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.

— Each time you visit, search "name index" or "subject index," choose another name or subject, and search it.

— If you read only recent posts, you miss most of what this site has to offer.

— Share site with friends.

Sunday, July 14, 2019


“The American Psychiatric Association Publishing Textbook of Psychiatry, 7th Edition [2019]”: Its mental status exam will miss multiple personality

This textbook, published by the American Psychiatric Association, has a chapter on Dissociative Disorders, which includes Dissociative Identity Disorder (Multiple Personality Disorder). But I am addressing the textbook’s first chapter, The Psychiatric Interview and Mental Status Examination, which is the textbook’s basic approach to making all psychiatric diagnoses.

The mental status examination includes an evaluation of memory. According to chapter one, it “screens for three types of memory dysfunction. Immediate recall…Recent or short-term memory…Long-term memory…Many patients with dementia will retain long-term memory, whereas patients with a dissociative disorder often present with clinically relevant memory gaps…” (p. 26).

It is saying that you should think of memory in the three traditional categories of immediate, short-term, and long-term, and that you should make sure to assess every patient for these types of memory. In the course of making that assessment, and in conducting the general interview, you may note a discrepancy characteristic of dementia (short-term worse than long-term). And if a patient “presents” with memory gaps, you should think of dissociative disorders like multiple personality.

When the textbook says that dissociative disorder patients “often present” with memory gaps, the implication is that memory gaps would be part of the patient’s “presenting problem” (the reason they came to see a psychiatrist) and/or it would be fairly obvious in the general interview.

Neither of those assumptions is true. You have to think of memory as having four categories: immediate, short, long, and gaps. And you have to explicitly ask patients (and people who know them) if they have memory gaps. Otherwise, you may never know, and never suspect that the patient has a dissociative disorder like multiple personality.

For previous discussions, search “memory gaps” and “mental status.”
Posted by at

No comments:

Post a Comment

Thank you for taking the time to comment (whether you agree or disagree) and ask questions (simple or expert). I appreciate your contribution.

Subscribe to: Post Comments (Atom)