unit should be controlled by one of the government agencies. Its main aim is to encourage students to openly say whatever unpleasant issue that they are facing in their homes. With this information, the government can swing into action to caution and counsel the parents or guardian on the adverse effect of their actions towards the child.

The area of interest I chose to base my research project on is dissociative identity disorder (DID), formerly known as multiple personality disorder. It is recognized as a complex psychological disorder, characterized by possessing two or more distinct and separate personalities, which are termed alter types or states that appear outside ones conscious control. Each “state” has its specific knowledge of the way it perceives and identifies with the self and acquires varied roles to serve the purpose of assisting the individual with daily struggles. In many cases the individual has no knowledge or regard of the split personalities. Although DID is rare, the mental health state of the individual can prove to be alarming, in that the individual has no recollection or memory of the behaviors or actions carried out within the various identities. The mental process, including thoughts and feelings becomes dissociated and a lack of connection becomes apparent. The intent of this paper is to discuss the psyche of the individual diagnosed with this disorder as well as examining the alter types and personalities. Counseling and treatment intervention options will also be explained.

Description of the Problem

The root of the disorder is said to be triggered by overwhelming traumatic, stressed, interpersonal events experienced early in life. Other factors in developing the disorder include extreme, emotional and/or sexual abuse, and negligence also occurring during childhood. The household environment, including the way mom and dad parent are also underlying elements. These repetitive encounters with emotional and physical pain disrupt the development of personality and produce mental suffering that allows for the individual to create alter personalities also viewed as defense mechanisms to help cope with the grief of situations that prove to be too severe to carry out with his/her conscious being. Dissociation is portrayed in this instance as support and reinforcement to maintain a wholesome level of operating. The illness affects the awareness of memory (amnesia), creates identity confusion/alteration, and skews the perception of an individual (derealization). The individual’s mental psyche becomes flawed causing damage and impairments such as mistaken sense of time or failure to recall personal information, which potentially could lead to more critical and severe psychiatric complications such as compulsions, sleep disorders, depression, eating disorders, suicidal thoughts, etc. Substance use disorders and addiction has been depicted to coincide with DID; often times the individual becomes desperate to numb the agony and resorts to stimulants that provide that comfort in dissociation and disconnect from the real world. The demeanor and behaviors detected during the “alter” states have complete control of an individual and the effect the actions have causes anxiety and panic to the life of an individual. The alter personality usually is cognizant of the prime or “host/core” personality, however the host personality is often times unfamiliar with the alternative personality. The alter personality is its OWN unique person (real or imaginary), meaning they carry their own identity including age, race, and ethnicity. “Switching” is the process used to describe the “alter” exposing itself and taking power of all thoughts and behaviors, many times these shifts happen involuntarily and become provoked by a negative occurrence. Anxiety, depression, and, personality/traumatic disorders are major conditions that become clear when diagnosing an individual with DID. Other indications may include headaches, depersonalization or “out of body experiences”, blackouts, etc. Treatment options vary and finding an effective fix may be challenging. There is no set “cure” for the disorder, however psychotherapy or talk therapy is noted as being the key mechanism. Other forms of cure include, cognitive, cognitive-behavioral, and supportive therapy, medications (anti-depressants), and hypnosis. The end goal is to unite the differentiating personality’s behavior, memory, and thinking to become one, a concept known as integration.

Significance of the Problem

It becomes vitally important to understand how an individual’s identity becomes disrupted and their sense of self obstructed. Functioning in life becomes a challenge (socially/occupationally) and their way of living productively is fractured. Unfortunately prevention from the disorder is not so clear cut since the core of it usually stems from traumatic exposure, however minimizing ones risk is possible by reducing our liability to such events and situations. It’s also imperative to know that “dissociation” is a process encountered by all, for example, day dreaming or getting “lost” while reading a novel or watching a film, however the severity of the experience is what deems it a psychological disorder.

Not only does DID impair our mental state it also affects our quality of life in the real world. Aside from mental illnesses, maintaining healthy relationships and employment prove challenging. Everyday roles and objectives that should operate without hassle become disrupted. Memory and identity become distorted within the conscious self.

Impairments and difficulty in psychological function associated with DID?

The mental illness DID is defined by its unique and distinct presence of altering personalities, consisting of various states of function, associated with emotions, behaviors, and reactions. These differentiating identities have their own outlook and view of the world. In many instances the “sub” alter initiates troublesome risks in an individual’s living, however findings have indicated that on rare occasions the “sub” alter can have a positive effect. For example, a quiet individual who is afraid to speak up to her unjust boss may suddenly possess assertive and confident qualities to stand up and defend herself.

Alter types/states behaviors and actions?

The objective is unifying the various identities into a single functioning, normal identity. Providing a safe environment is beneficial to the individual who may experience difficulty processing repressed memories, reinforcing that sense of security allows for optimal progress. Medical professionals often time’s debate over which treatment plans prove most appropriate and successful, however obtaining extensive treatment makes for an ideal hope at life.

Effective and efficient treatment options and counseling techniques?

Of the many mental disorders defined and researched in the DSM-5, DID is the most controversial, however the least explored. Many clinicians argue over the legitimacy of the disorder, nevertheless the DSM-5 recognizes the mental condition as a valid disorder despite skepticism. The history of DID dates back to 1791, where the term “exchanged personalities” began to surface. The theory was introduced by a 20 year old German woman, who spoke and acted as if she was of French decent, she knew her identity as a “French Woman” however when asked if she any recollection of this “French woman” under her “German Woman” identity she denied all claims. DID has had a long run with history and the concept has been altered and changed throughout time with developing evidence and material.

Dissociative disorders allow for an individual to break free from the real world and lose touch with reality, creating an unstable personality. Complications arise when the natural flow of thoughts, memories, and behavior become disconnected. No one particular ethnic, race, or age group is more susceptible then another, anyone can become diagnosed with the disorder with the exception of females more likely than males. Many studies have been conducted and much research has concluded that real and significant trauma induced exposure, especially during childhood, opens the gateway to the disorder. Such experiences may include military battles, natural disasters (flood, hurricane, earthquake) any form of abuse (physical, emotional, sexual, etc.), major life threatening accidents, etc. Other determinants to consider is loss of a loved one or long term isolation.

Individuals “dissociate” or develop a means to escape troublesome or disturbing visions that may be preventing them from a normal consciousness. This coping strategy allows individuals to sustain a normal functioning balanced life by alienating themselves from experiences that cause stress or anxiety. The mental disorder is described as an emergence of at least two or more “alters” that retains a dominant way of connecting and perceiving the world. Extensive research has confirmed conditions such as body functioning, for example blood pressure and pulse as well as personality traits/characteristics, are distinctively different from the “core” or prime identity. Amnesia is one way the altering states exert control and force over the core identity; behaviors and memories are forgotten when the alter personality is dominant.

Counseling intervention varies depending on the individual, however psychotherapy and medication are treatment methods proven useful regardless of the type of disorder. Psychotherapy also referred to as talk therapy is exactly how it sounds; expressing suppressed issues and establishing coping skills to

Sigmund Freud say’s “The individual does actually carry on a double existence: one designed to serve his own purposes and another as a link in a chain, in which he serves against, or at any rate without, any volition of his own.” Meaning that we have our own true self and then another self when our own self has been attacked or offended.Dissociative Identity Disorder (DID) ,formerly known as Multiple Personality Disorder, is a rare mental illness characterized by having at minimum of two distinct personality states. In this essay we will determine if Dissociative Identity Disorder is a valid disorder, and the many controversies about this disorder.

The criteria of Dissociative Disorder is two or more distinct personality states. In the DSM V, there are different states of sense of self and altered behavior, memory, and cognition. Secondly the individual with dissociative identity disorder must experience amnesia, and must be distressed. Other symptoms of DID include impulse, self-harm, detachment from ones self, mood swings, amnesia, and change consciousness. Recently it has been argued if Dissociative Identity Disorder should be in the DSM or not. Many argue that Dissociative Identity Disorder is a made up and created by therapy. The first time dissociative identity disorder was put in the DSM was in 1968 in the second edition, back then it was called Hysterical Neurosis. Back then it was defined as alteration to consciousness and identity. Then in 1980 it was put into the third edition of the DSM, and this was the first time it was identified as dissociative.

Some argue that dissociative identity disorder is an over diagnosis. There are many similarities between dissociative identity disorder and borderline personality disorder. In this article it say’s “They described, rather, a “syndrome” of symptoms that occurs in persons with disturbed personalities, particularly borderline personality disorder. They concluded that DID had “no unique clinical picture, no reliable laboratory tests, could not be successfully delimited from other disorders, had no unique natural history and no familial pattern.” (controversial diagnosis). That means that dissociative identity disorder has no real guidelines so it very well might be part of another diagnosis. It has certain symptoms but this disorder is so rare that when a patient comes to a therapist they have as short list of similar disorders to compare too.

