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Ji Young Song
English 202A, Section 012
Dr. J. Pirrone
April 14, 2016

Template for Final Report: The Health Journal

http://www.thehealthjournals.com/category/departments/mind-matters/
DID: Dissociative Identity Disorder
Most people know about Rosenhan experiment. David Rosenhan who was a famous
psychologist did not believe that the psychiatrists can distinguish the sane from the insane.
According to Rosenhan, he sent 8 sane people to 12 different hospitals to verify the psychiatric
diagnosis. There were 3 women and 5 men, and three psychologists, a paediatrician, a
psychiatrist, a painter, a house wife, and a psychology graduate student in his twenties were the
subjects of the studies. Surprisingly, all sane people were diagnosed with mental disorder. 7 of
the subjects were diagnosed with schizophrenia, and one was diagnosed with manic-depressive
psychosis. After Rosenhan experiment became famous, the psychiatrists complained about the
results. Thus, Rosenhan conducted the additional studies, and sent 193 people to different
hospitals again. However, the results were the same. The psychiatrists and hospital staffs
announced that 41 of them were the insane, although Rosenhan did not send any patients
suffering from mental illness. Rosenhan concluded that the psychiatrists cannot diagnose mental
disorder accurately.
A lot of people like Rosenhan do not believe in mental illness. Physical illness is visible,
and is easy to diagnose, but mental illness is an abstract idea. Therefore, people usually question

the presence of mental disorder. There is a mental disorder which is called Dissociative Identity
Disorder, and it is no exception. Dissociative Identity Disorder, also known as Multiple Identity
Disorder, is disruption of identity characterized by two or more distinct personality states, and
the disruption in identity involves marked discontinuity in sense of self and sense of agency,
accompanied by related alterations in affect, behavior, consciousness, memory, perception,
cognition, and/or sensory-motor functioning according to Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition. Speaking of the symptoms of DID, the patients with DID suffer
from auditory hallucinations, lost time, mood swings, suicide attempts, and so on. The symptoms
of DID and Schizophrenia seem similar, however, the professor Brian Kenneth Crosby at The
Pennsylvania State University says that DID and Schizophrenia are totally different. He said that
the patients suffering from schizophrenia do not experience memory or identity distortion, but
the patients with DID have these symptoms.
Most people do not believe in DID. There might be several reasons. Firstly, there is not
enough reported cases. According to Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition, the 12-month prevalence of dissociative identity disorder among adults in a small
U.S. community study was 1.5%. It is not a small number. People think Schizophrenia is more
prevalent, however, the lifetime prevalence of schizophrenia appears to be approximately 0.3%
to 0.7% according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. These
statistics show that DID is not a rare disorder, and lots of people suffer from this disorder. The
thing is that the patients with DID do not want to reveal that they have the mental illness, so they
usually do not go to see a doctor. Thus, there is not enough information about DID and case
studies, and that makes people keep questioning whether DID exists. Another reason why it is
hard to believe is due to the symptoms of DID. A person who suffers from cold has the

symptoms such as cough, fever, and headache. Otherwise, a person with DID reports the
symptoms including the switching between personalities, hallucinations, and amnesia. These
symptoms are not visible, and are even hard to measure. Therefore, a lot of people are still not
sure whether DID is real or not. It might be the most frequent question about DID. In order to
answer this question, there is a great reported case of DID.
Kaplan reported that the blind woman who had multiple personalities could suddenly see.
The case is about a German woman who suffers from DID, and has more than 10 different
personalities. She had an accident, and was diagnosed with cortical blindness. The fact that she
could not see was true, since she had several vision tests, and her doctor verified them. However,
she suddenly gained her sight during the therapy to cure DID, and started seeing and reading the
words. It is hard to believe, but her recovery of vision was also proven by brain scan. In addition,
the interesting part is that some of her personalities could see, while some of them could not. In
reality, she repeated the process that she could see and could not see depending on her
personality. It is a significant case, because DID was proven by the documents, and some tests
such as brain scan. Additionally, it also provides some evidence to support the presence of DID.
Then, what is the cause of DID? The patients suffering from DID have something in
common. They experienced some traumatic events, and some symptoms of DID developed.
While conducting the research and finding case studies, I read some stories of the patients with
DID. The notable thing is that most patients reported they had some traumatic events such as
physical and sexual abuse, and difficult childhood. These stressful events have a large impact on
the developing the disorder, however, not all people who experienced a tragic events have DID.
The professor Brian explained it by the genetic factors. If a person has a family member
suffering from depression, then the person would have a high possibility of developing

depression. Suppose there is a cup which is 10cm deep. For example, the person has the family
history of DID, the cup would start with 3cm filled with water. However, another person who has
no family history of DID has the empty cup which starts with 0cm filled. At that time, both
people have the same degree of stressful event which could fill 8cm of the cup. Even if both
people experienced the same traumatic event, the persons cup with family history overflow,
while the persons cup with no family issue is filled with the right amount of water. The thing is
that the person who has the family history of the mental disorder already has the potential of
developing DID. This example shows that the genetic factors can cause DID. The person who
has a family member suffering from DID is influenced by the environment. The person might see
family members development of DID and tough times due to DID. It makes the person much
more vulnerable to dealing with stressful events.
The patients with DID have the host personalities and the alter personalities. According to
Ringrose, the host tends to be the part who has executive control of the body most of the time.
However, often there are two or even several hosts. The patients can have many different
personalities such as child and infant alters, persecutor and violent alters, and helper alters. They
always fight to occupy the main part of personality. Therefore, the switching between
personalities often occur during the patients have therapy, since they want to talk about what they
want to the therapist. And the most interesting part is the switching between personalities. The
most common times that switching occurs are when an identity is reminded of a past trauma
event and the event acts as a trigger according to Ringrose. Some movies and TV shows deal
with DID as the subject matter, and most media describe that the patient with DID suffers from
severe headache and pain when their personalities are altered. It might be true, but some factors
are exaggerated, since TV shows need the dramatic settings. There is an interesting studies about

