Multiple personality. Multiple personality disorder

In the early 20th century, split personality was considered a symptom of hysteria. Gradually interest in him began to increase. Diagnostic criteria were identified. And in 1968, the American Psychotherapeutic Association identified it as a separate disease - “hysterical neurosis of the dissociative type.” This event became significant. Split personality has been discussed at conferences and symposiums. The American Journal of Clinical Hypnosis, Research, and other reputable publications have devoted articles and special issues to him. The disorder was renamed "multiple personality disorder" in 1980 and "dissociative identity disorder" in the late 1990s. By this time, the disease had been diagnosed in 6 thousand Americans. The wave of bifurcation has acquired epidemic proportions.

Proponents and opponents of the diagnosis

The opinions of psychiatrists and psychotherapists differ on a number of key points.

What caused the disease epidemic?

There are two waves of the multiple personality epidemic: European (1880-1890) and American (1980-1990).

Doctors who accept the diagnosis find an explanation in the increased scientific interest in the phenomenon of multiplicity. New research was carried out, diagnostic methods were improved, which improved the recognition of the disease. Professor of Psychiatry Richard Kluft emphasizes that only 20% of patients have clear symptoms, 40% have minor signs, and in the remaining 40% the disorder is determined only after a thorough examination.

Skeptical doctors associate the first wave with the emergence of hypnosis, and the second with the popularization of the disorder. Forensic psychiatrist V.V. Motov notes that after the film adaptation of the books “The Three Faces of Eve” (1957) and “Sibyl” (1973), American newspapers began to circulate semi-fantastic stories about multiple personalities. The symptoms of the disorder, dressed in an artistic wrapper, acquired an aura of mystery and enigma. Eventually, many suggestible patients began to exhibit similar symptoms.

Psychiatrists Thigpen and Cleckley also mentioned that after the book “The Three Faces of Eve” was published, their clinic experienced a real boom. Doctors referred hundreds of patients to them whose diagnosis was not confirmed. They noted unhealthy competition among colleagues fighting for the right to find the largest number of subpersonalities.

What is the cause of the disorder and what are the treatment methods?

American psychiatrist Frank Putnam suggests that dissociative identity disorder is formed in response to physical, emotional and/or sexual abuse in childhood. Since the child cannot prevent the traumatic influence, the unity of the personality is preserved by splitting the “I”. New personalities take on the burden of unbearable pain and try to adapt to reality. Children's personalities, as a rule, experience fear and cry, while adults express anger, protect or realize secret desires. They may not know about each other, be friends with each other or conflict. Individuals may differ in age, nationality and illness. For example, one may be myopic, while the other may have good vision but suffer from psychopathy. Each individual is assigned a unique name, which most often recalls the trauma experienced.

Putnam cites statistics that support the relationship between childhood trauma and disorder. According to the US National Institute of Mental Health, 97% of patients with multiple personality are victims of violence; 68% of them were sexually harassed by a relative. Memories of incest are repressed from memory because they are associated with shame, guilt and other strong emotions. In addition, incest can be masked by “family myths” about care and love. Putnam emphasized that therapy should be aimed at uncovering the patient's secrets and then working through them.

Psychiatry professor Paul McHugh has a different view on the nature of multiple personality. He is confident that multiple personality is a manifestation of hysteria, aggravated by inadequate treatment. As confirmation, McHugh cites an excerpt from a psychotherapeutic conversation. So, the psychiatrist asks: “Have you ever felt like another part of you was doing something that was beyond your control?” If the patient answers positively or ambiguously, then the question follows: “Does this complex of sensations have a name?” Even if he doesn’t call it anything, the specialist asks to talk to that part of the personality. In this way, the personality is purposefully divided, and the psychiatrist interacts with the patient's fantasies rather than helping to solve the problem.

Opponents of the diagnosis note that there is no refutable evidence that incest or other psychological trauma causes multiple personality. They also urge caution regarding memories gained during therapy.

In order for repressed memories to awaken, “age regression and guided visualization”, hypnosis and sodium amytal (“truth serum”) are used. For most, such treatment turned into a real tragedy. “Remembering” the sexual harassment, patients began to sue their parents. Families broke up, family ties were torn, reputations were tarnished. In response to the problem, in 1993 the American Psychiatric Association issued a warning that memories obtained through hypnosis and visualization are unreliable and may be false.

Humanity or personal interest?

Multiple personality therapy is an expensive procedure that can take a long time. long years. Adding a diagnosis to the Diagnostic and Statistical Manual of Mental Disorders allowed insurance companies to pay for the treatment of poor patients. On the one hand, this approach is dictated by humane considerations, and on the other hand, it is regarded by critics as a financial interest of the attending physicians.

To summarize, it can be noted that the phenomenon of multiple personality is again in the spotlight. The story of Billy Milligan is gaining popularity in popular culture, based on which a book was written and a film is being filmed. The debate continues in scientific circles. Research is carried out, articles and monographs are written. Extensive experience has been accumulated diagnostic methods, but still some specialists are still in opposition and do not recognize this diagnosis. And who knows, maybe soon the disputing parties will come to a consensus, and we will get a clear answer to the question of what multiple personality is.

Literature

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Name options:

• Dissociative identity disorder (DSM-IV)
• Multiple personality disorder (ICD-10)
• Multiple Personality Syndrome
• Limited dissociative identity disorder
• split personality

Multiple personality - a mental phenomenon in which a person has two or more distinct personalities, or ego states. Each alter personality in this case has its own patterns of perception and interaction with the environment. People with multiple personalities are diagnosed with dissociative identity disorder or multiple personality disorder. This phenomenon is also known as “split personality” and “split personality”.

Dissociative identity disorder

Dissociative identity disorder(English) Dissociative identity disorder, or DID) is a psychiatric diagnosis accepted in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which describes the phenomenon of multiple personality. To determine that a person has dissociative identity disorder (or multiple personality disorder), it is necessary to have at least two individuals who regularly took turns controlling the individual's behavior, as well as memory loss that would go beyond normal forgetfulness. Memory loss is commonly described as "switching." Symptoms must occur outside of any substance abuse (alcohol or drugs) or general medical condition. Dissociative identity disorder also known as multiple personality disorder(English) Multiple personality disorder, or MPD). IN North America such a disorder has been decided to be called "dissociative identity disorder" due to differences of opinion in psychiatric and psychological circles regarding this concept, according to which one (physical) individual can have more than one personality, where personality can be defined as the original sum of the mental states of a given (physical) ) individual.

Although dissociation is a psychiatric condition that can be proven and can be associated with a number of various disorders, particularly those relating to early childhood trauma and anxiety, multiple personality as a real psychological and psychiatric phenomenon has been questioned for some time. Despite differing opinions regarding the diagnosis of multiple personality disorder, many psychiatric institutions (for example, McLean Hospital) have wards specifically designed for dissociative identity disorder.

