Gloria Cain, the wife of embattled presidential candidate Herman Cain, came out in defense of her husband on Sunday. Speaking about the sexual harassment allegations against the former pizza magnate, Mrs. Cain quipped, “I’m thinking he would have to have a split personality to do the things that were said.” How many Americans have multiple personalities?
Somewhere between zero and 9 million. Multiple personality disorder, which is now known as dissociative identity disorder, is highly controversial. Those who believe it’s a legitimate diagnosis say that it affects between 1 and 3 percent of the population. The severity of the illness can vary, and it's claimed that most sufferers don’t know they have it. Many doctors, however, want the disorder stricken from the Diagnostic and Statistical Manual of Mental Disorders—the bible of psychiatric illnesses. They believe that the patients really are mentally ill, but that they merely act out the multiple personalities in response to suggestions from the therapist.
Dissociative identity disorder shares symptoms with other serious psychiatric illnesses. Most patients have a history of depression, intense headaches, and a failure to respond to antidepressants or other treatments. Many have attempted suicide or otherwise harmed themselves. When a therapist suspects dissociative identity disorder he asks questions like, “Do you sometimes feel like you’re someone other than yourself?” or “Are there ever gaps of time that you can’t remember?” A classic sign is a sudden loss of attention. The patient stares off into space and can’t remember what she and the therapist were discussing.
Proponents for the diagnosis say the moment of personality change has been mischaracterized in the media. Some readers may remember multiple personality patients on the talk show circuit in the 1980s and 1990s. When Oprah or Sally Jessy Raphael asked the guest to change personalities—"May I please talk to Lisa?”—she would suddenly and dramatically change her voice, facial expressions, and mannerisms. The alternate personality was usually the polar opposite of the original. Therapists say that, in most cases, the change is more subtle. An adult might start to sound more childlike, for example. Most patients are ashamed of the problem and prefer not to make a spectacle of themselves.
Skeptics point out several problems with all this. Like many controversial medical diagnoses, the symptoms are vague and vary tremendously from case to case. Some patients claim to have no knowledge of what their alter-egos are up to, while others have complete awareness, or can switch among them on demand. A few have one master personality that can keep tabs on the others. This inconsistency suggests to many doctors that the disorder is a construct.
Gloria Cain was obviously jesting about her husband, but her suggestion raises an interesting point about gender disparity in dissociative identity disorder. Ninety percent of the patients are female. The few male patients who have been identified typically receive the diagnosis only after committing some public wrong. Advocates say this is because crime is often what gets men into therapy, while skeptics say this disorder is a too-convenient post hoc explanation for antisocial behavior.
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Explainer thanks Bethany Brand of Towson University and Debbie Nathan, author of Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case.