Multiple personalities

We are always puzzled by situations in which our normal concept of a person seems to break down. One such situation is that where a patient presents with multiple personality syndrome. Although there are striking discontinuities of consciousness and personal integration, most cases do not show any evidence of brain dysfunction nor do they exhibit the profound disruption of mental function to be found in the major psychoses such as schizophrenia or manic-depressive psychosis.

The following is an attempt to give an account of the disorder and its genesis.

Also covered here is the problem posed for our concept of persons and the contribution that reflection upon this rare problem can make to our thinking about persons and their personalities.

Definition of Terms

A personality is the complex of attitudes, abilities, affective tendencies and grammatical practices of self-ascription which form the psychological constitution of a distinctive individual. In the description of this disorder, three subcategories will be used.

A primary personality is the postulated integral personality in which the multiple personalities arise. After treatment and resolution, this can be regarded as being reconstituted as a total personality which draws into itself the strands of personal life which were split during the disorder.

A presenting personality is the personality that originally turns up for psychiatric treatment.

A persona is "the face an individual manifests from time to time" (De Waele & Harre, 1976 p. 189).

Thesis Statement

The causal linkages between multiple personalities and major disease.

Description of the Disorder

Multiple personality is defined as "the presence in one patient of two or more personalities each of which is so well defined as to have a relatively coordinated, rich, unified, and stable mental life of its own" (Taylor S: Martin, 1944). Some two hundred cases have been described in the psychiatric literature, many of which were reported in the early twentieth century. There is a predominance of female cases (Taylor & Martin, 1944) and there is a strong suggestion that the number of cases is much larger than was once thought (Greaves, 1980).

The patients normally present themselves to the therapist suffering from increasingly troublesome psychosomatic complaints such as headaches, irritability, insomnia or blackouts, or with social problems in which their bizarre and inconsistent behaviour has compromised their normal interpersonal relations.

The general point can be illustrated by reference to the case of RenC (Congdon & Abels, 1983) who presented for therapy as a timid twenty year old female, prone to guilt, depressed, dependent and retiring. She was, at the time, in a failing second marriage. She had had a disturbed childhood during which she was beaten by both parents, rejected by her mother, raped by her father, and had watched her younger brothers physically and psychologically abused. She was repeatedly used as a convenient scapegoat upon which the parents vented the frustration arising from their own inadequacy and the mother exercised her irrational envy, most marked during Rene's adolescence. Rene had five alternative personalities, each with its own distinct personality profile, physiological characteristics and responses, and personal ...