Psychologists say that dissociative identity disorder can be caused due to childhood abuse, however in one article it was stated “As for patients’ presumed reluctance to report childhood abuse, I witnessed in every one of my fifteen alleged cases of DID (all female) not reluctance but a strong tendency to flaunt their diagnosis and symptoms and an eagerness to re-tell their stories with graphic detail, usually unprovoked. Patients with a DID diagnosis seem to have a “powerful vested interest”—to borrow Paul McHugh’s expression—in sustaining the DID diagnosis, symptoms, behaviors, and therapy as an end in itself.”(Current Psychiatry. 2009). After I read this article I thought one of two things. One, maybe that if there are repressed memories it can be induced by a pushy therapist. Basically a therapist could put the patient under such pressure that the patient mind makes up stories. Second, I thought maybe having the several personalities is a coping mechanism that they can tell what truly happened with such confidence because they are speaking of the truth as “another person”.

A major ethical consideration that relates to this topic is Principle D: Justice. This principle makes psychologists and therapists recognize justice for all people and for them to exercise reasonable judgement and precautions to ensure the potential bias. This principle relates to this topic because to be a therapist of someone with dissociative identity disorder you must be tentative. The side opposing dissociative identity disorder is failing to meet this ethical code because they are attacking the disorder itself, trying to make it “invalid”. In one article it discusses how in trial you can be found “not guilty” if you were insane while breaking the law. “persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency”(identity, control, and responsibility). This is a perfect example of Principle D: justice. If the patient does not have reasonable judgment they can’t take precautions.

I believe that Dissociative Identity Disorder is a valid disorder. There isn’t much evidence but it would definitely be hard for people to fake such an illness that’s as complex as this one. Dissociative Identity Disorder is an extremely rare disorder. The average number of alternate personalities a person with DID has between two and thirteen. There is no way someone can fake that many without slipping up. Dissociative Identity Disorder has been apart of the DSM since 1980. As the understanding of the disorder develops more questions come up against it, however there are no questions against if the symptoms or experiences are real.

Introduction

Dissociative Identity Disorder (DID) is a serious mental disorder which can be diagnosed in a patient with at least two split and distinct personalities within him. The mental disorder has been known as hiddenness disease and its availability frequency is higher than other mental illnesses. Most patients with DID report experiencing physical and sexual abuse, during their childhood. A study have found that a single child who experienced such terrible childhood is more likely to be diagnosed with DID than a child with siblings. “Dissociative identity disorder is a rare diagnosis. Because of the rarity of the diagnosis, there is much misunderstanding and ignorance among lay people and mental health professionals. Special attention is given to the reality of coping with the difficulties that dissociative identity disorder create”(Stickley & Nickeas 2006).

Manoj Nelliyattu Shyamalan aka M. Night is the producer and writer of the 2017 movie Split with An entertaining story of Kevin Windle Crumb, a serial killer suffering from DID, whose multiple personalities reached 23. Kevin is more than mentally ill as the 24th personality has superhuman strength making the plot switch from psychological thriller to supervillain origin story.

“Dissociative Identity Disorder have increased exponentially, currently recognized by the DSM-IV-TR as a true psychological disorder that emerges, most commonly, as a result of early childhood sexual abuse” (Haddock 2001). This very research examines the reasons behind dissociative disorders with the traumatic stress experiences and considers problems associated with the patient. I will first provide an analysis of Kevin Windle Crumb the lead character from the movie Split played by the actor James McAvoy, all related to the different personalities he portrays within himself, and identify their resemblance and state of awareness, and relating his condition to the real DID symptoms. Second, I will discuss the reasons behind such forming of each prominent personality and the development they went through, as each distinct personality resembles a part of fear inside the patient. Third, I will address the treatment and salvation and the validity of health insurance coverage, keeping in mind the hypothesis of what if Kevin had the right treatment before it is too late ?.

Review of Literature

“M. Night Shyamalan may be the most gifted director of the last 20 years to see his own name turn into a punchline.” Said Owen Gleiberman, that in the way his twist endings became a signature that devolved into a tic that began to inspire a collective eye roll. Shyamalan has never indulged in the luxury of directing a movie that wasn’t based on his (catchy) (gimmicky) concepts and (decent) (functional) dialogue. Yet his talent as a director is gold. In his best films, he displays the essential moviemaking gift that fuses rhythm, character, mood, and visual storytelling. He has the instinct for how to frame a shot so that it’s the cinematic equivalent of an enthralling sentence.

“Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder” (Boysen 329).

There comes that seemingly inevitable moment in each of his films call it the Shyamalanian “click” when everything falls into place and the viewer realizes (or is made to realize through a series of flashbacks) that everything that had appeared coincidental or nonsensical wasn’t accidental or meaningless at all but rather directed by some controlling force. The most famous of these ironic realizations and arguably the most effective is of course the terrific moment in The Sixth Sense (1999) when both child psychologist Malcolm Crowe and the viewer realize simultaneously that Malcolm is dead, having been shot at the very start of the film.

Critical Background

Kathryn observes that Dissociative Identity Disorder is the most complex dissociative disorder. It is also known as multiple personality disorder (MPD) which led some to see it as a personality disorder, although it is not. The defining feature is severe change in identity as in saying “I’d look in the mirror and it would be a different face. I was chaotic and unsettled.”. She adds that If someone experience DID, he may experience the shifts of identity as separate personalities. Each identity may be in control of your behaviour and thoughts at different times. (Livingston 6). Shirley J. addresses bullying and neglect by saying that it is important to remember that there is no right or wrong way to experience or express having endured trauma either as an adult or a child. We all respond differently to our circumstances. One person’s hang nail may be another person’s tragedy. That It is all up to our individual abilities to handle stressors in our world. (Davis 7). According to The National Alliance for the Mentally Ill (NAMI) Dissociative Disorders: “are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.” The author says that it is important to note that all dissociative disorders have their common root cause in severe trauma. (Davis 12).

Editor Rafer Guzmán offers an explanation of the film “Split,” as a psychological thriller starring James McAvoy as a man with 23 personalities. M. Night Shyamalan, a writer-director whose movies range so widely in quality that he also might have multiple personalities. He has been the Hitchcockian mastermind who gave us “The Sixth Sense,” the creative comic-book geek behind “Unbreakable” and the dunderhead who stapled together “The Last Airbender.” The good news is that, for most of its nearly two-hour running time, “Split” is quite enjoyable, a clever one-up of “Psycho” with some interesting twists and several funny-creepy moments. In its final 20 seconds, however, “Split” suffers a kind of psychotic break and does something so dumb, so exasperating so Shyamalanian that it nearly wrecks everything. For the moment, let’s focus on the positive. “Split” makes the absolute most of its star, and vice versa. We first see McAvoy as Dennis, a stern handyman who kidnaps three teenagers: friendly Marcia (Jessica Sula), pampered Claire (Haley Lu Richardson) and the school outcast, Casey (Anya Taylor-Joy). Dennis soon gives way to matronly Patricia, outgoing Barry, 9-year-old Hedwig and even a few minor supporting roles. McAvoy shifts his speech, posture and facial expressions with ease, but even more impressive always shows us the crack in each facade. The film’s other major asset is Taylor-Joy (“The Witch”). She’s a haunting presence as Casey, a black-haired, black-eyed misfit whose own troubled past, seen in flashbacks, gives her a unique empathy for her captor. Although “Split” repeatedly asks us to believe that the girls are too scared to fight back, grab weapons or flee through open doors, Taylor-Joy is so intriguing that we kind of want her to stick around. Shyamalan takes an inventive approach to the controversial theory of Dissociative Identity Disorder. Betty Buckley plays a renegade psychologist, Dr. Karen Fletcher, who believes each “alter” is a truly different person, even physically. When Dennis/Hedwig/Patricia talk of The Beast perhaps a 24th personality? you might feel a little shiver down your spine. As for the film’s ruinous final moment, involving a pointless reference to another Shyamalan movie and a celebrity cameo, it’s a real shame. Just when you were enjoying this clever, creative filmmaker, the dunderhead within takes over. (Newsday)

Content

From the behavioral perspective it shows that Kevin the main character with the dissociative identity disorder has no recollection of what has happened while his other personalities were in action. He suffers from an extreme case of Dissociative Identity Disorder (DID), and has 23 separate personalities plus a final abnormal one. His father Clarence Wendell Crumb left on a train and never came back, died in the Eastrail 177 train accident which is a Disaster that took place in 2000, as the Eastrail Train #177 derailed near Philadelphia due to mechanical failure that left only one surviving passenger, leaving left 3-year-old Kevin with his abusive, obsessive-compulsive mother who was supposed to be the protector of her child, but she is either so damaged herself that she could not do the job, greedy or villainous to the point that she never had any interest in doing it properly, including being emotionally, verbally, physically, or mentally abusive, or who neglectfully allow her child to be abused by others . Sometimes, the character manages to not grow up broken, bitter, and hateful, and instead a different and better person. Bear in mind that not everyone agrees on the line between actual abuse and merely heavy-handed parenting (or even normal parenting). Some include spanking as abuse; others think it’s appropriate given certain guidelines. If a parent has just dumped the child, for whatever reason, that’s Parental Abandonment; if they aren’t paying attention, that’s Parental Neglect. If the parents refuse to discipline their kids, they are Pushover Parents. “When a parent becomes maltreating, however, even an intensive program of home visitation by nurses in addition to standard treatment is not enough to prevent recidivism of physical abuse and neglect”(De Bellis207). As Kevin being abused, he began to take refugee by developing multiple personalities as a defense mechanism, he retreated from reality and created these many other personalities to help protect him from her.