voluntary switching between identities in DID. A middle-aged woman with DID was the subject
of the studies, and the woman has three personalities including adult, a baby, and a child. During
the experiments, researchers gave some cueing images to the subject, and she was tested the
ability to change her personalities voluntarily. The result showed that the woman had the ability
to switch her personalities in accordance with some iconic cues. In addition, these switching
processes occurred quickly consistently, and excessive head movements were not observed.
Therefore, the experiments also proved that the common thought of DID that the switching
between personalities is always accompanied by excessive head movements is misconception.
Moreover, the studies found that when switching is occurred, the cortical and subcortical areas in
the brain is activated. According to Savoy et al., another interesting fact is that both the
activations near sensory motor cortex seen during switching, and the deactivation seen in visual
cortex are presumably due to her tightening her facial musculature and partially closing her eyes
during the switching process. And this is actually consistent with behavioral reports from many
DID patients studied during switching.
Many people might wonder whether DID is cured or not, and whether there is a helpful
treatment for the patients with DID. The goal of the treatment for them is combining multiple
personalities in a single one, and general treatment for DID patients is talk therapy. As I
mentioned above, since the alter personalities want to be the host personalities, they often appear
during the therapy, and try to talk with the therapist. In addition, the professor Brian introduces
another useful treatment for them. He says that the treatment of DID would be similar to the
treatment of Post-Traumatic Stress Disorder. PTSD is a disorder that develops in some people
who have seen or lived through a shocking, scary, or dangerous event according to National
Institute of Mental Health. Both DID and PTSD are caused by some traumatic events, therefore

the way to approach the patients are similar. The Patients with DID or PTSD do not want to talk
about their traumatic events, and do not even want to think about them. However, it is significant
to recall the events, and talk about the stressful events. In order to lead the patients reaction, the
role of counselor is important. They should lead people to remember their traumatic events, and
address them. When they express their repressed feelings, they should become much better.
Many experts say that curing DID is hard, but it is not impossible. Since there are some cases
that the patients who had multiple personalities finally had only one personality, treatment for
DID patients would be helpful to them.
As I said above, the patients suffering from DID are not a small number. Even though we
do not know people who have multiple personalities around us, many people still suffer from,
and fight with DID. The most serious problem of DID is the suicide risk of DID patients.
According to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, over 70% of
outpatients with DID have attempted suicide; multiple attempts are common, and other selfinjurious behavior is frequent. We should pay more attention to DID patients. Still, there is not
enough information and knowledge of DID, and more reported cases are needed.
Moreover, experts of DID field are needed. DID patients need some special cares, but
there is only few experts who provide treatment for them. They also have the right to have the
treatment, thus the field should be developed. Additionally, another reason why experts are
required is that people who can distinguish the sane from the insane are needed. The professor
Brian concerned about over-diagnosis of DID for Not guilty by Reason of Insanity. Not guilty
by reason of insanity is a plea by a criminal defendant who admits the criminal act, but claims
he/she was so mentally disturbed at the time of the crime that he/she lacked the mental capacity
necessary to commit a crime according to uslegal.com. The plea should be an essential defense

for DID patients, if they did not mean to do the criminal act. And they might not know or
remember the crime, since the alternative personality did that. However, a person who does not
suffer from DID might use the plea to make an excuse for the act. Therefore, both attention and
more studies about DID is required.

References
Dissociative Disorders : Diagnostic and Statistical Manual of Mental Disorders. (n.d.).
Retrieved from
http://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.dsm08#BA
BBDCAG
NIMH Post-Traumatic Stress Disorder. (n.d.). Retrieved from
http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
Not Guilty by Reason of Insanity Law & Legal Definition. (n.d.). Retrieved from
http://definitions.uslegal.com/n/not-guilty-by-reason-of-insanity/
Ringrose, J. L. (2012). Understanding and treating dissociative identity disorder (or multiple
personality disorder). London: Karnac.
Rosenhan, D. L. (1973). On Being Sane in Insane Places. Science, 179(4070), 250-258.
doi:10.1126/science.179.4070.250
Savoy, R. L., Frederick, B. B., Keuroghlian, A. S., & Wolk, P. C. (2012). Voluntary switching
between identities in dissociative identity disorder: A functional MRI case study.
Cognitive Neuroscience, 3(2), 112-119. doi:10.1080/17588928.2012.669750
Schizophrenia Spectrum and Other Psychotic Disorders : Diagnostic and Statistical Manual of
Mental Disorders. (n.d.). Retrieved from
http://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.dsm02
The blind woman who switched personalities and could suddenly see - The Washington Post.
(2015, November 24). Retrieved from
https://www.washingtonpost.com/news/morning-mix/wp/2015/11/24/the-blindwoman-who-switched-personalities-and-could-suddenly-see/