Controversy: Are schizophrenia and multiple personality mutually exclusive? Can a person have both? Claire Bien’s memoir raises the issue.

DSM-5, the psychiatric diagnostic manual, assumes that schizophrenia and multiple personality (dissociative identity) are completely different and mutually exclusive.

But the person whose memoir I am reading (1) seems to have had symptoms of both schizophrenia (a psychosis) and multiple personality (not a psychosis).

For example, there is an episode in which she is studying a textbook on editing. In the passages she is reading, she is supposed to recognize editing mistakes. Suddenly, she hears a voice commenting on what she is reading.

She is frightened. How could the voice know what she is reading? There must be cameras in the room! She can’t find any cameras, but suspects they must be hidden in the lighting fixtures. So she smashes all the light bulbs in the room. Her behavior seems blatantly psychotic.

However, her study of editing makes sense. She is a nonfiction writer who gets employment at magazines. And what does the voice say to her? It tells her to look back two paragraphs in what she is reading, because she had missed a mistake in editing. She does look back, and finds that the voice was right.

The problem is that schizophrenic voices do not have a reputation for helpfully guiding a person to correctly perceive objective reality (in this case, the editing mistake). But an alternate personality might do just that.

So did the author have schizophrenia, multiple personality, neither, or both? As I continue to read the memoir, I am trying to decide.

1. Claire Bien. Hearing Voices, Living Fully: Living With The Voices in My Head. Foreword by Larry Davidson, PhD. London and Philadelphia, Jessica Kingsley Publishers, 2016.