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977).
DID is frequently confused with schizophrenia. The term, schizophrenia, literally means, “splitting
in the mind” (Reber, 1985). DID is actually a severe form of neurosis; the personality “in
command” at any given moment remains in contact with reality. Schizophrenia is a psychotic
disorder, in which the individual’s functioning is “split off” from external reality. Dissociative
identity disorder is one of the major dissociative disorders in which the individual develops two
or more distinct personalities that alternate in consciousness, each taking over conscious control
of the person for varying periods of time. Both dissociative identity disorder and the
schizophrenias are Axis I clinical syndromes.
Classic cases of dissociative identity disorder manifest at least two fully developed personalities,
and more than two are common. Of cases reported in recent years, about 50% had 10 or fewer
personalities and approximately 50 percent had more than 10. Each personality has its own
unique memories, behavioral patterns, and social relationships. Change from one personality to
another is usually sudden, with the change being accomplished in a matter of seconds to
minutes. The change is usually sudden, often triggered by psychosocial stress.
The original personality, the one from which all the others diverge, is usually unaware of the
existence of the others. However, the first personality to “split” from the original usually knows
about the original, and any additional personalities that may surface subsequently. This first
personality to split from the original is the active controller of which personality is “out,” when it
is out, why it is out, and for how long. This personality is referred to as the dominant personality,
and is often diametrically opposed to the original personality (e.g., Eve White and Eve Black). It
is not unusual for one or more of the “new” personalities to have a different gender than the
original personality, as well as a different sexual orientation.
At any given moment, there is only one personality interacting with the environment.
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PSYCHOLOGY AND LIFE
Interestingly, the personality that presents for treatment often has little-if any-knowledge of the
multiples-they just are aware that something is a little unusual.
Onset of dissociative identity disorder is usually during childhood, but may not be diagnosed
until adulthood. The disorder is chronic, and the degree of impairment varies from mild to
severe. In nearly all cases, the disorder is preceded by abuse, often sexual in nature, or from some
other form of severe emotional trauma during the childhood years. The disorder is seen three to
nine times more frequently in females than in males.
There is some indication that the incidence in first-degree biological relatives of dissociative
identity disorder is higher than that in the general population. Interestingly, a child is often the
first to notice the presence of multiples (e.g., “I have 2 mommies, but it’s okay because they both
love me.”)
This dramatic form of reaction is well illustrated by the widely publicized case of Eve White. Eve,
25 years old and separated from her husband, had sought therapy because of severe, blinding
headaches, frequently followed by “blackouts.” During one of her early therapy sessions, Eve
was greatly agitated. She reported that she had recently been hearing voices. Suddenly she put
both hands to her temples, then looked up at the doctor with a provocative smile and introduced
herself as “Eve Black.”
It was obvious from the voice, gestures, and mannerisms of this second Eve that she was a
separate personality. She was fully aware of Eve White’s doings, but Eve White was unaware of
Eve Black’s existence. Eve White’s “blackouts” were actually the periods when Eve Black was in
control, and the “voices” marked unsuccessful attempts of Eve Black to “come out.” With
extended therapy, it became evident that Eve Black had existed since Eve White’s early
childhood, when she occasionally took over and indulged in forbidden pleasures, leaving the
other Eve to face the consequences. This habit had persisted, and Eve White frequently suffered
Eve Black’s hangovers. After about eight months of therapy, a third personality appeared. This
one, Jane, was more mature, capable, and forceful than the retiring Eve White. She gradually
came to be in control most of the time.
As the therapist probed the memories of the two Eves, he felt sure that some shocking event must
have hastened the development of these distinct alternate personalities in the disturbed child. In
a dramatic moment, the climax of therapy, the missing incident became known. Jane suddenly
stiffened and in a terrified voice began to scream, “Mother … Don’t make me … I can’t do it!