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Dissociative Identity Disorder, formerly Multiple Personality Disorder, is a psychological diagnosis listed in the dissociative disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and also in the International Statistical Classification of Diseases and Related Health Problems (ICD-10). It has had a highly controversial history, falling into and out of popularity amongst psychologists. An internet culture, formed from people experiencing plurality, has a very different take on the diagnosis, and on related conditions.
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Dissociative Identity Disorder, formerly Multiple Personality Disorder, is a psychological diagnosis listed in the dissociative disorders section of the Diagnostics Standards Manual and also in the International Statistical Classification of Diseases and Related Health Problems. It has had a highly controversial history, falling into and out of popularity amongst psychologists. An internet community, the Healthy Multiplicity community, has a very different take on the diagnosis, and on related conditions.
   
It is similar to [[tulpamancy]], in that it is an experience of [[plurality]]. These persons experience alters, which are like other personalities, that can take over the body. The original idea is that all persons experiencing this condition must have had advanced trauma at some time in the past, causing it, but this is controversial.
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It is similar to [[tulpamancy]], in that it is an experience of [[plurality]]. These person experience alters, which are like other personalities, that can take over the body. The original idea is that all persons experiencing this condition must have had advanced trauma at some time in the past, causing it, but this is controversial.
   
 
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== Diagnosis ==
 
== Diagnosis ==
The DSM is the de facto standard for the diagnosis of this condition. However, in practise, diagnostics often diverge from the standards.
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The Diagnostic Standards Manual is the de facto standard for the diagnosis of this condition. However, in practise, diagnostics often diverge from the standards.
   
The DSM, revision 5, has five criteria for DID, all of which must be met. Several other dissociative disorders use the same criteria, but need fewer of them to be met.
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With the DSM, revision 5, has five criteria for DID, all of which must be met. Several other dissociative disorders use the same criteria, but need fewer of them to be met.
   
 
# Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
 
# Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
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:"The dissociative amnesia of individuals with dissociative identity disorder manifests in three primary ways: as 1) gaps in remote memory of personal life events (e.g., periods of childhood or adolescence; some important life events, such as the death of a grandparent, getting married, giving birth); 2) lapses in dependable memory (e.g., of what happened today, of well-learned skills such as how to do their job, use a computer, read, drive); and 3) discovery of evidence of their everyday actions and tasks that they do not recollect doing (e.g., finding unexplained objects in their shopping bags or among their possessions; finding perplexing writings or drawings that they must have created; discovering injuries; "coming to" in the midst of doing something)."
 
:"The dissociative amnesia of individuals with dissociative identity disorder manifests in three primary ways: as 1) gaps in remote memory of personal life events (e.g., periods of childhood or adolescence; some important life events, such as the death of a grandparent, getting married, giving birth); 2) lapses in dependable memory (e.g., of what happened today, of well-learned skills such as how to do their job, use a computer, read, drive); and 3) discovery of evidence of their everyday actions and tasks that they do not recollect doing (e.g., finding unexplained objects in their shopping bags or among their possessions; finding perplexing writings or drawings that they must have created; discovering injuries; "coming to" in the midst of doing something)."
   
:"Possession-form identities in dissociative identity disorder typically manifest as behaviors that appear as if a "spirit," supernatural being, or outside person has taken control, such that the individual begins speaking or acting in a distinctly different manner. For example, an individual's behavior may give the appearance that her identity has been replaced by the "ghost" of a girl who committed suicide in the same community years before, speaking and acting as though she were still alive. Or an individual may be "taken over" by a demon or deity, resulting in profound impairment, and demanding that the individual or a relative be punished for a past act, followed by more subtle periods of identity alteration. However, the majority of possession states around the world are normal, usually part of spiritual practice, and do not meet criteria for dissociative identity disorder."
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:"Possession-form identities in dissociative identity disorder typically manifest as behaviors that appear as if a "spirit," supernatural being, or outside person has taken control, such that the individual begins speaking or acting in a distinctly different manner. For example, an individual's behavior may give the appearance that her identity has been replaced by the "ghost" of a girl who committed suicide in the same community years
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before, speaking and acting as though she were still alive. Or an individual may be "taken over" by a demon or deity, resulting in profound impairment, and demanding that the individual or a relative be punished for a past act, followed by more subtle periods of identity alteration. However, the majority of possession states around the world are normal, usually part of spiritual practice, and do not meet criteria for dissociative identity disorder."
   
