How Different are Alternate Personalities (Alters), and Would You Realize It Was Multiple Personality if the Differences Were Obvious?

In my previous post about suspecting multiple personality from photographs, I said that alternate personalities may differ from each other in their facial expressions, body language, and dress. They may also differ in in speech, values, self-image, knowledge, skills, memories, names, etc. But how different are they?

Differences among alters may range from subtle to obvious. However, if you never think in terms of multiple personality, then even obvious differences may fail to make you realize that the person has multiple personality, as I’ll illustrate below.

I would compare subtle differences to the “tell” in the card game of poker. The poker “tell” is a small bit of behavior by which a player betrays that he thinks his current hand of cards is either strong or weak. Players try to avoid having tells by keeping a neutral “poker face.”

In multiple personality, when differences in dress between alters are subtle, the “tell” which indicates that a particular personality is out may be, for example, the wearing of a certain piece of jewelry, or not wearing any jewelry at all. It could be any little thing.

When differences are more obvious, it could, for example, be wearing bright colors (when the person usually dresses more conservatively). I once had a patient who occasionally came to appointments wearing bright colors, which I always assumed meant that she was a little manic. However, subsequently, when I discovered that she had multiple personality, I found that there was a particular alter—with her own name, separate memory bank, etc.—who wasn’t manic, but always dressed in bright colors.

In short, whether differences among alters are subtle or obvious, if you never consider multiple personality, you are likely to do what I always did: ignore subtle differences, and attribute obvious changes in behavior or dress to something else, such as eccentricity, fashion, histrionics, drinking, or moods.