What does a person with multiple personality look like? The following past posts will give you the general idea.

April 25, 2017

What does a person with multiple personality look like?

If you google that question, you will be told what a person with multiple personality looks like, their signs and symptoms, after they have been diagnosed, when the alternate personalities have had their cover blown, so to speak, not what the person looked like or how they behaved before that.

Before a person with multiple personality has been diagnosed, they do have all those signs and symptoms, and have had them since childhood, but not for show. You will probably meet only the person’s host personality, not their alternate personalities, who are usually not “out.” Thus, the signs and symptoms, though present, are inconspicuous.

So what does a person with multiple personality look like? They usually look like everyone else.

(For past posts on diagnosis, search “mental status,” “diagnostic criteria,” and “memory gaps.”)

August 6, 2016

Sylvia Plath’s “The Bell Jar” (post 4): Further symptoms of multiple personality that was diagnosable at the beginning of the novel (post 3)

Hearing Voices

The first-person narrator and protagonist, Esther Greenwood, never complains of, mentions to a doctor, or is ever treated for, auditory hallucinations. It is not considered one of her symptoms. Why not? Apparently, she had heard voices for a long time and they were not associated with distress or dysfunction. She mentions them only in passing:

When she is about to ski dangerously, she hears an “interior voice nagging me not to be a fool” and says she has had “year after year of doubleness” (1, p. 97).

“I summoned my little chorus of voices.

Doesn't your work interest you, Esther?

You know, Esther, you’ve got the perfect setup of a true neurotic.

You’ll never get anywhere like that, you’ll never get anywhere like that, you’ll never get anywhere like that” (1, p. 146).

These are the voices of some of her alternate personalities.

Alternate Personalities

“I decided I would spend the summer writing a novel. That would fix a lot of people…From another, distanced mind, I saw myself…(1, pp. 119-120).

“I tried to speak in a cool, calm way, but the zombie rose up in my throat and choked me off” (1, p. 126).

Alternate Handwriting

“And then, I thought, [the doctor] would help me, step by step, to be myself again…I told Doctor Gordon about not sleeping and not eating and not reading. I didn’t tell him about the handwriting, which bothered me most of all…when I took up my pen, my hand made big, jerky letters like those of a child…” (1, pp. 129-130).

Alternate personalities may have different handwritings. The “letters like those of a child” suggest that some of her distress and dysfunction may have been due to the presence of a depressed, child-aged, alternate personality.

Mirrors

Mirrors have been a recurrent subject in this blog, because persons with multiple personality may see an alternate personality when they look in the mirror. A previous instance in this novel—Esther saw a Chinese woman when she looked in the mirror—was cited in a previous post. Here is another example:

“I moved in front of the medicine cabinet. If I looked in the mirror while I did it [committed suicide], it would be like watching somebody else, in a book or play. But the person in the mirror was paralyzed and too stupid to do a thing” (1, p. 148).

Unreliable Narrator

Esther’s main complaints to psychiatrists (other than her suicidality) were her insomnia, anorexia, and inability to read, already mentioned above. Her claim not to have slept for a month is not only impossible, but belied by the fact of her reserves of energy when she was swimming in the ocean, and by the fact that a nurse in the hospital witnessed that she slept. She claimed not to be able to read, but then she admits reading books on abnormal psychology. She claims to have no appetite, but then realizes she has just demonstrated a good appetite. She is not knowingly lying. It is just that one personality often does not know what other personalities are doing.

“…I must be just about the only person in the world who had stayed awake for a solid month without dropping dead of exhaustion…I thought drowning must be the kindest way to die…[She is at the beach, and she challenges the young man she is with to swim out into the ocean with her] out to that rock out there. Are you crazy? That’s a mile out [he says]. What are you?, I said. Chicken?” (1, p. 157). They swim out, but he turns back due to exhaustion. She continues to swim out, and tries to drown herself, but she keeps bobbing up to the surface. “I knew I was beaten. I turned back” (1, p. 161).

“The only thing I could read, besides the scandal sheets, were those abnormal-psychology books. It was as if some slim opening had been left, so I could learn all I needed to know about my case to end it in the proper way” (1, p. 159).

“I can’t sleep…

They interrupted me. “But the nurse says you slept last night.”

“I can’t eat” [but] “It occurred to me I’d been eating ravenously ever since I came to” [after her recent, near-fatal, suicide attempt] (1, p. 177).

Pseudonym

The novel was originally published under the pseudonym “Victoria Lucas,” with the explanation that it would protect the feelings of people on whom characters were based. Another reason might have been that the author’s main writing personality did not identify with the author’s regular name.

Diagnosis and Treatment

No diagnosis is ever mentioned in the novel. Hospital treatment includes a supportive environment, insulin injections, psychoanalytic psychotherapy, and ECT.