A second dominant personality is Dennis, the protector similar to Kevin’s mother, has OCD with obsessive-compulsive cleaning habits, was a direct result of Kevin’s trauma. According to Dr. Fletcher’s files briefly seen in ‘Split,’ One of the more disturbing personalities, Dennis is cold, temperamental, and manipulative, with a perverted liking for watching young girls dance naked, and for that reason, the other personalities try to keep him from emerging. He demonstrates a firm, sometimes violent, tendency towards order, showing himself capable of talking on pleasant terms despite his explosive temper. The main reason of his formation is because of the spiteful ways Kevin’s mother punished him, and the only way to satisfy her was through keeping everything tidy and in order. “Lack of positive engagement during childhood and adolescence may contribute to a loss of the normal protection or resilience against traumatic stress”.

A third personality is Patricia. A British orderly, sophisticated, educated and polite woman who has considerable command over some of the other personalities. She is revealed to be surprisingly dangerous in her own right that can be vicious when disobeyed. She is also a priestess who only seeks to please the final abnormal character. Along with Dennis, they take a lead role in controlling the group throughout most of the time. “Multifactorial models of child maltreatment in long-term care propose that risk and protective factors in multiple domains contribute to child abuse and neglect. They include factors associated with the perpetrator; the young person in care; the type of care setting”{, 2000, Trauma`, violence & abuse}.

Hedwig, the forth personality a nine-year-old boy with several compulsive behaviours, that loves to dance crazily, do drawings. He is disciplined by the other personalities tending to act like his parents. A rather gullible as a result of his innocence and naivety, easily baited. His desire is to not be dismissed and made fun of anymore. Hedwig attempts to dress as such in a sports outfit. He also has a habit of mentioning his sock colours randomly to show his childishness. In an attempt to blend in with their supposed age group, dressed in an exaggerated, stereotypical version of what the surrounding is wearing.

Barry as the fifth personality is a flamboyant fashion expert, working tirelessly with Dr. Fletcher to keep Kevin’s more dangerous identities ‘out of the light’. Barry is a key personality inside Kevin, as the dominant one. His singular focus is the protection of Kevin, always concerned about him more than the others. Barry qualifies as the most normal personality of Kevin’s. Barry could determine what personality should come and at what time. This is the power he had until Patricia, Denisse and Hedwing seized Kevin’s mind. It is implied that he is a very commanding individual (described at one point as an extroverted leader).

The sixth and seventh personalities are is Orwell, the personality of an introverted and highly intelligent well educated, particularly about world history who appears in a video on Kevin’s computer, and Jade a personality that we only see a couple of brief times in Split. She appears briefly in a video file like Orwell. She is diabetic, a medical oddity since none of Kevin’s other personalities are. She appears to be a teen or a young adult with a foul mouth, though her exact age isn’t clear. She is flirtatious and young, and has to take insulin injections for diabetes.

There are 16 other personalities that are not shown, but the names of which are seen on Kevin’s computer. The final and abnormal personality is called The Beast, is by far the most dangerous, hostile and terrifying of all the personalities. It is the 24th identity that resides in Kevin’s mind. The Beast is a malevolent figure, idolized by Dennis, Patricia and Hedwig, who all awaited his arrival. The Beast is extremely violent to the point of savagery, having an unquenchable lust for human flesh, and an intense perspective that the rest of the world is impure because they haven’t suffered like he has. The Beast possesses superhuman strength, speed, agility, stamina, invulnerability and pain tolerance. Finally, the Beast is incredibly hard to kill, since bullets are virtually ineffective against it and knives shatter against its skin. Making the whole film switch from psychological thriller to supervillain origin story. Despite its savagery, wants to protect Kevin from all who would do him harm no matter what. Kevin’s body physically transforms to become more muscular and becomes violent personified and his freedom at the end of Split means that terrible things are likely to happen.

In summary, the serotonin system and the genes regulating the serotonin system are influenced by early trauma. The field has not yet advanced, however, to the point where treatment can be tailored to an individual child. More work needs to be done on gene-gene interactions, possible epigenetic effects, trauma variables, and other factors, such as social supports, to achieve this aim” (De Bellis & Zisk 200). “As with most traumatic events, children will exhibit symptoms such as regression, avoidance or reliving the event, hypervigilance, decreased concentration, sleep problems, and anger outbursts. However, most children will recover in a supportive environment” (Lonigan1991) and poorer response to evidence-based treatments during adolescence (McMakin2012). “Although the mental disorders found in maltreating parents and child victims are serious, they are amenable to prevention and treatment”(Allen207).

Works Cited

1. Allen, Jon G. Coping With Trauma: Hope Through Understanding. 2nd ed., American Psychiatric Publishing, Inc, 2005.
2. Bellis, Michael D. De, and Abigail Zisk. “The Biological Effects of Childhood Trauma.” Child and Adolescent Psychiatric Clinics of North America, vol. 23, no. 2, 16 Feb. 2014, pp. 185–222., doi:10.1016/j.chc.2014.01.002.
3. Boysen, G. The Scientific Status of Childhood Dissociative Identity Disorder. vol. 80, 2011, pp. 329–334, The Scientific Status of Childhood Dissociative Identity Disorder.
4. Carr, Alan, et al. “A Systematic Review of the Outcome of Child Abuse in Long-Term Care.” Trauma, Violence, & Abuse, 22 July 2018, p. 1., doi:10.1177/1524838018789154.
5. Haddock, Deborah Bray. The Dissociative Identity Disorder Sourcebook. 1 edition ed., Contemporary Books, 2001.
6. Kopstein, Andrea. Trauma-Informed Care in Behavioral Health Services. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2014.
7. Shyamalan, M. Night, director. Split. Universal Pictures, 2017.
8. Stickley, T., and R. Nickeas. “Becoming One Person: Living with Dissociative Identity Disorder.” Journal of Psychiatric and Mental Health Nursing, vol. 13, no. 2, 16 Mar. 2006, pp. 180–187., doi:10.1111/j.1365-2850.2006.00939.x.

The complex disorder when a single individual has two or more personalities within themselves is known as dissociative identity disorder (DID). Victims of this disorder have alternate personalities that are also called subpersonalities, this means that a single individual has two or more personalities within themselves. Alternate personalities are never the same, as they can vary from different genders and the way they act and dress, they also may enjoy different activities and have different hobbies, morals, and their handwriting can even be different (Murray, 1994). The switch between one identity to the next may be random and unexpected, affecting family and friend relationships. With the amount of cases increasing in DID since 1970, a lot of new information was released about the disorder since then.

It was found that each personality may be a fully integrated and complex unit with memories, behavior patterns, and social relationships that determine the nature of the individual’s action when that personality is dominant. Since alternative have their own memory, they respond to stimuli differently from other alternatives (Apter, 2008). In an investigation done on a woman who had ten personalities, three of those 10 personalities learned off of the others (Murray, 1994). In another investigation, two researchers named Thigpen and Cleckley studied the differences in allergic reactions in the different alternatives. They used galvanometers and kymographs to identify the physiological changes in the different alternatives. Thigpen and Cleckley showed the major differences in subpersonalities in their research and also proved that they can vary in which hand they write with, prescriptions for glasses and can have different allergies (Murray, 1994). The important findings of these investigations showed how unique each alter is from one another, they are their own person.

