While it seems that dissociative identity disorder, or MPD, is now accepted as a valid diagnosis by mainstream psychiatry/psychology, it still remains highly controversial and a large minority of interested psychiatrists/psychologists deny its existence.
I’m not focusing on why the dispute exists, although I am interested in that. (The only reason I’m not focusing is that might degenerate into a great debate, and y’all know how pissy the mods can be about that. :D) What I am curious about is that, if these patients don’t have MPD, what was the alternative diagnosis? Obviously they are, to use the technical terms, nuts.
According to an article at http://www.religioustolerance.org/mpd_did.htm, multiple personality disorder does not occur naturally, but is instead created by the psychiatrist. Basically, the therapist convinces the patient that they really do have multiple personalities, so they begin to act that way. Apparently, once the patient is removed from such a therapist’s care, the “personalities” usually vanish. The article likens this effect to recovered memory therapy, in which people suddenly “remember” that they have been abused by Satanic cults. These “memories” are often created by leading questions asked by therapists.
I gotta ask why the Ontario Conference on Religious Tolerance is even addressing DID. Other than the, ahem, rather remote possibility that DID is caused by demonic possession, I don’t see a connection between the disorder and religious tolerance, or the OCRT’s qualifications to address the issue.
Further, the OCRT quickly shows themselves to be non-credible concerning DID. The subtitle of their DID section is “All sides to the debate”, but their introductory paragraph is as follows:
If you’re biased, fine, declare your bias. State that you don’t accept DID and proceed to blast away. If you claim to be neutral, than start out like this, I ain’t gonna listen.
Never got to work with MPD’s during the couple of years I worked in psych hosptials, but my Father, and my sister both have.(my Dad and my sister are both shrinks). My sister worked with them in a hospital, and has said that there are more fake ones than real ones. The fake ones are Boderline Personality Disorder types, who start adopting the MPD thing as a way to get negative attention. Having worked with a whole herd of borderlines, I can easily believe this…they crave negative attention. Put a Boderline in room with patient that is hearing voices, the boderline will start hearing voices too when they see how much attention the other patient is getting.
I fully agree that the OCRT is biased, not only in this, but in many other areas. For instance, they seem to be quite biased against fundamentalist Christianity. Not a problem for me, since I am too. I agree that their pretensions of being “unbiased” do get annoying occasionally; however, in this case, I’m convinced by their arguments against DID. It’s not just their opinion; they do have sources to back it up. It’s true that I have no training in psychology, but I believe in evolution even though I have little training in biology because the vast majority of scientists who do have the training do. What it really boils down to is that. SuaSponte, you assert that DID is accepted as a valid diagnosis by “mainstream” psychology and that a “large minority” of psychologists deny its existence. OCRT says exactly the opposite; that those who BELIEVE in DID are a minority. Who is right?
I think you already understand this but just in case, my criticism of OCRT was not intended in any way to be a criticism of you, ricksummon.
As for your question about whether DID is an accepted diagnosis by the mainstream, I based my belief on the fact that DID is included in the DSM-IV. It is my understanding that diagnoses are not included in the DSM series unless and until the diagnosis is formally recognized by the appropriate governing bodies (who they are exactly, I forget :o).
I certainly agree that psychiatry and psychology have an unfortunate history of fad diagnoses. ADHD springs to mind. However, in most of these cases the problem has been overdiagnosis - I don’t think there is a strong movement denying the existence of ADHD; critics simply say that many psychiatrists diagnose ADHD when the kid is just excitable, etc.
DID is different. Many critics go beyond the allegation of overdiagnosis - they deny the existence of the disorder at all. That’s why I posed the question - I was wondering what these critics think these patients have instead.
The complaint I had was not against bias per se, but asserting non-bias when doing so. It is fundamentally unfair and misleading to claim that you are presenting all sides of an issue, but only present a few goofball articles from the side you don’t like, and then present the best argument of the side you do like.
And I still don’t know what a discussion of DID/MPD is doing on their site.
I remember somebody from the WOM chat who had MPD…
she had a lot of other problems too…
but to me it always seemed like her personality changes were triggered by touching certain topics. She had been abused by her father as a child and if anything reminded her of that she would first be that little girl again and then a protective personality would take over to block her feelings out. After a while she d get back to normal…
Roseanne Barre has MPD as well (as far as I know)…
You’re born with it. Personality disorders are listed on “Axis 2” of any mental exam. “Axis 1” are those illnesses which can be treated. Axis 2 are those that cannot and are pretty exclusive personality d/o’s, of which there are many.
