25.02.201827.05.2017

Multiple personality disorder is a bright, but rather controversial disease that still causes heated discussions among doctors and scientists. Someone doubts whether it exists at all, someone - whether it is worth considering this condition as a deviation from the norm. "Theories and Practices" remembered how the research of this psychiatric phenomenon began and why one should not rush to evaluate it.

Background

Dissociative identity disorder is a condition in which, in addition to the main personality, the patient has at least one (and often more) subpersonality, which periodically “takes control” of the body and acts in accordance with its own ideas about life. These ideas can be very different from the habits and philosophy of the real owner of the body.

Despite the fact that some experts consider this disease iatrogenic - that is, provoked by the careless words of doctors or watching a "scientific" TV show - there is a number of evidence that indicates the opposite. One of the most impressive is the history of the disease. Cases of dissociative disorder were recorded even when there were no psychotherapists or a TV show in sight. However, there was no psychiatry itself.

One of the first reported cases of dissociative personality disorder occurred at the end of the 18th century in the German city of Stuttgart. A revolution had just taken place in France, and the aristocrats, saving their lives, fled from home country to neighboring states, including Germany. The young resident of Stuttgart took their misfortunes too close to heart. She suddenly had a second personality - a Frenchwoman. She not only spoke excellent mother tongue”, but she also coped noticeably worse with German, she had a noticeable accent. The Frenchwoman who appeared was of aristocratic blood, and her manners and habits fully corresponded to her status. It is noteworthy that the German girl did not remember what the “Frenchwoman” was doing, and she did not know anything about the rightful mistress of the body.

The young German woman was not the only person with such a disease in her century, but, nevertheless, her illness turned out to be extremely rare - in total, 76 cases of dissociative identity disorder were documented until the middle of the 20th century. Interestingly, in recent decades, much more of them have been described - today more than 40 thousand people with this diagnosis live in the world. However, this does not mean the beginning of an "epidemic" - psychiatry, with all its arsenal of medicines, appeared only in the middle of the last century, and, accordingly, control over the incidence of such disorders began not much earlier.

Separation of functions

To date, quite a few books and articles have been written about multiple personality disorder, both popular and academic. The most interesting thing in it is, perhaps, the moment of the onset of the disease in childhood. No one is born a “ready-made”, whole person. Growing up, the child experiences a lot of emotions and experiences, loosely related to each other. Over time, they integrate together, forming one common identity. However, the development of the child does not always go smoothly. In cases where children are early age(about 2 years) are separated from their mother when they experience abuse or some traumatic experience, childhood experiences may remain segregated and result in the formation of two or more personalities. Almost all patients with multiple personality disorder (more precisely, 97-98%) mention a difficult childhood with traumatic experiences.

Dissociative identity disorder often begins in childhood, but may appear later. Over the years, patients tend to increase the number of "tenants". Since individuals, as a rule, perform certain functions, help to cope with certain life situations, with the advent of new tasks and problems, new tenants appear who are able to cope with them. Each of the subpersonalities has its own worldview, its own habits, gestures and facial expressions, even age and intelligence. At certain moments, by the good will of the "owner" or against it, some of the personalities gets control over the body, and everything done by her during the use, as a rule, is not controlled and is not remembered by the patient himself.

A key issue in the lives of patients with dissociative personality disorder is the relationship that has developed in the “collective”. Sub-personalities may or may not be aware of each other's existence, be aggressive or silently roam museums at their own time, arrange rental schedules with the owner of the body, or regularly stage power grabs. The treatment strategy also depends on these factors - it is based on psychotherapy, and although its ultimate goal is to come to the integration of personalities into one, an important task in the process is the "neutralization" of dangerous tenants, and the organization of harmonious relations between all subpersonalities.

More than one person in one body is unfortunately not the only symptom of dissociative identity disorder. It is often accompanied by depression, anxiety disorders, phobias, sleep and eating disorders, even hallucinations. Dissociative disorder is sometimes confused with schizophrenia, but these diseases can be distinguished - in schizophrenia, as a rule, the symptoms are perceived as enemy actions by aliens, the KGB or members of the Masonic lodge, which is not the case with dissociative disorder. In addition, splitting identities in schizophrenia is a simple separation of mental functions due to a general breakdown of personality, but with DID (Dissociative identity disorder - another name for multiple personality disorder), everything is much more complicated. The functions are not just separated, but also become full-fledged individuals: each of them has her own style of dressing, rooting for her football team and has her own ideas about how to spend time.

