Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is a mental health condition where a person has two or more separate personalities or “alters”. These personalities control their behavior at different times. Each identity has its own personal history, traits, likes and dislikes. DID has been misdiagnosed for centuries, and has become somewhat of a trend among TikTokers and Youtubers today. In this post you will read about the history of DID, how DID has been portrayed in media, how bad representation have harmed the community, and how we can help end the stigma surrounding those with DID.
History of DID
One fantastic website I found that described a detailed history of DID diagnoses was “Dissociative Identity Disorder Research” written by Katherine Reuben. Reuben is a doctoral student in Health Promotion and Behavior at Georgia State University. The following section remixes her article, “DID in History,” which is licensed under the (CC BY-SA 4.0) license. This is done to show how DID was commonly misdiagnosed throughout history.
The First Case
The first documented case of dissociative identity disorder (DID) was in 1584. Though not labeled such at the time, Jeanne Fery recorded her exorcism in detail (with additional details provided in the records of her exorcists), preserving documentation of symptoms that exactly match those that are found in individuals with DID today. She had multiple alters, each with their own name, identity, and identifying features and had alters that would today be described as an ISH, persecutory protectors, and child alters. Her alters were associated with actions that ranged from helping her to heal to self harm and disordered eating, were audible inside her head, and could take control of her body to allow for various actions, conversion features, and changes in knowledge and skills. The alters resulted from childhood physical and possibly sexual abuse. Jeanne Fery was actually called ”the most perfect case” of “dédoublement de la personnalité,” the most perfect case of DID, by Bourneville, the man who reissued a book about her life in 1886 (van der Hart, Lierens, Goodwin, 1996).
Continued Misdiagnoses
DID has a history of being mistaken for possession. After such a view was no longer acceptable, those with DID were seen as hysterics. Hysteria was seen as primarily dissociative in nature and could involve disturbances of memory, consciousness, affect, identity, and body functions (van der Hart, Lierens, Goodwin, 1996), the same symptoms today associated with dissociative disorders and particularly with dissociative identity disorder.
The first person to be officially diagnosed with multiple personality disorder (instead of double personality disorder as had eventually come into use in France) was Louis Auguste Vivet in 1882. Louis was physically abused and neglected as a child and had frequent “attacks of hysteria.” One such attack occurred when he was 17 and bitten by a snake. He lost use of his legs for almost one year, and when the use returned after a 50 hour attack, he didn’t remember any of the physicians who had been treating him in an asylum for the last month or any of his fellow patients. His manner, morals, and appetite were different as well. Following additional attacks, the next year, his character would change from impulsive and dangerous to calm and gentle. In 1884, he had another attack that left him gentle of manner but unable to walk, and yet another attack returned the use of his legs but left him quarrelsome and inclined to steal as he had done as a child in order to survive. Amnesia for intervals spanning episodes was noted. By 1888, he had been recorded as having 10 personality states, each of which were different in character, memory, and somatic symptoms. In 1885, integration of the youngest alters began (Faure, Kersten, Koopman, & Van der Hart, 1997).
Interestingly, the earliest reports by Louis’s treating physicians acknowledged only two of his eventually discovered alters as having presented while he was first hospitalized, though later examination of the hospital reports clearly indicated the presence of at least three alters. It is thought that Louis’s case was forced to fit the mold of double personality disorder for as long as possible. The same had happened to Azam’s patient Felida X. Though Azam recognized that Felida had three personalities, he publicly recognized only two in order to make her case fit the only diagnosis he could give it (Faure, Kersten, Koopman, & Van der Hart, 1997).
There’s always been a history of professionals attempting to diagnose DID as another more prominent disorder of the time, even if to do so was to willingly ignore information. Even after DID became a valid diagnosis, it was still often mistaken for other disorders. In 1918, it was first acknowledged in the predecessor of the DSM under Hysterical Psychoneuroses, a subgroup of Psychoneuroses and Neuroses that included alternate states of consciousness acting on normally unknown desires, amnesia, and sensory and motor disturbances (“Statistical Manual for the use of Institutions for the Insane,” 1918); this again placed DID under a hysteria label. Additionally, in 1910, Bleuler had introduced the term schizophrenia, and in 1927, the reported number of cases for this disorder rose dramatically, matched by a decrease in the diagnose of DID. One reason for this is that the original description of schizophrenia actually included multiple personalities! Many of those diagnosed and treated as having schizophrenia should have been diagnosed as having DID, but because schizophrenia was the more popular diagnosis, that was what was officially recognized (Rosenbaum, 1980).
