The movie, Split, is a 2016 American psychological horror film starring James McAvoy. In the film, he plays a man with 23 different personalities who kidnaps three teenage girls and torments them in an underground facility.
Although the movie has been criticized by mental health groups due to how it stigmatizes the mental disorder, it is a near description of what it means to have a dissociative personality disorder.
Dissociative identity disorder (DID), formerly known as multiple personality disorder, is a mental illness in which at least two distinct and enduring personality states are maintained. This is often accompanied by gaps in memory with no explanation.
These personalities can be observed in the person’s behavior, although they can vary in intensity and presentation. Other associated problems of dissociative personality disorder include substance abuse, anxiety, self-harm, borderline personality disorder, and post-traumatic stress disorder.
Mental health professionals attribute childhood trauma to be the root cause of dissociative identity disorder. It could also occur as a result of traumatic life problems like war or childhood health problems. Genetics is also believed to play a vital role in the development of the mental illness.
Treatment of dissociative identity disorder often involves counseling and care and support from family members. Women are six times more than men to be diagnosed with the disease. It is believed to affect a relatively small number of people in Europe and the US.
Dissociative identity disorder is very popular in pop culture. Several works of art, including films and books, have used it as a subject matter. It is also a source of controversy in the legal system where it has been used as a form of the insanity defense.
Symptoms of the illness may vary in different parts of the world, depending on how it is portrayed in the media.
Causes and Risk Factors of Dissociative Identity Disorder
Studies have shown that DID likely occurs as a result of developmental trauma. It is a psychological response to overwhelming stress or trauma, particularly during childhood. Emotional neglect and abuse may interfere with the child’s development.
The majority of people diagnosed with dissociative identity disorder have reported a history of disturbing or life-threatening trauma during their childhood years.
As they grow older, they begin to integrate the complicated information and experience from their environment into a complex personal identity. Abuse and trauma during childhood affect one’s ability to form a single, cohesive identity, especially when the abuse is from parents or guardians.
Over time, they develop different personalities as a means of escaping reality, a coping mechanism. Sometimes, there need not be overt physical or sexual abuse.
Children in families where parents are unpredictable and frightening are at risk of developing dissociative identity disorder.
Signs and Symptoms of Dissociative Identity Disorder
Amnesia
This occurs as gaps in memory of recent personal events. The person may not remember certain parts of their childhood or teenage years. There could also be gaps in memory of everyday activities and even experienced skills.
For example, the person may forget a personal recipe or how to use a computer. They may discover things that they have no memory of doing.
People may also find themselves in different places from where they last remember being after an episode of amnesia. They may have no memory of things they have done or the changes in their behavior.
Multiple personalities
The person may speak and act in a very different manner, as though they are being possessed. This is known as the possession form of DID
Sometimes, these personalities are not apparent to anyone watching. The person instead detaches from certain aspects of themselves, as if they were observing from a third party or seeing themselves in a movie.
They may suddenly say, feel, think, or do things that they have no control over. Opinions, preferences or attitudes may change at any moment’s notice and the change back.
This detachment from self is a condition known as depersonalization. Changes in preferences such as those regarding interest, clothing, or food, can be noticed by others.
The personalities sometimes may take on different ages or genders. They may often refer to themselves in the first person (we), or in the third person (they, he, she) sometimes with no reason.
The personalities may sometimes be aware of the other personalities, remembering personal information about the others, and even interacting with each other in a fantasy world.
Other symptoms of dissociative identity disorder include:
- Physical symptoms like headaches and pains, which may indicate the presence of another disorder.
- Depression
- Anxiety
- Substance abuse
- Self-harm
- Suicidal thoughts and behaviors
- Sexual dysfunction
- Hallucinations
Diagnosis
The diagnosis of the disorder is based on the person’s history and the severity of the symptoms.
A psychiatric interview is conducted by the doctors with the use of questionnaires to help identify the cause of dissociative identity disorder and to rule out other possible mental health disorders.
Physical exams would also be conducted to rule out other ailments that may cause the symptoms. The doctor may also try to make contact with other identities to get the full idea of the severity of the condition.
Treatment of Dissociative Identity Disorder
Although there is no cure for dissociative identity disorder, the treatment plans available aim at creating a harmonious interaction among all the personalities that enables a more normal functioning.
Effective treatment plans for dissociative identity disorder include:
- Psychotherapy: This therapy seeks to work through DID triggers. It can be a long and painful process where the patient can experience emotional crises and despair from recalling past emotional trauma during therapy. The goal of psychotherapy is to provide a way to stabilize intense emotions while negotiating relationships between the different personalities.
- Hypnotherapy: This is often used along with psychotherapy to gain access to repressed memories, and to control some behaviors associated with a dissociative identity disorder.
- Medication: There is no recommended medication treatment for dissociative identity disorder. Medicine, in this sense, is used to treat associated mental health issues like depression and anxiety. These include antipsychotic medications, anti-anxiety medication, and antidepressants.
