What does a person with multiple personality look like? (post 2): Quite different from what most psychiatrists, psychologists, and other people expect.

“My first case was encountered serendipitously…This raised my index of suspicion, and I found four additional cases…This caused me to wonder if, perhaps, multiple personality disorder was not as rare as it was alleged to be. I undertook a detailed study of these five patients. All five cases had extensive histories in the mental health care delivery system; all had been diagnosed borderline or schizophrenic (some had received both diagnoses from different clinicians); and all but one had been given an affective disorder diagnosis [depression or bipolar], as well. None had responded well to prior therapy. All were either trying to hide their multiple personality disorder or to deny it. None were exhibitionistic or inclined to flaunt or augment their pathology…All admitted they had withheld relevant data at the time of their initial assessments, and all had initially denied amnesia or covered over their amnestic periods. Hence, the patients’ actual presentations were counterexpectational to the then-stereotypic picture of multiple personality disorder…

“Multiple personality disorder patients in treatment often denied their disorder. In the face of powerful evidence and confrontation, they offered convincing alternative rationalizations to explain away signs and symptoms.  They often evaded rather than sought out therapeutic assistance. It became clear that personalities often passed for one another, could emerge and recede so rapidly that the only trace they left was a brief fluctuation in facial expression…Often several months passed during which personalities did not emerge fully. They influenced one another by hallucinated inner voices, or in some way by imposing themselves upon alters [alternate personalities] ostensibly in control of the body.

“I realized that a patient withholding or unaware of data, or who initially presented in the manner I often saw in sessions with individuals known to be classic multiple personality disorder patients, would never fall under suspicion for multiple personality disorder. This, and the alleged rarity of multiple personality disorder, led me to believe that multiple personality disorder is considered unusual because 1) clinicians expect to see and confirm a steady and public history of certain dramatic phenomena…2) the phenomena they expect to see are not displayed in an ongoing and continuous basis by the majority of multiple personality disorder patients, who try to keep their condition concealed…” (1, pp. 204-206).

Comment: Since this blog is about the normal version of multiple personality, and is not about the clinical, mental illness, is the above relevant? Yes, because the normal version is the same as the clinical version, except that the normal version is not causing the person a clinically significant amount of distress or dysfunction, and may even be an asset (e.g., in writing novels and winning Nobel prizes). Many more people have the normal version.

1. Richard P. Kluft, M.D., Ph.D. “The Natural History of Multiple Personality Disorder,” pp. 198-238, in Childhood Antecedents of Multiple Personality, Edited by Richard P. Kluft, M.D., Ph.D. Washington DC, American Psychiatric Press, 1985.