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I don't know about your source, "enchantedwings," but David Spiegel, MD (psychiatry) was responsible for the change in name from the DSM III and DSM IV (the diagnostic manual of the American Psychiatric Association), and it is from his research and assertion that an individual with DID is one person who lacks integration of different aspects of their personality, rather than being many persons in one body, that the change was made.

Dr. Ralph B. Allison:

I am a retired board-certified forensic psychiatrist who has been treating dissociators since 1972. With 24 years of clinical experience to look back on, now I can see previously obscure facts about dissociating patients. With this Website, I hope to make these insights available to psychotherapists, attorneys, and dissociated patients in need of understanding a complex and controversial subject.

Dual Personality, Multiple Personality,
Dissociative Identity Disorder - What's in a Name?

When I diagnosed my first case of MPD in 1972 (Janette in "Minds In Many Pieces"), I had had no professional training on the subject. I went to the Stanford Medical Library to look up articles on the subject since no computerized databases existed then. The book called "Index Medicus" was the only place one could start searching for published articles. There I found the listing of "Dual Personality."

In the 1970s, when I started meeting with other therapists of "multiples" (the term we all came to use for patients with MPD), we informally agreed to call the disorder "Multiple Personality Disorder" or MPD for short. I wrote to the editors of the Index Medicus to ask them to add Multiple Personality Disorder to the subject headings, and they did that.

At that time, a small group of us therapists were struggling with these patients, and we created our own networking methods. I published a newsletter, "Memos On Multiplicity," for one year as my way of trying to let such therapists know where fellow adventurers in this field were.

Eventually, the interest moved from the solo practitioner's office to the academic halls of learning. Some practitioners had teaching appointments in graduate schools where their opinions about MPD were not always greeted with acceptance. After all, the accepted dictums stated that people only were allowed one personality per body. Anyone claiming to have patients with two or more personalities had a difficult task convincing those in academia that such was possible.

This conflict of views between those therapists dealing daily with dissociated patients (some exhibiting dozens of alter-personalities, or "alters") and academic teachers who spent more of their days teaching and doing research than actually treating severely ill patients, came to a boil with the need to revise DSM III.

DSM I (Diagnostic & Statistical Manual of Mental Disorders, Version I) was created after WWI to provide a framework for labeling post-war psychiatric causalities. DSM II was written after WWII for the same purpose. Remember, these were written in the USA by American psychiatrists. However the same terms were accepted by the editors of the International Code of Diseases (ICD) through its present 9th edition.

When I met my first multiple, DSM II was in use. MPD was then a minor label under "Hysterical Dissociative Disorder." It did not even have its own code number.

DSM III was created while I was in the middle of my practice years. It recognized MPD as existing, gave it a code number, and defined its characteristics. We who treated these patients finally had found a degree of acceptance in officialdom. "If it is listed in here, it must exist."

Then the backlash began. There had always been doubters that such a disease really existed, and my struggles with critics are chronicled in "Minds In Many Pieces." Personally, I had withdrawn from public debates on the matter to deal with private matters, so I only know indirectly about the political battles behind the scene during the formulation of DSM IV, the current edition.

The field of "Dissociative Disorders" now had its own section. A committee of experts was appointed to decide what disorders should be listed in DSM IV. It was hoped that DSM IV would also be the psychiatric section of the new ICD-10, then in progress.

The committee was composed of two groups, psychiatrists whose primary role was as therapists and those whose primary roles were teaching and research. The therapists wanted to keep MPD much as it was in DSM III. The teachers wanted to eliminate MPD altogether, and replace it with "Dissociative Identity Disorder" or DID. I heard one of these teachers say in public, "Everybody is born with only one personality. Therefore, there can be no such thing as a Multiple Personality Disorder."

With this belief system, the teachers could not agree that MPD could be an accurate label for anyone. The treaters on the committee did not know how to explain that, in practice if not in theory, their patients acted as if they had other personalities. The teachers decided that the patients had the major mental problem of believing that they had more than one personality. The goal of therapy should not be integrating the various personalities, but getting the patients over their false belief (delusion) that they had other personalities at all. (Since I was not present for the deliberation, these ideas are only reasonable conclusions from what I heard from others who were there and position statements published about the debate.)

So the patients still had a problem, but it was redefined as a different problem than the one their therapists were treating them for. Instead of therapists trying to integrate "alters" into an original personality, they should now focus their attention on the patients "delusion" that they did not have a single identity. Now the teachers expected the treaters to treat the patients' "identity disorder," as no one could really have multiple personalities.

When the decision was reported out of committee, the teachers had won, and MPD suddenly ceased to exist. Now all our multiples had Dissociative Identity Disorder or DID.

However, the editors of the ICD did not accept DSM IV as their section on Mental Disorders. In the newest printing of ICD-9, they did add "Dissociative Identity Disorder" below MPD as a synonym. So, in the world outside the USA, MPD still exists. Only in the USA have all multiples been told they have a false belief that they have alters running their bodies.

But I know that, in the case of MPD, the patient's Original Personality (yes, teachers, the only one they have) goes "into hiding" at the time of a life threatening assault before the age of seven. Therefore, there is "no one home" to have the Disorder of Identity. The Original Personality is the only one capable of having such a "false belief," but she is not in executive control of the body or participating in social life at all. But the Allisonian ISH I met in these patients had created all sorts of alters to run the body in the absence of the Original Personality. Therefore, I could not honestly give up the accurate label of MPD and substitute an inaccurate label of DID.

But, I had met other dissociating patients who were of the "dual personality" type. They had never shown an ISH, and they manifested far fewer alters. Could I apply this new label to them? Yes, I decided I could.

So, personally, I came to realize that both MPD and DID can be considered accurate labels, but for two different groups of dissociators. Here is how I now use these acronyms in my writings.

The key differentiating criteria is the age of the first dissociation, with the seventh birthday being the approximate cut-off point for MPD, and the earliest date for DID to appear. This is the age the child's mind must mature to so that it can "hold it all together" when severely traumatized. After age seven, it may dissociate and form alters, but it will not dissociate into its two component parts, the Intellectual Self (ISH/Essence) and the Emotional Self (Original Personality).