Multiple personality disorder - symptoms and therapy

Multiple personality disorder - symptoms and therapy

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Who at one multiple personality disorder suffers, he splits his identity into different people. Most of the time, those affected have a main identity and can hardly remember what the other participants are doing.

Her memory has a lot in common with the hangover after an alcohol excess: Only fragments of what she has experienced are in the consciousness. Those suffering from it dissociate, and they appear to have stepped away when they “change”.

The sub-personalities have their own identities. For example, Sophia, a victim, knows an adult prostitute, a teacher and a 13-year-old girl. When she "walks", her voice and attitude change, as do her opinions and interests. Their fears are different, as are their preferences - and even their knowledge of certain topics.

Sometimes she would wake up naked in the shower without knowing how she got there. Her last conscious memory was many hours ago. Then again, sometimes working as a prostitute, she found herself on her sofa in her work clothes as a sex worker and with a full budget, without knowing how she got there.


The multiple personality was long regarded as either charlatanism, invented illness or fascinating curiosity. Esoterics even saw spirit beings at work. Trauma research, on the other hand, recognized the behavior of multiple personalities as typical splits in traumas.

The extent to which MPS is a disease of its own, and whether the “subordinates” really act as autonomously as those affected and witnesses report, is controversial in science. Quite a few “multiple people” also suffer from borderline or post-traumatic stress syndrome.

These two disorders not only characterize dissociations, but those affected also construct realities in which they themselves believe or fantasize in order to convey themselves in an encrypted manner: for example, a war-traumatized person regularly invents incidents in which strangers attack him at night, and he defends himself sits and lies injured in bed in the morning - his acquaintances meanwhile know that he is actually staggering home drunk without meeting anyone.

It is difficult for outsiders to judge whether these constructions are deliberate lies, symbolic stories that translate a trauma they have suffered, or the degree to which the victim believes them themselves.

This reservation also applies to the multiple personality. Sophia, for example, also fantasized with an ex-partner that they were both angels who had to suffer on earth and had a special mission.

It is difficult to draw the line between whether the other self is consciously and subconsciously invented in such multiple personality disorders in order to temporarily assume a different identity as a role play, or whether the unconscious builds up its own pattern that actually runs involuntarily, and this is not possible through empirical studies adequately clarified.

However, if the consequences of a trauma are involved, it is at least clear what the sub-personalities serve. Those who have a traumatic experience often divide the real experience from consciousness. The victim must continue to live in the traumatizing situation - be it that he remains in the position as a soldier in the war, or that she continues to live with the raping father as an abused child.

All traumatized people who split off experiences like this suffer in later life from the fact that they cannot integrate the experience: They panic when a (harmless) trigger reminds them of what is happening, they become aggressive towards innocents, the similarities with the causer show the trauma (hairstyle, smell, first name, voice etc.).

If it is true that the multiple personality represents its own disorder, these splits have become independent among those affected.

Dissociative Identity Disorder Symptoms

People with this disorder find it difficult to cope with everyday life. They do not appear on appointments because they "walk", their sub-personalities make agreements that the "normal character" forgets, they lose a large part of their time and cannot build a stringent structure of life.

The diagnosis is not only controversial, it is also extremely embarrassing for many of those affected. They lose a lot of time and energy by jumping from one state to another. In addition, they invest time in appearing normal to the outside world.

Their states are easily confused with other psychological problems. In the first place, they look chaotic; they cannot bring their thoughts together; they cannot concentrate and, above all, cannot keep what they previously promised. All this also applies to people who suffer from attention deficits, borderline and sometimes bipolar disorders.

In the case of multiple personalities, however, the supposed agility lies in the fact that they walk, and often none of the participants come to light “pure”. Those affected then appear as if they have speech disorders, they “talk to themselves” when they write, their sentences suddenly stop, and they write with a different script on a completely different topic.

Other symptoms overlap with various disorders such as borderline or PTSD, which are also based on trauma: multiple suffer from flashbacks, in which the traumatizing event reappears unfiltered, most of them have clinical depression. Their feelings break out like borderliners, their behavior is compulsive, they have eating disorders like those suffering from anorexia and bulemia, and many of them are addicted to alcohol and other drugs.

Multiple personality and schizophrenia

Those who experience themselves split into several personalities are popularly known as “schizophrenic”. But this does not correspond to the clinical picture: Schizophrenics suffer from visual and acoustic hallucinations. They hear voices, they think someone is breaking into their apartment, they think they are "bewitched" and they think they see invisible powers that are hidden from others.

Multiple personalities also hear voices that drive them to act. In their main identity, however, those affected know that they are hallucinations. On the other hand, they forget what they were doing while in their sub-personalities.

The opposite is true for schizophrenics: they firmly believe in their hallucinations and believe that mentally healthy people are part of a conspiracy because they doubt that, for example, dark magicians send magic rays into the abdomen of those affected. But they usually remember what they do and experience.