:"Many features of dissociative identity disorder can be influenced by the individual's cultural background."
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:"Many features of dissociative identity disorder can be influenced by the individual's cultural
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background.:
   
The DID further discusses comorbidity, showing that depression, anxiety, substance abuse, self-injury and non-epileptic seizures all correlate with DID. It suggests that those with DID are often unaware, or conceal their symptoms at first. It says that disorienting flashbacks can occur. The DSM discusses the reporting of maltreatment and other trauma, but it's not part of the diagnostic criteria. The DSM lists higher than average hypnotizability and dissociativity, and transient psychotic events as also correlating with DID. Attempted suicide is ridiculously common, with 70% having attempted it.
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The DID further discusses comorbidity, suggesting depression, anxiety, substance abuse, self-injury and non-epileptic seasures are all possible signs of DID. It suggests that those with DID are often unaware, or conceal their symptoms at first. It says that disorienting flashbacks can occur. The DSM discusses the reporting of maltreatment and other trauma, but as you see, it's not part of the diagnostic criteria. The DSM lists higher than average hypnotizability and dissociativity, and transient psychotic events as further signs. And attempted suicide is ridiculously common, at 70%
   
 
Prevalence is estimated, roughly, at 1.5% of the population, based on the study of a U.S. town.
 
Prevalence is estimated, roughly, at 1.5% of the population, based on the study of a U.S. town.
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Other Specified Dissociative Disorder: The division of identity (aka plurality) is shared with one variant of OSDD. OSDD does not require amnesia symptoms, and it can be supported by dissociative symptoms not strong enough to meet the first criteria of DID.
 
Other Specified Dissociative Disorder: The division of identity (aka plurality) is shared with one variant of OSDD. OSDD does not require amnesia symptoms, and it can be supported by dissociative symptoms not strong enough to meet the first criteria of DID.
   
Major Depressive Disorder: Most people with DID are also depressed, and this can disguise symptoms of DID.
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Major Depressive Disorder: Most people with DID are also depressed, and this can disguise symptoms.
   
 
Bipolar: Personality changes can easily be misinterpreted as mood swings.
 
Bipolar: Personality changes can easily be misinterpreted as mood swings.
   
Post Traumatic Stress Disorder: Has heavy overlap of symptoms with DID. This can mean the presence of PTSD can hide further evidence of DID. Dissociation unrelated to trauma is a sign it's not just PTSD.
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Post Traumatic Stress Disorder: Has heavy overlap of symptoms with DID. This can mean the presence of PTSD can hide further evidence of DID. Dissociation unrelated to trauma is a sign it's not PTSD.
   
 
Psychotic disorders: Personified voices can be mistaken for hallucinations, one of the criteria for various psychotic disorders. Furthermore, possession events can be confused for formal thought disorder, thought insertion, and thought withdrawal, other symptoms. People with DID may also experience trauma related hallucinations. However, people with DID do not have delusional explanations for their symptoms.
 
Psychotic disorders: Personified voices can be mistaken for hallucinations, one of the criteria for various psychotic disorders. Furthermore, possession events can be confused for formal thought disorder, thought insertion, and thought withdrawal, other symptoms. People with DID may also experience trauma related hallucinations. However, people with DID do not have delusional explanations for their symptoms.
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== Alters ==
 
== Alters ==
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=== The Clinical Perspective ===
 
=== The Clinical Perspective ===
   
The diagnosis was initially created in the eighteen hundreds, at a time when efforts to standardise psychological diagnosis were underway. The subject of multiple personalities were discussed amongst psychologists as a topic of fascination. Around this time, it became recognised that traumatic events could indeed cause long lasting mental harm.
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The diagnosis was largely created in the eighteen hundreds, at a time when efforts to standardise psychological diagnosis were underway. The subject of multiple personalities were discussed amongst psychologists as a topic of fascination. Around this time, it became recognised that traumatic events could indeed cause long lasting mental harm.
   
 
Around the start of the nineteen hundreds, interest in this topic began to wane. This is most likely because the condition was seen as very rare, though accusations of fraud also factored in. Around this time, the diagnosis of Schizophrenia was broadened to be more inclusive, capturing much of what dissociative identity disorder was. This overbroadening of Schizophrenia persisted and got worse, mainly in the united states, but has since been largely rectified, with the creation of a new category of dissociative disorders, one that contains DID, as well as other categories for PTSD and similar, and stricter diagnostic standards for Schizophrenia.
 
Around the start of the nineteen hundreds, interest in this topic began to wane. This is most likely because the condition was seen as very rare, though accusations of fraud also factored in. Around this time, the diagnosis of Schizophrenia was broadened to be more inclusive, capturing much of what dissociative identity disorder was. This overbroadening of Schizophrenia persisted and got worse, mainly in the united states, but has since been largely rectified, with the creation of a new category of dissociative disorders, one that contains DID, as well as other categories for PTSD and similar, and stricter diagnostic standards for Schizophrenia.
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More modernly, starting roughly in the 1980s, an alternate interpretation of this diagnosis has been put forward. Though it is not to say that those with DID are free of disorder, it may be that they are specifically DID for cultural reasons. This phenomenon is more strongly recognised in the category of culture bound disorders, a category for diagnoses that seem to only happen in one place or time on earth. Many of these are also examples of multiplicity or possible multiplicity, and DID could be an American example of this. One example of this is Ian Hacking's concept of multiplicity within his dynamic nominalism theory.
 