Alters have been seen as a type of defense mechanism in DID subjects, as it helps them cope with their reality. People with DID may have experienced trauma in their childhood years, usually sexual abuse. Murray included a report made by Ross in 1991, which concluded that 90% of people diagnosed with DID had experienced physical and/or sexual abuse in their childhood (1994). Having different identities can be a way to allow the person to escape their reality. A significant amount of people who are abuse sexually or physically develop alternate personalities as a type of defense mechanism to protect themselves (Murray, 1994). Although the statistics may show a positive correlation between childhood trauma and the development of DID, this does not mean that every child that experiences abuse will be diagnosed with DID because this also depends on the child’s memory. There are no studies that show the direct correlation between childhood abuse and the development of DID or is there enough evidence that shows that children who were physically or sexually abused have a higher chance of developing DID than children who did not experience abuse (Murray, 1994). DID develops if the child is going through trauma when his or her personality is in the process of forming. This may lead to the child having imaginary friends, which is common among young kids and does not guarantee that they will have DID, but it can be a start. Erxleben and Cates talk about the Four Factor Theory that is a theorized address to how DID develops (Erxleben and Cates, 1991). First, the traumatized child has the ability to disconnect from their reality (Erxleben and Cates, 1991). Second, the traumatic experience or experiences overwhelm the child’s ability to respond to stress using internal resources that they already have (Erxleben and Cates, 1991). Third, the child displays dissociative splitting of the self into different identities (Erxleben and Cates, 1991). Personality formation continues quickly, although within the identities that have been made to protect them (Erxleben and Cates, 1991). Fourth, if the traumatic experience continues, overwhelming internal resources, the dissociative splitting action continues to grow, creating the potential for each part to develop into a discrete personality (Erxleben and Cates, 1991). Although, there are fewer reports on DID among younger children, this stage of their life when DID begins to form with a couple alternative personalities, but as they grow up that number increases.

Treatment for DID patients is only beneficial or active if they accept the therapy, rather than rejecting it. DID symptoms are usually hidden; therefore, keeping it secret is an important aspect to be considered while diagnosing and treating the DID subjects (Murray, 1994). Helping DID patients can come in many different forms of therapy. Therapists have used behavior therapy, psychodynamic therapy, hypnotherapy, and sodium amobarbital to help patients with DID (Murray, 1994). Although, these approaches may be a slow process, they are effective if the patient decides to follow through with them. Difficulties trying to get patients to cooperate do occur as many of the patients have trust issues due to past experiences and are afraid of their own disorder. Also, the understanding that having multiple personalities is a way for the patient to cope with their past experiences is important. A therapist’s failure to this understanding can lead the patient to more problems, such as self-destructive behavior, addiction, and/or eating disorders. In order to get the patient to cooperate, the therapist may assign instructions to the patients’ friends and family to slowly get the patient to open up. Hypnotherapy may be useful with alters that are more difficult. Hypnosis is useful towards those who usually reject help because it can allow the therapist to see “secret” identities, the only downfall is if not used correctly this can only make matters worse if not used correctly (Murray, 1994). Again, understanding plays a big role in therapy, as the patients also needs to be able to start to understand themselves throughout the process as well. If the patient is unable to understand and realize, it is not helpful because then the patient will not talk to the therapist about their symptoms or loss of memories (Murray, 1994). Hypnosis is only useful in therapy when it allows the patients understand and use the past and present for self-growth and understanding (Murray, 1994). However, more complications may occur if a less dominant alter is not ready to completely vanish from existence, this is a form of death to them. The alternative may help the host see the alters as a sort of community. When the host becomes accepting of their alter personalities, this may lead to the patient not wanting integration of their different identities because they no longer feel the need for it (Erxleben and Cates, 1991). A sense of community replaces earlier feelings of chaos and discontrol, further fostering communication and positive relationships (Erxleben and Cates, 1991). In the end, the process of treatments may be slow and require patience, the end goal is to help the MPD patients retrieve lost memory, be able to recognize their disorder, and eventually combine their subpersonalities into one.

The number of DID cases have increased in the past years, but there still is not enough cases to conclude the most effective treatment. Cases of DID in children is fairly low as may be less noticeable, leading to the formation of multiple alternate personalities for when they are older. Although the correlation between physical and/ or sexual abuse in one’s childhood and the development of DID is positive, it is not a guarantee that this is the official cause of DID. More research is required to say a patient diagnosed with DID is completely dependent on their childhood history of physical or sexual abuse (Murray, 1994). Official treatment of the disorder remains unknown, but not completely. There are methods out there that do seem effective, such as hypnosis. The role of hypnosis in treatment seems secure, but researchers must be cautious in drawing conclusions because they may alter the subjects’ memory (Murray, 1994).

References

1. Apter, A. (1991). The Problem of Who: Multiple personality, personal identity and the double brain. doi: 10.1080/09515089108573028
2. Erxleben, J. and Cates, J. (1991). Systemic Treatment of Multiple Personality: Response to a Chronic Disorder. American Journal of Psychotherapy, Vol. 45 (Issue 2), pp.269-278.
3. Murray, John B. (n.d). Demensions of multiple personality disorder. Journal of Genetic Psychology. Jun94, Vol. 155 (Issue 2), p233. 14p. doi:10.1080/00221325.1994.9914774

In the 1800s; Dr. Jean-Martin Charcot has discovered a new disease. He called the diseases hydro- epilepsy. By the name, she believed that the two existing mental illnesses; hysteria and epilepsy were combined to make a new disease. Later, Scientists studied more into the diseases and renamed it multiple personality disorder. At first, the symptoms of this disease were fainting, convulsions and conscious. When Charcot first discovered Hydro-epilepsy a lot of people doubted him; especially one of his students; Joseph Babinski. He believed that Charcot made up the diseases and convinced his patients that they had this disorder. Babinski believed that the patients were not having seizures because of epilepsy.

The reason why Babinski thought they were having seizures because of Charcot’s treatment. Even though Hydro-epilepsy was a real disorder; Babinski did prove that some of the patients were convinced of having the diseases. Later on, Babinski and Charcot’s teamed up and made a program for people with hydro-epilepsy. How the program works is the patient gets diagnosed with hydro-eclipses and they go into the ward and the patients with the same symptoms are separated so no one gets hurt. After separating the painets the next step is counter suggestions. Counter suggestions are helping patents a different self-view. Counter suggestions are not welcomed into today’s world due to the fact that they used electro-shock therapy. In Today’s times, no doctor follows by Charcot’s and Babinski’s rules anymore. By Charcot and Babinski’s method they were overdiagnosing people who did not have the disorder.

Stephen E. Buie, M.D. came along and made a guideline for multiple personality disorder so when diagnosing someone they do not play the guessing game with patients. He has noticed the disorder mostly comes out when they are in a therapy session. He figured out how to get each personality to talk to him during the therapy questions; He will start out having very broad questions then start asking specific questions and calling out the different personalities to talk to them one at a time. Some times patients will be convinced that they have the disease and they will be in a room for 24 hours to see if they still have the symptoms and soon therapists will find out if they have the disease or not by the patients getting confused with reality and fantasy.

Therapists found out that most patients with multiple personality disorders will start with two or three personality then they will develop overtime over one hundred. A therapist also found out that personalities can be either gender or any animals. Some people think that multiple personality disorder is a disorder where people switch one from personality to the others and this disorder does no harm. That is far away from the truth. If multiple personality disorder is untreated it can cause damage. When the disorder is not handled properly they can lead the patients to commit suicide, murder, rape, and etc. The reason why they act like this is due to them being separated from reality and their own physical mind. Most multiple personality disorder patients have similar pasts/childhood. ( raped, physical/mental abuse and Ptsd). Having that kind of childhood makes the child break off from reality and make multiple personalities to comfort them.

In 1984, Schafer; a psychiatric observer has discovered an extremely increased in Multiple personality disorder. In South California, there were over 50 million cases of multiple personalities. Often people think that split personality is rare but the disorder is quite often. tHey did psychotherapy on a 7 and a half-year-old little girl. During the day the young girl was bright, nice and sweet but when nightfall comes around she stalks her mom by the bedside, screams and says dreadful things. They decided to use play therapy to help with the young girl. The therapy helped so much that her grades became better and relationships with parents, classmates, and teachers improved.

In 1994 the name “multiple personality disorder” name changed into DID (Dissociative identity disorder). Same disorder but different name. The reason for changing the name is to have a better understanding of the condition. When people hear about multiple personality disorder they think of different personalities like happy, sad, scared, etc. When new therapists named it dissociative identity disorder it helps people understand that this disorder makes it difficult for the person to know the true identity because they have many personalities.

