small but committed band of therapists, unwittingly aided and abetted
by sensational stories in the tabloids and afternoon TV talk shows?

We at once arrive at what sounds like the big question: Is it real? That
is the first question people ask me when they hear I am interested in
multiple personality. It is not only amateurs who ask. The American Psy-
chiatric Association staged a debate at its annual meeting of 1988: “Re-
solved That Multiple Personality Is a True Disease Entity.” For: Richard
Kluft and David Spiegel. Against: Fred Frankel and Martin Orne. The
debaters, all leading professionals, remain in bitter disagreement today.
The rest of us, once we see how vehemently the two camps of experts
oppose each other, are bewildered. Multiple personality has become the
most contested type of diagnosis in psychiatry. So we bystanders repeat,
rather helplessly: Is it real?

What is “it,” this controversial multiple personality? Not schizophre-
nia. Schizophrenia is often called split personality, so we reason that mul-
tiple personality = split personality = schizophrenia. Not so. The name
schizophrenia was introduced at the beginning of the twentieth century.
It is Greek for “split brain.” The metaphor of splitting has been used in
many different ways—Freud, for example, used it in three distinct ways
at different stages in his career. ⁷ The idea behind the name schizophre-
nia was that a person's thoughts, emotions, and physical reactions are
split off from each other, so that the emotional reaction to a thought, or
the physical response to an emotion, is completely inappropriate or bi-
zarre. There are delusions, thought disorders, and a terrible range of
suffering. It is unclear whether schizophrenia is one disease or several.
One form of it develops in the late teens or early twenties, so that this
disease was once called dementia praecox, or premature senility. Schizo-
phrenia probably has neurochemical causes; some forms of it might be
genetic. Since the 1960s there has been an increasing battery of drugs
that radically improve the quality of life for many schizophrenics.

None of the things I have just said about schizophrenia is true of mul-
tiple personality. No medication has specific effects on multiple person-
ality as such, although switches in personality, like any other exceptional
behavior, can be damped down by mood-altering drugs. Multiple per-
sonality has most commonly been first diagnosed in patients over thirty
years of age, not in adolescence. It is not characterized by a splitting of
thought, emotion, and bodily response. Multiple personality may mimic
schizophrenia, in that there may be short periods of “schizophreniform”
behavior, but these episodes do not endure. I shall return to schizophre-
nia, but for the present we must put it to one side.

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