People suffering from the borderline symptom also move in a fragmented identity made up of fragments of personalities, and sometimes the diagnosis of borderline syndrome is associated with the (unsecured) diagnosis of multiple personality disorder, as in the case of Sophia .

However, there are serious differences between most borderliners and the "classic" patterns of multiple personalities. Borderliners change out of uncertainty about their identity, often their opinions, positions and self-images. Although they also split off traumatized experiences, are firmly convinced that a newly accepted role is themselves, and so many people haunt them that therapists feel a minority towards them.

Borderline, however, does not primarily identify a main personality with uncontrolled participants, but an inner emptiness and an as-if behavior. They behave as if they were a pop star, a rebel, a femme fatale, anything special because they want to get away from their fear of being nothing.

In cases where this applies to multiple personalities, it would not be a more or less autonomous partial personality, but a pathological theater to escape the inner emptiness. However, this does not do justice to the very real dissociations that affect those affected.

The dissociative identity disorder in fact characterizes that the sick cannot remember essential experiences without simulating this loss of memory. Your normal identity is not aware of what the other identities are doing.

An invented disorder?

The dissociative identity disorder was already known in the 19th century; Until about 50 years ago, however, psychology was not particularly interested in it. In the 1970s, the “multiples” then became an issue - especially in the United States. In certain patients, thousands of people are said to be haunted, and therapists meticulously classified these hosts.

The dissociative identity disorder became a fashion diagnosis. In the midst of increasingly frequent diagnosed multiple personalities, critical psychologists made massive statements.

In some cases it was shown that the sub-personalities came about through suggestive questions from the therapists and that the patients did not have such “other selves” at all before the therapy.

Stagings in which "victims" assumed the identity of animals, for example, did not accidentally recall Voodou rituals in which believers believe that a god is working in them or "new witches" who claim to recognize through trance, that they were the rebirth of a woman persecuted by the Inquisition.

Trials in which criminals said they were in someone else's crime revealed that the perpetrators discovered the dissociative identity disorder to wash away the guilt.

The "multiple personality" in these cases was nothing more than fraud, perhaps associated with the repression of a person who did something bad and says "that was not me" because his ethically conscious part would not do that.

The critics felt confirmed by such scams. Even more: in many cases, tests showed that the traumatic experiences of childhood were also manipulated - often without the therapist's intention. Suggestions from the therapists, the omnipresence of the MPS in the media and the drive for validity of the "affected" people produced more and more and more exciting people.

Patients sued their allegedly abusive parents until the courts found that there had never been an abuse; others brought their therapists to court for telling them false memories.

In 1980, however, the dissociative identity disorder was internationally recognized as a mental disorder.

The alienated self

The theatrical performances concealed the real essence: the "real" multiple personality disorder is not very sensational, but it is associated with a lot of suffering.

The term "dissociative identity disorder" refers to the fact that it is very rarely about autonomously acting characters, but about alienation from aspects of one's own biography. So those affected hardly show themselves as Dr. Jekyll, whose dark side independently does evil deeds, but complain about not being able to reconcile their different memories.

Fragments of their memory patterns appear without the patient knowing what has happened. These contents of consciousness rarely take the form of people, but they are stored without any connection to one another.

Multiple traumas are also typical, which the victims are forced to re-enact and put themselves in situations that repeat the trauma. The dissociative identity disorder does not appear to be detached from other mental illnesses, but rather as the behavior of traumatized people.

So the multiple personality loses its magic - presumably because there are effective therapies for traumatized people today and childhood abuse came out of the taboo in public.

The blatant self-portrayals of multiple personalities in the 1970s were perhaps also an attempt to map traumatic experiences as psychodrama.

The knowledge of today's trauma and memory research demystifies the dissociative identity disorder on the one hand, on the other hand it turns the controversy between "invented phenomenon" and autonomously acting characters of the unconscious from head to toe.

A person who experiences extreme stress switches emotions, and thus himself, from systematic thinking. It is a mechanism of survival of the brain: This enables the person concerned to function in situations in which his usual reactions make an action impossible.

For example, an abused would normally run away from his tormentor. A child who is dependent on an adult cannot do this, however, so it splits off.

The multiple personality is relativized as a completely independent phenomenon by the fact that in many cases the participants reflect those involved in the trauma, such as the helpless child, the perpetrator and equalizing justice.

This corresponds exactly to the images that other traumatized people develop without perceiving these aspects of the split-off as independent figures.

Affected people who see hundreds of people at work in themselves are extremely rare, if at all. Most likely, the therapists suggestively suggested this "storyline" to them without perhaps wanting to. The urge to apply and autosuggestion probably also played a role.

However, even with such patients, the question between "real and invented disorder" is resolved: our brains do not differentiate between experienced and invented, even those who only hear of traumatic situations without being there can develop the symptoms of a traumatized person.

