Rethinking 'Multiple Personality Disorder': Recovering Moral Agency

By Nicki, Andrea | Social Alternatives, October 1, 2008 | Go to article overview

Rethinking 'Multiple Personality Disorder': Recovering Moral Agency


Nicki, Andrea, Social Alternatives


Held up to the window light, the amethyst has elegant corridors that give and take light. The discipline of its many planes. . . . Its exterior is jagged, but in the inner house all is in order. Its corridors become ledges, glorified thoughts that pass each other. This chunk of amethyst is a cool thing, hard as a dragon's tongue.. . . It turns four or five faces toward us at once, and four or five meanings enter the mind.

-Robert Bly, 'Amethyst'

Introduction

Much research on 'personality disorders' has assumed both the viability of these categories and the necessary compromise they present to moral character. According to the DSM-IV (Diagnostic Statistical Manual of Mental Health Disorders), the most current version of the DSM, 'multiple personality disorder,' in particular, (now seen as 'dissociative identity disorder'), while 'hotly debated, is poorly understood,' although possibly 'relatively common, particularly in milder forms' (Tomb 1999, 95). The topic of 'multiple personality disorder' is controversial and fraught with images of people who are presented as grotesquely fractured, with values and ideals heavily in flux. There is a belief found throughout many philosophical writings that a fragmentary identity made up of various, potentially conflicting parts is necessarily confused; that only internal cohesiveness can afford stability in a chaotic world. Without a unified self, it is believed an individual will be unable to lead a good life. There is an assumption that internal unity is always ideal and that fragmentation necessarily damages integrity. According to common understandings of moral integrity, moral integrity involves continual and unfluctuating loyalty to one's commitments and values. It is a trait that is used as a yardstick to measure moral character. Most people would judge a person who lacked this kind of reliability to be morally untrustworthy and self-centred, given to whim and ruled by shifting desire. Given the pervasive belief in the ideals of self-determination and self-transparency and in the importance of an internally coherent self for moral agency and behaviour, philosophers, such as Stephen Braude (1996) and Jennifer Radden (1996), have asked whether people with 'multiple personality disorder' should be seen as responsible for their acts. There is a suspicion that they may not be moral agents at all, as they are seen as having successive selves or several different identities that vie for dominance.

For people who have experienced prolonged abuse, splitting and a sense of fragmented identity, may be their norm; the idea of an internal unity is foreign to their experience, as well as an understanding of or commitment to the humanist, modernist notion of selfhood. Different ways of viewing identity and integrity validate their lives and experiences. Psychiatrist Judith Herman has argued for revisioning 'borderline personality disorder' and 'multiple personality disorder' as complex post-traumatic stress disorders, since those diagnosed with them frequently are survivors of severe, chronic physical/and or sexual abuse (1992, 123). She maintains that, unlike these categories of personality disorder, the category of 'complex post-traumatic stress disorder'i does not assail or problematise the personality and character, and carries less of a risk of reducing sufferers to their disorders. Notably, the new classification of 'dissociative identity disorder' seems no better than the previous ones; rather than problematising a person's personality it finds fault with a person's identity.

Herman has reasonable cause for concern. While women have been excluded from many studies on physical illnesses, they have been subject to excess and intense scrutiny in studies that over-medicalise women's psychological and emotional suffering. Many articles and books on 'borderline personality disorder' and 'multiple personality disorder' refer very derogatively to people diagnosed with them, the majority of whom are women. …

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