Dissociative Disorders

Ordinarily, a personality has unity and coherence, and many facets of self are usually integrated with people making them act, think, and feel with a certain degree of consistency. Memory plays a critical role in this integration connecting the past and present, providing a sense of personal identity which extends over time. 

Dissociative disorders involve the breaking down of normal personality integration, which results in significant alteration of memory or identity. Three such forms can be taken by this disorder are Dissociative Identity Disorder (DID), Psychogenic Amnesia, and Psychogenic Fugue.

Psychogenic Amnesia

A person with psychogenic amnesia responds to a stressful event with extensive yet selective memory loss. Some are unable to recall their past. Others cannot recall specific events, places or people, even though other contents of memory such as memory, as well as cognitive and language skills, remain intact.

Psychogenic Fugue

A more profound dissociative disorder is Psychogenic Fugue, in which a person can lose all sense of personal identity, making such a person give up his or her customary life and wander off to a new, further away location with a new identity.

The fugue (derived from the Latin word fugere meaning 'to flee'), is usually triggered by a highly stressful traumatic event, which could last from a few hours to days—or even years.

Some adolescent runaways have been associated with fugue state. Married fugue victims may wed someone else and even make career changes. The fugue state typically ends when the person suddenly recovers their original identity, waking up mystified and distressed at the event of being in a strange place, under strange circumstances.

Dissociative Identity Disorder

In Dissociative Identity Disorder (DID) (formerly known as multiple personality disorder), two or more separate personalities coexist in one person. DID is the most striking and widely-publicised of the dissociative disorders.

In DID, a primary or host personality appears more often than the others (called alters), but each personality has its own integrated set of memories and behaviour. The personalities may or may not know of each other's coexistence. They can differ in age and gender and can also differ mentally, behaviorally, and psychologically.

Alters

An example of this was a case about a 38-year-old woman named Margaret who was admitted to a hospital with paralysis of her legs following a minor car accident. During her interview, the woman, who was a member of an ultra-religious sect, reported of sometimes hearing a strange voice inside her, threatening to take over completely. The physician's suggestion to her was to let it take over, which led to the report below.

The woman closed her eyes, clenched her fists, and grimaced for a few moments during which she was out of contact with the others in the room. She suddenly opened her eyes and was a different person. She called herself Harriet. Even though as Margaret; she had been paralysed, complained of fatigue, headache, and backache; as Harriet, she felt well and suddenly proceeded to walk around the room unaided.

She spoke scornfully about Margaret’s religiousness, her invalidism, and her puritanical life; professing of her need to drink and go partying, but Margret's interest was only to go to church and read the Bible. At the interviewer's suggestion, Harriet reluctantly agreed to bring Margret back. After more grimacing and fist-clenching, however, Margret reappeared paralysed, complaining of a headache and backache, and completely amnesic of the brief period of Harriet's release from her prison (Nehemiah).

Biological variations

Mental health workers and researchers have reported dramatic differences among the alternate personalities in DID patients. For example, physical health differences, voice changes, and even changes in left and right handedness.

In some patients, one personality’s presence can bring on allergies which aren't present with the other personalities. One patient almost died due to a violent allergic reaction of a bee sting, yet when an alternate personality was stung a week, later there was no such effect.

In female patients, each personality can have a different menstrual cycles, causing the patient to have several periods for a month. In some patients, each personality needs a different eyeglass prescription. One maybe farsighted while the other is nearsighted (Miller).

Causes of DID

According to Frank Putnam's Trauma-dissociation Theory, the development of new personalities occurs due to severe stress. For the vast majority of patients, this begins at early childhood, which is frequently in response to sexual or physical abuse.

According to Putnam's studies of 100 patients, 97 of them had reported severe abuse and trauma in early and middle childhood, which is a time when children's identities are not well-established, which makes it easy for them to disassociate. In response to trauma and their helplessness to resist it, children may engage in something similar to self-hypnosis and dissociate from reality.

They create an alternate identity to help them detach from their trauma, thereby transferring it to a stronger personality which can handle it and numb the pain. According to the theory, over time, the protective functions served by the new personality remains separate in the form of an alternate personality without being integrated to the host personality (Meyer and Osborne, 1987, followed by Putnam, 2000).

DID has become a controversial diagnosis, with some critics questioning the actual occurrence rate, while others question its very existence. Prior to 1970, only around 100 cases of DID had been reported worldwide. Even today, DID is virtually unknown in some cultures, including Japan (Takahashi).

However, after the disorders were published in popular books and movies, there were many additional cases reported. There has been an increase in the number of alternate personalities in a person (Spanos). A person can be so immersed in an imagined role such as an alternate personality), it can make them feel quite real, making them act accordingly (Spanos). Further research into DID can help better understand factors that can explain the production in memory alteration, psychological responses, as well as behaviour.