According to one classification, dissociative identity disorder is considered a type of psychogenic amnesia (that is, having only a psychological, and not medical, nature). Through such amnesia, a person is able to repress memories of traumatic events or a certain period of life. This phenomenon is called splitting of the “I”, or, in other terminology, the self, as well as experiences of the past. Having multiple personalities, an individual may experience alternative personalities with individually different characteristics: such alternative personalities may have different ages, psychological genders, different health conditions, different intellectual properties, and also different handwriting. Long-term therapies are usually considered to treat this disorder.

As two characteristic features Dissociative identity disorder consists of depersonalization and derealization. Depersonalization is an altered (in most cases described as distorted) perception of oneself and one's own reality. Such a person quite often appears detached from consensual reality. Patients often define depersonalization as “a feeling of being outside the body and being able to observe it from a distance.” Derealization - altered (distorted) perception of others. According to derealization, other people will not be perceived as really existing for this person; patients with derealization have problems identifying another person.

Research has shown that patients with dissociative identity disorder often hide their symptoms. The average number of alternate personalities is 15. They usually appear in early childhood. This is probably why some of the alternate personalities are children. Many patients have comorbidity, that is, along with multiple personality disorder, they also express other disorders, for example, generalized anxiety disorder.

diagnostic criteria

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), diagnosis dissociative identity disorder is posed if a person has two or more distinct identities or personal states (each with its own relatively long-term pattern of perception and relationships with the environment and oneself), at least two of these identities recurrently seize control over the person’s behavior, the individual unable to recall important personal information beyond normal forgetfulness, and the disorder itself is not caused by the direct physiological effects of any substance (for example, loss of consciousness or chaotic behavior for alcohol intoxication) or a general medical condition (eg, complex partial seizures). It is noted that in children such symptoms should not be attributed to imaginary friends or other types of games involving imagination.

Despite the emergence of new personalities, the basic personality, which has the person’s real first and last name, remains among them. The number of personalities inside can be large and grow over the years. This is mainly due to the fact that a person unconsciously develops new personalities within herself that could help her better cope with certain situations. So, if at the beginning of treatment the psychotherapist usually diagnoses 2-4 personalities, then during treatment another 10-12 appear. Sometimes the number of people exceeds a hundred. Personalities usually have different names, different manners of communication and gestures, different facial expressions, gait and even handwriting. Usually a person is unaware of the presence of other persons in the body.

The criteria for diagnosing dissociative identity disorder published by DSM-IV have been criticized. One study (2001) highlighted a number of data shortcomings diagnostic criteria: This study claims that they do not meet the requirements of modern psychiatric classification, are not based on a taxometric analysis of the symptoms of dissociative identity disorder, describe the disorder as a closed concept, have poor content validity, ignore important data, interfere with taxometric research, have low reliability and sufficient often lead to incorrect diagnosis, they contain contradictions and the number of cases of dissociative identity disorder is artificially low. This study proposes a solution to the DSM-V in the form of new, investigator-considered, user-friendly, polythetic diagnostic criteria for dissociative disorders (Common Dissociative Disorder, Generalized Dissociative Disorder, Extensive Dissociative Disorder, and Non-Specific Dissociative Disorder).

additional symptoms

In addition to the main symptoms listed in the DSM-IV, patients with dissociative identity disorder may also experience depression, suicide attempts, mood swings, anxiety and anxiety disorders, phobias, panic attacks, sleep and eating disorders, other dissociative disorders, in some cases hallucinations. There is no consensus as to whether these symptoms are related to the identity disorder itself or to the psychological trauma experienced that caused the identity disorder.

Dissociative identity disorder is closely related to the mechanism of psychogenic amnesia - memory loss, and is of a purely psychological nature, without physiological disorders in the brain. This is a psychological defense mechanism, thanks to which a person is able to repress traumatic memories from consciousness, but in occasional identity disorders, this mechanism helps individuals “switch.” Too much involvement of this mechanism often leads to the development of daily memory problems in patients suffering from identity disorder.

Many patients with dissociative identity disorder also experience depersonalization and derealization, and experience bouts of confusion and loss when a person cannot understand who she is.

Multiple personality disorder and schizophrenia

It is difficult to distinguish schizophrenia from multiple personality disorder during diagnosis and mainly relies on the structural features of the clinical picture, which are not typical for dissociative disorders. In addition, the corresponding symptoms are perceived by patients with schizophrenia more often as a result of external influences, and not as belonging to self. The split personality of multiple disorders is massive or molecular and forms quite complex and integrated personal substructures in relation to oneself. Splitting in schizophrenia, which is referred to as discrete, nuclear or atomic, is the splitting off of individual mental functions from the personality as a whole, which leads to its disintegration.

Timeline of the development of understanding multiple personality

1640s - 1880s

The period of the theory of magnetic somnambulism as an explanation of multiple personality.

• 1784 - The Marquis de Puysegur, a student of Franz Anton Mesmer, introduces his worker Victor Race using magnetic techniques (Victor Race) into a certain somnambulistic position: Victor showed the ability to remain awake during sleep. After awakening, he finds himself unable to remember what he did in the altered state of consciousness, whereas in the latter he remained fully aware of the events that happened to him both in the normal state of consciousness and in the altered state. Puysegur comes to the conclusion that this phenomenon is similar to somnambulism, and calls it “magnetic somnambulism.”
• 1791 - Eberhard Gmelin describes a case of “personality changing” in a 21-year-old German girl. She developed a second personality that spoke in French and claimed to be a French aristocrat. Gmelin saw similarities between such a phenomenon and magnetic sleep and decided that such cases could help in understanding the formation of personality.
• 1816 - The Medical Repository describes the case of Mary Reynolds, who had a "dual personality."
• 1838 - Charles Despina describes a case of dual personality in Estella, an 11-year-old girl.
• 1876 ​​- Eugene Azam describes a case of dual personality in a young French girl whom he called Felide X. He explains the phenomenon of multiple personality using the concept of hypnotic states, which was popular at the time in France.

1880s - 1950s

Introducing the concept of dissociation and that a person can have multiple psychic centers, which arise when the psyche attempts to deal with traumatic experiences.