What is a multiple personality disorder? This disorder makes the patients feel like they are watching themselves from second person view. Multiple personality disorder is when the brain has a disconnection with feeling, memories, and a lack of identity. The showing symptoms of dissociative identity disorder are fainting, contortions and convulsions. The mental symptoms are suicidal trendies, depression, separation from reality and lack of sense of identity.

Gacy’s childhood is a good example. Gacy lived in Illinois, with his two sisters, his mother, and his father. He is named after father. His father is a mechanical repairman and a World War One veteran. Sadly, His father was an abusive alcoholic and abused Gacy basically whenever he felt like it. The reason why he beat Gacy because he wanted Gacy to become a ‘real man’. Gacy’s mother tried her best to protect her child from the father but she failed miserably. By the mother trying to stop the father made the beating even worst. It made the father believed that he was a ‘sissy boy’ for letting the mother stand up for him. Later on, Gacy got sexually molested by a family friend. Later into his teenage years, he developed a heart condition for being overweight and that cause bullies to make fun of him. His father’s abusive behavior did not light up and Gacy decided to move to Las Vegas. Due to his trauma from his childhood, he developed Dissociative identity disorder and lead him to do evil things.

Who is Gacy? Gacy’s fulls name is John Wayne Gacy jr. He was born on March 17, 1942. He was a child entertainer for birthday parties. He would dress up like a clown named Pogo the clown. Soon he earned another name “ Killer clown”. While performing for children he would take ( mostly boys between 12-14) them away and ether rape, kill or torture them. This is what happens when Multiple personality disorder does not get treated. The police went to his house after over 30 reports of missing children and he was the number one victim since he went to jail for sexually assaulting a ten-year-old boy before he started murdering. The police asked questions and later found out that he had 26 bodies in the claw space of his house and 4 of the bodies were thrown into the nearby creek. While in the interrogation room they found out that he had Multiple personality disorder. Gacy said that he had 3 Johns and 1 Jack. Jack did most of the evil things. After three hours of court deciding if was guilty or innocent they choose guilty and sent him to the death penalty.

Can people live a happy life with Multiple personality disorder? They can live happily if they take precautions such as therapy. Psychotherapy Is where you talk about how you were feeling. Eye Movement Desensitization and Reprocessing (EMDR) help patients treat their flashbacks and nightmares. Cognitive-behavioral therapy helps you get through bad habits and patterns. Family therapy is when all the family comes in and they explain what is Multiple personality disorder and how they can help the family member with the disorder. Medication can

help with the symptoms and help people with this disorder to live a decent life. Kim Noble is an amazing example.

Who is Kim Noble? Kim noble is an American Comedian. Noble history was mostly the same as Gacy; she got physically abused. She suffered from mental problems and try to overdose several times. Around In her 20’s fice of her personalities start to show up. # of them were named Hayley, Julie, and Patrica. Patrica was the most dominated one. Noble later got help from Oprah and her Noble’s daughter.

Multiple personality disorder can be a difficult time for people around and for the person who has the disorder. The best anyone can do with someone this disorder is to help them seek help and understand their condition.

This research investigates whether the Memory Malingering Test (TOMM) could identify individuals with psychiatric dissociative identity disorder (DID) from students who are coached with DID malingering.

Amnesia is a distinctive symptom of DID. Analyzes showed that TOMM ratings correctly classified medical and malingering DID subjects and that simulators were not capable of malingering DID. This research is the first to confirm TOMM in persons with complex trauma and dissociation, a brief test that is suitable for medical and forensic environments. This is crucial given the severe symptomatology and high costs associated with untreated DID, which can be mitigated through accurate diagnosis and treatment.

Dissociative Identity Disorder

DID diagnoses, previously referred to as multiple personality disorder (MPD), have increased exponentially over the past 35 years, leading the nature of this condition to be challenged by various psychological experts and practitioners. However, DID is currently recognized by the DSM-IV-TR as a true psychological disorder that most commonly results from sexual abuse in early childhood.

Evidence for Dissociative Identity Disorder dates back to the Paleolithic era, however, it was not until the late 18th century that cases of ‘exchanged personalities’ were recorded. A 20-year-old woman from southern Germany took on a French aristocrat’s character in 1791 and even started to speak fluent French. Apparently, the woman formed two distinct nationalistic identities (French and German) that rejected any memory or knowledge of it when asked about the other.

Method

Participants

Participants from the DID. Thirty-one individuals diagnosed with DID were recruited either from a Mid-Atlantic psychiatric hospital system or from private regional outpatient practices. The medical department is specialized in trauma condition assessment and treatment, including DDs. Participants in the hospital were recruited by announcements made at community meetings and were encouraged to talk to their treatment team (i.e. doctor and therapist) if they were interested in participating.

Measures

SCID-D-R is a 277-item semi-structured questionnaire that is considered the ‘gold standard’ for the treatment of dissociative disorders. The SCID-D-R has good to excellent reliability and good validity for discrimination. The DESis a 28-point self-report measure of good reliability and validity of dissociative symptoms. It was used as a screening tool for the experimental DID participants to dissociate. The simulators provided accurate responses to the DES and removed those with scores above 30 to ensure they did not have a DD.

The TOMM is a visual memory recall method designed to measure cognitive effort in memory tasks. Every trial begins with 50 typical line drawn photos being shown for 3 every. Such 50 pictures were accompanied by 50 panels, each with one of the previously shown pictures and a new picture. Every when they recognise an object they have previously seen, participants earn a score. For the present study, only the first two trials (total of 100 items) were used as they are deemed sufficient to detect malingering. Previous research has shown that the TOMM is highly successful in differentiating real from feigned commitment, correctly classifying 95% of cases. The internal reliability of the present test was 0.98.

Procedure

The findings of this study were collected as part of a larger evaluation system focused on the treatment of clinical and feigned DID. The research was accepted by the clinical review boards of the sponsoring university as well as the sponsoring psychiatric inpatient facility specialized in the care of traumatized individuals. Before beginning participation, all participants read and signed an informed consent detailing research procedures, risks and drawbacks and reiterating the voluntary nature of participation. A series of assessments and interviews were performed by DID members, which took about 3–5 hours to complete. At the beginning and end of the test, DID members got two $20 gift cards. Members had opportunities to break throughout the evaluation period and were offered the opportunity to discontinue the assessment indefinitely or use additional support resources if required.

DID simulation providers in 90 minutes completed their assessment packages in small groups, gave their informed consent to receive additional credit and the chance of winner of a $50 gift card if they had the most reliable DID picture for their six-month period. In a questionnaire that identified signs of DID and other psychiatric disorders, they were asked to receive a score of 70% or higher to demonstrate DID symptoms. The knowledge test was passed by each simulator. Simulators were then instructed to complete the TOMM and to answer as if they had DID as much as they could. After the majority of the steps were taken, simulators were advised that a $50 donation card would be randomly distributed to ensure DES responses were anonymous.

Analysis

Research was carried out using version 23 of IBM SPSS. Discriminant Function Analysis (DFA) was used as a classification system for the detection of clinical and simulated DID based on TOMM ratings, including Trial 1, Trial 2, and full scores. DFA was used instead of such methods as logistic regression due to the small sample size that would not have had sufficient power to detect statistical effects in models that were parsimonious with only three predictors. All DFA data-analytic assumptions have been fulfilled.

Results

Statistically significant was the omnibus discriminant method, meaning that the overall TOMM score of a participant in Trials 1 and 2 statistically defined their DID status, whether a person had DID or perceived DID. Trial 1 results reported DID classification, The results of the predictors accounted for 59% of the variance. Trial 1 scores established DID status, meaning that DID results in Trial 1 were lower than those simulating DID.With TOMM Trial 1 scores, 81 percent of the participants were properly classified, the strongest utility scores were achieved. TOMM Trial 1 scores were 78 percent adaptive, 87 percent general, 94 percent positive predictive and 63 percent negative. Furthermore, TOMM Trial 2 scores obtained appropriate utility levels and correctly categorized 73% of participants. TOMM Trial 2 scores had a 64% sensitivity, 97% specificity and 98% positive predictive value, but a 53% negative predictive value.

Discussion and Conclusion

DID can be a majorly underestimated or misdiagnosed disorder in clinical settings. Scientists could test for DID more effectively with a clear distinction between actual DID and imagined and malingered dissociative amnesia or DID. Although it is challenging to diagnose clinical DID and malingered DID accurately, there are well-validated tools and literature. This is a great benefit to us, not only to help us understand the complexity that is DID, but also to help to correctly diagnose a patient suffering from this mental disorder.

