What Colin Ross Really Thinks of Multiples

" . . The most important thing to understand is that alter personalities are not people. They are not even personalities. That might seem obvious,but it is a truth one can lose sight of during therapy. It is probably impossible to construct a satisfactory definition of an alter personality, as Stephen Braude (1995) has pointed out in compelling detail. Alter personalities are highly stylized enactments of inner conflicts, drives, memories, and feelings. At the same time, they are dissociated packets of behavior developed for transaction with the outside world. There is only one person. The patient's conviction that there is more than one person in her is a dissociative delusion, and should not be compounded by a folie a deux on the part of the therapist.

There is often a lot of drama in DID. This does not invalidate the diagnosis. It is a fact about a serious and treatable form of human suffering. The second thing to remember about the personality system is that it is driven by pain. Despite the color, complexity, and fascinating theater of the personalities, their wars, love affairs, and internal friendships, they are not people, and they exist to help the patient cope with pain. There is no need to be wistful or regretful about the disappearance of an alter on integration, because that is a step toward healing the pain. The patient may mourn the loss of the alter, but the therapist shouldn't.

DID is an elaborate pretending. The patient pretends that she is more than one person, in a very convincing manner. She actually believes it herself. Some DID patients enter therapy aware that the different parts are all parts of one person, but most don't. Someone asked me at a workshop once if integration results in a loss of richness and creativity for the patient. Isn't the patient more interesting as a multiple than as a unified person with problems? My answer was to say that the personality system is driven by pain. DID isn't pleasant entertainment. Part of the problem with the iatrogenesis and social-role explanations (which are really dismissals) of DID is that they imply that patient and therapist are having an interesting tea party together, making up mutually satisfying illusions. Therapy is hard work for both parties.

The alters, put another way, are devices. Like any theater, the personality system is based on certain conventions and structural rules. Part of the therapy involves mapping and dismantling these, replacing them with normal,happier, and more functional rules and structure. The patient is acting as if she is more than one person, but she isn't. This is diferent from Hollywood acting because the patient is so absorbed in the different roles that she believes in their reality. When I discussed this point with a drama professor, he said that acting students who are too absorbed in their roles become poorer actors. DID is not acting in the sense that Hollywood actors perform a role.

It only takes a moment's reflection on the film industry to realize this. An actor has to do many takes, jump from scene to scene numerous times in a day, start and stop acting instantaneously, make minute adjustments in posture, tone, and facial expression, and carry out numerous other highly controlled actions. If the actor really felt like a cowboy or science fiction hero, he wouldn't be motivated to act and would probably be perplexed as to where he was and what was going on. The actor who became too absorbed in his role would be disoriented and dysfunctional, like the DID personality who comes out of a blank spell in a bar, surrounded by strangers."

From Ross, Colin A. (1997). Dissociative Identity Disorder: Diagnosis, Clinical Features, and Treatment. New York: John Wiley & Sons, p. 144.

See also Alters in dissociative identity disorder Metaphors or genuine entities? in Clinical Psychology Review - Volume 22, Issue 4, May 2002, Pages 481-497.