Deviation or norm?

Treatment of patients diagnosed with multiple personality disorder is usually long, difficult, and emotionally costly. However, not everyone agrees that it should be treated at all. American psychologist James Hillman, the founder of the school of archetypal psychology, is convinced that the position that multiple personality syndrome is considered a disorder is nothing more than a stereotype that can and should be fought, advocating the right of people with this diagnosis to be considered no less normal than others. The goal of therapy, according to Hillman, is only the creation of harmonious relations of all subpersonalities. His position is supported by many patients. The ideologist of such a movement was Truddy Chase, who refused to integrate subpersonalities into a single whole and instead established mutually beneficial cooperation with them. She wrote about her experience in the book When the Rabbit Howls. Today, Truddy is far from the only one who refuses to integrate. It is not surprising: it is still not easy to kill good friends and useful assistants with your own hands, albeit symbolically.

Robert Oxnam

"Split Mind"

Oxnam, president of the Asia Society and well-known public figure, tells in his book about how he tried to mask his illness with alcoholism, struggled with memory lapses and worked in a rehabilitation center to integrate his 11 subpersonalities.

Dissociative identity disorder (split or split personality, multiple personality disorder, multiple personality syndrome, organic dissociative personality disorder) is a rare mental disorder in which personal identity is lost and it seems that there are several different personalities (ego states) in one body .

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ICD-10	F44.8
ICD-9	300.14
DiseasesDB	Comorbid
MeSH	D009105
eMedicine	article/916186

The personalities that exist in a person periodically replace one another, and at the same time, the currently active personality does not remember the events that took place before the moment of “switching”. Some words, situations or places can serve as a trigger for a change in personality. The change of personalities is accompanied by somatic disorders.

"Personalities" may differ from each other mental faculties, nationality, temperament, worldview, gender and age.

General information

The syndrome of split personality was mentioned in the writings of Paracelsus - his notes about a woman who believed that someone was stealing money from her were preserved. However, in fact, the money was spent by her second personality, about which the woman knew nothing.

In 1791, the Stuttgart city doctor Eberhard Gmelin described a young city woman who, under the influence of the events of the French Revolution (Germany at that time became a refuge for many French aristocrats), acquired a second personality - a Frenchwoman with aristocratic manners, who spoke excellent French, although the first person (German girl) did not own it.

There are also descriptions of the treatment of such disorders with Chinese drugs.

Split personality is often described in fiction.

The disease was considered extremely rare - until the middle of the 20th century, only 76 cases of a split personality were documented.

The existence of split personality syndrome became known to the general public after research conducted in 1957 by psychiatrists Corbett Thigpen and Hervey Cleckley. The result of their research was the book "Three Faces of Eve", which describes in detail the case of their patient - Eva White. Interest in the phenomenon was also aroused by the book “Sybil” published in 1973, the heroine of which was diagnosed with “multiple personality disorder”.

After the release and screening of these books, the number of patients suffering from dissociative identity disorder increased (up to 40 thousand cases were registered from the 1980s to the 1990s), so some scientists consider this disease iatrogenic (caused by the influence of psychotherapists).

The Diagnostic and Statistical Handbook of Mental Disorders has included multiple personality disorder as a diagnosis since 1980.

In some cases, people who have multiple personality disorder do not consider the condition to be a disorder. Thus, the author of the bestselling book When the Rabbit Howls, Truddy Chase, refused to integrate her subpersonalities into a single whole, arguing that all her personalities exist as a collective.

Dissociative identity disorder currently accounts for 3% of all mental illnesses. In women, due to the peculiarities of the psyche, the disease is fixed 10 times more often than in men. This dependence on gender may be associated with the difficulty in diagnosing split personality in men.

Reasons for development

The etiology of a split personality is not yet fully understood, but the available data speak in favor of the psychological nature of the disease.

Dissociative identity disorder occurs due to the mechanism of dissociation, under the influence of which the thoughts or specific memories of ordinary human consciousness are divided into parts. Divided thoughts expelled into the subconscious spontaneously pop up in consciousness due to triggers (triggers), which can be events and objects present in the environment during a traumatic event.

