Discussion on Whether Dissociative Identity Disorder is a Valid Disorder

Introduction

Sigmund Freud says, “The individual does actually carry on a double existence: one designed to serve his own purposes and another as a link in a chain, in which he serves against, or at any rate without, any volition of his own.” This implies that we have our true self and another self that emerges when our true self is attacked or offended. Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is a rare mental illness characterized by having at least two distinct personality states. In this essay, we will determine if Dissociative Identity Disorder is a valid disorder and explore the many controversies surrounding it.

Understanding Dissociative Identity Disorder

The criteria for Dissociative Identity Disorder include two or more distinct personality states. According to the DSM-V, these states involve different senses of self and altered behavior, memory, and cognition (American Psychiatric Association, 2013). Additionally, the individual with DID must experience amnesia and significant distress. Other symptoms include impulsivity, self-harm, detachment from oneself, mood swings, amnesia, and altered consciousness. Recently, there has been debate over whether Dissociative Identity Disorder should remain in the DSM. Critics argue that DID is fabricated and induced through therapy. The disorder was first included in the DSM in 1968 under the term Hysterical Neurosis, defined as an alteration of consciousness and identity. It was reclassified in 1980 as dissociative.

Controversies and Criticisms

Some argue that Dissociative Identity Disorder is overdiagnosed. There are notable similarities between DID and borderline personality disorder. An article stated, “They described, rather, a ‘syndrome’ of symptoms that occurs in persons with disturbed personalities, particularly borderline personality disorder. They concluded that DID had ‘no unique clinical picture, no reliable laboratory tests, could not be successfully delimited from other disorders, had no unique natural history and no familial pattern’” (Spanos, 1994). This suggests that DID lacks specific guidelines and might overlap with other diagnoses. The disorder is so rare that therapists often have a limited set of similar disorders for comparison when diagnosing patients.

Etiology and Ethical Considerations

Psychologists suggest that DID may stem from childhood abuse. However, an article noted, “As for patients’ presumed reluctance to report childhood abuse, I witnessed in every one of my fifteen alleged cases of DID (all female) not reluctance but a strong tendency to flaunt their diagnosis and symptoms and an eagerness to re-tell their stories with graphic detail, usually unprovoked” (McHugh, 1995). This raises two possibilities: first, that repressed memories could be induced by a persuasive therapist, leading patients to fabricate stories under pressure. Second, the presence of multiple personalities might serve as a coping mechanism, allowing individuals to recount events with confidence as if they are speaking as “another person.”

A major ethical consideration related to this topic is Principle D: Justice. This principle requires psychologists and therapists to recognize justice for all individuals and to exercise reasonable judgment and precautions to avoid bias. This principle is relevant because therapists working with DID must be cautious and attentive. Critics of DID fail to adhere to this ethical code by attacking the disorder and attempting to invalidate it. An article discussing legal considerations states, “Persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency” (Radden, 1996). This example underscores Principle D: Justice. If a patient lacks reasonable judgment, they cannot be expected to take necessary precautions.

Conclusion

I believe that Dissociative Identity Disorder is a valid disorder. Although evidence is limited, it would be challenging for individuals to fabricate such a complex illness. DID is an extremely rare disorder, with an average of two to thirteen alternate personalities per individual. It seems improbable that someone could maintain such an elaborate deception without making mistakes. Dissociative Identity Disorder has been part of the DSM since 1980. As our understanding of the disorder evolves, more questions arise, but none challenge the reality of the symptoms and experiences associated with it.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• McHugh, P. R. (1995). The diagnosis of multiple personality disorder. British Journal of Psychiatry, 166(1), 15-19.
• Radden, J. (1996). Divided Minds and Successive Selves: Ethical Issues in Disorders of Identity and Personality. MIT Press.
• Spanos, N. P. (1994). Multiple Identity Enactments and Multiple Personality Disorder: A Sociocognitive Perspective. Psychological Bulletin, 116(1), 143-165.