Today I will discuss dissociative identity disorder (DID) (better known as multiple personality disorder (MPD)). Also, I’ll talk about DID in popular culture and particularly in the movies Fight Club and Sybil, and I will unfortunately have to spoil parts of those movies.
Let’s discuss semantics first. Why is this disorder called DID, while it is better known as MPD?
In the world of psychiatry, there are two most used manuals: the DSM published by the American Psychiatric Association (which I have been taught to use) and the ICD, published by the World Health Organization. The current edition of the DSM that is now used is the fourth (the APA has been working on a fifth edition for over a decade – it is due to be published in 2013). The two manuals agree about most symptoms, it’s just that they use a different term for the same disorder. It needs to be said, however, that in the third edition of the DSM, the disorder was called MPD as well. The reason for the transition isn’t mentioned anywhere, particularly, but my guess is that in the APA’s collective opinion, DID covered the disorder better than MPD.
DSM: The symptoms
As per the Diagnostic and Statistical Manual of Mental Disorders (IV):
- A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
- B. At least two of these identities or personality states recurrently take control of the person’s behavior.
- C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
- D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.
For the DSM V, the description of the disorder has changed slightly. You can read more about it here.
More concrete symptoms can include severe memory loss, depersonalization, multiple mannerisms, attitudes, and beliefs that are not similar to each other, depression, sudden anger without cause, unexplainable phobias and panic attacks, paranoia, and many more. Because of the wide array of symptoms, sufferers of DID are often misdiagnosed with eating or mood disorders, schizophrenia, personality disorders or PTSD.
DID in popular culture
It is amazing how often DID is used in stories. Perhaps it’s because it usually makes for such awesome plot twists. Just a few examples are Lord of the Rings (Smeagól/ Gollum), the movie Me, Myself & Irene (Charlie/Hank), the movie Mr. Brooks (Earl/Marshall) and the movie Secret Window (based on the Stephen King novella – Mort/Shooter). These are examples of characters that really suffer from the DI disorder, whereas in many other movies, the characters have something based on it. The movie Fight Club (based on Chuch Palahniuk’s novel) and the movie Sybil (based on the novel by Flora Rheta Schreiber), are another two great examples, which I will discuss further.
DID in Fight Club
“Welcome to Fight Club. The first rule of Fight Club is: you do not talk about Fight Club.”
In Fight Club, you have two main characters, “The Narrator”, played by Edward Norton and Tyler Durden, played by Brad Pitt. The two build an organization called “Fight Club”. This club is all about venting aggression, as men can beat each other up without consequences (except for the blood and the bruises, of course). Tyler Durden is everything The Narrator ever wanted to be: cool, witty, successful with the girls, and very independent. They become very close, and are rarely separated.
At the end of the movie, The Narrator finds out he actually is Tyler Durden.
What is noteworthy in this film is that The Narrator sees Tyler as a separate person (this is the case in both Secret Window and Mr. Brooks, too). A person with DID does not see their other personality, but are them completely, and forget about having been that person entirely, when they shift back to their original personality (or another personality, but I’ll come back to that later). In Fight Club, The Narrator would not be aware of Tyler Durden altogether, if the story were based on true facts.
DID in Sybil
Sybil is one of the movies (I have not read the book, unfortunately) that is pretty much spot on about the disorder. Sybil has multiple alter egos. She has, in total, 12 different personalities, among which two boys. They all have their own personality traits and are all extremely different from Sybil herself.
Sybil’s disorder was caused by severe physical (and sexual) abuse she suffered from her mother, and, as is often seen in people with DID, forming multiple personalities is an escape mechanism. In fact, most individuals diagnosed with DID report that they have been severely abused in their childhood.
More than two personalities
As I mentioned, Sybil has more than one different personality, whereas in other movies, you often see a character has only one other personality (such as Earl in Mr. Brooks, Smeagól in LotR, etc). Two years ago, I went to a symposium about DID, and a clinical psychologist specialized in DID spoke. She had a patient who had 26 different personalities, and she was not aware of them. She had two children, and the psychologist feared she could not take care of them properly because she was so instable, but whenever the patient was with her children, her personality “the mother”, would come forth. This personality was loving and caring, and took care of the children perfectly. She had other personalities, however, that were hostile. Interestingly, many of these characters were aware that they were not the “original” personality and spoke about the “original” as if it were a friend (or not).
This is what you see in Sybil, as well. For instance, a personality of Sybil’s, called “Vanessa”, helps Sybil pursue her romantical interests, “Peggy” is a child that cries a lot because of Sybil’s fears, and “Marsha” wants to kill Sybil. You could say Sybil had unconsciously compartmentalized her own personality. Sybil herself reported “blackouts” whenever any of her other personalities took hold of her.
Treatment and prognosis
DID is treatable. As DID is usually caused by traumatic experiences, the patients often have to go through intensive behavioral therapy, after which they (can) recover. However, frequently other disorders are seen in persons with DID (such as mood, sleep and eating disorders), and if those are not treated properly and separately, the road to recovery is usually much slower and complicated. Individuals that face the poorest prognosis are those that are still attached to their abuser.
If you have any questions or comments, please feel free to reply!