• 1888 - Doctors of Burro (Bourru) and Bureau (Burrot) publish the book “Personality Variations” (Variations de la personnalité), which describes the case of Louis Vive (Louis Vive) who had six different personalities, each with their own muscle contraction patterns and individual memories. The memories of each individual were strictly tied to a certain period of Louis' life. Doctors used hypnotic regression as a treatment during these periods; they viewed this patient's personalities as successive variations of a single personality. Another researcher, Pierre Janet, introduced the concept of "dissociation" and proposed that these personalities were coexisting psychic centers within the same individual.
• 1899 - Theodore Flournoy's book From India to the Planet Mars: A Case of Somnambulism with Fictitious Languages ​​is published. (Des Indes à la Planète Mars: Etude sur un cas de somnambulisme avec glossolalie).
• 1906 - In Morton Prince's book "Dissociation of Personality" (The Dissociation of a Personality) describes the case of multiple personality patient Clara Norton Fawler, also known as Miss Christine Bechamp. As a treatment, Prince proposed to unite Besham’s two personalities, and repress the third into the subconscious.
• 1908 - Hans Heinz Evers publishes the story "The Death of Baron von Friedel", which was first called "The Second Self". The story talks about the splitting of consciousness into male and female components. Both components take turns taking over the personality and, finally, enter into an irreconcilable dispute. The Baron shot himself, and at the end of the story it says: “It goes without saying that suicide is out of the question here. Most likely it’s like this: he, Baron Jesus Maria von Friedel, shot Baroness Jesus Maria von Friedel; or vice versa - she killed him. I do not know this. I wanted to kill him or her, but not myself, I wanted to kill something else. And so it happened.”
• 1915 - Walter Franklin Prince publishes the story of patient Doris Fisher - "The Case of Doris' Multiple Personality" (The Doris Case of Multiple Personality). Doris Fisher had five personalities. Two years later, they were given a report on the experiments performed with Fisher and her other individuals.
• 1943 - Stengel states that multiple personality disorder no longer occurs.

After 1950s

• 1954 - The Three Faces of Eve, a book based on the story of psychotherapy involving Chris Costner-Sizemore, a patient with multiple personality, is published. The publication of this book raised the interest of the general community in the nature of the phenomenon of multiple personality.
• 1957 - Film adaptation of the book “The Three Faces of Eve” with the participation of Joanne Woodward.
• 1973 - Publication of Flora Schreiber's best-selling book Sybil, which tells the story of Shirley Mason (Sibyl Dorsett in the book).
• 1976 - Television adaptation of "Sibyl" (Sibyl), in leading role— Sally Field.
• 1977 - Chris Costner Sizemore publishes his autobiography, I Am Eve. (I'm Eve) in which she claims that Tipan and Cleckley's book misinterpreted her life story.
• 1980 - Publication of the book Michelle Remembers, co-authored by psychiatrist Lawrence Puzder and Michelle Smith, a patient with multiple personality.
• 1981 Keys publishes The Minds of Billy Milligan, based on extensive interviews with Milligan and his therapist.
• 1981 - Publication of When the Rabbit Howls by Truddy Chase (When Rabbit Howls).
• 1994 - Publication in Japan of Daniel Keyes' second book about Milligan, entitled "Milligan's Wars" (Milligan Wars).
• 1995 - Launch of Astraea's Web, the first online resource dedicated to recognizing multiple personalities as a healthy condition.
• 1998 — Publication of Joan Acocella’s article “Creating Hysteria” (Creating Hysteria) in the New Yorker, which describes the excesses of multiple personality therapy.
• 1999 - Publication of Cameron West’s book “First Person Plural: My Life as Several Lives” (First Person Plural: My Life as a Multiple).
• 2005 - Robert Oxnam's autobiography, The Split Mind, is published. (A Fractured Mind).
• 2007 - Second television adaptation of “Sibyl”.

definition of dissociation

Dissociation is a protective mechanism of the psyche that usually triggers in painful and/or traumatic situations. Dissociation is characterized by disintegration of the ego. Ego integrity can be defined as a person's ability to successfully incorporate external events or social experiences in one's perception and later act in a consistent manner during such events or social situations. A person who is unable to cope successfully with this may experience both emotional dysregulation and a potential collapse of ego integrity. In other words, the state of emotional dysregulation in some cases may be intense enough to force ego disintegration, or what, in extreme cases, is diagnostically termed dissociation.

Dissociation describes a collapse of ego integrity so severe that the personality literally splits. For this reason, dissociations are often called “splitting,” although this term is reserved to designate another mechanism of the psyche. Less profound manifestations of this condition are in many cases clinically described as disorganization or decompensation. The difference between a psychosomatic manifestation and a dissociative manifestation is that although the person experiencing dissonance is formally detached from a situation that he or she cannot control, certain part this person remains connected to reality. While the psychotic “breaks” with reality, the dissociative is disconnected from it, but not completely.

Since a person experiencing dissociation is not completely disconnected from his or her reality, it can, in certain cases, have a large number of “personalities.” In other words, there are different "people" (read personalities) to deal with different situations, but broadly speaking, no personalities are completely switched off.

Controversy about multiple personalities

Until now, the scientific community has not reached a consensus on what is considered multiple personality, since in the history of medicine until the 1950s there were too few substantiated cases of this disorder. In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the name of the condition was changed from “multiple personality disorder” to “dissociative identity disorder” to remove the confusing term “personality.” The same designation was adopted in ICD-9, but in ICD-10 the variant “multiple personality disorder” is used. It should be noted that the media quite often make a serious mistake when they confuse multiple personality disorder with schizophrenia.

A 1944 study of 19th- and 20th-century medical literature on the topic of multiple personality found only 76 cases. In recent years, the number of cases of dissociative identity disorder has increased sharply (according to some sources, about 40,000 cases were reported between 1985 and 1995). But other studies have shown that the disorder does have a long history, stretching back about 300 years in the literature, and affects less than 1% of the population. According to other data, dissociative identity disorder occurs among 1-3% of the general population. Thus, epidemiological data indicate that in the population, dissociative identity disorder is actually as common as schizophrenia.

Dissociation is now viewed as a symptomatic manifestation in response to trauma, critical emotional stress, and is associated with emotional dysregulation and borderline disorder personality. According to a longitudinal study by Ohawa and others, the strongest predictor of dissociation in young adults was lack of access to mother at age 2 years. Many latest research have shown a link between early childhood attachment disturbances and subsequent dissociative symptoms, and the evidence is also clear that childhood abuse and child abandonment quite often contribute to the formation of aroused attachment (which manifests itself, for example, when the child very carefully observes whether the parents' attention is paid to her or not ).

Critical attitude towards the diagnosis

Some psychologists and psychiatrists believe that dissociative identity disorder is iatrogenic or contrived, or argue that cases of true multiple personality are quite rare and most documented cases should be considered iatrogenic.

Critics of the dissociative identity disorder model argue that the diagnosis of multiple personality disorder is a phenomenon more common in English-speaking countries. Until the 1950s, cases of split personality and multiple personality were sometimes reported and treated quite rarely in the Western world. The 1957 publication of the book The Three Faces of Eve and later the release of the film of the same name contributed to the growth of public interest in the phenomenon of multiple personalities. 1973 The book Sybil, which describes the life of a woman with multiple personality disorder, was later filmed. But the diagnosis of multiple personality disorder was not included in the Diagnostic and Statistical Manual of Mental Disorders until 1980. Between the 1980s and 1990s, the number of reported cases of multiple personality disorder increased to between twenty and forty thousand.

Multiple Personality as a Healthy State

Some people, including self-identified multiple personalities, believe that the condition may not be a disorder but a natural variation of human consciousness that has nothing to do with dissociation. One of the staunch supporters of this version is Trudy Chase, author of the bestseller “When Rabbit Howls.” While she admits that her occasional multiple personalities were the result of violence, she also claims that her personalities have refused to be integrated and live together as a collective.

