Why Multiple Personality is Hidden and Overlooked

Patients tend to fear, avoid, and hide symptoms of multiple personality, because it is the oddest thing they can think of, and would seem to mean that they are crazy. But the fact is that the chapter on psychotic (“crazy”) disorders in the diagnostic manual of the American Psychiatric Association does not even mention multiple personality disorder. It does mention Delusional Disorder (1, p. 90), Brief Psychotic Disorder,” Schizophreniform Disorder (1, p. 96), Schizophrenia (1, p 99), Schizoaffective Disorder (1, p. 105), Psychotic Disorder Due to Another Medical Condition (1, p.115), and Catatonia (1, p. 119). The manual does not mention multiple personality disorder (renamed Dissociative Identity Disorder) until its chapter on Dissociative Disorders (1, pp. 291-307).

Comment: Most persons with Dissociative Identity Disorder are not psychotic, and it is as common as schizophrenia (1, p. 294), but most psychiatrists, psychologists, and therapists have not had much training in how to diagnose and treat it. Putnam’s textbook is a good introduction (2).

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA, American Psychiatric Association, 2013.

2. Frank W. Putnam, MD. Diagnosis and Treatment of Multiple Personality Disorder. New York, The Guilford Press, 1989. 

"And Only to Deceive" by Tasha Alexander: Author says the story invented itself

“I knew I wanted to write about an English woman in the late Victorian period and had a strong image of her standing on the top of the cliff path on the Greek island of Santorini, one of my very favorite places. Once I started asking questions about how she came to be there, the story started to invent itself” (1, p. 312).

Comment: The author says that she did not experience herself as figuring out the story, but that the story invented itself, as if the story had a mind of its own, which is a split-personality creative process.

1. Tasha Alexander. And Only to Deceive. New York, Harper, 2005.

“A Beautiful Blue Death” by Charles Finch: Quoting Dividedness

“I only mean that she had two sides to her. As we all do, I expect” (1, p. 34).

“Lenox made…a silent pact with himself…” (1, p. 172).

1. Charles Finch.  A Beautiful Blue Death. New York. Minotaur Books, 2007. 

“The Strange Case of Jane O.” By Karen Thompson Walker

The author says Jane has a strange case of “dissociative fugue” (front flap) (1). And since Dissociative Fugue is one of psychiatry’s Dissociative Disorders, and the chief Dissociative Disorder is Multiple Personality (a.k.a. dissociative identity disorder), any novel with a dissociative patient under psychiatric care should evaluate the patient for multiple personality, which real-life patients often try to hide. But this novel never mentions multiple personality.

And since the author is a professor of creative writing (back flap) (1), she may have heard of Agatha Christie’s famous real-life case of dissociative fugue: When Christie was already famous, she disappeared from her home, and the search for her was headline news for weeks. She had disappeared after her husband was unfaithful, and she was eventually discovered checked-in at a hotel under another name (her dissociative identity).

In short, “time loss” is the single most common symptom of MPD, and fugue episodes are found in 55% of MPD patients (2, p. 59). Once a novel raises the issue of dissociation, a conscientious author must consider multiple personality.

1. Karen Thompson Walker. The Strange Case of Jane O. NewYork Random House, 2025.

2. Frank W. Putnam, MD. Diagnosis and Treatment of Multiple Personality Disorder,  New York, The Guilford Press, 1989. 

“Dangerous Minds” by Priscilla Masters: Gratuitous Symptoms of Multiple Personality

“From deep inside, her naughty voice spoke up in her own defense.

“But she still got herself murdered, didn't she?” (1, p. 20).

Comment: An italicized voice inside the protagonist’s head, suggestive of an opinionated alternate personality.

“For someone like Barclay, a voice growled inside her, there is no ‘enough.’ "(1, p. 98).

Comment: As above.

“Then she gathered herself up and continued in a voice she hardly recognized as her own: prim, tight-mouthed, business-like…Heart tumbling over head, head tumbling over heart. She was dizzy, then that voice came out again” (1, p. 129).

Comment: The alternate personality takes over and she speaks in its voice.

“She [her alternate personality] spoke only to her reflection in the bathroom mirror [her regular personality] What are you waiting for, Claire…” (1, p. 133).

Comment: Since no character in this novel is labelled as having multiple personality, the above quotations are probably inadvertent reflections of the author’s normal, creative version of multiple personality disorder, which I call “multiple personality trait.”

1. Priscilla Masters. Dangerous Minds. Surrey England, Severn House, 2016.