Schizophrenia is not Dissociative Identity Disorder (D.I.D.)

This chapter discusses the difference between paranoid schizophrenia and dissociative identity disorder (D.I.D.). We briefly comment on the movie "The Three Faces of Eve (1957)" starring Joanne Woodward, the movie "A Beautiful Mind" by screenwriter Akiva Goldsman from a biography of John Nash by Sylvia Nassau, and the Apple TV series "The Crowded Room" also by screenwriter Akiva Goldsman from a non-fiction book by Daniel Keyes called "The Minds Of Billy Milligan."

Pastime With Good Company by King Henry VIII, played by The Chestnut Brass Company 

Pastime With Good Company, composed by King Henry VIII, played by The Chestnut Brass Company

Chapters

• 0:00 Schizophrenia is not Dissociative Identity Disorder

Transcript

Podcast 11: Schizophrenia is not D.I.D.

Hello, my name is Diana Dirkby and I live with paranoid schizophrenia.

The soundbite you heard is “Pastime With Good Company” composed by King Henry VIII and performed by The Chestnut Brass Company.

You are listening to my Podcast Show: “Schizophrenia As I Live It.” This podcast will air during the prepublication phase of my forthcoming book “The Overlife, A Tale Of Schizophrenia.” The website for the book is: https://overliveschizophrenia.com/ . The book will appear soon, and after it does, we will start a new Podcast Show: “Schizophrenia As I Live It, II.” The new podcast show will assume you have access to my novel, but you will be able to follow the podcast independently of the book. Also, there will be no “spoilers,” so you will be able to read the novel at your own pace if you do purchase it. 

Today is Chapter 11, entitled:“Schizophrenia is not D.I.D.”

In today’s podcast D.I.D. (pronounced DID) stands for "Dissociative Identity Disorder.” According to the website https://www.psychiatry.org there are several different types of dissociative disorders. We will concentrate only on DID. DID is a mental health condition. Someone with DID has multiple, distinct personalities. The various identities control a person's behavior at different times.

Dissociative identity disorder is associated with overwhelming experiences, traumatic events and/or abuse that occurred in childhood. Dissociative identity disorder was previously referred to as multiple personality disorder.

By contrast to all the bad representations of mental health consumers in the media, there are at least two examples where DID is dealt with intelligently. One is the 1957 drama movie “The Three Faces Of Eve,” starring Joanne Woodward. 

For her performance in this movie, Joanne Woodward won the Academy Award for Best Actress, making her the first actress to win an Oscar for portraying three personalities (Eve White, Eve Black, and Jane).

More recently, an Apple TV series called “The Crowded Room” starring Tom Holland and Amanda Seyfried features DID. It’s well done and I recommend it. As the series is current, I won’t say anymore about it so as not to drop a “spoiler.”

My main reference for D.I.D. when preparing this chapter was the website  https://www.psychiatry.org 

Symptoms of dissociative identity disorder, or criteria for diagnosis, include: 

The existence of two or more distinct identities (also referred to as “personality states”). The distinct identities are accompanied by changes in behavior, memory and thinking. The signs and symptoms may be observed by others or reported by the individual.

Ongoing gaps in memory about everyday events, personal information and/or past traumatic events. The symptoms cause significant distress or problems in social, occupational or other areas of functioning.

The Sidran Institute, a mental health service in Towson, Maryland, notes that a person with dissociative identity disorder “feels as if she has within her two or more entities, each with its own way of thinking and remembering about herself and her life. It is important to keep in mind that although these alternate states may feel or appear to be very different, they are all manifestations of a single, whole person.” Other names used to describe these alternate states include “alternate personalities,” “alters,” “states of consciousness” and “identities.”

People who have experienced physical and sexual abuse in childhood are at increased risk of dissociative identity disorder. The vast majority of people who develop dissociative disorders have experienced repetitive, overwhelming trauma in childhood. Among people with dissociative identity disorder in the United States, Canada and Europe, about 90 percent had been the victims of childhood abuse and neglect.

Treatment typically involves psychotherapy. Therapy can help people gain control over the dissociative process and symptoms. The goal of therapy is to help integrate the different elements of identity. Therapy may be intense and difficult as it involves remembering and coping with past traumatic experiences. Cognitive behavioral therapy and dialectical behavioral therapy are two commonly used types of therapy. Hypnosis has also been found to be helpful in treatment of dissociative identity disorder.

D.I.D. and schizophrenia are often mistaken for each other. This confusion has its roots in the introduction of the word “schizophrenia” by Eugene Bleuler in 1908. It comes from the Greek roots “schizo” (split) and “phrene” (mind). Bleuler used this name to emphasize the mental confusion and fragmented thinking characteristic of people with the illness. The concept of "split mind” has since been confused with “fragmentation into more than one personality.”

