Multiple personality disorder

I was asked by a lady at a conference yesterday what my views were on Multiple Personality Disorder. This is a set of symptoms where it seems like there are two or more distinct personalities present within one person. It is called Dissociative Identity Disorder in modern psychological literature and the full criteria are bulleted below.

"Did I think there was a role for exorcism?" [this was her experience and she said it helped] In brief, I think there are a number of facts about MPD/DID that it is important to be clear on and then each individual needs to be approached differently.

The patient has at least two distinct identities or personality states. Each of these has its own, relatively lasting pattern of sensing, thinking about and relating to self and environment.
At least two of these personalities repeatedly assume control of the patient's behavior.
Common forgetfulness cannot explain the patient's extensive inability to remember important personal information.
This behavior is not directly caused by substance use (such as alcoholic blackouts) or by a general medical condition.

1:

Most people who think they have MPD/DID do not - atleast not according to the psychiatric classifications. Instead they have features of their personality that can make it seem as though there are two people there. People say things like, "he just flipped" or "I lost control, like someone else was taking over" or "there are two completely different sides to her personality". However, what is actually going on is that the person has am immature personality and defends against this by living a number of steroetypes. A good example is what is commonly called Borderline Personality Disorder where there is a fragile border mainitained between fantasy and reality, between coherency and fragmentation, and this can seem like two personalities. A look at some of the stories and poetry on this website will illustrate what I mean - www.bpdcentral.com. A key way to tell this apart from MPD/DID is that the person is aware of these differnet facets to the way they behave. BPD requires a different approach to DID, however both are severe problems.

2:

MPD/DID does seem to exist, and i have seen a small number of cases as a psychiatrist. I have seen it in a very pure form one - it was a person who had another personality within them (a child) who they became from time to time. Neither personality was aware of the other. This was true "dissociation" and has a sound grounding in psychoanalytical theory, where it is an immature defense to unbearable stress such that there is total and complete dissociation of the brain into a number of parts. But this level of dissociation is rare!

What is probably more common is a less pure dissociation, and there may be a spectrum with BPD. Over recent years, there has been a growing awareness of people who dissociate to greater or lesser degress. For some of these people, their problems will be better seen as DID that Borderline Personality Disorder. A good website with lots of helpful resources and training sessions is PODS - Positive Outcomes for Dissociative Survivors. This is a generic website, but is run by Christians who I have got to know and trust.

3:

I believe that demon possession can happen today and that this can look like MPD/DID if there is 'another person' inside. I wrestle with the question of whether this can happen to believers - my theology says no, but my experience says that believers can be at least strongly influenced by demons. However, I again think full demon possession to be rare.

So, what do you do if you think you might have MPD/DID? From the three points above

1. try and work out of it is really dissociation and not just two facets of your personality
2. see if there is an understandable psychological formulation to explain why there might be dissociation - don't just go on hints, test out the formulation, though it might be best if a trained therapist does this.
3. get someone with the gift of discerning spirits and who is experienced in working with the supernatural to see if this could be demonic.

The best thing to do in most circumstances anyway is not to get too hung up on the original cause or the exact terminology, but try to develop holistically, to grow into a full and healthy person. At times you will need to see a therapist too. This would be the starting point for 1, will help with 2 and 3 may become obvious and can be dealt with later.

Rob Waller, 23/07/2008