Within depth or archetypal psychology, James Gillman argues against defining multiple personality disorder as a single-category disorder. Gillman supports the idea of ​​all personifications and refuses to acknowledge "multiple personality syndrome." According to his position, to view multiple personality as either a “mental disorder” or a failure to integrate “private selves” is to exhibit a cultural bias that falsely identifies one particular personality, the “I,” with the whole person as such.

intercultural studies

Anthropologists L. K. Suryani and Gordon Jensen are confident that the phenomenon of pronounced trance states in the society of the island of Bali has the same phenomenological nature as the phenomenon of multiple personality in the West. It is argued that people in shamanic cultures who experience multiple personalities define these personalities not as parts of themselves, but as independent souls or spirits. There is no evidence of a relationship between multiple personality, dissociation, and memory retrieval and sexual violence in these cultures. In traditional cultures, plurality, as manifested by shamans for example, cannot be considered a disorder or disease.

Potential Causes of Multiple Personality Disorder

Dissociative identity disorder is believed to be caused by a combination of several factors: intolerable stress, the ability to dissociate (including the ability to separate one's memories, perceptions or identity from consciousness), the manifestation of defense mechanisms in ontogenesis and - during childhood - a lack of care and participation in the child's relationships with a traumatic experience or lack of protection from subsequent unwanted experiences. Children are not born with a sense of a unified identity; the latter develops based on a large number of sources and experiences. In critical situations child development encounters barriers and many parts of what should be integrated into a unified identity remain segregated.

North American studies show that 97-98% of adults with dissociative identity disorder describe situations of violence in childhood and that violence can be documented in 85% of adults and in 95% of children and adolescents with multiple personality disorders and other similar forms of dissociative disorder. These data indicate that childhood abuse is a major cause of the disorder among North American patients, whereas in other cultures the effects of war or natural disaster may play a major role. Some patients may not have experienced violence but have experienced early loss (eg, the death of a parent), serious illness or another extremely stressful event.

Human development requires the child to be able to successfully integrate different types of complex information. In ontogenesis, a person goes through a number of developmental stages, in each of which different personalities can be created. The ability to generate multiple personalities is not observed or manifested in every child exposed to abuse, loss or trauma. Patients with dissociative identity disorder have the ability to easily enter trance states. This ability, in relation to the ability to dissociate, is believed to act as a factor in the development of the disorder. However, most children who exhibit these characteristics also have normal adaptive mechanisms and are not exposed to environments that might cause dissociation.

treatment

The most common approach to treating multiple personality disorder is that alleviating symptoms to ensure the individual's safety and reintegrating different personalities into one identity works well. Treatment can occur using various types psychotherapy - cognitive psychotherapy, family psychotherapy, clinical hypnosis and the like.

Insight-oriented psychodynamic therapy has been used with some success to help overcome trauma, open up conflicts that define needs in individuals, and correct related defense mechanisms. Maybe positive result treatment is to ensure conflict-free cooperative relationships between individuals. The therapist is advised to treat all alters with equal respect, avoiding taking sides in an internal conflict.

Drug therapy does not achieve noticeable success and is exclusively symptomatic; There is no single pharmacological treatment for dissociative identity disorder itself, but some antidepressants are used to relieve comorbid depression and anxiety.

Dissociative identity disorder (multiple personality disorder, multiple personality disorder, organic dissociative identity disorder) is a rare mental disorder in which there is a loss of personal identity and the impression that several different personalities (ego states) exist in one body. .

The personalities existing in a person periodically replace one another, and at the same time, the currently active personality does not remember the events that occurred before the moment of “switching”. Some words, situations or places can serve as a trigger for a change of personality. Changes in personalities are accompanied by somatic disorders.

“Personalities” may differ from each other mental abilities, nationality, temperament, worldview, gender and age.

General information

Split personality syndrome was mentioned in the works of Paracelsus - his notes were preserved about a woman who believed that someone was stealing money from her. However, in fact, the money was spent by her second personality, about whom the woman knew nothing.

In 1791, the Stuttgart city doctor Eberhard Gmelin described a young city woman who, under the influence of the events of the French Revolution (Germany at that time became a refuge for many French aristocrats), acquired a second personality - a Frenchwoman with aristocratic manners, who spoke excellent French, although the first personality (German girl) did not own it.

There are also descriptions of the treatment of such disorders with Chinese drugs.

Split personality is often described in fiction.

The disease was considered extremely rare - until the middle of the 20th century, only 76 cases of split personality were documented.

The existence of multiple personality disorder became known to the general public after research conducted in 1957 by psychiatrists Corbett Thigpen and Hervey Cleckley. The result of their research was the book “The Three Faces of Eve,” which describes in detail the case of their patient, Eva White. The book “Sybil”, published in 1973, also aroused interest in the phenomenon, the heroine of which was diagnosed with “multiple personality disorder.”

After the release and film adaptation of these books, the number of patients suffering from dissociative identity disorder increased (from the 1980s to the 1990s, up to 40 thousand cases were registered), so some scientists consider this disease iatrogenic (caused by influence).

The Diagnostic and Statistical Manual of Mental Disorders has included multiple personality disorder as a diagnosis since 1980.

In some cases, people with multiple personality disorder do not consider the condition a disorder. Thus, the author of the best-selling book “When the Rabbit Howls,” Trudy Chase, refused to integrate her subpersonalities into a single whole, arguing that all her personalities exist as a collective.

Dissociative identity disorder currently accounts for 3% of all mental illnesses. In women, due to mental characteristics, the disease is diagnosed 10 times more often than in men. This dependence on gender may be associated with the difficulty of diagnosing split personality in men.

Reasons for development

The etiology of split personality is currently not fully understood, but the available data speaks in favor of the psychological nature of the disease.

Dissociative identity disorder occurs due to the mechanism of dissociation, under the influence of which thoughts or specific memories of ordinary human consciousness are divided into parts. Divided thoughts expelled into the subconscious spontaneously emerge in consciousness thanks to triggers, which can be events and objects present in the environment during a traumatic event.

For multiple personality disorder to occur, a combination of:

• Unbearable stress or severe and frequent stress.
• Dissociation abilities (a person must be able to separate his own perceptions, memories or identity from consciousness).
• Manifestations in the process of individual development of protective mechanisms of the psyche.
• Traumatic experiences in childhood with a lack of care and attention towards the injured child. A similar picture arises when the child is insufficiently protected from subsequent negative experiences.

A unified identity (the integrity of the self-concept) does not arise at birth; it develops in children through many experiences. Critical situations create an obstacle to the child's development, and as a result, many parts that should be integrated into a relatively unified identity remain separate.

