Dissociative Identity Disorder
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 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.
Health and Safety
This page covers a clinical diagnosis of a mental disorder. As a matter of a person's health, it is important to handle this topic carefully. You might believe that you should redirect anyone who appears to be suffering from this to seek professional help. This presupposes that the person is ill, and that they need help. You are not a doctor. Don't do this.
Similarly, if a person comes to you claiming to have DID, treat them with respect. You are not a doctor, and you don't know what the label means. However, anyone diagnosed with DID has a lot more going on than multiple personalities. According to all professional standards, having multiple personalities is not sufficient reason to apply any diagnosis whatsoever in and of itself. Respect that they may have additional concerns and needs.
A large number of misconceptions surround alters. Alters are the official label used for the other personalities in those diagnosed with DID or a similar condition. However, what this means, is highly ambiguous. The diagnosis has changed and morphed over time. And plurality in general does not fit the diagnosis. To be a DID alter is different than to be a OSDD alter. There is also great difficulty in defining the concepts of personality, identity, and personhood, all of which the definition of alters depends upon.
The official definition of of alters is that they are "distinct personality states". Due to the looseness of this definition, it is even possible that some people with DID don't experience plurality as a tulpamancer would recognise it, though field experience reveals that many with DID do experience plurality of this type.
In practise, most alters experience communication difficulties. This means they cannot read each others thoughts, they cannot watch each other, and they cannot both be active in order to talk to each other at the same time. This leads to amnesia, where one personality fails to remember what happened while another one was active. They also usually experience control difficulties, where they cannot control who is out in front, and can be pushed to the front through the use of trigger words. A side effect of this is they can almost always switch.
The Clinical Perspective
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 PTSD and similar, and stricter diagnostic standards for Schizophrenia.
In 1957, a book called The Three Faces of Eve, was published, and created a resurgence in the popularity of the diagnosis. In it, in dramatic fashion, was the depiction of "eve", a person with three personalities. This was further strengthened by the story of "Sybil" (real name Shirly Ardell Mason). Despite a sudden jump in the number of people with this diagnosis, more books, and more research, the diagnosis again died amongst rumours of fraud and fakery.
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, 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 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. 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 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.