It's time to revisit Dissociative Identity Disorder

This paragraph introduces the growing visibility of Dissociative Identity Disorder (DID), formerly known as multiple personality disorder, particularly on social media in the United States. It raises questions about the recent surge in DID's popularity and whether it is a result of overdiagnosis or underdiagnosis in the past. The paragraph also addresses the controversies surrounding DID, such as its legitimacy as a mental health diagnosis and the impact of its portrayal on social media and other platforms. The speaker, a mental health professional, intends to delve deeper into the topic to provide a comprehensive understanding beyond the trend.

The speaker outlines the diagnostic criteria for Dissociative Identity Disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). To be diagnosed with DID, an individual must meet five specific criteria, including the presence of two or more distinct personality states, recurrent gaps in memory, clinically significant distress or impairment, the disturbance not being part of a cultural or religious practice, and not being attributable to the physiological effects of a substance or other medical condition. The explanation clarifies the difference between personality and personality states, and introduces the concept of 'alters' or alternate identities within a person with DID.

This paragraph delves into the intricacies of living with Dissociative Identity Disorder. It discusses the concept of 'switching,' where one identity or 'alter' takes control, and the experience of 'fronting.' The speaker explains that individuals with DID have a core identity and may have a 'host' identity that is most present. The paragraph also touches on the varying number of alters within a person's system, the experience of amnesia, and the fact that DID is not always easily recognizable. It emphasizes the importance of understanding DID beyond media stereotypes and acknowledges the covert nature of the diagnosis for many individuals.

The speaker presents two main perspectives on the origin of Dissociative Identity Disorder: the traumatogenic perspective, which attributes DID to severe childhood trauma, and the iatrogenic model, which suggests that DID may be induced by therapists or social influences. The paragraph discusses the development of metacognitive abilities in children and how trauma before these abilities are fully formed can lead to the mind using dissociation as a defense mechanism. It contrasts this with the idea that some individuals may internalize the concept of multiple personalities due to suggestions from therapists or exposure to related content in media.

This paragraph explores the historical roots of DID, dating back to 1584 with the case of Jean Fery, a French nun who exhibited symptoms aligning with contemporary understanding of DID. It also discusses the case of Louis V in 1885, who was the first person explicitly diagnosed with multiple personalities. The speaker mentions the influence of literature and media, such as Shirley Jackson's novel 'The Bird's Nest' and the book and film 'The Three Faces of Eve,' in shaping public perception and possibly contributing to the recognition of DID as a distinct diagnosis.

The speaker discusses the influence of the book 'Sybil' and the subsequent TV movie on the recognition and diagnosis of multiple personalities, leading to a significant increase in reported cases. It raises concerns about the ethical practices of the psychiatrist involved in the case and the potential for iatrogenic effects. The paragraph also touches on the role of the DSM in formalizing the diagnosis of multiple personality disorder and the subsequent renaming to dissociative identity disorder in later editions.

This paragraph examines the sensationalization of multiple personality disorder in the 1980s and early 90s, particularly during the 'satanic panic,' which led to false memories and accusations. It discusses the decline in diagnoses and the subsequent lawsuits against psychiatrists for inducing the disorder. The speaker also comments on the continued presence of DID in popular media and the mixed feelings about its inaccurate portrayals, which can contribute to stigmatization.

The speaker addresses the recent surge in self-diagnoses of DID, especially among young people on TikTok. They consider the possibility that social media platforms may provide a space for genuine sufferers to connect and share experiences, while also acknowledging the risk of misdiagnosis and imitation due to social influence. The paragraph discusses the contrasting views on TikTok's role in the increase of DID diagnoses and the importance of recognizing the line between entertainment and reality.

This paragraph discusses the broader implications of social media on the perception of mental health issues, particularly DID. It highlights the potential for increased awareness and connection through platforms like TikTok and YouTube but also warns of the dangers of misinformation and sensationalism. The speaker emphasizes the importance of accurate representation and the potential negative impact of fad elements on the legitimacy and treatment of DID.

The speaker shares their professional opinion on the validity of Dissociative Identity Disorder as a distinct psychiatric disorder. They discuss the high comorbidity of DID with other mental health diagnoses, such as PTSD and borderline personality disorder, and suggest that DID may not require a separate diagnosis. They propose reclassifying DID as a subtype of other disorders, such as PTSD with dissociative identity type or borderline personality disorder with dissociative amnesia, to provide a more useful framework for understanding and treating the condition.

In the final paragraph, the speaker emphasizes the significance of accurate diagnosis and the potential benefits of reclassifying DID. They argue that a more specific classification could lead to better tailored treatments, increased research, and a reduction in stigma and misunderstanding. The speaker acknowledges the validity of the experiences of those diagnosed with DID and invites further discussion on the topic.