For multiple personality disorder to occur, a combination of:

Intolerable stress or severe and frequent stress.
Ability to dissociate (a person must be able to separate from consciousness their own perception, memories or identity).
Manifestations in the process individual development defense mechanisms of the psyche.
Traumatic experience in childhood with a lack of care and attention in relation to the affected child. A similar picture arises when the child is not sufficiently protected from subsequent negative experiences.

A unified identity (the integrity of the self-concept) does not arise at birth, it develops in children through a variety of experiences. Critical situations create an obstacle to the development of the child, and as a result, many parts that should be integrated into a relatively unified identity remain isolated.

Studies by North American scientists have revealed that 98% of people suffering from a split personality were victims of violence in childhood (85% have documented evidence of this fact). The remaining group of patients experienced serious illnesses, the death of loved ones and other serious stressful situations in childhood. Based on these studies, it is assumed that it is the violence experienced in childhood that is main reason split personality.

A long-term study by Ogawa et al. shows that lack of access to a mother at two years of age is also a predisposing factor for dissociation.

The ability to generate multiple personalities does not appear in all children who have experienced abuse, loss, or other severe trauma. Patients suffering from dissociative identity disorder are characterized by the ability to easily enter a trance state. It is the combination of this ability with the ability to dissociate that is considered a contributing factor to the development of the disorder.

Symptoms and signs

Dissociative identity disorder (DID) is the modern name for the disorder that is known to the general public as multiple personality disorder. This is the most severe disorder of the group of dissociative mental disorders, which is manifested by the majority of known dissociative symptoms.

The main dissociative symptoms include:

Dissociative (psychogenic) amnesia, in which sudden memory loss is caused by a traumatic situation or stress, and the assimilation of new information and consciousness is not impaired (often observed in people who have experienced military operations or a natural disaster). Memory loss is recognized by the patient. Psychogenic amnesia is more common in young women.
Dissociative fugue or dissociative (psychogenic) flight reaction. It manifests itself in the sudden departure of the patient from the workplace or from home. In many cases, the fugue is accompanied by an affectively narrowed consciousness and subsequent partial or complete loss of memory without awareness of the presence of this amnesia (a person may consider himself a different person, as a result of having a stressful experience, behave differently than before the fugue, or not be aware of what is happening around him).
Dissociative identity disorder, in which a person identifies with several personalities, each of which dominates him with a different time interval. The dominant personality determines the views of a person, his behavior, etc. as if this personality is the only one, and the patient himself, during the period of dominance of one of the personalities, does not know about the existence of other personalities and does not remember the original personality. Switching usually occurs suddenly.
Depersonalization disorder, in which a person periodically or constantly experiences alienation of his own body or mental processes, watching himself as if from the outside. There may be distorted sensations of space and time, the unreality of the surrounding world, the disproportion of the limbs.
Ganser's syndrome ("prison psychosis"), which is expressed in the deliberate demonstration of somatic or mental disorders. Appears as a result of an internal need to look sick without the goal of gaining. The behavior that is observed in this syndrome resembles the behavior of patients with schizophrenia. The syndrome includes passing words (a simple question is answered out of place, but within the scope of the question), episodes of extravagant behavior, inadequacy of emotions, decreased temperature and pain sensitivity, amnesia for episodes of the syndrome.
A dissociative disorder that manifests itself in the form of a trance. Manifested in a reduced response to external stimuli. Split personality is not the only condition in which trance is observed. The trance state is observed with the monotony of movement (pilots, drivers), mediums, etc., but in children this state usually occurs after trauma or physical abuse.

Dissociation can also be observed as a result of a long and intense violent suggestion (processing the consciousness of hostages, various sects).

Signs of a split personality also include:

Derealization, in which the world seems unreal or distant, but there is no depersonalization (no violation of self-perception).
Dissociative coma, which is characterized by loss of consciousness, a sharp weakening or lack of response to external stimuli, extinction of reflexes, changes in vascular tone, impaired pulse and thermoregulation. Stupor (complete immobility and lack of speech (mutism), weakened reactions to irritation) or loss of consciousness not associated with somato-neurological disease is also possible.
Emotional lability (sudden mood swings).