Dissociative Identity Disorder (DID) “involves problems with memory, identity, emotion, perception, behavior, and sense of self. Dissociation is when there is [an involuntary and unwanted] disconnection between a person’s thoughts, memories, feelings, actions or sense of who he or she is” (cite source). This is a condition where a person has two or more alter states to escape their reality of traumatic experiences or abuse; these alter states each has their own identity, their own personality, and possibly their own voice because each state may feel differently (cite source). There are many factors that contribute to DID, like natural disasters or war, because it is a way the body or person responds to the traumatic event; however, childhood trauma, such as emotional, psychical, or sexaul abuse, over a long period of time is the leading factor of DID.

Around 99 percent of people who develop DID had a traumatic event that happened usually before the age of the nine, which is said to be a “sensitive developmental stage of childhood” (cite sources). According to Kinship United, “[a] child experiencing trauma affects them more seriously than an adult would be impacted because of the brain development that is taking place in children” (cite source). The brain of an adult is not as impressionable as it would be in the brain of a child; due to the repetition of traumatic experiences, this impressionable brain can cause a long term effect on their life. The repetition of traumatic experiences, such as abuse, creates a “fight or flight” response that will kick in over and over again. During the fight or flight response, the body releases adrenaline that increases the heart rate, while cortisol increases the blood pressure and helps regulate the body’s immune response.

The constant need for the production of those two hormones negatively affects the body due to the constant stress; this leads to damages in the amygdala, prefrontal cortex, and hippocampus, which are associated with thoughts, memories, and emotions. “The constant stress on a child and the damage done to their brain development have a major influence on their behavior and how they approach the world” (cite source). Children often rely on dissociation as a way to cope with the traumatic experiences, and if the abuses is repetitive “dissociation becomes reinforced and conditioned” (cite source). Due to the dissociation being reinforced and conditions, it causes the child to turn into a dissociative state during stress related events, even if it has nothing to do with abuse. Some people who have experienced severe trauma do not develop DID because there’s another critical factor involved: the absence of a normal, healthy attachment to an adult. In the field of developmental psychology, ‘attachment’ has a specific meaning: it’s a bond that forms between an infant and a caregiver who supports and looks after that child, emotionally and practically, while also helping that child to learn about and manage his or her responses. Without that bond – prevented by bereavement, neglect or abuse – a child undergoing a trauma is left to fend for itself (Young, 2017, para. 11).

If DID in children is caught at a young age, the treatment can be successful leading them to a normal life; while there is no cure for adult to have DID, they can still live a normal life that hold a high functional job, some may not even notice that they suffer with DID. Adults with severe DID have trouble with normal daily activities; most people who have DID often lose their job and have a difficult time trying to communicate with others. “People with the condition typically have a number of other problems. These include depression, self-harm, anxiety, suicidal thoughts, and increased susceptibility to physical illness” (cite source).

Introduction

The dissertation tries to portray the condition, Multiple Personality Disorder from the movie Shutter Island. Multiple Personality Disorder is a type of psychological condition where a person comes across several personalities in himself. Multiple Personality Disorder is otherwise known as Dissociative Disorder. It was Dr Jean Martin Charcot, a physician at a hospital in Paris who discovered the disease in 1880. He called this disorder Hystero-Epilepsy and later came up with the name Multiple Personality Disorder. At first people were not aware of this psychological condition but later through explanations and illustrations, people came to know about this. The problem is that the symptoms found in multiple personality disorder are found in other diseases. At the beginning, the patients will start with two or three personalities which may develop into more numbers. One of the common factors amongst the patients suffering from MPD is that most of them share a similar background. He also claims that most of the people suffering from this disease had faced some kind of childhood sexual trauma and they might also have a personality which just stopped when the trauma happened. The problem with this disorder is that Multiple Personality Disorder cannot be completely cured but it can only be controlled.

Actually, Multiple Personality Disorder was firstly found in1791, in a 20-year-old German Women who started to speak French and behaved like a French woman also she started speaking German in a French accent. When she was a French women she remembered every single thing she said and being a German woman she denied the knowledge of French. 67% of Multiple Personality Disorder cases has been reported during 1880, 1920 and 1944 and because of this reason, MPD was focused on for study at this period of time. As the number of cases were reported was increasing, more and more alternative personalities was reported. Now also there are many people who even think that whether MPD exists or not. The symptoms of this disorder are convulsions, contortions, impaired consciousness and fainting. Most of these symptoms are seen for other diseases as well, so people find them difficult to recognize. This disorder produces a lack of connection in person’s thoughts, feelings, memories and actions. The people with Multi Personality Disorder usually has mood swings, depression, alcohol and drug abuse, anxiety, panic attacks, phobias and suicidal tendencies.

The people with MPD may do something that they wouldn’t do normally such as stealing money, speeding, etc. There are different forms of Multiple Personality Disorder which includes amnesia, fugue, depersonalization disorder. When another personality of a person assumed control over him he could not recall the events for a span of time. This disorder can be a result of child abuse (may be physical, emotional or even sexual) or any other trauma experience which might have affected the person in his young age and this disorder is diagnosed more in women when compared to men.

The problem is that many of the peoples diagnosed with this disorder are unaware of their condition and they think it might be a symptom of depression. Usually the people don’t understand their condition and they change in personality from one to another and is sudden and non predictable. After the change of personality from one to another they don’t have any idea about how they are going to react. The patients suffering from such disorder may try to attempt suicide and they might become violent. The patients who undergo MPD may find it difficult to recall the things which happened earlier.

In our day-to-day life we come to know about this disorder from movies, articles, fictional writing, newspapers etc. Literature and psychology are two divisions of science that studies about Human mind. The only difference between psychology and literature is that psychology researches about human behavior while literature researches human behavior through fictions. A literary work benefits from psychology if the writer has successfully presented the characters, expressed their moods and bring the reader into psychological dimensions of human reality. Literature and psychology meet in their focus of emotions and human soul.

Beside literature and psychology, there is no other branch of science that is engaged so much in the study of the relationship between human body and soul with its contradictions and dilemmas, making efforts to define the relationship in terms of certain rules, to know the mysterious aspects of the human soul and its subconscious areas by means of long and detailed journeys: at the same time both branches have been struggling in their existence between arts and science for about a century.This was the explanation given by Academic Ismet Emre about the relationship between literature and psychology. As long as humans are the theme of the texts, psychological elements will be present in every literary works.

Shutter Island: Separating Fact From Fiction

With a producer like Martin Scorsese, each picture we see has inside it, the subjects and greater thoughts of the motion picture. The opening shot turns into the examination of the film as we see a broad view of the ship leaving its haze. On board is Teddy who is becoming ill adrift alongside his accomplice Chuck. Teddy is ill because currently, he is on a moving ship in the ocean, searching for answers. He does not know the reason behind his travel on the ship, in other words we say that, Teddy is in kind of amnesia.

Teddy is researching a 67th patient that he trusts exists on the island and he is looking to cut down the staff of “Ashcliff” as he trusts they are Nazis endeavoring to penetrate America through mentally programming investigations. Teddy is first acquainted with the primary layer of the island when he is enabled access to the ship. He is in a spot few get the chance to go. The second layer is presently in entering Ashcliff’s closed up office where he clashes with the specialists there who tries to control reality. Lastly he enters Ward C. An impervious stronghold to ward off the very fierce mentally unstable people from the society. The more profound Teddy goes, the more profound he is going into his mind and therefore further into reality of his story. Also, from here is demonstrated what has truly occurred.

The last piece is to get him to the beacon. A beyond reach place that he realizes he will discover reality. In any case, it’s anything but a fact about crazy lab rat specialists indoctrinating patients, yet rather it is Dr. Cawley and his accomplice, Chuck, who is really his essential doctor there to uncover to him the genuine idea of his life and the untruths he has made to secure himself. The finish of the film demonstrates him being Teddy once more, as though to state that he has relapsed. In any case, Scorsese surrenders the completion over to the choice of the group of onlookers. As Andrew inquires as to whether it is smarter to live as a beast or kick the bucket as a decent man. This is a message that he might not have relapsed, however can’t live with himself for what he has done by murdering his better half, nor with the recollections of the passings of his kids. He is open to the beacon where he will be given a lobotomy.

‘Shutter Island’ is one of those films that rips the rug out from under your expectations with the frequency and intensity of a magican’s act. Initially, we think we are watching a well-intentioned U.S. Marshall named Teddy enter an insane asylum/prison hoping to uncover the whereabouts of a recently-disappeared patient/inmate. Later, our strangeness barometer begins to beep and we recalibrate our assumptions. Now we think we are witnessing a brave and bereaved soul searching for damning evidence that will expose Shutter Island as an expensive, cutting-edge torture chamber. Only during the final act (unless you’ve connected the foreshadowing dots), when our barometer falls off the charts, do we realize that the narrative is really about tragic psychosis and elaborate role play.