Recognition
It wasn’t until Ferenczi’s “Confusion of Tongues” paper in 1932/1949 that dissociation and subsequent splitting of the personality were explicitly linked to childhood abuse. However, at the time, any theory involving the subconscious mind was unpopular, and few paid attention to what Ferenczi had discovered. As well, the schizophrenia diagnosis still included and dominated over the DID diagnosis. It wasn’t until shell shock was noted in soldiers and then recognized as posttraumatic stress disorder (PTSD) in abused women and children that attention finally returned to dissociation. (Howell, 2011). After this point, it was specific case studies that brought attention to the disorder, starting with that of Clara Norton Fowler (“Christine Beauchamp,” 1898-1904) and followed by that of Chris Sizemore (Eve).
Myths and Facts on DID
Dissociative Identity Disorder is a rare disorder that only effects roughly 1.5% of the population. This disorder is often misdiagnosed and often requires multiple assessments for an accurate diagnosis. Because of these reasons, DID is severely under-researched, and as an effect, there are many misconceptions about the disorder and the people who are diagnosed with it. These are a few of the myths I remixed from the “Dissociative Identity Disorder Research” page that I have commonly seen be used to discredit those with Dissociative Identity Disorder:
- Myth: DID is caused by therapists / the media / thinking oneself into it.
- Fact: There is an abundance of evidence that supports that DID is due to long term or repeated childhood trauma. Research supports that iatrogenic/sociocognitive DID (DID resulting from therapeutic or social influences) is not the same as genuine DID.
- Myth: DID is easy to fake / is often faked.
- Fact: While non-professionals may not be able to distinguish between those who do and do not truly have DID, professionals are trained to recognize the difference between DID and disorders that may present similarly (such as C-PTSD or BPD) or between DID and factitious disorders or malingering. Diagnoses done using the “gold-star” Structural Clinical Interview for Dissociative Disorders are very likely to be reliable (Welburn et. al, 2003). As well, it must be noted that DID is not faked at exceptionally high rates. Studies have found rates of factitious or malingered dissociative disorders to be between 2% and 14%, with higher rates being found in inpatient and expert consultant settings. This is comparable to general rates of malingering, which range from 7% to 17% with higher rates found in forensic settings, and factitious disorders, which range from 0.5% to 6% in the general population (Brand, McNary, Loewenstein, Kolos, & Barr, 2006).
- Myth: Those with DID are dangerous killers!
- Fact: Like other mentally ill populations, those with DID are no more likely to be dangerous or abusive than anyone else. However, DID forms because of chronic childhood trauma, and individuals with DID are highly likely to be re-traumatized and be victims of further abuse and violence. Contrary to popular belief, it’s not common for those with DID to have an “evil” alter. A study of 173 individuals with dissociative disorders found that dissociative, posttraumatic, emotion dysregulation, depressive, or substance use symptoms cannot predict criminality in this population. This is somewhat in contrast with the general population, in which substance use disorders are the most common mental illnesses among violent offenders, emotion dysregulation is a mediator for violent behavior among individuals with BPD, and dissociation among inpatients is associated with sexual aggression, general aggression, and intergenerational abuse. Only 3% of the individuals in the study had been charged with an offense within the past 6 months, 1.8% had been fined, and 0.6% had been incarcerated. No convictions or probations were reported. A handful of older studies specifically on individuals with DID found that the majority are not violent and do not have violent alters; the exceptions were a 1990 study of 11 individuals with DID and another small 1990 study of only males with DID that found higher rates of violent alters and incarceration. A newer and large 2014 study found that only 3.5% of individuals with DID had engaged in any form of interpersonal violence. Another more recent international study reported that only 2% of clinicians had patients with DID or OSDD who had sexually coerced or assaulted a partner; 3.5% of patients were reported by their therapists to have engaged in any physical or sexual abuse of their partners. In contrast, high rates of internally directed violence (ie, suicidal alters) have been found, and a study found that 26.1% of individuals with DID are at risk of being assaulted. Unfortunately, mentally ill individuals are often aware of others’ perceptions of them as potentially violent, and this can worsen their isolation, negative emotions, and treatment adherence (Webermann & Brand, 2017).
Movie’s Effects on the Perception of DID
Movies have always had a big influence on public perception. They can be used for a multitude of reasons such as mindless entertainment, pushing a narrative, or propaganda. This is also the reason why I, and many in the DID community, have such a big issue with the movie Split. Because there is not much information on DID, many people’s first introduction to this disorder was through this movie. The reason why this is a bad thing is because this movie portrays people with DID to be insane, murderous, cannibalistic monsters. Now I don’t believe that it was the creator’s intention to put this kind of stigma on those with DID, but it does not erase the massive amount of harm that was done to the DID community. A DID youtuber that goes by the name DissociaDID explains in depth why this movie was harmful to the DID community’s image.