Research by North American scientists has found that 98% of people suffering from multiple personality disorder were victims of violence in childhood (85% have documented evidence of this fact). The remaining group of patients experienced childhood with serious illnesses, death of loved ones and other serious stressful situations. Based on research data, it is assumed that violence experienced in childhood is the main cause of split personality.

A longitudinal study by Ogawa et al. suggests that lack of access to the mother at age 2 is also a predisposing factor for dissociation.

The ability to generate multiple personalities does not appear in all children who have experienced violence, loss, or other serious trauma. Patients suffering from dissociative identity disorder are characterized by the ability to easily enter a trance state. It is the combination of this ability with the ability to dissociate that is considered a factor contributing to the development of the disorder.

Symptoms and signs

Dissociative identity disorder (DID) is the modern name for a disorder that is known to the general public as multiple personality disorder. This is the most severe disorder of the group of dissociative mental disorders, which manifests itself with most of the known dissociative symptoms.

The main dissociative symptoms include:

1. Dissociative (psychogenic) amnesia, in which sudden memory loss is caused by a traumatic situation or stress, and learning new information and consciousness is not impaired (often observed in people who survived military operations or disaster). Memory loss is recognized by the patient. Psychogenic amnesia is more common in young women.
2. Dissociative fugue or dissociative (psychogenic) flight reaction. Manifests itself in the sudden departure of the patient from the workplace or home. In many cases, fugue is accompanied by an affectively narrowed consciousness and subsequent partial or complete loss of memory without awareness of the presence of this amnesia (a person may consider himself a different person, as a result of a stressful experience, behave differently than before the fugue, or may not be aware of what is happening around him).
3. Dissociative identity disorder, as a result of which a person identifies himself with several personalities, each of which dominates him at different times. The dominant personality determines a person's views, behavior, etc. as if this personality is the only one, and the patient himself, during the period of dominance of one of the personalities, does not know about the existence of other personalities and does not remember the original personality. The switch usually happens suddenly.
4. Depersonalization disorder, in which a person periodically or constantly experiences alienation from his own body or mental processes, observing himself as if from the outside. There may be distorted sensations of space and time, the unreality of the surrounding world, and disproportion of limbs.
5. Ganser syndrome (“prison psychosis”), which is expressed in the deliberate demonstration of somatic or mental disorders. Appears as a consequence of the internal need to look sick without the goal of gaining benefit. The behavior that is observed with this syndrome resembles the behavior of patients with schizophrenia. The syndrome includes passing speech (a simple question is answered out of place, but within the topic of the question), episodes of extravagant behavior, inadequacy of emotions, decreased temperature and pain sensitivity, amnesia regarding episodes of the syndrome.
6. A dissociative disorder that manifests itself as trance. Manifests itself in a reduced reaction to external stimuli. Split personality is not the only condition in which trance is observed. A trance state is observed during monotony of movement (pilots, drivers), among mediums, etc., but in children this state usually occurs after injury or physical violence.

Dissociation can also be observed as a result of long-term and intense violent suggestion (processing of the consciousness of hostages, various sects).

Signs of multiple personality disorder also include:

• Derealization, in which the world seems unreal or distant, but there is no depersonalization (no violation of self-perception).
• Dissociative coma, which is characterized by loss of consciousness, a sharp weakening or lack of response to external stimuli, extinction of reflexes, changes in vascular tone, disturbances in pulse and thermoregulation. Stupor (complete immobility and lack of speech (mutism), weakened reactions to irritation) or loss of consciousness not associated with a somatoneurological disease is also possible.
• Emotional lability (sharp mood swings).

Possible anxiety or depression, suicide attempts, panic attacks, phobias, sleep or eating disorders. Sometimes patients experience hallucinations. These symptoms are not directly associated with multiple personality disorder, since they may be a consequence of psychological trauma that caused the disorder.

Diagnostics

Dissociative identity disorder is diagnosed based on four criteria:

1. The patient must have at least two (possibly more) personality states. Each of these individuals must have individual characteristics, character, their own worldview and thinking; they perceive reality differently and differ in behavior in critical situations.
2. These personalities control a person's behavior in turn.
3. The patient has memory lapses; he does not remember important episodes of his life (a wedding, the birth of a child, a course he took at the university, etc.). They appear in the form of phrases “I can’t remember,” but usually the patient attributes this phenomenon to memory problems.
4. The resulting dissociative identity disorder is not associated with acute or chronic alcohol, drug or infectious intoxication.

Split personality needs to be distinguished from role-playing games and fantasies.

Since dissociative symptoms also develop with extremely pronounced manifestations of post-traumatic stress disorder, as well as in disorders associated with the appearance of pain in the area of ​​some organs as a result of an actual mental conflict, split personality must be distinguished from these disorders.

The patient has a “base” personality, which is the owner of the real name, and which is usually unaware of the presence of other personalities in his body, so if the patient is suspected of having chronic dissociative disorder, the therapist needs to explore:

• certain aspects of the patient's past;
• current mental status of the patient.

Interview questions are grouped by topic:

• Amnesia. It is advisable that the patient give examples of “time lapses”, since microdissociative episodes, under certain conditions, also occur in absolutely healthy people. In patients who suffer from chronic dissociation, situations with gaps in time are often observed, the circumstances of amnesia are not associated with monotonous activity or extreme concentration of attention, and there is no secondary benefit (it is present, for example, when reading fascinating literature).

On initial stage When communicating with a psychiatrist, patients do not always admit that they are experiencing such episodes, although every patient has at least one personality who has experienced such failures. If the patient has given convincing examples of the presence of amnesia, it is important to exclude possible connection these situations with the use of drugs or alcohol (the presence of a connection does not exclude split personality, but complicates the diagnosis).

Questions about the presence of things in the patient’s wardrobe (or on herself) that she did not choose help to clarify the situation with time gaps. For men, such “unexpected” objects can be vehicles, tools, weapons. Such experiences may involve people (strangers claiming to know the patient) and relationships (actions and words that the patient knows about from loved ones). If strangers, when addressing the patient, used other names, they need to be clarified, since they may belong to other personalities of the patient.

• Depersonalization/derealization. This symptom is most often found in dissociative identity disorder, but it is also common in schizophrenia, psychotic episodes, depression, or temporal lobe epilepsy. Transient depersonalization is also observed in adolescence and during near-death experiences in situations of severe trauma, so the differential diagnosis must be kept in mind.

It is necessary to clarify with the patient whether he is familiar with the condition in which he observes himself as by a stranger, watching a “movie” about himself. Such experiences are common to half of patients with multiple personality disorder, and usually the observer is the patient's main, base personality. When describing these experiences, patients note that at these moments they feel a loss of control over their actions, look at themselves from some external, located on the side or above, fixed point in space, and see what is happening as if from the depths. These experiences are accompanied by intense fear, and in people who do not suffer from multiple personality disorder and have had similar experiences as a result of near-death experiences, this state is accompanied by a feeling of detachment and peace.

