Newsgroups: bit.listserv.psycgrad
Date:         Wed, 30 Sep 1992 00:35:24 -0700
              <PSYCGRAD@UOTTAWA.BITNET>
From:         MaryAnne Murray <murray@SEATTLEU.EDU>
Subject:      More on MPD

Richard Kluft, one of the better known researchers in the study of MPD
and dissociation, has constructed a profile of persons with MPD:

The average Multiple spends 6.8 years in the mental health system
before receiving an accurate diagnosis of MPD, and usually has been
diagnosed as borderline and/or schizophrenic.

70 to 80 percent of persons who have MPD also have Borderline
Personality Disorder. (That's SOME but not ALL.)

Persons with MPD tend to be above-average in intellect and creativity.
Different alters may enthusiastically undertake studies in different
fields, such that an integrated multiple may be an incredibly
well-read (and often self-educated) person. Also, they may artistic in
many media. For example, one Multiple whom I know is an accomplished
pianist, award-winning poet, scrimshaw artist, scholar in several
fields of study, computer wizard, floral arranger and credentialed
judge of flower shows, business administrator, human services program
designer... It's a long list! This person also draws well, and
depending on the alter who is "on board" at a given time, she may draw
with her right hand or her left hand (she is a right-hand-dominant
person) with equal proficiency and visual drama.

Persons with MPD, especially those who are not-yet diagnosed, may
function at very high levels, and these are likely to be workaholics.
I have read case studies of persons who are physicians, lawyers,
award-winning school teachers, writers, musicians and others--people
who are well-respected and hard working in their fields--who have MPD.
I am personally aquainted with 4 multiples who are psychotherapists--and
they are good therapists. I also know some psychotherapists who have
chosen to NOT work as therapists during their healing processes, and I
particularly respect the very difficult choices they have made to
place their first priorities on getting healed and whole, for their
own sakes as well as for the welfare of their clients.

Persons with MPD often (usually?) also have substance addictions
(alcohol and benzodiazepines being most common), eating disorders,
self-mutilation habits, and/or sexually promiscuous behavior.

It is not uncommon for persons with MPD to require several bouts of
treatment for alcoholism or other substance abuse. After all, the
alcoholic multiple has likely used alcohol to numb the feelings and
flashbacks which would erupt in sobriety, and it is difficult to tell
which alters are using drugs/alcohol and whether or not these alters
are "on board" for treatment.

When I encounter a client who has been through treatment several times
and who has an eating disorder as well as self-mutilation and high
suicidality, and it is known that the client has come from a highly
dysfuntional family or is the victim of rape or sexual abuse, I know I
am dealing with a person who has a high likelihood of dissociative
disorder. I watch and listen carefully. For my purposes, I consider
the possibility of dissociative disorders insofar as such a factor
affects the client's ability to become clean and sober and stay that
way. I do not treat the MPD as such, because I am in a chemical
dependency treatment agency rather than a mental health agency. So, I
observe and document that which I observe. And when a client
"switches" and I recognize it with my well-tuned antennae, it is time
to call in reinforcements to diagnose and treat the issue of MPD.

Most of the MPD cases which are documented in journals or written as
books for the popular press are cases of women. I am not so sure that
this means there are more female multiples than male multiples. We
once thought that men comprised about 90% of all alcoholics and that
there were relatively few female alcoholics, but now it is believed
that alcoholism affects equal numbers of men and women--the difference
is that women were less visible and less recognized, and often they
were "protected" by their families, in part because society placed
(and still places) greater social stigma on female drunkenness than
male drunkenness. And it used to be unheard of that little boys were
sexually abused--sexual abuse was considered the plight of a few
unfortunate girls. Now we are finding that there are a lot of little
boys who are abused along with their sisters (literally and
figuratively). We also know that depression is more common in women,
while violent crimes are more commonly committed by men--and we also
know that these statistics are changing toward greater balance between
the sexes.

OK, so if there are male multiples, how come we aren't hearing about
them? I suspect it is because they are more likely to act out and be
arrested. So, most of the male multiples may be incarcerated. The men may
be more likely to act out against others. And the women may be more
likely to act out against themselves, in the form of self-mutilation
and suicide attempts. Note: this does NOT mean that men with MPD are
all criminals! I am acquainted with several male multiples who are
high-functioning and caring individuals.

For good reading on the subject of MPD, I recommend:

Casey, Joan Frances with Lynn Wilson. (1991). The flock: the
     autobiography of a multiple personality. New York: Fawcett
     Columbine.
     (This book is an account of treatment composed of narratives and
     diary/journal entries written by a client with MPD. In this case,
     the therapist and her entire family became involved in helping
     the client get well. All of them became exhausted and eventually
     had to 'cut the client loose' --but the client did get well.
     Shortly after therapy was completed, the therapist was killed in
     a car accident, and the client seems to have worked through that
     loss.)

Cohen, Barry, Esther Giller and Lynn W. (eds.) (1991). Multiple
     personality disorder from the inside out. Baltimore: The Sidran
     Press.
     (Barry Cohen is an art therapist who works with multiples in a
     hospital-based treatment program. The book includes prose and
     poetry written by multiples to convey their own experiences.)

LaCalle, Trula Michaels. (1989). Voices. New York: Berkley Books.
     ("A startling real-life account of a psychologist and her
     patient--a man of many faces, tormented by . . . voices"--that's
     what the cover says! This is a sensitively written account of a
     clinical psychologist's therapeutic work with a multiple. You may
     not agree with the way she worked with the client, but she had a
     successful outcome, and the book is interesting reading.)

Mayer, Robert (1991). Through divided minds: probing the mysteries of
     multiple personalities. New York: Avon Books.
     (Dr. Robert Mayer is a psychoanalyst, but the book does not state
     in what field of study he earned his doctorate. This book is a
     case study.)

Putnam, Frank W. (1989). Diagnosis & treatment of multiple personality
     disorder. New York: The Guilford Press.
     (Putnam is a psychiatrist and researcher on MPD.)

Ross, Colin A. (1989). Multiple personality disorder: diagnosis,
     clinical features, and treatment. New York: John Wiley & Sons.
     (Ross gives an excellent presentation of the history of medical,
     psychological and ecclesial thought about MPD. He also provides
     meta-analyses of numerous studies on dissociation.)
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