What's In A Name?

Recently, with the publishing of the current edition of the Diagnostician's Manual - DSM IV - this condition underwent an official "name change." Why? What's in a name? Here I hope to help you understand the "politics" involved in this decision.

It took several years of struggling by individual therapists to have Multiple Personality Disorder recognized as a real diagnosis. They were the ones "in the trenches" so to speak.... working with the patients who suffered from this disorder. However, anyone claiming to have patients with two or more personalities had a difficult task convincing those in academia that such was possible.

This conflict of views between those therapists dealing daily with dissociated patients (some exhibiting dozens of alter-personalities, or "alters") and academic teachers who spent more of their days teaching and doing research than actually treating severely ill patients, came to a boil with the need to revise DSM III.

"DSM III had recognized MPD as existing, gave it a code number, and defined its characteristics. Then the backlash began. There had always been doubters that such a disease really existed. And now, even though the field of "Dissociative Disorders" had its own section, a committee of experts was appointed to decide what disorders should be listed in the DSM IV.

The committee was composed of two groups, psychiatrists whose primary role was as therapists and those whose primary roles were teaching and research. The therapists wanted to keep MPD much as it was in DSM III. The teachers wanted to eliminate MPD altogether, and replace it with "Dissociative Identity Disorder" or DID. Their belief was that "Everybody is born with only one personality. Therefore, there can be no such thing as a Multiple Personality Disorder."

With this belief system, the teachers could not agree that MPD could be an accurate label for anyone. The treaters on the committee did not know how to explain that, in practice if not in theory, their patients acted as if they had other personalities. The teachers decided that the patients had the major mental problem of believing that they had more than one personality. The goal of therapy should not be integrating the various personalities, but getting the patients over their false belief (delusion) that they had other personalities at all.

So the patients still had a problem, but it was redefined as a different problem than the one their therapists were treating them for. Instead of therapists trying to integrate "alters" into an original personality, they should now focus their attention on the patients "delusion" that they did not have a single identity. Now the teachers expected the treaters to treat the patients' "identity disorder," as no one could really have multiple personalities."

When the decision was published the teachers had won, and MPD suddenly ceased to exist. Now all multiples had Dissociative Identity Disorder or DID.

However, the editors of the ICD (International Code of Diseases) did not accept the DSM IV definition for their section on Mental Disorders. In the newest printing of ICD-9, they did add "Dissociative Identity Disorder" below MPD as a synonym. So, in the world outside the USA, MPD still exists. Only in the USA have all multiples been told they have a false belief that they have alters running their bodies.

Dr. Ralph B. Allison of Dissociation.Com - All About MPDfurther explains.....

"But I know that, in the case of MPD, the patient's Original Personality (yes, teachers, the only one they have) goes "into hiding" at the time of a life threatening assault before the age of seven. Therefore, there is "no one home" to have the Disorder of Identity. The Original Personality is the only one capable of having such a "false belief," but she is not in executive control of the body or participating in social life at all. But the ISH I had met in my MPD patients had created all sorts of alters to run the body in the absence of the Original Personality. Therefore, I could not honestly give up the accurate label of MPD and substitute an inaccurate label of DID.

But, I had met other dissociating patients who were of the "dual personality" type. They had never shown an ISH, and they manifested far fewer alters. So, personally, I came to realize that both MPD and DID can be considered accurate labels, but for two different groups of dissociators.

Here is how I now use these acronyms in my writings: The key differentiating criteria is the age of the first dissociation, with the seventh birthday being the approximate cut-off point for MPD, and the earliest date for DID to appear. This is the age the child's mind must mature to so that it can "hold it all together" when severely traumatized. After age seven, it may dissociate and form alters, but it will not dissociate into its two component parts, the Intellectual Self (ISH/Essence) and the Emotional Self (Original Personality). "

Ok, now I know this is starting to get complicated, but let's see if this will help.....

"In TV "literature," the same story is repeatedly played out by "Mr. Spock" on the original Star Trek series. Leonard Nemoy played the role of the Intellectual Self very well. He sounds close to the way the ISHs talked to me when I was doing therapy with multiples. In "Star Trek, The Next Generation," Lt. Cmd. Data, an "android," plays the same role. In one show, he shows what happens when emotions are added to his brain with the insertion of a new chip, which makes him able to emote for the first time. "

To read more about the differences between the Intellectual Self and the Emotional Self, as well as other factors of MPD, please read "Definition of MPD."

DID/MPD

What's In A Name?