DID as a Trend
Before DID YouTubers started sharing their lives with the disorder on a public platform, not much was known about DID. When a famous YouTuber named Anthony Padilla made a video called “I spent a day with MULTIPLE PERSONALITIES (Dissociative Identity Disorder)“, the video blew up and a lot of people learned about DID for the first time. When people heard about this disorder, they decided to fake having DID, and thus it became a trend. One of the first people to start this trend was a YouTuber named Trisha Paytas. Trisha made a video called “Meet My Alters” where she made up various personalities and described them to her audience. In the beginning of this video she admits that she has never had a professional diagnosis, and she claims that she does not see DID as being an actual disorder. She called a person with DID (DissociaDID) ”crazy” and has made herself an enemy of the DID community.
Another influencer that has hopped on the DID trend is the TikTocker twosoulsonebod. The woman’s name is Jessie and her ”alter” is James. Yes, like Team Rocket from Pokémon. Jessie is a transwoman and many believe that she made James as an excuse to cover up her ”man voice”. The reason why I and many others believe that Jessie is faking having DID is because there are too many inconsistencies. One example of this is when on a livestream “James” tells the audience that they do not have an inner world. Inner worlds are a crucial part to DID, and while the host may not be aware of it, the other alters absolutely would be. When she received backlash, she backtracked just a few minutes later and said that they do indeed have an inner world. Another thing that she does that no other DID system does is have flawless communication and switching outside of the body. On her social media, Jessie talks to herself outside of the body and then pretends to switch to James, who then answers immediately. This simply does not happen in a DID system. A YouTuber named Repzilla has a video on twosoulsonebod that goes into more depth on their inconsistencies and a few other things they have done.
What’s the harm?
Movies that poorly portray DID, such as “Split”, feed into the stigma that already surrounds those with Dissociative Identity Disorder. This can lead to those who are generally uninformed about the disorder to view people with DID as harmful or monstrous. In terms of social media, although both Trisha Paytas and twosoulsonebod have been called out, proven to have been faking, and have taken down their videos/channels, there was still major damage done to the DID community in terms of credibility. Because of people like them, those that really have the disorder may not be believed immediately and psychiatrists will have to be more skeptical with their future patients.
How can we fix this?
I believe we can help fix this problem by creating more movies and television shows that portray DID in a more accurate and positive light. Disney has recently done this by creating a show called “Moon Knight“, which accurately portrays some of the struggles that those with DID face on a regular basis. This is also the first show I have seen that has the person with DID be the protagonist and hero of the story. This show was a huge milestone in DID history and although there is a lot more to be done, this was a step in the right direction in showing that those with DID are just traumatized people that should be shown the same respect and kindness as any other human being.
This blog post “Discourse on Dissociative Identity Disorder” by Alex Danielowich is licensed under (CC BY-SA 4.0). It is an adaptation of:
“DID in History” and “Myths and Misconceptions” by Katherine Reuben licensed under (CC BY-SA 4.0).
Citations
Van der Hart, O., Lierens, R., & Goodwin, J. (1996). Jeanne Fery: A sixteen century case of Dissociative Identity Disorder. The Journal of Psychohistory, 24.
Faure, H., Kersten, J., Koopman, D., & Van der Hart, O. (1997). The 19th century DID case of Louis Vivet: New findings and re-evaluation. Dissociation, 2.
Statistical Manual for the use of Institutions for the Insane. (1918). In Statistical manual for the use of institutions for the insane. New York: American medico-psychological association/National committee for mental hygiene.
Rosenbaum M. (1980). The role of the term schizophrenia in the decline of diagnoses of multiple personality [Abstract]. Archives of General Psychiatry, 37(12), 1383-5. DOI: 10.1001/archpsyc.1980.01780250069008
Howell, E. (2011). The Dynamic Unconscious and the Dissociative Structure of the Mind. In Understanding and treating dissociative identity disorder: A relational approach. New York: Routledge.
Welburn, K. R., Fraser, G. A., Jordan, S. A., Cameron, C., Webb, L. M., & Raine, D. (2003). Discriminating dissociative identity disorder from schizophrenia and feigned dissociation on psychological tests and structured Interview [Abstract]. Journal of Trauma & Dissociation, 4(2), 109-130. doi:10.1300/j229v04n02_07
Brand, B. L., McNary, S. W., Loewenstein, R. J., Kolos, A. C., & Barr, S. R. (2006). Assessment of genuine and simulated dissociative identity disorder on the Structured Interview of Reported Symptoms. Journal of Trauma & Dissociation, 7(1), 63-85. doi:10.1300/j229v07n01_06
Webermann, A. R. & Brand, B. L. (2017). Mental illness and violent behavior: The role of dissociation. Borderline Personality Disorder and Emotion Dysregulation, 4(2). doi: 10.1186/s40479-017-0053-9