There may also be a feeling of the unreality of someone or something in the surrounding reality, the perception of oneself as dead or mechanical, etc. Since such perceptions manifest themselves in psychotic depression, schizophrenia, phobias and obsessive-compulsive disorder, a broader differential diagnosis is necessary.

• Life experience. Clinical practice shows that people suffering from split personality have certain life situations recur much more often than in people without this disorder.

Typically, patients with multiple personality disorder are accused of pathological lying (especially in childhood and adolescence), denying actions or behavior that other people have observed. The patients themselves are convinced that they are telling the truth. Recording such examples will be useful at the therapy stage, as it will help explain incidents that are incomprehensible to the main personality.

Patients with multiple personality disorder are very sensitive to insincerity and suffer from extensive amnesia, covering certain periods of childhood (the chronological sequence of school years helps to establish this). Normally, a person is able to consistently talk about his life, recalling year after year. People with multiple personality disorder often experience sharp fluctuations in school performance, as well as significant gaps in the chain of memories.

Often, in response to external stimuli, a flashback state occurs, in which memories and images, nightmares and dream-like memories involuntarily invade consciousness (flashback is also included in the clinical picture of PTSD). Flashback calls severe anxiety and negation ( defensive reaction main personality).

There are also intrusive images associated with the primary trauma, and uncertainty about the reality of some memories.

It is also typical to manifest certain knowledge or skills that surprise the patient, since he does not remember when he acquired them (sudden loss is also possible).

• The main symptoms of K. Schneider. Patients with multiple personality disorder may “hear” aggressive or supportive voices arguing in their head, commenting on the patient's thoughts and actions. Phenomena may be observed passive influence(often this is an automatic letter). By the time of diagnosis, the main personality often has experience communicating with his alternating personalities, but interprets this communication as a conversation with himself.

When assessing the current mental status, attention is paid to:

• appearance (can change radically from session to session, up to sudden changes in habits);
• speech (timbre changes, lexicon etc.);
• motor skills (tics, convulsions, trembling of the eyelids, grimaces and reactions of the orientation reflex often accompany a change in personalities);
• thinking processes that are often characterized by illogicality, inconsistency and strange associations;
• the presence or absence of hallucinations;
• intelligence, which generally remains intact (only long-term memory reveals mosaic deficits);
• prudence (the degree of adequacy of judgments and behavior can change dramatically from adult behavior to child behavior).

Patients typically present with a marked learning disability based on past experiences.

EEG and MRI are also performed to exclude the presence of organic brain damage.

Treatment

Dissociative identity disorder is a disorder that requires the help of a psychotherapist experienced in treating dissociative disorders.

The main areas of treatment are:

• relief of symptoms;
• the reintegration of the various personalities that exist within a person into one well-functioning identity.

For treatment use:

• Cognitive psychotherapy, which is aimed at changing thinking patterns and inappropriate thoughts and beliefs using the methods of structured training, experimentation, and mental and behavioral training.
• Family therapy aimed at teaching the family how to interact in order to reduce the dysfunctional impact of the disorder on all family members.
• Clinical hypnosis to help patients achieve integration, relieve symptoms and promote change in the patient's character. Multiple personality disorder should be treated with hypnosis with caution because hypnosis can trigger multiple personalities. Works by multiple personality disorder treatment specialists Ellison, Caul, Brown, and Kluft describe cases of hypnosis being used to relieve symptoms, strengthen the ego, reduce anxiety, and create rapport (contact with the hypnotist).

Insight-oriented psychodynamic therapy is relatively successfully used to help overcome trauma received in childhood, revealing internal conflicts, which determines a person’s need for certain individuals and corrects certain defense mechanisms.

The treating therapist must treat all of the patient's personalities with equal respect and not take any one side in the patient's internal conflict.

Drug treatment is aimed solely at eliminating symptoms (anxiety, depression, etc.), since there are no medications to eliminate split personality.

With the help of a psychotherapist, patients quickly get rid of dissociative escape and dissociative amnesia, but sometimes amnesia acquires chronic form. Depersonalization and other symptoms of the disorder are usually chronic.

In general, all patients can be divided into groups:

• The first group is characterized by the presence of predominantly dissociative symptoms and post-traumatic symptoms, general functionality is not impaired, thanks to treatment they recover completely.
• The second group is characterized by a combination of dissociative symptoms and mood disorders, eating behavior etc. Treatment is more difficult for patients to tolerate, it is less successful and takes longer.
• The third group, in addition to the presence of dissociative symptoms, differs pronounced signs other mental disorders, so long-term treatment is aimed not so much at achieving integration, but at establishing control over symptoms.

Prevention

Dissociative identity disorder is a mental illness, so there are no standard preventive measures for this disorder.

Since child abuse is considered the main cause of this disorder, many international organizations are currently working to identify and eliminate such abuse.

To prevent dissociative disorder, it is necessary timely appeal to a specialist if a child has psychological trauma or experiences severe stress.

Psychological illnesses are among the most complex; they are often difficult to treat and, in some cases, remain with a person forever. Split personality or dissociative syndrome belongs to this group of diseases; it has similar symptoms to schizophrenia; identity disturbances become signs of this pathology. The condition has its own characteristics that are not known to everyone, so this disease can be misinterpreted.

What is split personality

This is a mental phenomenon that is expressed in the presence of two or more personalities in the patient, which replace each other with a certain periodicity or exist simultaneously. For patients faced with this problem, doctors diagnose “personality dissociation,” which is as close as possible to split personality. This general description pathology, there are subtypes of this condition, which are characterized by certain features.

Dissociative disorder - concept and manifestation factors

This is a whole group of psychological disorders that have characteristic features violations psychological functions that are characteristic of humans. Dissociative identity disorder affects memory, awareness of the personality factor, and behavior. All functions affected. As a rule, they are integrated and are part of the psyche, but when dissociated, some streams separate from consciousness, gaining a certain independence. This may manifest itself in the following moments:

• loss of identity;
• loss of access to some memories;
• the emergence of a new “I”.

Features of behavior

A patient with this diagnosis will have an extremely unbalanced character, will often lose touch with reality, and will not always be aware of what is happening around him. A dual personality is characterized by large and short memory lapses. TO typical manifestations pathology includes the following symptoms:

• frequent and severe sweating;
• insomnia;
• severe headaches;
• impaired ability to think logically;
• inability to recognize one's condition;
• mobility of mood, a person first enjoys life, laughs, and after a few minutes he will sit in the corner and cry;
• conflicting feelings towards everything around you and yourself.

Reasons

Mental disorders This type can manifest itself in several forms: mild, moderate, complex. Psychologists have developed a special test that helps identify the signs and causes that caused split personality. There are also common factors that provoked the disease:

• the influence of other family members who have their own dissociative disorders;
• hereditary predisposition;
• childhood memories of a mentally or sexually abusive relationship;
• lack of support from loved ones in situations of severe emotional stress.

