Many identities, one head.

We were discussing dissociative identities last night and there surfaced the observation that pathological psychologies were merely extreme examples of much more common human tendencies, which is to say that nearly everyone harbors characteristic dissociative personal identity states to some degree or another. One symptom of switching identity states is saying one thing in one identity state and then saying the exact opposite after the switch, and being totally unaware of the blatant contradiction. This is not to be confused with bare-faced lying, in which the person knows the falsity of the statement.

Helen Schucman, co-scribe of A Course In Miracles, was diagnosed by her boss and co-scribe, Bill Thetford, as being quite dissociative. In Absence From Felicity, Ken Wapnick  discusses the diagnosis of Helen's dissociative identities in a chapter titled Beyond Heaven and Helen: The Priestess, "My primary focus in this book has been the two sides of Helen's personality." Others have used the phrases, "Helen and Hell" or "St. Helen and the Bitch."

I suppose that coming to the office each day with Helen must have been a continuing game of The Lady or the Tiger. Which is it today?

Here is more than you ever wanted to know about the history of the dissociative disorder, adapted from Wikipedia.

In Roman mythology, the god Janus was described as having "two-faces", but primarily, before the 19th century, people exhibiting symptoms similar to those were believed to be possessed by demons.

An intense interest in spiritualism, parapsychology, and hypnosis continued throughout the 19th and early 20th centuries. Hypnotists reported what they thought were second personalities emerging during hypnosis and wondered how two minds could coexist. The 19th century saw a number of reported cases of multiple personalities which Rieber estimated would be close to 100. Epilepsy was seen as a factor in some cases,and discussion of this connection continues into the present era. The public, however, was exposed to psychological ideas which took their interest. Mary Shelley's 1818 Frankenstein, or; The Modern Prometheus, had a formidable impact.

By the late 19th century there was a general acceptance that emotionally traumatic experiences could cause long-term disorders which might display a variety of symptoms. These conversion disorders were found to occur in even the most resilient individuals, but with profound effect in someone with emotional instability like Louis Vivé (1863-?) who suffered a traumatic experience as a 13 year-old when he encountered a viper. Vivé was the subject of countless medical papers and became the most studied case of dissociation in the 19th century.

Between 1880 and 1920, many great international medical conferences devoted a lot of time to sessions on dissociation. It was in this climate that Jean-Martin Charcot introduced his ideas of the impact of nervous shocks as a cause for a variety of neurological conditions. One of Charcot's students, Pierre Janet, took these ideas and went on to develop his own theories of dissociation. One of the first individuals diagnosed with multiple personalities to be scientifically studied was Clara Norton Fowler. American neurologist Morton Prince studied Fowler between 1898 and 1904, describing her case study in his 1906 monograph, Dissociation of a Personality.

Published in 1886 Robert Louis Stevenson's Strange Case of Dr Jekyll and Mr Hyde is well known known for its portrayal of a split personality.

In the early 20th century interest in dissociation and multiple personalities waned for a number of reasons. After Charcot's death in 1893, many of his so-called hysterical patients were exposed as frauds, and Janet's association with Charcot tarnished his theories of dissociation. Sigmund Freud recanted his earlier emphasis on dissociation and childhood trauma.

A review of the Index Medicus from 1903 through 1978 showed a dramatic decline in the number of reports of multiple personality after the diagnosis of schizophrenia became popular, especially in the United States. A number of factors helped create a large climate of skepticism and disbelief; paralleling the increased suspicion of DID was the decline of interest in dissociation as a laboratory and clinical phenomenon.

Starting in about 1927, there was a large increase in the number of reported cases of schizophrenia, which was matched by an equally large decrease in the number of multiple personality reports.Bleuler also included multiple personality in his category of schizophrenia. It was concluded in the 1980s that DID patients are often misdiagnosed as suffering from schizophrenia.

In 1957, with the publication of the book The Three Faces of Eve and the popular movie which followed it, the American public's interest in multiple personality was revived. During the 1970s an initially small number of clinicians campaigned to have it considered a legitimate diagnosis.

Between 1968 and 1980 the term that was used for dissociative identity disorder was "Hysterical neurosis, dissociative type". The APA wrote: "In the dissociative type, alterations may occur in the patient's state of consciousness or in his identity, to produce such symptoms as amnesia, somnambulism, fugue, and multiple personality."

The highly influential book Sybil was published in 1974, which popularized the diagnosis through a detailed discussion of the problems and treatment of the pseudonymous Sybil. Six years later, the diagnosis of multiple personality disorder appeared in the DSM III. Controversy over the iconic case has since arisen, with some calling Sybil's diagnosis the result of the therapist's methods, while others have defended the treatment and reputation of Sybil's therapist, Cornelia B. Wilbur. As media coverage spiked, diagnoses climbed. There were 200 reported cases of DID (dissociative identity disorder) as of 1980, and 20,000 from 1980 to 1990. Joan Acocella reports that 40,000 cases were diagnosed from 1985 to 1995. The majority of diagnoses are made in North America, particularly the United States, and in English-speaking countries more generally with reports recently emerging from other countries.

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