Based on what I have cited from the text in this and prior posts, I am sure that Esther had multiple personality. She also had major depression, but, based on available information, I cannot be sure of whether her depression was a separate condition or was secondary to the multiple personality (confined to only certain personalities, and would have remitted with appropriate psychotherapy for the multiple personality).

Esther proclaims her recovery in terms of a restoration of her regular personality:

“I took a deep breath and listened to the old brag of my heart. I am, I am, I am” (1, p. 243).

However, for Sylvia Plath, the cure was only temporary, because multiple personality was rarely diagnosed and treated in those days.

1. Sylvia Plath. The Bell Jar [1963/1971]. New York, Harper Perennial Modern Classics, 2006.

June 29, 2015

Stephen King quoted on Writing: His voices, visions, trances; his becoming or observing autonomous characters; his cowriter muse and discovered stories

“…to be a writer…you have to imagine worlds that aren’t there…You’re hearing voices…As children…we’re told to distinguish between reality and those things. Adults will say, ‘You have an invisible friend, that’s nice, you’ll outgrow that.’ Writers don’t outgrow it” (1, p. 4).

“When I write as Richard Bachman [a pseudonym under which King wrote several novels], it opens up that part of my mind. It’s like a hypnotic suggestion that frees me to be somebody who is a little bit different…and it was fun to be somebody else for a while, in this case, Richard Bachman” (1, pp. 138-139).

“After writing more than a dozen novels, one thing hadn’t changed: Steve rarely provided detailed physical descriptions for the characters he created. ‘For me, the characters’ physical being is just not there. If I’m inside a character, I don’t see myself because I’m inside that person,’ he explained” (1, p. 147).

“[King] was by himself…he was thinking about getting high later…Then, out of the blue, came a voice that told him to reconsider. You don’t have to do this anymore if you don’t want to was the exact phrase he heard. ‘It’s like it wasn’t my voice,’ he said later” (1, pp. 159-160).

“There is a muse—traditionally, the muses were women, but mine’s a guy…He may not be much to look at, that muse guy, and he may not be much of a conversationalist (what I get out of mine is mostly surly grunts, unless he’s on duty…” (2, pp. 144-145).

“You may wonder where plot is in all this. The answer—my answer, anyway—is nowhere. I won’t try to convince you that I’ve never plotted…I believe plotting and the spontaneity of real creation aren’t compatible…I want you to understand that my basic belief about the making of stories is that they pretty much make themselves. The job of the writer is to give them a place to grow (and transcribe them, of course)…When, during the course of an interview for The New Yorker, I told the interviewer that I believed stories are found things, like fossils in the ground, he said that he didn’t believe me. I replied that…I believe it. And I do…Stories are relics, part of an undiscovered pre-existing world…My job [is to] watch what happens and then write it down…I have never demanded of a set of characters that they do things my way. On the contrary, I want them to do things their way…” (2, pp. 163-165).

“And if you do your job, your characters will come to life and start doing stuff on their own. I know that sounds a little creepy if you haven’t actually experienced it, but it’s terrific fun when it happens. And it will solve a lot of your problems, believe me” (2, p. 195).

“Part of my function as a writer is to dream awake. And that usually happens. If I sit down to write in the morning, in the beginning of that writing session and the ending of that session, I’m aware that I’m writing. I’m aware of my surroundings…But in the middle, the world is gone and I’m able to see better…I can remember finding that state for the first time and being delighted. It’s a little bit like finding a secret door in a room [or like Alice falling down a rabbit hole?] but not knowing exactly how you got in…And after doing that for a while it was a little bit like having a posthypnotic suggestion” (3, pp. 141-142).

All the above is characteristic of multiple personality (in this case, normal multiple personality). People with multiple personality may hear the voices of their autonomous, alternate personalities, or may see them, or may switch to become them. It all has similarities to hypnosis; indeed, one old theory of multiple personality is that it is a kind of self-hypnosis.

1. Lisa Rogak. Haunted Heart: The Life and Times of Stephen King. New York, Thomas Dunne St. Martin’s Griffin, 2008.

2. Stephen King. On Writing: A Memoir of the Craft. New York, Scribner, 2000/2010.

3. Naomi Epel. Writers Dreaming. New York, Carol Southern Books, 1993.

January 3, 2015

Denial and Dissimulation: Patients Usually Reject the Diagnosis of Multiple Personality and Disclaim the Evidence and Behavior on Which It is Based

With most psychological conditions, the person knows that they have it. They may or may not know what it’s called, but they know, and acknowledge, that they have the symptoms.

For example, a person with panic disorder may or may not know that they have “panic disorder,” but they know that they have panic attacks. For a psychiatrist to say, “Well, you may not know that you experience panic attacks, but I know that you do, unconsciously,” would be ridiculous.