Our memory is less a chronicle than a creative cluster, which “remembers” so that they develop meaningful patterns. In a traumatized person, entering into different roles that are not integrated can represent such a pattern.


The therapy of multiple personalities is complicated. It lasts a long time and the underlying trauma cannot be healed like a broken leg.

Psychologists of the 1970s probably made the mistake of encouraging patients to act out their participants and thus driving the division instead of resolving it. The result was probably always new people.

On the other hand, the aim is to familiarize those affected with the fact that their problem is not a “magical ability”, but to relate the reaction to a trauma and the participants.

In the first step, the characters should get to know each other in the subconscious in order to then work with each other. In the second step, they should dissolve piece by piece - ideally they merge into one being, that is, the person concerned integrates them into their whole person.

But that's exactly what many patients resist. They have become so used to these different people that they fear losing themselves if they lose these other selves.

In the past, the trauma was often not considered or not found in “multiples”. Once the patient remembers no traumatizing experience, the reason is usually that he suppressed the trauma.

A rule of thumb could even be: the more sophisticated the participants are and act, the greater the separation, the smaller the conscious memory of the real event. Dissociation means that different areas of the experience separate - in terms of content. The brain does not forward certain information.

There are many indications that multiple personality disorders occur particularly in the case of repeated traumatizations: those traumatized by abuse in childhood unconsciously seek out situations that are reminiscent of the trauma, are traumatized again and at the same time become familiar with dissociation as a “way out”. Dissociation is now becoming easier, the participants split up and share the suffering that would completely surprise the person concerned.

At the same time, the person concerned goes with his "protectors" in role models of the real world, which mirror the trauma - the abused girl is looking for sexual partners, whom she detests or sells her body in sex work. Partial people like the helpless child, the ice-cold whore or the tormentor can now act in a structure.

A dissociative disorder has its roots mostly in childhood traumatizations, because children dissociate far better than most adults.

The person concerned must first get involved with the therapist. First of all, it is about a structure for everyday life, which both work out together. The patient's head must be free of secondary effects such as financial chaos or stressful acquaintances.

The therapist then takes the participants seriously. He does not throw the patient at the head "you only imagine it", but inquires about details such as age, preferences, nature and gender of the "other me".

Then the therapist and the person concerned jointly examine the relationship between the individual alter egos. If you know each other, if he follows one another, protect yourself. Do they form relationships like "good friends", "mother and child", "big brother, little sister", are they rivals, perpetrators and victims or do they have no relationship at all?

As in the dream work, the person concerned slowly encounters the “evil” figures that work in him. These refer to the unresolved conflicts and often offer the key that helps to deal with the trauma.

The therapist therefore includes the trauma, but only cautiously, by approximating the actions of the participant to the traumatizing experience.

In the end, the person affected should accept the traumatizing memories and recognize that he is the one who goes into the dissociations, but has more meaningful ways of living with what he has experienced.

Depending on the severity of the traumatization and other behavior of the person concerned, the treatment is more or less successful. Drug and alcohol abuse can increase secession, alcohol addiction alone can lead to perceptions that resemble dissociative disorders.

Recognize multiple?

Multiple personalities with weak symptoms often do not even know about their disorder. They know it no other than temporarily losing control of their multiplicity, and often think that the alter egos are completely normal, because they live with them 24 hours a day.

Most of those affected have a main personality; At times outsiders find their behavior strange, but they don't know anything about the disturbance. If multiple strikes, it is often due to accompanying phenomena: they wander around aimlessly, they have unreasonable fears, they “seem like they have stepped away”, and many walk in their sleep.

They are often known as "chaots" in their environment, their jobs and partnerships zigzag, their feelings change by leaps and bounds, and many others find it difficult to respect those affected.

Normal multiple?

All people dissociate. "Who am I, and if so, how many?" Asked the philosopher Richard David Precht. The character we occupy differs from our side as a husband, family man or lover; I behave differently towards friends than towards strangers if I pursue my hobby differently than if I conclude a contract with the bank.

In contrast to the "multiple disturbed", we bring these different aspects of our personality together: We express aspects, but no sub-people. We can separate if necessary and then put it back together.

However, those who have been exposed to sexual abuse in childhood do not have this option.

So while "normal neurotics" mostly know that they play a role and cultivate their hobbies and dislikes as one (!) Person, the participants of the multiple personality mostly have very different talents, interests, clothing or voices. Sometimes they correspond to the characters of a short story and represent a certain facet: sadness, anger, hatred, naivety or confidentiality.

In contrast to the "normal", multiple personalities often have different handwriting, and even different diseases.

But in their splits, the dissociative disorders reveal a lot about how our "normal" brain works and how we construct our identity anew every day. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch


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ICD codes for this disease: F44ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.

Video: DID aka. Multiple Personality Disorder Explained! (November 2022).