Before 1980, when the condition made it into the psychiatrists' handbook, the total number of cases ever reported was about 200: the number of current cases in North America is about 6,000, according to one expert. Does that support the fad theory? Or does it reflect a new awareness that a real disorder was long overlooked, that sometimes what sounds like a horse really is a zebra?

Julia is 33, an articulate, college-educated woman. She is pretty, with delicate features and light brown hair pinned up on top of head. She seems nervous, though no more skittish than many people; this is a woman you would be glad to sit next to on the bus, or chat with in line for a movie.

We met at the office of her therapist, Anne Riley. Julia and I were at either end of a brown corduroy couch, with Riley in a chair in front of us. Julia sat smoking and drinking one Diet Pepsi after another, trying to convey to me some sense of what her days are like.

Listening to her was like reading a novel whose pages had been scattered by the wind and then hastily gathered up - the individual sections were clear and compelling, but chunks were missing and the rest hard to put in order. What was most disorienting was her feeling of not knowing firsthand about her own life. She is continually obliged to play detective.

"Sometimes I can figure out who's been 'out,'" she said. "Obviously, if I find myself curled up in a closet and crying, that's a pretty good indication it's somebody fairly young - but most of the time I just don't know what the hell's been going on. The little ones tend to do things with their hair. Sometimes I have braids or pigtails and I think, 'Patty.' If my hair is cut shorter, I know one of the guys has been out."

She recounted such stories with a kind of gallows humor, but occasionally her tone grew darker. "This gets into scary stuff," she said at one point. "I have some old scars, they've always been there, and I don't know where they came from."

Riley asked for details. "I can remember my father having razor blades," Julia said. "I remember once feeling like I was getting cut, but I'm real detached from it." Her voice had become quieter, slowing and drifting almost to a murmur.

She was silent for a moment and changed posture slightly. It was subtle and far from histrionic - she pulled a bit closer to the edge of the couch, turning slightly from me, drawing her legs under her a bit more closely, and holding both hands to her mouth. Several seconds went by.
"Who's here?" Riley asked.
A tiny voice. "Elizabeth."
"Were you listening?"
"Yeah." Long pause. "We got cut a lot, if that's what you're asking."
"You remember your dad cutting you?"
Julia shifted posture, stretching her legs out toward the coffee table and picking up her cigarettes. "He's not my dad," she spit out venomously. The voice was slightly deeper than Julia's, the tone far more belligerent.
"Who's there? George?" asked the therapist.
"Yeah." George is 33, the same age as Julia, and tough. And male.

"Can you explain what it's like for. George, being a guy?" Riley asked. "Whose body is it?"

"I don't think about it too much. I'm real glad I'm a guy. It somebody messes with me, I can hurt them more than a girl can."

George paused. "he" seemed jumpy. "People (Julia's personalities) are kind of close today. There's lots of us around.

Riley continued asking questions, but in the parade of names and references I lost track of which personality was speaking. Julia was talking in a tiny, childlike voice that I could barely pick up, though I was only three feet from her.

An ambulance in the distance sounded its siren. Julia jumped. "Why are those there?" she asked.

Riley explained, but the noise continued.

They're kind of loud," Julia whined. She seemed almost frantic.

The sirens faded, and Julia became a shade more composed. "You know what I wish?" the tiny voice asked. "I wish people would take better care of children. I don't think mommies and daddies should make 'em take off their clothes and do things. Not even if the children were bad."

"What makes you say you're bad?" Riley asked.

"I am bad. If you don't listen to people who are bigger than you, like moms and dads, that's bad."

"Sometimes you're right not to listen." Riley reassured Julia.

Then something - I'm not sure what - panicked her. She whipped her head toward me, wide-eyed like a cornered doe, and leapt off the couch we'd been sharing. She cowered on the floor in front of the office door, trembling, hands to her mouth. Her nose and cheekbones were beaded with sweat. On her face was a look of terror I'd never seen on anyone before. If this was acting, it was a performance that Meryl Streep would have envied.