Anxiety or depression, suicide attempts, panic attacks, phobias, sleep or eating disorders are possible. Sometimes patients experience hallucinations. These symptoms are not directly associated with a split personality, as they may be a consequence of the psychological trauma that caused the disorder.

Diagnostics

Dissociative identity disorder is diagnosed based on four criteria:

The patient must have at least two (possibly more) personality states. Each of these personalities must have individual characteristics, character, their own worldview and thinking, they perceive reality differently and differ in behavior in critical situations.
These personalities control the person's behavior in turn.
The patient has memory lapses, he does not remember important episodes of his life (wedding, childbirth, attended a course at the university, etc.). They appear in the form of phrases “I can’t remember,” but usually the patient attributes this phenomenon to memory problems.
The resulting dissociative identity disorder is not associated with acute or chronic alcohol, drug or infectious intoxication.

Split personality must be distinguished from role playing and fantasies.

Since dissociative symptoms also develop with extremely pronounced manifestations of post-traumatic stress disorder, as well as disorders associated with the appearance of pain in the area of some organs as a result of an actual mental conflict, a split personality must be distinguished from these disorders.

The patient has a "basic", main personality who is the owner of the real name and who is usually unaware of the presence of other personalities in his body, so if the patient is suspected of having a chronic dissociative disorder, the therapist needs to examine:

certain aspects of the patient's past;
current mental status of the patient.

Interview questions are grouped by topic:

Amnesia. It is desirable that the patient give examples of “time gaps”, since microdissociative episodes, under certain conditions, occur in absolutely healthy people. In patients who suffer from chronic dissociation, situations with time gaps are observed frequently, the circumstances of amnesia are not associated with monotonous activity or extreme concentration of attention, and there is no secondary benefit (it is present, for example, when reading fascinating literature).

At the initial stage of communication with a psychiatrist, patients do not always admit that they experience such episodes, although every patient has at least one personality who has experienced such failures. If the patient gave convincing examples of the presence of amnesia, it is important to exclude the possible connection of these situations with the use of drugs or alcohol (the presence of a connection does not exclude a split personality, but complicates the diagnosis).

Questions about the presence in the wardrobe (or on herself) of the patient of things that she did not choose help to clarify the situation with time gaps. For men, such “unexpected” items can be vehicles, tools, weapons. These experiences can involve people (strangers claim to know the patient) and relationships (deeds and words that the patient knows about from the stories of loved ones). If strangers used other names when addressing the patient, they should be clarified, as they may belong to other personalities of the patient.

Depersonalization/derealization. This symptom is most common in dissociative identity disorder, but it is also characteristic of schizophrenia, psychotic episodes, depression, or temporal lobe epilepsy. Transient depersonalization is also observed in adolescence and at moments of near-death experience in a situation of severe trauma, so one must be aware of the differential diagnosis.

The patient needs to clarify whether he is familiar with the state in which he observes himself as an outsider, watches a “movie” about himself. Such experiences are characteristic of half of patients with a split personality, and usually the main, basic personality of the patient is the observer. When describing these experiences, patients note that at these moments they feel a loss of control over their actions, they look at themselves from some external, located on the side or from above, a fixed point in space, they see what is happening as if from the depths. These experiences are accompanied by intense fright, and in people who do not suffer from multiple personality disorder and have had similar experiences as a result of near-death experiences, this state is accompanied by a feeling of detachment and peace.

There may also be a feeling of the unreality of someone or something in the surrounding reality, a perception of oneself as dead or mechanical, etc. Since such perception is manifested in psychotic depression, schizophrenia, phobias and obsessive-compulsive disorder, a broader differential diagnosis is needed.

Life experience. Clinical practice shows that in people suffering from split personality, certain life situations recur much more frequently than in people without the disorder.

Usually, patients with multiple personality disorder are accused of pathological deceit (especially in childhood and adolescence), denial of actions or behavior that other people have observed. The patients themselves are convinced that they are telling the truth. Fixing such examples will be useful at the stage of therapy, as it will help to explain incidents that are incomprehensible to the main personality.

Multiple personality patients are very sensitive to insincerity, suffer from extensive amnesia covering certain periods of childhood (the chronological sequence helps to establish this). school years). Normally, a person is able to consistently tell about his life, restoring in his memory year after year. Individuals with multiple personalities often experience wild fluctuations in school performance, as well as significant gaps in the chain of memories.

