Dissociative Identity Disorder (DID): Iatrogenic or Biological Origin?
Maria K. Almoite
The Skeptical Inquirer published Multiple Personality Disorder: Witchcraft Survives in the Twentieth Century authored
by August Peele Jr. (1998)in an effort to examine the history, causes
and the etiology of the disorder. This analysis will explore the
controversy behind the validity of the condition, the skepticism due to
flawed and unsound reasoning, and finally, the logical inconsistencies
of the MPD literature.
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"Split" film by M. Night Shymalan 2017 |
Dissociative Identity
Disorder (DID) formerly known as Multiple Personality Disorder (MPD) is
marked by oppressive memory impairment without a lucid physical or
organic cause. The term dissociation alludes to the disruption in one
or more mental functions that integrates the cornerstone of
consciousness (e.g. establishing and holding memories, and maintaining a
sense of one’s own identity). One study suggests that individuals with
this condition are controlled by at least two or more alters (e.g. subpersonalities, alternates, ego states)
– each encompassing a unique set of memories, behaviors, thoughts, and
emotions (Putnam, 1991). Advocates for this condition claim that
memory failures occur because patients are periodically taken over by
one or more alter personalities. The behavioral disturbances
prominently manifested in dissociative disorders are considered to be
unconscious, or beyond the patient’s awareness and voluntary control.
This ailment is theoretically linked with the interaction of
overwhelming stress, traumatic antecedents, insufficient childhood
nurturing, and an innate ability to dissociate memories or experiences
from consciousness. People diagnosed with DID often report that they
have experienced severe physical and sexual abuse. Nonetheless, others
postulate that the symptoms of DID are created iatrogenically by
therapists using certain treatment techniques with suggestible patients.
Although many theories have been proposed to construe DID, the most
recent viewpoints sparked curiosity and interest in the condition.
The most contemporary viewpoints
integrate cognitive, behavioral and biological principles while
emphasizing two main factors thought to be responsible for the
condition: state-dependent learning and self-hypnosis. State-dependent
learning is a learning technique that becomes associated with the
circumstances under which it transpired to maximize recall ability
under the same conditions. Previous study has shown that
state-dependent learning can be associated with mood states as well
(e.g. material learned during a happy mood is recalled best when the participant is happy again).
One viable cause for state-dependent learning is that arousal levels
play a paramount role in learning and memory. Thus, the different
arousal levels found in DID may generate an entirely diversified groups
of memories, thoughts and abilities (i.e. subpersonalities or alters).
Another method suggested is the self-hypnosis, a process of hypnotizing
oneself for the purpose of forgetting unpleasant events. The two most
colloquial treatments for DID are those of hypnotherapy and
psychodynamic therapy. The psychodynamic therapy approach navigates
patients with this condition to search to their unconsciousness in hope
to bringing forgotten experiences back to consciousness (Loewenstein,
1991). Hypnotic therapy is another approach in which the patient
undergoes hypnosis and is then guided to recall forgotten events.
Although both psychodynamic and hypnotic therapy may seem like a logical
and valid treatment, these may not quite be the case. Both types of
therapy risk implantation of false memories, possibly triggered by
leading questions used by the therapist or the general high-level
arousal.
The author pose queries
which challenge the general MPD literature originally proposed. First,
how do we differentiate those individuals professing that their
behavior was overpowered by one’s alters from those who attempt to
avoid legal sanctions? Second, how can we legitimize the claims of the
adherents for the condition when MPD practitioners are supposedly and
accurately keep track of about fifteen up to 4, 500 alters without
enough empirical evidence to support their claim (Peele, 1998:46-47)?
The considerable
dispute over DID is predominantly due to lack of empirical evidence and
verifiable mood. The dissociation is primarily subjective for both the
patient and the treatment provider. While other disorders which are
more readily accepted, have more objective or testable symptoms. Assuredly, the
DSM-IV-TR attempts to decipher every possible condition and disorder the
best way possible. Notwithstanding, it’s inevitable to encounter a
flaw in any diagnostic classifications. The significance of discussing
the pitfalls of this disorder isn’t to simply nullify its existence –
rather, it is to raise concerns and skepticism towards the disorder and
encourage a more empirically supported standpoint, especially for
future classifications or diagnosis.
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