Symptoms of the disease

Identity disorder in some cases has symptoms similar to other mental illnesses. You can suspect a split personality if there is a whole group of signs, which include the following options:

• patient's imbalance - sudden mood swings, inadequate reaction to what is happening around;
• the appearance of one or several new hypostases within oneself - a person calls himself by different names, behavior is radically different (modest and aggressive personalities), does not remember what he did at the moment of dominance of the second “I”.
• loss of connection with the environment – ​​inadequate reaction to reality, hallucinations;
• speech disorder – stuttering, long pauses between words, slurred speech;
• memory impairment - short-term or extensive lapses;
• the ability to connect thoughts into a logical chain is lost;
• inconsistency, lack of coordination of actions;
• sudden, noticeable mood swings;
• insomnia;
• profuse sweating;
• severe headaches.

Auditory hallucinations

One of the common abnormalities in the disorder, which may be independent symptom or one of several. Impaired functioning human brain create false auditory signals, which the patient perceives as speech that does not have a sound source, sounds inside his head. Often these voices tell you what needs to be done, the only way to drown them out is medications.

Depersonalization and derealization

This deviation is characterized by a constant or periodic feeling of alienation from one’s own body, mental processes, as if the person is an outside observer of everything that is happening. These sensations can be compared with those that many people experience in their sleep, when a distortion of the sensation of temporal and spatial barriers and disproportionality of limbs occurs. Derealization consists of a feeling of unreality of the world around, some patients say that they are a robot, often accompanied by depression, anxiety states.

Trance-like states

This form is characterized by a simultaneous disorder of consciousness and a decrease in the ability to adequately and modernly respond to stimuli from the outside world. The trance state can be observed in mediums who use it for spiritualistic seances and in pilots who perform long flights at high speed and with monotonous movements, monotonous impressions (the sky and clouds).

In children, this condition manifests itself as a result of physical trauma or violence. The peculiarity of this form is possession, which is found in some regions and cultures. For example, amok - among the Malays this condition manifests itself sudden attack rage followed by amnesia. A man runs and destroys everything that gets in his way, he continues until he injures himself or dies. The Eskimos call the same condition piblokto: the patient tears off his clothes, screams, imitates animal sounds, after which amnesia sets in.

Changing your sense of self

The patient completely or partially experiences alienation from his own body; on the mental side, it can be expressed by a feeling of being observed from the outside. The condition is very similar to derealization, in which mental and time barriers are broken and a person loses the sense of the reality of what is happening around. A person may experience false feelings of hunger, anxiety, or the size of his own body.

In children

Children are also susceptible to personality splitting; it occurs in a somewhat unique way. The child will still respond to the name given by the parents, but at the same time there will be signs of the presence of other “I”s, which partially take over his consciousness. The following manifestations of pathology are typical for children:

• different manner of speaking;
• amnesia;
• food preferences are constantly changing;
• amnesia;
• mood lability;
• self-talk;
• glassy gaze and aggressiveness;
• inability to explain one's actions.

How to Recognize Dissociative Identity Disorder

This condition can only be diagnosed by a specialist who evaluates the patient according to certain criteria. The main task is to exclude herpes infection and tumor processes in the brain, epilepsy, schizophrenia, amnesia due to physical or psychological trauma, and mental fatigue. A doctor can recognize mental illness by the following signs:

• the patient shows signs of two or more personalities that have an individual attitude towards the world as a whole and certain situations;
• the person is unable to remember important personal information;
• the disorder does not occur under the influence of drugs, alcohol, toxic substances.

Criteria for split consciousness

There are a number of common symptoms that indicate the development of this form of pathology. These symptoms include memory lapses, events that cannot be logically explained and indicate the development of another personality, alienation from one’s own body, derealization and depersonalization. All this happens when many personalities coexist in one person. The doctor must take an anamnesis, conduct conversations with the alter ego, and observe the patient’s behavior. The following factors are indicated in the reference book as criteria for determining split consciousness:

• in a person there are several alter egos that have their own attitude towards to the outside world, thinking, perception;
• capture of consciousness by another person, change in behavior;
• the patient cannot remember himself important information, which is difficult to explain by simple forgetfulness;
• all of the above symptoms were not a consequence of drug use, alcohol intoxication, exposure to toxic substances, other diseases (complex seizures of epilepsy).

Differential analysis

This concept means the exclusion of other pathological conditions that can cause symptoms similar to the manifestation of split consciousness. If studies show signs of the following pathologies, then the diagnosis cannot be confirmed:

• delirium;
• infectious diseases (herpes);
• brain tumors that affect the temporal lobe;
• schizophrenia;
• amnestic syndrome;
• disorders due to the use of psychoactive substances;
• mental fatigue;
• temporal lobe epilepsy;
• dementia;
• bipolar disorder;
• somatoform disorders;
• post-traumatic amnesia;
• simulation of the state under consideration.

How to exclude the diagnosis of “organic brain damage”

This is one of the mandatory stages of differential analysis, because the pathology has many similar symptoms. A person is sent for testing based on the medical history collected by the doctor. The examination is carried out by a neurologist who will give directions for the following tests:

• CT scan– helps to obtain information about the functional state of the brain, allows you to detect structural changes;
• neurosonography - used to identify tumors in the brain, helps to examine the cerebrospinal fluid spaces;
• rheoencephalogram - examination of cerebral vessels;
• ultrasonography brain cavities;
• MRI – performed to detect structural changes in brain tissue, nerve fibers, vessels, stage of pathology, degree of damage.

How to treat split personality

The treatment process for patients is usually complex and lengthy. In most cases, observation is required for the rest of the person's life. You can get a positive and desired result from treatment only if correct intake medicines. Drugs and dosages should be prescribed exclusively by a doctor based on studies and tests. Modern schemes Treatments include these types of drugs:

• antidepressants;
• tranquilizers;
• neuroleptics.

In addition to medications, other methods of therapy are used that are aimed at solving the problems of split consciousness. Not all of them have a quick effect, but are part of a comprehensive treatment:

• electroconvulsive therapy;
• psychotherapy, which can only be carried out by doctors who have completed specialized additional practice after graduation medical institute;
• the use of hypnosis is allowed;
• Part of the responsibility for treatment falls on the shoulders of others; they should not talk to a person as if they were sick.

Psychotherapeutic treatment

Dissociative disorder requires psychotherapy. It should be carried out by specialists who have experience in this field and have undergone additional training. This direction is used to achieve two main goals:

• relief of symptoms;
• the reintegration of all of a person's alter egos into one fully functioning identity.

To achieve these goals, two main methods are used:

1. Cognitive psychotherapy. The doctor’s work is aimed at correcting stereotypes of thinking, inappropriate thoughts through persuasion, structured training, behavioral training, mental state, and experiment.
2. Family psychotherapy. Consists of working with the family to optimize their interactions with the individual in order to reduce the dysfunctional impact on all members.