Often, in response to external stimuli, a flashback state occurs, in which memories and images, nightmares and dream-like memories involuntarily invade consciousness (flashback is also included in the clinical picture of PTSD). The flashback causes a lot of anxiety and denial (defensive reaction of the main personality).

There are also obsessive images associated with the primary trauma and uncertainty about the reality of some of the memories.

Also characteristic is the manifestation of certain knowledge or skills that surprise the patient, because he does not remember when he acquired them (sudden loss is also possible).

The main symptoms of K. Schneider. Multiple personality patients may "hear" aggressive or supportive voices arguing in their head, commenting on the patient's thoughts and actions. Phenomena of passive influence can be observed (often this is automatic writing). By the time of diagnosis, the main personality often has experience of communicating with his alternating personalities, but interprets this communication as a conversation with himself.

When assessing the current mental status, attention is paid to:

appearance (can change radically from session to session, up to sudden changes in habits);
speech (timbre changes, vocabulary etc.);
motor skills (tics, convulsions, trembling of the eyelids, grimaces and reactions of the orienting reflex often accompany a change of personalities);
thinking processes, which are often characterized by illogicality, inconsistency and the presence of strange associations;
the presence or absence of hallucinations;
intelligence, which as a whole remains intact (only in long-term memory is mosaic deficiency revealed);
prudence (the degree of adequacy of judgments and behavior can change dramatically from adult to childish behavior).

Patients usually present with a marked learning disability based on past experience.

EEG and MRI are also performed to exclude the presence of an organic brain lesion.

Treatment

Dissociative identity disorder is a disorder that requires the help of a psychotherapist experienced in treating dissociative disorders.

The main areas of treatment are:

relief of symptoms;
the reintegration of the various personalities that exist in a person into one well-functioning identity.

For treatment use:

Cognitive psychotherapy, which is aimed at changing stereotypes of thinking and inappropriate thoughts and beliefs by methods of structured learning, experiment, mental and behavioral training.
Family psychotherapy, aimed at teaching the family to interact in order to reduce the dysfunctional impact of the disorder on all family members.
Clinical hypnosis to help patients achieve integration, relieve symptoms, and change the patient's character. Split personality needs to be treated with hypnosis with caution, as hypnosis can provoke the appearance of a multiple personality. Ellison, Kohl, Brown, and Kluft, the multiple personality disorder specialists, describe cases of using hypnosis to relieve symptoms, strengthen the ego, reduce anxiety, and create rapport (contact with the hypnotist).

Relatively successfully, insight-oriented psychodynamic therapy is used, which helps to overcome the trauma received in childhood, reveals internal conflicts, determines a person’s need for individuals and correcting certain defense mechanisms.

The treating therapist should treat all the patient's personalities with equal respect and not take any one side in the patient's internal conflict.

Drug treatment is aimed solely at eliminating symptoms (anxiety, depression, etc.), since there are no medications to eliminate personality splits.

With the help of a psychotherapist, patients quickly get rid of dissociative flight and dissociative amnesia, but sometimes the amnesia becomes chronic. Depersonalization and other symptoms of the disorder are usually chronic.

In general, all patients can be divided into groups:

The first group is distinguished by the presence of predominantly dissociative symptoms and post-traumatic signs, the overall functionality is not impaired, and due to the treatment, they fully recover.
The second group is distinguished by a combination of dissociative symptoms and mood disorders, eating behavior, etc. Treatment is more difficult for patients to tolerate, it is less successful and longer.
The third group, in addition to the presence of dissociative symptoms, is characterized by pronounced signs of other mental disorders, so long-term treatment is aimed not so much at achieving integration as at establishing control over symptoms.

Prevention

Dissociative identity disorder is a mental illness, so there are no standard preventive measures for this disorder.

Since violence against children is considered the main cause of this disorder, many international organizations are currently working to identify and eliminate such violence.

As a prevention of dissociative disorder, it is necessary to timely contact a specialist if a child has psychological trauma or experienced severe stress.

Liqmed reminds: the sooner you seek help from a specialist, the more chances you have to maintain your health and reduce the risk of complications.

