scientificamerican

Thank you for this question! This is an important issue. Because we don't have a definitive test of psychiatric conditions like x-rays or blood tests, it is always possible that someone is faking any mental illness. A trained therapist knows how to gather comprehensive information that can reveal inconsistencies or signs someone is not for real. That doesn't mean it doesn't happen. Therapists are still human. But I do find it interesting that DID is viewed with such suspicion compared to other disorders like schizophrenia. When someone tells us they are hallucinating, we only have their word for it. But we don't tend to doubt them the way we do with claims of DID. I think it's because DID challenges a really fundamental commitment of western psychiatry to a particular concept of the "self."

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Sure. We all have "parts" of ourselves. What we experience as our "self" is really a dynamic system of different aspects of our ways of being in the world. For example, I have a perfectionist part that is diligently trying to answer every question here or wants to get everything done on deadline, etc. I'm not really experiencing my "mom" part at the moment, which is more present when I'm hanging out with my kids. For me, those different parts still feel like "me" and I remember things from each experience without difficulty. With DID, the parts we all have are so dissociated from one another that they don't share consciousness or memory.

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Well, that's an interesting question. I don't necessarily believe there is a "true self," for Ella or any of us, really. We all have parts--just for most of us, there's not a disconnect among them. For Ella, the person who originally came to see me for therapy was referred to by the parts as "Big Her," and they insisted she was not a real person but just a shell.

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The two-year-old didn't come "out" often but was often present in the background and sometimes came out in therapy. You're right that the child parts could put her at risk. We talked about that quite a bit.

The transition between personalities was often quite subtle, often preceded by a brief pause. Ella did learn how to control her DID to a certain extent, how to call particular parts forward or try to prevent them from coming out. It didn't always work, though.

The only time I witnessed parts actively conversing with each other was over email. They would sometimes email each other and copy me on the emails.

They have! People with DID have different brain scans on fMRIs than people who pretended to have DID (as part of the study).