Overall, I found the film to be a very intense, somewhat entertaining discussion of lines – the kind of elusive, easily blurred lines that exist between perception and reality, normalcy and insanity, even exceptional and subpar filmmaking. There is another extremely relevant though largely ignored line of which I’d like to discuss, the line between realistic and melodramatic portraits of clinical psychology. Although issues like delusions and 20th century inpatient treatment are aggressively examined within the plot, many of its exclamation points are in fact question marks that warrant further discussion:

Does Teddy suffer from an actual psychological disorder?

Teddy is a strange case. In retrospect he presents as an intelligent, high functioning individual, so much so that his traumatic experiences during WW II merely dented, rather than overwhelmed, and his coping resources. However, the mild and (then) socially acceptable alcoholism and workaholism he exhibited as a family man provided just enough emotional detachment to blind him from the murderous insanity bubbling up within his bipolar wife. One Saturday, an unsuspecting Teddy arrived home from a work trip to his three drowned children and a creepy, suicidal wife (whom he promptly put out of misery). Although such an experience would seem to virtually garuntee the development of Post-Traumatic Stress Disorder, somewhere along the way his symptoms tipped into the very real but much less common psychiatric condition known as Delusional Disorder.

As indicated by the DSM-IV you can be advanced – subjectively, socially and inwardly – and not just experience the ill effects of dreams (fixed, resolute convictions that negate clear, consensual proof) however experience such a state without clear mental hiccups. Teddy additionally meets this analysis, as per the manual, since he encounters the hallucinations for all the more then one month (don’t request that I clarify the time cutoff) and not as the consequence of disposition issues (he isn’t especially discouraged or restless) chronic drug habits (the jug is never again an issue) or schizophrenia (far and away also socially sagacious, and his fancies are not bizzare – ‘outsiders arrived in my kitchen’). As the DSM-IV further groups Delusional Disorder by means of substance of the daydream, an analyst may likewise take note of that Teddy experiences a Mixed Type. His psyche produces subjects of gaudiness (I will reveal a mass connivance!) and oppression (I will be kept from consistently leaving this island!)

Is the film’s diatribe against the mental health field warranted?

Do the trick it to state that ‘ShutterIsland’ isn’t the most reassuring true to life depiction of psychological wellness. Two primary concerns that should be tended to are the ‘cavern scene’ and the ‘last scene.’

Cavern Scene: In the mid seventies -, all things considered, not dream – an analyst named David Rosenhan led an analysis that endeavored to inspect exactly how well the mental network analyzed wildness. It went poorly. A bunch of research confederates acted like ‘counterfeit’ schizophrenics, entering an inpatient medical clinic with reports of mental trips. Once inside they continued to act like their typical, high accomplishing selves each and every minute paving the way to release. Shockingly they were not permitted to leave without a schizophrenia mark and medicine for psychoactive drugs.

The viewers may perceive remainders of this investigation in the cavern scene, as an analyst, also known as fabrication of Teddy’s creative ability, rails against the impasse of being articulated crazy in spite of being normal. Obviously, this scene is a noteworthy exaggerated jump from the real world. Jumpy if not pernicious specialists, obsolete if not counter-intuitive treatment approaches and vulnerable if not martyred patients is the stuff of the removed past if not absurdist connivance. The present the truth is that finding remains an intricate blend of craftsmanship and science with mental preparing comprising of best quality level logical measures and insightful, non-judgmental clinical points of view. Indeed, the field has entered an unchartered area with respect to understanding rights, a fair power dynamic among treator and treatee and all around contemplated, exactly upheld treatment. In the event that just the truth was as edge-of-your-situate intense…

Last Scene: Are we truly to trust that the agreeable and achieved Teddy (no earlier history of dysfunctional behavior over an unmistakable example of flexibility), goes insane from a familial injury, at that point more than once gets through his hallucinating outlook amid treatment, just to return to insane mode like a music CD stuck on rehash? Albeit singular contrasts and the sensitive, unpredictable mix of qualities, condition and identity can make the visualization of steady sickness a sporadic, once in a while perpetual undertaking, the stuck-on-continue finishing does not bode well. By and by ‘Shade Island’ need an update, as psychological maladjustment is introduced in the antiquated restorative model organization in which a mystic ‘infection’ emerges, sneaks up on the rationally solid personality without hardly lifting a finger, makes irreversible harm and rejects at any point let go. In the event that you ask me this last scene is the craziest thing in the entire film, and that is stating something…

Do places like Shutter Island really exist?

Without first-hand knowledge I think it’s safe to say that Shutter Island is a caricature. But it is a caricature inspired by the ‘snake pit’ mental hospitals of the ’50s and ’60s in which many chronically ill patients suffered a lifetime of filth and mistreatment. When public outrage finally caught up to the reality a national deinstitutionalization commenced during the 70’s that did little more then demote mental patients from marginalized status to homelessness status. The movie also discusses the ‘ice pick’ frontal lobotomy. Before you dismiss this as horror movie fiction you should know that approximately sixty years ago over five thousand procedures were performed in the U.S. Yes, the procedure was performed with an ice pick-like instrument. Yes, the surgeon could be seen jamming the pick through the eyeball before proceeding with a frenzied wiggling motion. Yes, my attempt to save the image of psychiatric history from cinematic misrepresentation is backfiring..

What is this current film’s general decision?

From one viewpoint, prosecutions of the emotional well-being field in this motion picture go from deplorable correctnesses to sensational embellishments to head-scratching contortions. Then again we are furnished with at last good natured specialists and essential exhibitions of mental anguish. To the extent this current film’s depiction of clinical brain research is concerned, if it’s not too much trouble email with your decisions.

Figure 1 – The cover photo of Martin Scorsese’s movie Shutter Island

A Study of multiple personality disorder/ dissociative identity disorder with real life examples

Dissociative Identity Disorder, formerly called Multiple Personality Disorder, is one of the most controversial disorders in the field of psychology. The scientific explanation for the disorder is: the presence of two or more conscious identities in the same person, although only one is conscious at a time. In simpler words, a person who has the disorder suffers from a break in his or her personality. Their mind separates into several distinct people. There are two separate theories on how this disorder came to be. The first theory is one that many people are familiar with; DID is caused by severe trauma. The second theory, which is less known, is that DID is an iatrogenic condition, caused by the therapist themselves.

The first theory on why people suffer from DID is extreme traumatic experience that causes the victim to dissociate from their life. The traumatic experience could be severe and horrific child abuse, frequent cult ritual activities, and a victim of sexual crimes. To deal with the event, the person retreats into his or her mind. They turn away from the experience and lock it deep within their minds. According to theory, this causes them to create personalities, people, who are stronger and better equipped to deal with the trauma. These extra people are called “alters” or “others”.

Their habit of retreating into their minds once the abuse occurs causes them difficulty in creating an integrated personality. Instead their personality develops in pieces, divided into categories. As they go through life, living in such an unpredictable environment, they learn to react differently to certain situations. They change and mold their personalities to better protect themselves. After several years, these dissociations become personalities, a mind of their own, that acts and thinks independently. The sudden split in their personality is identified as a desperate survival strategy for someone who did not having any other option to escape the abuse they suffered through. Even after they escaped the abuse, the personalities have been established and became independent.

The second theory for DID’s existence is that therapist are the ones who induce their clients to dissociate from themselves. The disorder originally involves the victim suffering from amnesia without apparent brain damage. The victim is also unaware that he or she has several different people living in their minds. To cure DID, some therapists use hypnosis, a technique that leaves the receiver extremely susceptible to the tiniest hint of suggestion. Because of the usage of hypnosis, the theory suggests that the memories recovered during the sessions are false memories. Prior to seeking counsel, the client did not have memories of abuse nor have they reported or manifested alters. They only began reporting about their past experiences with abuse and manifesting alters after undergoing sessions of hypnosis. The recovered memories are also impossible to prove. The people, dates, and times of the abuse that the clients claimed to have remembered contradict the information given by other sources.

In extreme cases, clients report to be victims to satanic ritual abuse. Their recovered memories involve prolonged abuse at the hands of devil worshippers. The abuse ranged from sexual, psychological, and physical. They often claim remembering seeing butchered infants, breeding of babies for later sacrifice, ritual sexual abuse of a child, drinking of blood, cannibalism, and sex orgies. However, the FBI reported that they had investigated the claims and have found no evidence of satanic cults. It is proven, through the FBI’s extensive investigations that satanic cults do not exist. Despite the second theory’s suspicion about DID, it does not mean the disorder isn’t real. It’s as real as the hunger people feel every day. Those with DID do suffer and therapists are looking for ways to cure the disorder.