In a situation of strong, unbearable, the human mind begins to look for a way out of the current state. Most often, we use one or more defense mechanisms that were first described by the well-known Sigmund Freud, and then several defense mechanisms were brought out by his followers. The human subconscious is able to contrive, coming up with ways to protect our psyche from the destructive effects of stress factors, and if one of these mechanisms continues to operate for a long time, it completely absorbs the work of the human consciousness and leads to serious mental disorders. Everyone remembers American films when, in response to the sad news, the actress wails, repeating the words: “Oh, no, no. This cannot be. It is not true".

This is a vivid example of one of the most common defense mechanisms of the psyche - denial. In a situation of stress on a huge scale, a person gets stuck in a state of denial of reality and invents his own reality, which is far from reality. Due to the protracted process of protecting the body's own psyche, or dissociation occurs - its division into several independently existing parts that are completely different from each other (and there can be three, four, five or even ten of them).

The essence of split personality

This mental illness consists in launching a complex mechanism in which the subconscious mind seeks the possibility of dividing into several parts specific painfully experienced memories or thoughts that correspond to ordinary consciousness and taken from its once realistic perception of the surrounding world. Once in the subconscious, these thoughts cannot be removed from it, so they resurface in consciousness again and completely unexpectedly, due to stimuli - people, objects or events that surrounded a person in a traumatic situation for him.

Symptoms of a split personality

If you notice one or more of these symptoms in yourself or your loved ones, do not rush to jump to conclusions. To make an accurate diagnosis, psychiatrists use a range of proven tests and techniques, and take a complete history to make a final diagnosis.

Split personality is a mental disorder, expressed in a person of two personalities at the same time. It leads to the destruction of the life of the subject, the emergence of severe disorders, up to accidents, suicides and crimes.

Since a split personality is called differently in medicine, it is worth remembering its second name - dissociative identity disorder.

Split personality - causes

AT modern world The reasons for the split personality may be online games where people just get used to their characters. Experts believe that in recent years, gambling addiction, along with are the main reasons for the increase in cases of morbidity. A split personality can be triggered by shocks - mental or physical trauma, accidents, death of loved ones. In addition, people with a weak and weak-willed character who subconsciously seek protection for themselves most often suffer from dissociative disorder.

Treatment of split personality symptoms

A split personality is almost always manifested by the patient's imbalance and loss of connection with the outside world. The people around the patient cannot understand him. Often he has memory lapses, that is, he cannot remember some events from his life. The patient complains of insomnia, headaches, severe and frequent sweating. In addition, the sick person has no logic, inconsistency of actions is committed. A person may have good mood, but after a while he will be in unreasonable sadness. Their feelings are contradictory and inconsistent, both within themselves and in relation to surrounding things and events.

The symptoms of a split personality are the appearance of a second personality, the realization of oneself as two different people. That is, a person in the same situation can behave differently and make completely opposite decisions, a different view of the same things. It depends on which personality prevails at the moment. The person appears to be talking to different people, is in two different dimensions, performs different actions.

split personality disease

Simone Reynders, a researcher at the Institute of Psychiatry, and colleagues decided to look into the question of whether a split personality is a disease by scanning the brains of volunteers who are prone to fantasies and have this disorder. The subjects were divided into two groups and asked to recall unpleasant events from the past. The results confirmed that multiple personality disorder is a disease, as healthy people were not able to be as active even when they imagined that they had two personalities. In addition, a split personality occurs only in adults who suffered some kind of mental trauma in childhood.

Split personality - treatment

You can't cure a split personality on your own. Only a psychotherapist can help a patient get rid of this disease. To date, psychotherapy or clinical hypnosis is used to treat a split personality, as well as drug treatment. The whole process takes a very long time. Sometimes, patients are under observation even after the elimination of symptoms.

Split personality and schizophrenia

Often, a split personality is confused, and many believe that this is one and the same thing. However, these are completely different diseases. The symptoms of a split personality are similar to schizophrenia and therefore often disorders are referred to as schizophrenia.

The main difference between multiple personality disorder and schizophrenia is that dissociative disorder is not congenital. This condition is caused, as a rule, by psychological trauma received in childhood. But there are some signs that are similar for both schizophrenia and split personality disorder. For example, hallucinations.

