The role of the social contagion hypothesis in dissociative identity disorder

An early Tuesday evening discussion about how ‘real’ dissociative identity disorder (DID) was prompted by a youtube video titled, ‘Is Genuine Multiple Personality Disorder an Actual Thing? Or Just a Hollywood Invention for Movies?’. Joan Acocella, writer of creating hysteria, insinuates that DID is a product of mass media sensation using the explosion in the diagnosis rates of the disorder, after it had been featured in popular books and TV programmes in the 1980’s, as an arsenal for her arguments. The Youtube video stated above, insinuates the same thing; with a leading title like that, it sings the same tune as Acocella. It heavily leans on an iatrogenic cause for most multiple personalities and mentions several books believed to contribute to a social contagion that saw hundreds of caucasian women in their 30s emerging with a diagnosis of multiple personality disorder (MPD) in the late 80’s. I decided to explore DID and the role social contagion has played in the history of its portrayal to the general public.

First of all, what is DID?

Previously named, MPD, the DSM-IV defines DID as follows:

A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).

B. At least two of these identities or personality states recurrently take control of the person’s behaviour.

C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behaviour during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

What is the contagion hypothesis?

The American Psychology association defines social contagion as the spread of behaviours, attitudes, and affect through crowds and other types of social aggregates Hence, the theory implies that individuals’ thoughts, emotions and behaviours are influenced by displayed emotions of other individuals who are part of their network.

The role of Social contagion in the tale of DID

Simon Whistler, host of the video, mentions the influence of 2 main publications that coincide with a rapid increase in DID diagnoses in the 1980’s. Sybil, the account of Dr Cornelia Wilbur's diagnosis and treatment of a woman with MPD, was one of them. Prior to Sybil, MPD had been one of the rarest of mental disorders. In a 1944 article, two researchers, W. S. Taylor and Mabel Martin, reported that a search of the medical literature of the 19th and 20th centuries saw only 76 cases that met their definition of MPD. After Sybil was published in 1974, the diagnosis of MPD changed from that of a rare disorder, with patients presenting with 2 or 3 alters (other personalities) to a more commonplace diagnosis where some members of the public emerged with hundreds of alters. It was estimated that between 1985 and 1995, there were almost 40,000 new MPD cases. And curiously, the modal MPD patient of that time looked a lot like Sybil, a white North American female around the age of 30.

Acocella attributed the increased diagnosis of MPD, especially among women, to the interaction of several factors: the media promoting and sensationalising stories about MPD, misguided clinicians who were falsely guiding their patients towards an MPD diagnosis and thirdly, the medical population-wide acceptance that disorder was solely caused by traumatic memories such as child abuse. This was prevelantly reported by those diagnosed. Infact, the biggest selling self help books in 1988 were those that presented symptom checklists for readers to use in determining whether they were abused, even if they could not remember the abuse.

The Fall of MPD: according to Acocella, the MPD ‘craze’ began to die through public education by organisations like the False Memory Syndrome Foundation, scrutinisation by professional organisations and senior mental health professionals of the rise in rate of diagnoses, and huge lawsuits against psychiatrists for iatrogenic MPD.

The dangers of social contagion in the tale of DID

Currently, most psychiatrists believe that DID is a legitimate diagnosis, that it is a rare condition when it occurs spontaneously but that it can be created, or at least influenced, iatrogenically. This is demonstrated by the social contagion of the 1980’s which is where admittedly, the video correctly depicts. The number of MPD patients grew after the rise of media publications of the condition, and naturally, so did the field designated to treat them. It was only in the 1980’s we saw MPD even listed in the DSM, the guidebook to diagnosis, as a disorder in it’s own right.

Iatrogenic MPD, while it pointed to a number of cases where clinicians had induced more alters in patients, does not take away from the original 76 cases of MPD diagnosed before the sybil-sensation and also should not discredit the patients who later presented, and who perhaps benefited from a bigger MPD medical field of interest in order for their symptoms to be recognised and diagnosed. An insinuation that cases were more common in women who only looked like Sybil, caricatures the average patient who suffered from the disorder and may perhaps, blindside a genuine patient population in the 1980’s for the condition.

The danger of videos such as ‘Is Genuine Multiple Personality Disorder an Actual Thing? Or Just a Hollywood Invention for Movies?, is that your average YouTube subscriber will be unwilling to research the context in which its dramatised title was made. Nor would they be able to accept that although, yes, mass media popularised a disorder and consequently, the prevalence of the disorder skyrocketed, this does not make the condition any less genuine when it presents. DID is then disregarded as a recognised condition still affecting people in the world and misconstrued as a social construct sensationalised by mass media in the 1980’s.