Those who live with Dissociate Identity Disorder often live their lives in confusion. One of the many effects of the disorder is losing track of time and memory. Most often, the victim would black out at the most unfortunate moments and wake up to find themselves in a different location, the time had moved forward extremely fast, and sometimes they’d be in possession of things that they know they’ve never bought before. There are also times when they’re called a different name by people who claim that they have known each other for quite a long time but yet they’re complete strangers.

Not only do they live in constant confusion, victims of DID also suffer from unexplained body pain and headaches. They may have sleep disturbances, unable to reach the REM stage. Some may be able to reach the REM stage but suffer constantly from nightmares and are always tired. Those with the disorder often report family dysfunctions such as one or both parents being abusive or neglectful, sexual abuse from a relative, or their parents having drug addictions that left them incapable of caring for a child. Victims also have distortions in cognitive thought. They experience a sense of hopelessness or helplessness. They may also experience anxiety or panic. In extreme cases, the victims may also hear voices or hold conversations within their own minds. It is also possible for victims to refer to themselves as “we” or “us”. It is suggested that this is done subconsciously. Having the disorder may also include having depression and suicidal thoughts.

Dissociative Identity Disorder became extremely well known throughout the years after the famous movie Sybil that was based on a novel with the same name. Prior to the movie there was a reported number of approximately fifty cases that involved DID. After the movie’s premiere, the number of DID cases skyrocketed to about four thousand. Sybil was about a real life woman who underwent therapeutic sessions of hypnosis. Her therapists used sodium pentothal (truth serum) on her during these sessions. Her therapist suggested giving names to her various emotional states as a means to help her cope better with her problems. However, the woman did not suffer from Dissociate Identity Disorder. The author of the novel said herself that if she didn’t write Sybil as a woman who suffered from DID, the book wouldn’t sell. Because of Sybil and several other movies that featured DID, the disorder became extremely popular amongst society and reported cases of the disorder began to rise.

Dissociative Identity Disorder: it is defined as a dissociative disorder in which a person reports having more than one identity or alter. Those diagnosed report to have more than one identity or alter. Each alter presents with individual characteristics. Each alter presents at different times and is determined by the alter in charge. The primary alter may be unaware of the alters and may have no memories during episodes in which another alter present. During diagnosis it is common to identify 2-4 alternative personalities. The longer the treatment the more alters can emerge. It is usually the primary alter that seeks to treatment. Those with DID may hear the voices of the other alters but they cannot identify them. May experience a gap in time which occurs when another alter takes over. Researchers have linked severe abuse and childhood trauma to the development of this disorder.

The first detailed case of Dissociative Identity Disorder traces back to 1791, where a German woman began to speak French without having learnt the language before and no connections to the country. This woman also took on the characteristics of a French aristocrat and spoke German with a French accent. Between 1880-1944 numerous studies on DID had been undertaken, with an influx of cases happening around this time (“The Amazing History of Dissociative Identity Disorder (DID) | Healthy Place’, 2020). It was not until 1980 that DID was written in the Diagnostic and Statistic Manual of Mental Disorders (DSM) as an official disorder.

The knowledge of Dissociative Identity Disorder is mostly used in the treatment of this disorder, in which the main goal is too assure the patient that their alters are no longer needed as the trauma is over (Ann Kring et al., 2018). The International Society for the Study of Trauma and Dissociation provides a three-stage treatment model to increase the feeling of safety and reduce symptoms of the disorder. This includes; confronting the trauma, working through and merging traumatic memories. Medication is also used, however it mostly reduces the severity of other outlying factors such as anxiety and depression (Ann Kring et al., 2018).

This movie (youtube.com/watch?v=I-6XHJFUBDI) depicts Kevin Wendell Crum who suffers from an extreme case of DID, which was the result of traumatic abuse perpetrated by his mother. This caused Kevin to develop alters in order to cope with the trauma. Kevin has 23 distinct personalities which call themselves ‘the horde’. Only 5 of these alters mainly appear in the movie. Each of the alters sit in a room in Kevin’s head on chairs until given the ‘light’ in which they can take full control. This movie depicts the traits of this disorder well, from the district accents, posture and facial expressions that each personality has.

It exaggerates the disorder through the main antagonist ‘the beast’ in which this personality possesses extreme physical strength, superhuman speed and skin that’s impenetrable. This personality is said to have come from Kevin’s exposure to animals while working at the zoo. Thus, this movie may cause additional stigma to be placed on DID, as the ‘beast’ is very superficial.

This movie and a novel (psychology2.wordpress.com/2010/04/27/sybil-summary/) is about a young girl names Sybil who was sexually abused by her mother and neglected by her father, which caused her to split into different personalities in order to cope with the trauma she was experiencing. This movie is accurate in its presentation of the symptoms associated with DID, where each personality has its own accent, memories and communication abilities. An example being the alter of ‘Vicki’ is well spoken and presented and is presented to have the ability to speak another language, when spoken it is unclear but sounds like French.

This movie is correct in demonstrating the interaction of Sybil and Dr. Wilbur in each therapy session and through the diagnosis and the treatments available. Treatments presented include; psychotherapeutic sessions, where Dr. Wilbur sits down with Sybil and her alters and talk about what has been troubling them or when getting to know an alter, and clinical hypnosis, which is used to uncover information about Sybil’s past so as to help her come to terms with it, as well as identifying other alters. After this movie was released, the diagnosis of DID has been said to have increased which may have been because ability to provide a sense of understanding of the disorder to those who previously placed a stigma towards it.

This video (youtube.com/watch?v=ek7JK6pattE) explores the reality behind the media’s stigmatic portrayal of Dissociative Identity Disorder (DID), which has blocked society from fully understanding what it is like to live with this disorder by interviewing those who have been diagnosed with DID. It allows those with DID to explain how they have developed it, which is through severe childhood trauma, and demonstrate how incorrect the media is in showcasing this disorder. Each of those interviewed demonstrate different characteristics of DID, from caretaker alters, co-consciousness, dissociative amnesia and derealisation. The video depicts the reality of how subtle the changes in alters are, with the changes not being noticeable unless the person identifies it and it shows how this disorder is different among each individual who has it.

References:

1. Kring, A., Kyrios, M., Fassnacht, D., Lambros, A., Mihaljcic, T., & Teesson, M. (2018). Abnormal psychology (1st ed., pp. 290-296). John Wiley & Sons Australia.
2. Bernstein, D., Pooley, J., Cohen, L., Gouldthorp, B., Provost, S., & Cranney, J. (2017). Psychology PSY1011/PSY1022: A Custom Edition (2nd ed., pp. 515-516). Cengage Learning Australia.
3. Abnormal Psychology. McLeod, S.A. (2018, August 05) Retrieved from https://www.simplypsychology.org/abnormalpscyhology.html
4. Sybil and Dissociative Identity Disorder. Cheng, F. (2010). Psychology2’s Blog. Retrieved 1 April 2020, from https://psychology2.wordpress.com/2010/04/27/sybil-summary/.
5. History – Dissociative Identity Disorder. Didmpd.weebly.com. Retrieved 1 April 2020, from https://didmpd.weebly.com/history.html.
6. Dissociative Identity Disorder (Multiple Personality Disorder) | Psychology Today. Psychology Today. (last reviewed 2019). Retrieved 1 April 2020, from https://www.psychologytoday.com/us/conditions/dissociative-identity-disorder-multiple-personality-disorder.
7. The Amazing History of Dissociative Identity Disorder (DID) | HealthyPlace. Healthyplace.com. (last updated 2019). Retrieved 1 April 2020, from https://www.healthyplace.com/abuse/dissociative-identity-disorder/the-amazing-history-of-dissociative-identity-disorder-did.
8. Movie Clips (2017, August 5) Split (2017) – The Horde Takes Over Scene (7/10) | Movieclips. Retrieved from https://www.youtube.com/watch?v=I-6XHJFUBDI
9. FilmComicsExplained (2018, April 21) SPLIT (2016) Explained. Retrieved from https://www.youtube.com/watch?v=gyDLuG7riHA
10. AnthonyPadilla (2020, March 4) I spent a day with MULTIPLE PERSONALITIES (Dissociative Identity Disorder) Retrieved from https://www.youtube.com/watch?v=ek7JK6pattE
11. Támara Hill, MS NCC CCTP LPC (2019, February 14) How To Treat Multiple Personality/Dissociation – Psychotherapy Crash Course. Retrieved from https://www.youtube.com/watch?v=lmBwqH7f8uk