And so a split personality is a defense mechanism in the mind. A person decides that he is not him, and therefore problems are solved by themselves. However, if you notice at least a number of signs of this disease in the behavior of loved ones or your own, you should immediately contact a specialist.

Mood swings and anxiety are not always a sign of an unstable character. This may be a symptom of the most serious disorder in psychiatry, which is characterized by a split personality. Not everything is as simple as they say in English-speaking countries, where the phenomenon of split personality was first discovered and described by scientists.

Split personality: symptoms and signs

Disorientation in space, depressive states, a feeling of unreality of the environment - these are the symptoms, with the appearance of which a person is still able to pull himself together and go to see a psychiatrist. Treatment by a psychiatrist is not a stigma or a stain on a person, it is an ordinary doctor who treats patients even for migraines and various headaches. And when making a diagnosis of "split personality", the symptoms and signs are well known to the doctor, and he will not confuse them with anything.

As a special term in psychology and psychiatry, personality split has been known for a long time, and it does not cause much surprise if the patient talks about anxiety states, eating disorders at the reception. Symptoms of a person's transition from one state to another are manifested in the conscious sensation of such changes. At this stage, the psychiatrist can help his patient. If a person is not aware of the transitions from one individuality to another, this may cause fear in the doctor, since such a patient can be potentially dangerous to society.

The main causes and signs of a split personality in humans

The usual sleep disturbance in the feeling of being lost, misunderstanding of oneself as a certain person leads to the fact that a certain phobia gradually develops in a person. This is how a split personality is gradually formed, which is defined in psychiatry as MPD or DID - dissociative identity disorder. This is one of the most severe forms of this mental disorder, which is always manifested by the corresponding symptoms.

Mental disorders of a dissociative nature are manifested in several forms: complex, moderate and mild. Psychologists have developed an appropriate test for a split personality, indicating the symptoms and signs behind this disorder in each individual person. Individuality is manifested in the causes of deviations from the norm and symptoms, but psychiatrists note the general factors inherent in each patient.

Any form of dissociation develops in different patients for common reasons:

hereditary predisposition;
the external influence of other family members with their existing dissociative type disorders;
cases of sexual or mental abuse in memory from childhood;
lack of support and assistance from loved ones in a situation of cruel influence.

Against this background, disorders of a dissociative type are formed, which, according to symptoms and signs, are a split personality in children and adolescents with specific changes in behavior, speech, and communication.

Mental abnormalities that are signs of a split include:

memory functions;
personal identity;
consciousness;
awareness of the continuous identity of oneself.

These are integrated components of the psyche, reflecting its functionality. When forming a dissociation, they can “break out” of the whole mental state of a person and, after separation, can even acquire a certain level of independence. The identity and integrity of the personality is lost, in parallel with the existing consciousness, a new form of it arises. At the same time, consciousness ceases to remember specific life episodes, and the psychiatrist considers the situation of psychogenic amnesia.

This situation, especially against the background of severe stress, becomes a factor provoking a split personality. If at the same time, adolescents show symptoms and signs of a dissociative state, then they are clearly manifested in the separation of some personal memories from their own consciousness.

Along with this, defense mechanisms are manifested that are individual for the mental state of each individual person.

Dissociations in children

A split personality is an integral, special mechanism of mental disorder, when consciousness is divided into various components, determined by specific thoughts and event memories. They are not erased from memory, but are repeated and suddenly appear in the child's awareness of himself. They come to life under the influence of triggers, which can be traumatic events or objects that were present during stressful situations associated with psychological trauma.

In childhood, the psychiatrist notes the manifestation of protective mechanisms associated with a lack of care for the child from the people around him, who allowed the child to receive a mental trauma. However, in a situation of insufficient protection, the experience of behavior in subsequent undesirable situations is formed. A unified identity is not an awareness given from birth, it develops with the growth of children and depends on different life experiences. This form of conversion disorder often develops in men, and their split personality is characterized by specific symptoms and signs.

Meanwhile, a dissociative type disorder is not a mental illness, it is a response of the human psyche to being in a stressful situation. In children, moderate conversion disorders appear after an accident, after complex dental treatment. Mental disorders of the dissociative type in moderate and complex form are fixed for a long time and remain in the minds of people who have had traumatic experiences and abuse in childhood. Violence experienced by children stands out as a major factor in dissociative disorders in its various forms. The same reaction of the psyche is caused by serious stress from the loss of loved ones by children, from the transferred complex diseases. Psychotherapists, with the permission of the person or his relatives, record sessions on video, where a split personality, its symptoms and signs are clearly visible and understandable to specialists who need to gain work experience.