Indeed, there is no diagnosis in the psychiatric diagnostic manual (DSM-5) that involves a psychoanalytic interpretation. And this has been true since 1980 (DSM-3), when psychoanalytic terms and concepts were deleted from the manual.

Unlike other diagnoses in the manual, the person with multiple personality usually doesn’t know that they have it. The reason is that the “patient”—the host personality—usually has amnesia for any period of time during which an alternate personality (alter) has come “out.”

But, even if the host doesn’t know that the person has multiple personality, don’t the alters know? Yes, they do have self-awareness. But, no, they don’t see it as multiple personality. To them, they are other people. (They are alters, not other people, but I’m telling you how they see it.)

Moreover, the alters don’t want either the host or any meddling outsider (like a psychiatrist) to know about them, so they usually come out incognito (answering to the regular name, even though, secretly, they may have their own name).

So how is the diagnosis made? Clues such as puzzling behavioral inconsistencies and memory gaps—the host may know that he or she has a history of memory gaps—will alert the clinician to recognize when an alter does come out. And when the alter is “caught” being out, the alter will often acknowledge who they are and provide information that can be corroborated.

How can you recognize that you are speaking to an alter? To give one clinical example, a patient once came to see me for her usual appointment, and immediately expressed outrage about the antidepressant medication that I had been prescribing for some months. She angrily insisted that I discontinue it. This surprised me, because at past appointments she had always praised the medicine and wanted to continue it.

When I remarked on her inexplicable inconsistency, the alter knew that she had been “outed.” And she explained that when the host personality took this medicine, it became very hard for the alter to come out. So the alter would sometimes hide the medicine.

Which reminded me that the patient—the host—had occasionally complained that her medicine would, mysteriously, get misplaced.

Thus, the diagnosis of multiple personality is based on overt behavior, and not on psychoanalytic interpretation. But the “patient” (host personality) will usually deny the diagnosis, and disclaim the behavior upon which the diagnosis was based, since, after all, the host doesn't remember it; and, moreover, the host doesn’t like the whole idea.

Indeed, if, prematurely, you try to prove to the host that they have multiple personality—e.g., by telling the host about a specific item that is hidden in a specific drawer at home, which the alter had told me about—then when they go home and are shocked to find that very item in that very drawer, they may drop out of treatment.

October 24, 2017

Seven reasons that skeptics, psychiatrists, psychologists, philosophers, literary professors, writers, and others are against multiple personality.

One reason people give for being against multiple personality is that they have never seen it. But there are many conditions that they have never seen, yet they are not antagonistic toward them.

A second reason some people are against multiple personality is that it is absurd to think that a person could have other people inside them. But multiple personality does not mean, and has never meant, multiple people.

Indeed, to get away from that misunderstanding, the American Psychiatric Association changed the name from “multiple personality disorder” to “dissociative identity disorder” to emphasize that the person is psychologically divided, not physically multiplied. When the person switches from one personality to another, it may look like they are more than one person (hence the persistent popularity of the older term), but the diagnosis has never claimed that anyone is more than one person.

Moreover, the diagnosis of multiple personality has nothing to do with schizophrenia and is not a psychosis. It is unfortunate that use of the nonspecific term “madness” has often confused multiple personality with schizophrenia.

A third reason is that many people come from religious traditions that believed in demon possession. They may see the diagnosis of multiple personality as infringing on religion, or may feel that multiple personality actually is demon possession, which is frightening. But the diagnosis of multiple personality assumes that it is a psychological condition.

A fourth reason goes back to the first reason, and is that even eminent and vastly experienced psychiatrists may never have seen a case of multiple personality. I discuss this at length in past posts on the standard mental status examination: it fails to inquire about memory gaps or to investigate puzzling inconsistencies. Most psychiatrists in the USA and probably elsewhere have never been taught how this diagnosis is made or how undiagnosed cases present.

A fifth reason is the false connection between multiple personality and “repressed memory” and “satanic ritual abuse,” which were fads.

A sixth reason is the lingering effect of Freud and the concepts of “repression” and “the unconscious.” In contrast, multiple personality is based on the concepts of dissociation and multiple dissociated consciousness. In multiple personality, things that are “unconscious” to one personality are perfectly conscious to another personality.

A seventh reason is the claim that multiple personality is a meaningless idea, because, in a sense, everyone has multiple personality. But everyone does not have the subjective sense of being more than one person, and does not have memory gaps for the periods of time that an alternate personality was in control.

The kernel of truth in the idea that everyone has multiple personality is that many more people do have it than most people think, because, as I discuss in this blog, there is a normal version, which is much more common than the clinical version.

The normal version is normal in that it does not cause the person clinically significant distress or dysfunction. Indeed, the normal version may be an asset; for example, in writing novels.