Dissociative Identity Disorder: The People Inside - Symptoms of MPD

Written by Edward Dolnick

"I once treated a man who in almost all his personalities, except one called Tommy, was allergic to citric acid." recalls Bennett Braun of Rush-Presbyterian-St. Luke's Medical Center in Chicago. "If Tommy drank orange or grapefruit juice and stayed 'out' for a couple of hours, there would be no

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allergic reaction. But if Tommy drank the juice and went 'in' five minutes later the other personalities would break out in itching and fluid-filled blisters. And if Tommy came back, the itching went away, though the blisters remained."

Some researchers have tried to verify such differences with controlled experiments. Scott Miller, a psychologist in Cathedral City, California, has just completed a careful, but limited, study of vision in multiple personalities. Miller recruited nine patients who were able to switch to any of three alternate personalities at will. His control group, nine normal volunteers, was sown the movie Sybil as well as videotapes of actual patients switching personalities, and told to fake the disorder.

An ophthalmologist, not told who was who, gave all 18 a standard eye exam. He held up different lenses, and each subject eventually settled on the best correction. Then the ophthalmologist left the room, the patient switched personality (or the faker faker pretended to), and the doctor returned to administer new tests.

When the real patients switched from one personality to another, they showed marked and consistent changes in vision. The fakers did not. Other findings were even more curious. One multiple had a four-year-old personality with a "lazy eye" an inward-turning eye. The problem is common in childhood and usually outgrown. The same women's 17 and 35-year-old personalities revealed no sign of the lazy eye, not even the residual muscle imbalances that one might expect. But Miller acknowledges that his findings are not airtight. He chose subjective measurements ("Is this better, or this?"), for example, rather than objective ones such as the curve of the cornea.

Putnam believes these physical differences may not be so inexplicable as they seem. "People look at the brain scans of multiples' personalities and say, 'See, they are so different they're like different people,'" he says. He draws a long, exasperated breath. "It's not true. They're not different people- they're the same person in different behavioral states. What makes multiples different is that they move between states so suddenly. Normal people might show similar abrupt physiological shifts, if you could catch them at the right times. "An example: You're calmly listening to your car stereo when a tractor trailer cuts in front of you on the freeway; you slam on your brakes and your blood pressure and adrenaline skyrocket.

But why all the personalities? "Their basic coping strategy has been 'divide and conquer,'" Putnam says. "They cope with the pain and horror of the abuse they suffered by dividing it up into little pieces and storing it in such a way that it's hard to put back together and hard to remember."

Multiple personality disorder is an extreme form of what psychiatrists call dissociation. The term refers to a kind of "spacing out," a failure to incorporate experiences into one's consciousness. At one end of the spectrum are experiences as common and innocuous as daydreaming or "highway hypnosis," where you arrive home from work with only the vaguest memory of making the drive. At the other extreme lie multiple personality and amnesia.

Dissociation is a well-known reaction to trauma. In memoirs recalling his experiences as a prisoner in Dachau and Buchenwald, for example, the psychologist Bruno Bettelheim wrote of his and his companions' reaction after being forced to stand outdoors through a night so cold that 20 men dies. "The prisoners did not care whether the SS shot them: they were indifferent to acts of torture.... It was as if what was happening did not 'really' happen to oneself. There was a split between the 'me' to whom it happened, and the 'me' who really did not care and was just a vaguely interested, but essentially detached, observer."

In multiple personality cases, the trauma is most often child abuse of a sort that is far more sadistic and bizarre than usual. Some children exposed to overwhelming violence in wartime have also developed multiple personalities. Cornelia Wilbur, the psychiatrist who treated Sybil, reported one case, for example, where a man buried his nine-year-old stepson alive, with a stovepipe over his face so he could breathe. The man then urinated through the pipe onto the boy's face.

According to Julia's therapist Anne Riley, both Julia's mother and father, and a brother, abused her physically and sexually for many years. Riley doesn't go into details. "I don't consider that I've led a sheltered life - for six years I was a Washington, D.C. cop, specializing in child abuse - but I had no inkling that anything like this existed."

Age is a key to multiple personality. The trauma at its roots occurs during a window of vulnerability that extends to about age 12. One proposed explanation of why age makes a difference is that it takes time for infants and children to develop an integrated personality. They have fairly distinct moods and behaviors and make abrupt changes from one to another - a happy baby drops his rattle and instantly begins howling in misery. "We all come into the world with the potential to become multiples," Putnam suggests, "but with hallway reasonable parenting, we learn to smooth the transitions and develop an integrated self. These people don't get a chance to do that."

Another part of Putnam's theory holds that the personalities are outgrowths of the imaginary companions of childhood. Think of the incentive for a trapped and tormented six-year-old to try to foist the pain onto an imaginary companion. The child could tell herself, in effect, "This didn't really happen to me. It happened to her." Then because the abuse occurs again and again, the child may come to depend on these alter egos. In time, the personalities might take on "lives" of their own.