Symptoms in the formation of a personality split

In a detailed professional examination, the symptoms of a personality split are manifested by the following aspects:

as dissociative amnesia of a psychogenic nature. This may be an unexpected loss of memory properties dysfunction after a traumatic stressful event. However, at the same time, a person assimilates new information quite adequately, and a person is fully aware of the fact of memory loss. This variant of a split personality with its symptoms and signs in young women is observed most often;
like a dissociative fugue. This is a state of flight of a psychogenic type, manifested in the form of unreasonable dismissal from work or leaving home. At the same time, a person's consciousness is significantly narrowed, memory is partially or completely lost. Often a person is not aware of memory loss, he imagines himself in a different personal state and even responds to other people's names;
as dissociative identity disorder. This suggests a personality disorder when she presents herself in the plural. More than one personality manifests itself in a person at the same time, they alternately dominate, which is noticeably reflected in behavioral reactions and attitudes. Formed additional personalities often have different sex, age and even national origin;
as a depersonalization disorder. This is the alienation of one's body of a periodic or permanent nature, realized by the person himself as an outside observer, which is similar to the awareness of dreams. In this state, spatial and temporal perception is distorted, a person can see disproportionate limbs and feel the unreality of the environment. Here, as a rule, anxiety and depressive states are present;
as a dissociative disorder in the form of a trance. In this state, consciousness is upset, the reaction to stimuli coming from the external environment decreases.

In all types of personality disorders, there are suicide attempts, anxiety and depressive states, panic attacks, hallucinations. Combinations are noted different types disorders accompanied by psychogenic amnesia. In the photo, the symptoms and signs of a split personality are reflected little, however, photographs of patients are actively used in training courses for students of medical universities.

Diagnosis of personality split

Diagnosis of dissociative disorders is based on the following factors:

a person has two distinct personal states that periodically control his worldview and behavioral reactions;
the patient forgets information about himself, and this is not a simple forgetfulness caused by somatic diseases, drug exposure or alcohol intoxication.

When diagnosing a personality split in children, it is important not to confuse the mental state with games of a fantasy nature. However, at any age, doctors seek to exclude the presence of an organic lesion in the structures of the brain, and prescribe an Encephalogram, Magneto-Nuclear or Computer examination. It is required to exclude infectious diseases, brain tumors, organic lesions of the temporal lobes of the brain, schizophrenia, and various dementias. The simulation of the state of splitting, which is inherent in a completely different mental disorder, is also excluded. Wikipedia about split personality, its symptoms and signs writes specifically that "diagnoses are being established: multiple personality disorder, split personality, split personality."

According to Wikipedia, a personality split can be established as a final diagnosis if the exact criteria are confirmed during the examination:

the patient demonstrates 2 or more characteristic personal states that have a stable worldview, a separate worldview;
these personalities alternately control the behavior of a person;
the patient does not remember personal information, which cannot be defined as ordinary forgetfulness;
the patient is not under the influence of alcohol or drugs.

Different formulations of the diagnosis are considered correct - multiple personality disorder, conversion disorder, split personality. Today, psychotherapists use the term "dissociative identity disorder", considering it the most accurate and correct. This formulation of the diagnosis most closely matches the characteristics of the patient's condition.

Treatment for split personality

The treatment of dissociative disorders is a course of psychotherapy in combination with medication support. Psychotherapists help to get rid of a split personality, based on relevant experience in ridding their patients of dissociative disorders. Of the medicines, antidepressants and tranquilizers are used, which suppress excessive activity and relieve depression. However, there are no targeted drugs in the arsenal of physicians yet. Therefore, it is not about drug treatment but only about drug support.

One of the methods of treatment is hypnosis, thanks to which psychotherapists "close" unnecessary personalities in the minds of their patients. The prospects for recovery are individual character. Dissociative flight and amnesia heal fairly quickly, but they can become chronic. In general, all types of personality splits are chronic disorders that require long-term continuous treatment.