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Health : More to me than meets the eye

BY KAREN ANN MONSY
Meet me, myself...and more of me. How freaky is it if each time you awoke, you found yourself in a different place, with no recollection of what you are doing there or even how you got there? What would you do if it were to happen on a regular basis? It's one thing to be at loggerheads with those around you but to battle it out with your own mind, your very own self, is to play a mind game of an entirely different genre altogether.

Yet, this is exactly what the condition of Multiple Personality Disorder (MPD) evokes in an individual. MPD has been classified as a psychiatric disorder which is characterised by having at least one "alter" personality that controls behaviour. 'Alters', in this context, would refer to the alternate personalities that take control of the individuals as the occasion demands. When an occasion arises that the individual cannot handle, his alter, or a personality more capable of 'handling the situation' steps in. The 'alters' are said to occur spontaneously and involuntarily, and are more or less independent of each other. Each alternate personality possesses a unique name and identity. It is this presence of multiple personalities that leads to a chaotic and fragmented life.

Thus, the central feature of this controversial disorder is the existence of two or more distinct personality states residing in a single individual, each with its own pattern of perceiving the environment. Incredible as it may seem, personalities are switched with no much ado, just like flipping on a light switch. No doubt, you'll agree that this is nothing short of a living nightmare. True, we may have no choice when we put up with nightmares in the dark solitary hours of the night but how do you propose living each day not knowing who you are, or who you're going to be, in this case.

The most famous case of MPD so far is that of William S. Milligan who was arrested for rape in Ohio in 1977. As police and psychologists examined him, most unbelievably they found him to possess several personalities -- 24 to be exact! The first personality was the host personality, Billy, 27 years old, blue eyes, brown hair. The second was Arthur and the third Leigen, who was adept in handling guns and at combat. As and when the situation arose, the respective personality stepped out. When Billy was about to be hit by a car, he turned into Leigen and jumped out of his vehicle, rolling onto the road. With time and upon further examination, psychologists were able to draw up exact descriptions of Billy's other personalities, some of whom were even female. This is just a tiny peek into the routine (special emphasis on 'routine') life of one suffering from this rare condition. It would be no shocking revelation that having to undergo such mental torture each waking day would bring one almost to the brink of insanity. Real-life incidents like Billy Milligan's raise up a storm of questions which psychiatrists find themselves at a loss to deliver a surefire answer, let alone a remedy. Although research is being carried out, they have only as much conclusive proof of its existence as would fit a thimble. Medical experts are unable to determine the exact cause for the development of this state of mind. It has, more or less, been attributed to childhood sexual trauma so great that the victim was forced to create another personality that could deal with the pain.

Critics of MPD have brought certain issues to light and things boiled to a head when they purported that MPD was just a condition created by therapists in their labs. They believe that because the therapist points in a certain direction so vigorously, the patient is eventually inclined to believe that he is indeed a victim of MPD and even begins to act in a manner that would seem to fit the diagnosis. But it wouldn't be fair to place these patients in the hot seat as these concepts are constantly reinforced in their memory during every session. Also, this group of individuals can be hypnotised easily and are highly suggestible. This only serves to strengthen the opposition's case.

One of the threats that this condition poses is that sometimes the alter commits crimes without the knowledge of the host personality. The individual is whisked away and treated like a criminal for a crime that was allegedly committed by him but technically one he didn't commit. Unbeknownst to authorities, it was his alter who'd broken the law. But then again, just like criminals who plead insanity, there are lawbreakers and offenders who claim to be affected by this condition. A jury or judge who falls for their act would let them get away scot-free and no one would be any the wiser for it. It is imperative that these issues be addressed at the earliest before the climax sees us unable to tackle the soaring rate of crimes committed by those claiming to be affected by MPD.

According to Clinical Psychiatry by Robert E. Hales and Stuart G. Yudofsky, the number of cases has risen over the years. Primary factors are the general awareness among medical health professionals, availability of specific diagnostic criteria and reduced misdiagnosis of MPD as schizophrenia and the like. It should be noted that books and films have had a strong influence on the general public beliefs, e.g., Sybil, The Three Faces of Eve or The Minds of Billy Milligan. These mass media presentations have had an impact on MPD patients as well. The statistics speak for themselves: Flora Rheta Schreiber's Sybil is the story of a woman with sixteen personalities which were supposedly created as a result of child abuse. Before the publication of Sybil, there had been only about 75 reported cases of MPD. But since Sybil, there have been some 40,000 diagnoses, which you have to admit, is quite an alarming number to account for. This increase is best documented in North America.

When asked whether such a condition has been reported in the UAE, Dr P Sivasankaran , MD (Psy), replied, "One has to understand that there is a lot of trans-cultural psychiatry. MPD has mostly been reported in the US right now. Conditions like dissociative fugues are well-established but MPD is a condition I've only heard and studied about." In approximately 30 years of experience, he has never come across such a case. "But", he quickly adds, "that does not mean it doesn't exist. It may or may not exist and that is the controversy in medical circles."

No matter how much of probing is undertaken into such cases, to the layman, it would seem next to impossible to determine whether someone was feigning an act or was truly a cause for medical concern. And then again, one needs to question: would it be possible for so many people to recollect false memories? How can so many individuals carry themselves as though possessed, as though their body is controlled by a mind not quite their own? How can one identify an individual with MPD? These and more are just some of the questions that have been posed as a result of increasing awareness of the existence of MPD.

Jim Carrey's portrayal of a character with a dual personality in the movie Me, Myself and Irene was indeed an eye-opener into an unexplored, little-known world of mind conflicts. But one has to agree, whatever may be the situation, patients of MPD should be treated with care and not contempt. Handling a situation of such a sensitive nature doesn't just demand special attention; it practically hollers for it. As is so often encountered, though, this seems to be yet another case of juggling too many questions and hardly any answers. Science needs to come up with some pretty good answers - and fast - before the world sees too many ugly faces to this disease.

Courtesy : Gulf Today


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