Electroconvulsive therapy

The treatment method was first used in the 30s of the 20th century, when the doctrine of schizophrenia was actively developing. The basis for the use of this treatment technique was the idea that the brain cannot produce localized bursts of electrical potentials, so they must be created in artificial conditions, which will help achieve remission. The procedure is performed as follows:

1. 2 electrodes were attached to the patient's head.
2. A voltage of 70-120 V was supplied through them.
3. The device released current for a fraction of a second, which was enough to affect the human brain.
4. The manipulation was carried out 2-3 times a week for 2-3 months.

This method has not taken root as a treatment for schizophrenia, but it can be used in the field of therapy for multiple splits of consciousness. For the body, the degree of risk from the technique is reduced due to constant monitoring by doctors, anesthesia, and muscle relaxation. This helps to avoid everyone discomfort, which could arise during the creation of nerve impulses in the substance of the brain.

Application of hypnosis

People experiencing multiple splits of consciousness are not always aware of the presence of other alter egos. Clinical hypnosis helps the patient achieve integration in order to alleviate the manifestations of the disease, which helps to change the patient’s character. This approach is very different from conventional treatments because the hypnotic state itself can trigger the appearance of multiple personalities. The practice is aimed at achieving the following goals:

• ego strengthening;
• relief of symptoms;
• reduction of anxiety;
• creating rapport (contact with the conductor of hypnosis).

How to treat multiple personality syndrome

The basis of therapy is medications that are aimed at alleviating symptoms and restoring the full functioning of a person as an individual. The course is selected, the dosage is only by a doctor, a severe form of bifurcation requires more strong drugs than easy. Three groups of medications are used for this:

• neuroleptics;
• antidepressants;
• tranquilizers.

Neuroleptics

This group of drugs is used for the treatment of schizophrenia, but if a split personality develops, they can also be prescribed to eliminate a manic state, delusional disorders. The following options can be assigned:

1. Haloperedol. This is a pharmaceutical name, so this medicinal substance can be included in various medications. Used to suppress delusional and manic states. Contraindicated in patients with disorders of the central nervous system, angina pectoris, liver dysfunction, kidney dysfunction, epilepsy, active alcoholism.
2. Azaleptin. It has a powerful effect and belongs to the group of atypical neuroleptics. It is used more to suppress feelings of anxiety, strong arousal, and has a strong hypnotic effect.
3. Sonapax. It is used for the same purposes as the means described above: suppressing feelings of anxiety, manic state, delusional ideas.

Antidepressant

Often, split personality occurs due to a psychogenic reaction to the loss of a loved one; in a child this often occurs against the background of lack of parental attention and in early childhood this does not manifest itself, but in adulthood it leads to psychiatry. Dissociative experience manifests itself as a consequence of a prolonged depressed state and severe stress. To treat such causes, the doctor prescribes a course of antidepressants to eliminate all symptoms of depression and apathy towards planning one’s future. The following drugs are prescribed:

• Prozac;
• Porgal;
• Fluoxetine.

Tranquilizers

These drugs are strictly prohibited from being used independently without a doctor's prescription. These potent drugs can cause significant harm to health and worsen the patient’s situation. Doctor after general examination may prescribe these medications to achieve an anxiolytic effect. You should not take tranquilizers if you are suicidal or protracted depressions. In medical practice, multiple personality disorder is usually treated with Clonazepam.

Video

Many of us sometimes feel a slight dissociation, for example, in the process of working on a project, when a person seems to go into a state of half-asleep, ceases to sense time and at the same time is strongly focused on something. Multiple personality disorder or multiple personality syndrome is a similar condition only in a very severe form.

Such severe dissociation creates psychological process, which confuses thoughts, separates one from another, mixes up memories, feelings, and some specific actions.

Why does split personality occur?

Psychologists suggest that the disorder is directly related to the shock, which gave rise to the development of this process. It is believed that dissociation is a protective mechanism of the psyche that separates the person himself from an unpleasant situation or actions (pain, psychological trauma) that were committed against him.

Multiple personality disorder can arise due to severe psychological shock in childhood and adolescence. As a result of regular psychological, physical or sexual abuse.

How real is split personality?

A person without appropriate medical education may not believe this. psychological disorder, because even specialists sometimes find it difficult to figure out whether a patient has split personality or not. But, unfortunately, such a concept as split personality exists and it is not a myth.

Similar to this species mental illness described in textbooks on psychiatry. Such diseases include amnesia and the flight reaction.

How to determine the disease?

This type of disorder is characterized by the appearance of two or even more different personalities in one person. Sometimes one of these personalities declares itself to be in charge and completely controls the person and his behavior. The person suffering from the disorder is unable to remember any key, important information about himself at such a level that this cannot be attributed to simply poor memory or absent-mindedness. Additionally, other memory problems can be diagnosed.

Other personalities in a person’s split consciousness may have different genders, ages, and show belonging to one or another race. Each of these individuals manifests their own character, manner of conversation, behavior, gestures, it seems even their voice changes. There are times when one of a person's personalities suggests that she is some kind of animal.

Switching between these personalities can occur from a few minutes to several days. In this case, a person’s thoughts and behavior will depend solely on which personality is in charge today. If a doctor puts a patient who suffers from a split personality into a state of hypnosis, he can conduct a conversation with any of the personalities, usually they easily make contact.

Are there other manifestations of split personality?

In addition to the above manifestations, a number of accompanying symptoms such as:

• depression;
• rapid change of mood;
• predisposition to suicidal behavior and thoughts;
• insomnia and nightmares;
• a state of increased anxiety, panic (the patient sees or hears something incomprehensible that awakens traumatic memories in his imagination);
• drug and alcohol addiction;
• rituals or compulsions (a person feels that it is necessary to perform certain actions in a certain order and a certain number of times);
• psychotic manifestations - auditory or visual;
• eating disorders (obesity, anorexia or).

Also, along with these symptoms, there may be amnesia, time lapses, a trance state, headaches, a feeling that a person is not in his body, but outside of it. It happens that patients say that they seem to wake up and find themselves in the act of performing some action that they would never have done on their own.

For example, drunk driving at high speed, theft and other unpleasant actions that are usually not characteristic of this person. Patients also claim that at the moment of this action they cannot do anything, stop, as if they do not control their body and thoughts.

Sufferers of the disorder claim that they feel like passengers in their own body, and not drivers. At the same time, patients cannot do anything about it.

How is split personality different from?

These two concepts are often confused in psychiatry, although they have significant differences.

A person who has schizophrenia sees and hears unreal objects and sounds. Such a patient is in a state of delusional obsessions and hallucinations, which he considers real. Patients with schizophrenia do not have many different personalities. Although suicidal tendencies can manifest themselves in both types of disorders.

Is it possible to cure a person with split personality?

To date, there are no specific drugs to treat this disorder. Each time, the method of combating the disease is selected individually. If a person fully undertakes to follow all the doctor’s instructions, then after a long period of treatment, the person begins to feel much better or recover.

For treatment to be effective, it is carried out comprehensively and includes: psychotherapy, medications, hypnosis, social rehabilitation and movement therapy.