In this review, I will discuss the article ‘The Evolution of Alter Personality States in Dissociative Identity Disorder (DID)’ (Pica, 1999). Pica’s article is about to explain what the causes are the alter personality states formed in early childhood, and how the personality develops during a critical period. In particular, the author proposed that the reason why the original character develops dissociative states is due to the imaginary companions as a defensive mechanism to protect the children get away from the unbearable pain, which he suggests that the emotional trauma might have taken place in childhood.
The treatments of merging the dissociative states have also been discussed in different ways, which the key is to early diagnosis the DID. The arguments will briefly summarise and criticise in the following paragraphs. I shall be claiming that the perspectives of DID evolution although interpreted quite reasonable in the article, but still remain controversial. The importance of this article lies in pulling all theories together and discussing DID in a developmental context.
First of all, the author provides a brief history of DID. Pierre Janet, a French physician and psychologist, who coined the term dissociation to represent the patients whom were affected by traumatic experiences that the consciousness was split into two or more sections. The concept then swept across Europe during the late 19th century, only used for the rise of behaviorism and the emergence of schizophrenia. As a result, only a few cases had been recorded in the literature during the mid of 20th century (Ross, 1989).
Dissociative Identity Disorder was not referred to as Multiple personality Disorder until two cases “Eve” and “Sybil” were spread, and then have come into public notice. According to these two cases, the professionals started psychophysiological research and committed to the recognition of MPD, along with the increasing number of cases have confirmed and reported in the literature during the decades, the disorder is eventually defined as DID (Ross, 1991). As people have a certain degree of understanding of DID, which has considered as the most complex disorder so that the experts begun to search for the causation.
Some questioned that the disorder is an iatrogenic artifact of the therapeutic relationship, which means patients would be able to create altered personalities in response to the hypnotic instruction of their therapists. The hypothesis of iatrogenic position has been examined whether hypnosis has direct relevance of alter identities. Cases were divided into three groups: patients who had never been hypnotized, patients who had been hypnotized only after diagnosis, and patients who had been hypnotized before and after diagnosis (Pica 1999: 406).
If the iatrogenic position is true, the group that had diagnosed after hypnosis should have a majority number of personality presentations. However, no remarkable differences were found. The finding poke a hole in the notion that DID is affected by therapists’ hypnotic techniques. Furthermore, another theory talked about that the alter personalities may be formed during a window of vulnerability, with which the author agrees. The period of greatest vulnerability for the development of DID is between age 4 to 5 and age 18, during this time the original personality tends to use splitting defenses to developing alter personalities.
The phenomenon consist with the observations, which the children who had a trauma before age 6 are likely to perform a larger number of personalities and display greater disorganisation, while the children who had a trauma after age 8 tend to exhibit fewer personalities. That is because the development of ego strength had a significant increased after this age. Author believes that the early traumatic experiences may make the infant in ways, which may lead him or her splitting personality, and evolving into distinct personalities later in life (Pica 1999: 406).
The piece of evidence is quite reliable, but also makes us to consider if the window of vulnerability is a key factor that human may take a different form of personalities in order to protect human mind, why not all humankind would be able to use this feature to get away from any intolerable issue. The point is many of us have chances to face many difficulties in childhood, but most of us achieved through perseverance- thus the window of vulnerability may be one of the reasons that influenced alter personalities, but not sufficient to explain what do alters emerge in the everyday world.
According to Stern’s (1985) research, there is a critical period for infants to develop a core self, which is the first 6 months of life. In this period, the core self as the basic context to integrate all experiences people would face, and make them meaningful in order to being a unified, integrated person. Once people experience the self as a single, bounded entity, they are leading to the self-control and development of a healthy life history (Pica 1999: 406-407).
Return to DID, Dr. Fink has suggested that the “pathologic findings inherent in MPD reflect a predominant disorganization in core self experiences” (Pica 1999: 407). Assuming the theory is correct, the evidence shows that patients with lack of self-control over their body applied disruptions of the core self, to escape from the unbearable emotional experiences by experiencing internal fragmentation. In additional, the disruptions may not be traumatically induced but may be genetically predetermined.
However, the author doubt Fink’s suggest, because the author strongly believes that what determines the child will develop DID depends more on whether he or she is traumatised to a point in life that allows for the creation of alter personalities (ibid. ). In fact, both their views seem to be considerably reasonable, but I may be inclined to agree with Fink’s point of view. The main reason, like I said earlier, a group of children who have been trough traumatic events are not all developed alter personalities.
In which means that each child has varying acceptance of trauma, so there must be a determinant to shape dissociative states – Genes. Everyone knows that genes, as the material basis of human cells, and genes control the biological characteristics, including the morphological structure, physiological feature, and behavioural pattern etc. Some experts also stated that personalities are highly likely determined by genes and thus whether a child forms split personality could also be decided by genetics.
Last but not least, researchers provided a fascinating theory, that patients diagnosed with DID have difficulty to implement ambiguity and have issue integrating new experiences. Findings revealed most of the DID patients tend to thinking in a fairly compartmentalized way, for example, over-generalizations, dichotomous thinking, and selective abstraction. These features of thinking are known as cognitive distortions, which might be in charge of maintaining the dissociation of powerful influences (Pica 1999: 407). In my personal case, I am a person whose thinking is usually polarized and concrete as well as some people I know or else.
If the statement above is right, people who are this type would be likely to develop multiple personalities, would not we be, as well? Whereas, for all I know none of us had DID. I questioned perhaps the factor is not directly related to the disorder, or it is a fraction of shaping the dissociation, right or wrong, the theory is still profound and worthy of thinking. In this review, I have discussed Pica’s article to a certain extent. The article covers several points – Is DID an iatrogenic artifact? What is the window of vulnerability portrays in DID?
Is it possible that genetically determined is a vital factor of forming DID? Is polarized personality responsible for DID? I have judged most part of views skeptically, but that is the way to find the truth. This certainly does not mean that the perspectives the author agreed are unreliable. By reading through the article, I gained a lot of knowledge about the disorder, and it also gives various aspects for the reader to think deeply. Further discussion and development of this issue is needed to advance research on these matters especially in the area of crucial treatment.