Incidentally, the difference, as I understand it, between a borderline pd and an antisocial pd is that in the former the person is more likely to injure himself, and in the latter others. There’s nothing “borderline” about a borderline pd. It’s a very serious problem, for which not much can be done now.
Also incidentally, as to the post that a mpd is “schizophrenia,” schizophrenia is a completely separate d/o, and is a psychotic condition in which the person loses contact with reality: hallucinations and delusions. In spite of the name, it has nothing to do with a split personality.
As for the OP, if mpd does not exist, these guys must have anxiety, induced by those who claim they have mpd. Since DSM-4 lists mpd, that is the conventional diagnosis, and as the OP states to argue otherwise would put this in GD. I have never heard of anxiety reaching psychotic proportions. Another possibility is a somatoform disorder, but that refers to an imagined physical condition, not an imagined mental condition. Nonetheless, I guess it can be extended to a mental condition.
*In short, Spanos argues that most cases of MPD have been created by therapists with the cooperation of their patients and the rest of society. The experts have created both the disease and the cure. This does not mean that MPD does not exist, but that its origin and development are often, if not most often, explicable without the model of separate but permeable ego-states or “alters” arising out of the ashes of a destroyed “original self.” *
*Spanos makes a very strong case for the claim that “patients learn to construe themselves as possessing multiple selves, learn to present themselves in terms of this construal, and learn to reorganize and elaborate on their personal biography so as to to make it congruent with their understanding of what it means to be a multiple.” Psychotherapists, according to Spanos, “play a particularly important part in the generation and maintenance of MPD.” According to Spanos, most therapists never see a single case of MPD and some therapists report seeing hundreds of cases each year. It should be distressing to those trying to defend the integrity of psychotherapy that a patient’s diagnosis depends upon the preconceptions of the therapist. *
I’ve been mulling over the OP. If mpd does not exist, then the diagnosis must be schizophrenia: loss of contact with reality. These people believe they have multiple personalities. But if they don’t, and that is impossible, and they are suffering from a delusion. By definition, that’s schizophrenia.
There is a theory that Boderline is not Organic, I.E your not born with it, but that it is caused by a lack of positive attention during the first few years of your life. Boderlines tend to crave negative attention, are confused about identity, and seek extremes in intrapersonal relationships. They tend to adopt other peoples personality problems, anything that cause conflict, and seem to like to stir up trouble between other people. They do a lot of minor self harm kind of things…wrist scratching, fake suicide attempts etc…barbitu8 is right, there is little that can be done about it, other than educating the patient on how to recongnize and manage the problem. I lived with a Girl who was borderline(as a roomate, not dateing her), and she was a real pain in the ass to deal with. I had a whole unit of adolescents to ride herd over one time, and one of them decided to start banging her hand into a wall, so all of them had to…we would the exray guy out there 3 times a week.
Delusions can be cause by a large number of things, not just schizophrenia. Schizophrenia is specific organic disorder. Someone who is severly bipolor can be delusional, as well as people suffering from all sorts of psychological trauma(which can be a temporary condition…Schizophrenia is permenant). There is a bunch more, but I don’t have a dsm handy right now.
Yes, but bipolar or depression is an affective disorder. That’s not the case here. The person is neither depressed or manic. I guess the only other diagnosis would be: “psychosis, not otherwise differentiated,” or some such verbiage.
To answer SuaSponte’s OP, people like the OCRT are NOT saying that Multiple Personality Disorder does not exist. They’re saying that it doesn’t exist naturally, and when it does occur it’s due to psychiatrists’ meddling. Are we clear now?
Actually yes, and thanks.
But it does lead to a follow-up question. If a psychiatrist’s meddling can inadvertantly cause MPD in a patient, I gotta think something was major-league wrong with that patient in the first place. David B.'s links talks about “extreme suggestibility”. I posit that suggestibility so extreme as to allow the creation of a completely delusional life-story and mindset is, again in pure psychospeak, not a good thing.
Any diagnosis attached to this?