More modernly, starting roughly in the 1980s, an alternate interpretation of this diagnosis has been put forward. Though it is not to say that those with DID are free of disorder, it may be that they are specifically DID for cultural reasons. This phenomenon is more strongly recognised in the category of culture bound disorders, a category for diagnoses that seem to only happen in one place or time on earth. Many of these are also examples of multiplicity or possible multiplicity, and DID could be an American example of this. One example of this is Ian Hacking's concept of multiplicity within his dynamic nominalism theory.
   
Also starting roughly in 1980, the diagnosis came back with a vengeance, with a dramatic uptake in the number diagnosed, but fell off sharply again near the end of the millennium. Also roughly during this period, this diagnosis has been refined and split, creating the new dissociative diagnoses, Dissociative Disorder Not Otherwise Specified and Other Specified Dissociative Disorder.
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Also starting roughly in 1980, the diagnosis came back with a vengeance, but fell off sharply near the end of the millennium. Also roughly during this period, this diagnosis has been refined and split, creating the new dissociative diagnoses, Dissociative Disorder Not Otherwise Specified and Other Specified Dissociative Disorder.
   
 
The word hysteria has been associated with this diagnosis during various historical periods, but it was its own diagnostic category.
 
The word hysteria has been associated with this diagnosis during various historical periods, but it was its own diagnostic category.
   
 
=== The Healthy Multiplicity Perspective ===
 
=== The Healthy Multiplicity Perspective ===
After the invention of the internet, starting in the 2000s, A number of people experiencing plurality, many of whom are diagnosed with DID or similar, formed an internet subculture. This is a group most represented by a group of vocal bloggers, and it consists primarily of a loose collection of websites. As a subculture, this group has no unified goals or opinions. They are related by a shared experience of plurality. Nonetheless, certain ideas and opinions have come out of the writings of this group. One such idea is the idea that the alternate personalities are persons in their own right. Another is that multiplicity is not a disorder. Though it is unclear if this means more that people with plurality should not be diagnosed with DID or that DID is not a diagnosis of disorder. Those in the community still recommend that people should look at getting psychological support if they feel that is best for them.
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After the invention of the internet, starting in the 2000s, A number of people experiencing plurality, many of whom are diagnosed with DID or similar, formed an internet subculture. As a subculture, this group has no unified goals or opinions. They are related by a shared experience of plurality. Nonetheless, certain ideas and opinions have come out of the writings of this group. One such idea is the idea that the alternate personalities are persons in their own right. Another is that multiplicity is not a disorder. Though it is unclear if this means more that people with plurality should not be diagnosed with DID or that DID is not a diagnosis of disorder. Those in the community still recommend that people should look at getting psychological support if they feel that is best for them.
   
Dealing with plurality is not easy. In asserting that their condition is not a disorder, the community has created the problem that they need to provide support and methods for dealing with plurality in a non-clinical setting. This community has done so, establishing several ideas. A system of organisation should be established, such that the alters can cooperate with each other, schedule with each other, and communicate with each other, creating a mode of organised plurality. Instead of seeking "integration", the psychological process where the personalities are blended into one, those in the healthy multiplicity community seek conflict resolution strategies, so that the various personalities can work together and live as a family.
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Dealing with plurality is not easy. In asserting that their condition is not a disorder, the community has created the problem that they need to provide support and methods for dealing with the condition in a non-clinical setting. This community has done so, establishing several ideas. A system of organisation should be established, such that the alters can cooperate with each other, schedule with each other, and communicate with each other, creating a mode of organised plurality. Instead of seeking "integration", the psychological process where the personalities are blended into one, those in the healthy multiplicity community seek conflict resolution strategies, so that the various personalities can work together and live as a family.
   
 
There has been some feedback from this culture's coping strategies back into psychological theory and practise. Many professional psychologists no longer pursue integration as the first solution to this diagnosis, as one example, and now also look towards conflict resolution strategies.
 
There has been some feedback from this culture's coping strategies back into psychological theory and practise. Many professional psychologists no longer pursue integration as the first solution to this diagnosis, as one example, and now also look towards conflict resolution strategies.
 
== References ==
 
   
 
== External links ==
 
== External links ==
 
https://tulpa.io/clinical-perspectives
 
https://tulpa.io/clinical-perspectives
 
http://www.isst-d.org/downloads/GUIDELINES_REVISED2011.pdf
 
 
https://pdfs.semanticscholar.org/5105/09b4c28c60d1c4d28681af633784d0a4af26.pdf
 
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