Indeed, we have all heard someone in every day conversation refer to a “schizophrenic situation” when they have to decide between, or they experience, two or more possible choices. Not only is this a politically incorrect depiction of schizophrenia, it is quite simply incorrect.

I describe in detail in my forthcoming book “The Overlife, A Tale Of Schizophrenia” the fragmentation of cognitive abilities when the character Sarah has a psychotic break or relapse of her schizophrenia. We have also talked about such symptoms in past chapters of this podcast. 

Because of the confusion between D.I.D. and schizophrenia, the term "schizophrenia" has been criticized by some people who believe that it is misleading. They argue that the word "schizophrenia" implies that people with the illness have a split personality, or D.I.D. which, as we have remarked, is not the case. However, the term "schizophrenia" is still widely used by psychiatrists and other mental health professionals.

A struggle with schizophrenia arises from a combination of genetic predisposition and an environment that worsens the symptoms. There is no genetic component in D.I.D. which is purely the result of trauma of some kind.

The character Sarah in my forthcoming book suffers from PTSD (post traumatic stress disorder) from childhood experiences as well as the more dominant condition, for her, of schizophrenia. However PTSD is not D.I.D. as Sarah is aware of the stress that her PTSD imposes on her symptoms originating in schizophrenia, and doesn’t identify as several personalities. PTSD is a manifestation of trauma, not a psychological attempt to escape it by assuming an alternate identity.

A lot of confusion about mental health diagnoses originates in the media, TV, movies, books and audio books, TV and movies being the main culprits. That’s why it’s so refreshing to encounter a film like “The Three Faces Of Eve,” and the series “The Crowded Room.”

Another film is worth mentioning as having done a good job. I am thinking of the movie “A Beautiful Mind” from 2001, an American biographical drama film directed by Ron Howard. Written by Akiva Goldsman, its screenplay was inspired by Sylvia Nasar's 1998 biography of the mathematician John Nash, a Nobel Laureate in Economics. “A Beautiful Mind” stars Russell Crowe as Nash, along with Ed Harris, Jennifer Connelly, and Paul Bettany. 

The movie won four Academy Awards, for Best Picture, Best Director, Best Adapted Screenplay and Best Supporting Actress for Connelly. It was also nominated for Best Actor, Best Film Editing, Best Makeup, and Best Original Score.

My spouse and I had the privilege to know John Nash during our combined years as academics spent in the Princeton, New Jersey, area. John Nash told us he was happy with the film “A Beautiful Mind” even though the way it portrayed his experience of paranoid schizophrenia wasn’t entirely accurate. John Nash thought the film portrayed what it feels like to struggle with this condition better than if it had tried to be strictly scientifically accurate. I venture that a similar comment applies to the Apple TV series “The Crowded Room” in its treatment of D.I.D.

You may ask whether the story “Dr Jekyll and Mr Hyde” is about D.I.D. or about schizophrenia. In my view, it’s about neither, even though, in the tale, two identities live in the one character. It’s not D.I.D. for all that, as the change between the two characters is due to a potion, not a trauma. It certainly isn’t schizophrenia for the reasons we have already put forth that distinguish a personality change from the fragmentation of cognitive abilities characteristic of that condition.

Elsewhere in this podcast, I have described a technique I use to help me with social contact when I am struggling with schizophrenia, see for example Chapter 5 of this podcast, entitled: “Socializing While Living With Paranoia.” If I must go outside my home and I do not feel as if I can cope with that, I may pretend to be someone else for my outing. I have adopted  a version of this technique since I was a child. However, this is a conscious device, not an uncontrolled switch between personalities characteristic of D.I.D.. I have always been able to “keep track” while using this device that helps me cope with difficult times. I revert easily back to myself once I am again back home.

We shall certainly in future podcasts address the distinction between D.I.D. and schizophrenia. People living with D.I.D. suffer a stigma not unlike those living with schizophrenia, in part because of the confusion between the two diagnoses. When someone living with D.I.D. or living with schizophrenia, experiences a mental health emergency, there is an associated lack of control over their behavior which is at the heart of the stigma they face. The uneducated onlooker sees danger lurking in someone who cannot maintain a single personality (D.I.D) and in someone whose cognitive fragmentation results in uncontrolled paranoia and its consequences. Often they label the person living with D.I.D. and the person living with schizophrenia as suffering from both conditions: D.I.D. and schizophrenia. Therefore the stigma is doubled and based on inaccurate assumptions.

We’ll talk about such matters again either in this podcast series or the future one after my book is available!  

Thank you for listening!

Let’s end by listening again to “Pastime With Good Company.”