BASIC CONCEPTS

— When novelists claim they do not invent it, but hear voices and find stories in their head, they are neither joking nor crazy.

— When characters, narrators, or muses have minds of their own and occasionally take over, they are alternate personalities.

— Alternate personalities and memory gaps, but no significant distress or dysfunction, is a normal version of multiple personality.

— normal Multiple Personality Trait (MPT) (core of Multiple Identity Literary Theory), not clinical Multiple Personality Disorder (MPD)

— The normal version of multiple personality is an asset in fiction writing when some alternate personalities are storytellers.

— Multiple personality originates when imaginative children with normal brains have unassuaged trauma as victim or witness.

— Psychiatrists, whose standard mental status exam fails to ask about memory gaps, think they never see multiple personality.

— They need the clue of memory gaps, because alternate personalities don’t acknowledge their presence until their cover is blown.

— In novels, most multiple personality, per se, is unnoticed, unintentional, and reflects the author’s view of ordinary psychology.

— Multiple personality means one person who has more than one identity and memory bank, not psychosis or possession.

— Euphemisms for alternate personalities include parts, pseudonyms, alter egos, doubles, double consciousness, voice or voices.

— Multiple personality trait: 90% of fiction writers; possibly 30% of public.

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Friday, September 30, 2016

DSM-5: Order of Diagnostic Criteria for Dissociative Identity Disorder (multiple personality) prevents most clinicians from making this diagnosis.

Every condition in the psychiatric diagnostic manual (DSM-5) has “diagnostic criteria,” which is a list of symptoms that define it.

In DSM-5, the two main diagnostic criteria for multiple personality are listed in the following order:
Criterion A is about having more than one personality.
Criterion B is about having memory gaps.

The above order suggests, incorrectly, that:
First, you will see that a person has more than personality.
Second, you will discover that one personality has a memory gap for the period of time that another personality was in control.

But in the typical case, a clinician discovers memory gaps first.
The diagnosis of multiple personality is typically made by screening all patients for memory gaps: Have you ever had memory gaps? Do you ever lose time?

If the person has had memory gaps (not due to another medical condition), the presence of alternate personalities will be discovered in the course of accounting for the memory gaps.

Proposed order of the diagnostic criteria:
Criterion A should be about having memory gaps.
Criterion B should be about having more than one personality.

For previous, related posts, search “diagnostic criteria” and “mental status.”

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