Dissociative Identity Disorder: Sense of Self, Social Stigmatization, and the Question of Definition

Senior Seminar in Biology and Society
September 29, 2009
Anna Dela Cruz

Dissociative Identity Disorder: Sense of Self, Social Stigmatization, and the Question of Definition
the three faces of eve
Defined as the occurrence of two or more personalities within the same individual, each of which during sometime in the person's life is able to take control. This is not often a mentally healthy thing when the personalities vie for control.

Symptoms are of course somewhat self-explanatory, but it is important to note that often the personalities are very different in nature, often representing extremes of what is contained in a normal person. Sometimes, the disease is asymmetrical, which means that what one personality knows, the others inherently know.

• The patient has at least two distinct identities or personality states. Each of these has its own, relatively lasting pattern of sensing, thinking about and relating to self and environment.
• At least two of these personalities repeatedly assume control of the patient's behavior.
  
• Common forgetfulness cannot explain the patient's extensive inability to remember important personal information.
  
• This behavior is not directly caused by substance use (such as alcoholic blackouts) or by a general medical condition.
  

                                                                                            ~DSM-IV
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October 4-10, 2009 is Mental Illness Awareness Week. But what constitutes mental illness?
(Disclaimer: this blog post is not intended to offend persons clinically diagnosed with mental illness or who are undiagnosed but strongly believe they have a mental ailment.)

The Diagnostic and Statistical Manual (DSM), the psychiatrists’ handbook of mental illnesses, has long been used as an authoritative guide to identifying and categorizing perceived “odd” behavior. However, since there is no single objective test to determine mental illnesses, diagnosing such disorders are based on symptomatic evidence—a problem since symptoms can be cross-listed in two or more seemingly distinct mental illnesses. In addition, the manual is in constant revision. In fact, the fifth edition is anticipated for publication in 2012.

In defining mental illness, the condition referred to as Dissociative Identity Disorder (formerly Multiple Personality Disorder), has of late, been subject to criticism as to whether it is an actual mental disease. Hollywood portrayals of the condition such as The Three Faces of Eve, Sybil, and The United States of Tara have put forth conflicting views from unrealistic and comical to heart wrenching to likable and quirky, respectively.
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Media Portrayals of MPD/DID:

Multiple Choice - CBS Sunday Morning Program

TV's Split Personality- Newsweek

Basic Information:

DID on WebMD

The Defenders of MPD/DID:

A Physiological Case for DID- brain size in terms of hippocampal and amygdalar volumes differ significantly between mentally 

                                           healthy participants and those diagnosed with DID 

Identity Crisis- the voice of a former DID sufferer

The Skeptics:

Criticism from a Psychiatrist- problems with the current definition of mental illness in the DSM-IV (the current version) such as

                                          burden of proof, determining causation, tautology, and vague language pose the question on

                                          whether DID is even a disease

Sense of Self:

The Ever Elusive "I"- "We can all attest to feeling internally divided at some point in our lives. It's not that hard to pinpoint such an experience; most instances of indecision are good examples, and so are displays of "uncharacteristic" behavior under the influence of drugs, and times of internal rationalization for things we do that "feel bad." Have you ever heard of an athlete prepping himself for a critical moment in a game, or of a student telling herself to calm down before an exam? Who is prepping the athlete, and who is being prepped by him? Likewise, who is calming the student, and who is being calmed by her? It really isn't that foreign a notion that there really may be a 'jostling crowd of "I"s' within us, and the workings of the nervous system seem to provide a rather convincing manifestation of this notion of multiple "I"s"-- What if, in reality, our notions of self for even normal, mentally healthy people incorporate multiple personas?