Most
clinicians believe that dissociative processes
exist on a continuum. At one end are mild dissociative
experiences common to most people (such as daydreaming
or highway hypnosis). At the other extreme is
severe, chronic dissociation which may result
in serious impairment or inability to function.
There is a wide range of experiences in between.
Some people with MPD can hold highly responsible
jobs, contributing to society in a variety of
professions, the arts, and public service. To
co-workers, neighbors, and others with whom
they interact daily, they apparently function
normally.
Dissociation is normal in children, as anyone
who has observed an imaginative, three-year-old
can attest. When faced with highly anxiety-provoking
situations from which there is no physical escape,
the child may resort to "going away" in his
or her head. This ability is typically used
by children as an extremely effective defense
against acute physical and emotional pain caused
by highly traumatic situations, most commonly
severe abuse. Over time, for a child who has
been repeatedly abused, dissociation becomes
reinforced and conditioned. The dissociative
process may result in a series of discrete states
which eventually may take on identities of their
own. Often referred to as alternate personalities,
these are the internal members of the MPD system.
Changes between these personalities, or states
of consciousness, are described as switching.
Individuals most likely to develop MPD present
several factors in a common profile. They have
endured repetitive, overwhelming, and often
live-threatening trauma at a sensitive developmental
stage of childhood (usually before the age of
nine), and they may possess a biological predisposition
for auto-hypnotic phenomena (a high level of
hypnotizability). MPD is often referred to as
a highly creative survival technique, because
it allows individuals enduring "hopeless" circumstances
to preserve some areas of healthy functioning.
Fortunately, the problems caused by dissociation
are highly responsive to treatment, and people
with MPD and other Dissociative Disorders can
improve their lives through appropriate therapy.
Multiple Personality Disorder is one of the
four Dissociative Disorders identified in the
Diagnostic and Statistical Manual of Mental
Disorders: Third Edition - Revised (DSM-III-R),
published by the American Psychiatric Association.
It is significant to note that the 1980 edition
of the Manual was the first to include
MPD and the other Dissociative Disorders, indication
the very recent "legitimacy" of the diagnosis
within the psychiatric community. However, many
mental health professionals remain skeptical
about the existence of Dissociative Disorders,
compounding difficulties of survivors in getting
appropriate diagnosis and treatment.
MPD survivors often spend years living with
misdiagnoses, consequently floundering within
the mental health system. They change from therapist
to therapist and from medication to medication,
getting treatment for symptoms but making little
or no actual progress. This is not surprising,
since the list of presenting symptoms of MPD
reads like the DSM-III-R itself: depression,
mood swings (alter shifts), suicidality, sleep
disorders (usually night terrors and sleep walking),
panic attacks and phobias (reactions to stimuli
or "triggers"), alcohol and drug abuse, compulsions
and rituals, psychotic-like symptoms (including
auditory and visual hallucinations), and eating
disorders. In addition, individuals with MPD
experience headaches, amnesias, time loss, fugues,
trancing, and out of body experiences. Some
people with MPD have a tendency toward self-persecution,
self-sabotage and even violence (both self-inflicted
and outwardly directed).
since
May, 1998. 
