11. Window of Diagnosability

NOTE: Each alter’s name has a number after it the first time

it is on the page to show which group s/he belongs to.

See the right of this page for the group.

Most of you probably don’t know this but multiple personality is not that easy to detect. Many of the books and movies about it portray the multiple as clearly switching from one personality to the next but that is not very common. And there are at least two reasons why that might be. First of all, Dr Richard Kluft, in his article “Clinical Presentations of Multiple Personality Disorder”, said that a lot of multiples try to hide their condition. About 6% consistently display and overtly call attention to their symptoms, while another 14% may show the symptoms but don’t try to call attention to them. They may even try to hide the multiplexity. About 40% will show enough symptoms that a clinician could spot the disorder HOWEVER there is another 40% who do the opposite – hide it so well that a clinician has to take great pains to find it.

The second reason why multiplexity might not be that easy to detect is because the person has very different “presentations” throughout their life. By “presentations” we mean how the group of alters work together and the symptoms of the condition are seen. The “classic” presentation described by Dr Kluft is when the person clearly fits the DSM criteria (see our posting “3. What is multiple personality anyway?”)and the change of control, or switching, is frequent and alters’ memories are different. But the most common presentation is actually when the person has been in therapy for a long time but doesn’t seem to feel any better. So the symptoms are not detected, the alters try to hide the condition and the therapist does not know the person is multiple. In other words, there is no window of diagnosability.  

Kluft also says that some multiples stay in one presentation for most of their adult life but most show several over the course of time. Back in our posting “3. What is multiple personality anyway?” we told you that Kluft said that “most of what is so arresting to the beholder about Multiple Personality Disorder is secondary and what is hidden is quintessential”. Most of us don’t want you to know we are multiple. First, because you will think we are crazy, and second, because it will make us more vulnerable and subject to more humiliation and pain and abuse.

We have a friend that goes way back with us, to when we were 8 years old. We played a lot together. Best friends and all that. When we first fell apart back in 1990, she was one of the first people to rally our friends around to help us. But over the years, as we uncovered who we are and what happened to us, we withdrew from her out of fear. The fear she would not believe us. How could she? As far as we know, she had never seen any evidence of our multiplexity. And we could not tell our friends, least of all in our childhood, what was happening to us. I, Shell (1, 2), was especially created for this role – not to simply pretend nothing was wrong, but to believe nothing was wrong. I had no idea I was multiple, and had no idea I was being abused. So how the hell could she have known?

We were even able to hide it from our son, who was with us day in and day out, for all of his growing up years. We worked together Inside to keep it well hidden from him.

The most wonderful part of Dr Kluft’s article is a list and description of 25 different presentations a multiple might have. They are like the constellations of the stars. They show how well alters in a system can work together , or what can trigger certain ones to come forward and take over control. They may display a highly chaotic individual, someone who switches frequently or have only one alter in control, or “out” for many years. At some point we will tell you more about these. The main thing is that we have never seen any other literature that covers this topic. When we can see how many different ways a person can be multiple it’s easy to see how difficult it can be to detect. And Richard Kluft seems to be the only one who understood and wrote about it.

DO YOU HAVE ANY QUESTIONS ABOUT PRESENTATIONS? ANY COMMENTS ABOUT SOMEONE YOU KNOW WHO IS MULTIPLE? Please ask, please comment. We would love to hear from you.

Thanks for listening.