Reality vs. Media Depiction

Hollywood screenwriters have done a terrible job of portraying Dissociative Identity Disorder, something made more all-the-more disturbing when we consider how obsessed they are by it. When looking at DID through Hollywood’s distorted lens, I see the appeal: the disorder allows for extremes of character development with personal conflict, tormented souls and almost-surreal mysteries, all packed within a single person. The possibilities are too attractive to ignore. 

The truth is that real-life DID is interesting enough without having to warp or add anything to it. That people have this disorder and are able to function is remarkable in itself. Unfortunately, this doesn’t satiate Hollywood’s appetite and we have to endure the disorder depicted within inaccurate horror movies and offensive psychological thrillers, none of which help viewers to understand the condition. It may surprise you to realize that having DID doesn’t make anyone more dangerous than your average person. But that isn’t the stuff of movies, is it?

So how did this misrepresentation come about? The answer stems back to an era long before Hollywood became a thing. Robert Louis Stevenson made the connection between horror and conjectured-DID as far back as 1886 in his novel: The Strange Case of Dr Jekyll and Mr Hyde, where both a respectable gentleman and a bestial monster reside in a single body. It seems like an extreme case of DID, but is it? Let’s take a look at the DSM-5 Diagnostic Criteria for DID and compare it with Stevenson’s novel.

Diagnostic Criteria A: Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption of marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual. 

The Novel: Stevenson’s character is often interpreted by historians and literary critics as depicting a man undergoing oscillations between two distinct personalities. What is considered less frequently is that the modern definition and symptoms of bipolar disorder better match what Dr Jekyll describes in his point of view within the novel. According to the National Institute of Mental Health, “people with bipolar disorder may be explosive and irritable during a mood episode. Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood.” Meanwhile, the last chapter of the novel constantly switches perspectives, from Jekyll being Hyde to Hyde being altogether separate from Jekyll, even switching into a third person narrative. Historically, this was a time when emerging psychological theories would likely have influenced Stevenson’s character development of Dr Jekyll/Mr Hyde.  The question is, which of the developing disorders was Stevenson likely to be acquainted with? The answer is evasive. 

Diagnostic Criteria B: Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting. 

The Novel: There is little to no evidence of Dr Jekyll or Mr Hyde experiencing gaps in their memory. To the contrary, Dr Jekyll appears to have a lucid understanding of his storyline. 

Diagnostic Criteria C: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

The Novel: At times, Dr Jekyll appears to enjoy his experiences, describing how, “for two months, (he) enjoyed the compensations of an approving conscience.” Meanwhile, Jekyll laters refers to his dependency on the drugs he takes as slavery, and when he tries to stop taking them, he begins, to be tortured with throes and longings.” Clearly, Jekyll has struggles, but drug-related struggles are not part of DID. Quite the opposite, in fact. Also worth noting is that until the later chapters, Jekyll feels joy and happiness with Hyde. 

Diagnostic Criteria D: The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play. 

The Novel: We can assume that neither Dr Jekyll’s nor Mr Hyde’s behaviors were part of a cultural or religious practice.

Diagnostic Criteria E: The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).” 

The Novel: Dr Jekyll switches to Mr Hyde because of drugs he’s concocted. He’s also able to prevent switching by avoiding the drugs. When he does take the drugs and turns into Mr. Hyde, he has what might be referred to as a mood episode. As the National Institute of Mental Health states: People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” Each mood episode represents a drastic change from a person’s usual mood and behavior. Jekyll’s state of normalcy might be what psychologists consider a symptom-free interval. It’s not until he takes the drugs that he experiences a mood episode as Mr. Hyde. 

I venture that Stevenson’s novel more closely illustrates bipolar disorder than it does dissociative identity disorder.

Mistakes in the Movies

  1. Auditory hallucinations of alters or parts.

When a person with a dissociative has communication between their alters/parts, this typically involves hearing voices inside our minds – not as auditory hallucinations coming from outside the head. This being said, the voices we hear can sound distinct in tone and accent. At other times, there’s no voice at all but something more like projected thoughts. Some people communicate through a journal or an online blog, or within a multi-use telephone app. 

  1. Visual hallucinations of alters or parts.

People with DID tend not to see their parts as hallucinations, though we often have an idea of what they would look like if they could appear. Within my home, I’ve found photographs of people I’ve never met in the real world, but have come to realize they resemble the way I imagine my insiders to look. My disclaimer is that I have a habit of deliberately projecting parts into a shared world so that I can see them. This might be closer to maladaptive daydreaming than DID. What doesn’t happen is for multiple parts to appear and interact with each other in the outside world.

  1. Not all mental health issues are portrayed.

Typically, DID and PTSD are the only issues shown, but a person with DID usually has a combination of many different diagnoses. Additionally, we tend to adopt unhelpful coping mechanisms to help numb our emotions: depression, anxiety, substance abuse, eating disorders, etc. 

  1. Blackouts aren’t demonstrated

Movies tend to mention blackouts but don’t do a good job of portraying them, or showing the confusion of a DID sufferer when they realize they’ve lost time. Characters don’t forget who anyone is, or meet somebody they’re meant to know, or forget where they live, or fail to remember where they’re going. 

  1. Dissociative symptoms go beyond amnesia

Dissociative symptoms include a lot more than the obvious alters/parts and amnesia. Symptoms include:

Depersonalization: the sense of our inner self being detached from the body. Sometimes while feeling dissociated, we may look in the mirror and feel like we don’t recognize who we’re seeing, or feel disconnected from our body in a way that feels numb, or in my case, like my body is a cloud.

Derealization: the sense of the world around us not being real. For me, it feels like I’m watching the world through an old-fashioned television set with poor sound. Others describe derealization as the world looking phony, foggy, or far away, or as though they’re detached.

Bodily Sensation: tingling, dizziness, feeling spacey, feeling numb.

  1. Alter/parts cannot be killed.

While parts can go dormant, or go into hiding, they can’t die or be killed off. They can merge (integrate) with other parts, but not every DID sufferer wants to do that. From my perspective, it would feel like part of myself had faded away and would disrupt my inner world. It’s for this

  1. Child alters/parts are common but seldom shown

Having child parts who speak with childlike voices is one of the hardest aspects of this disorder. Hearing them speak causes people to question whether the disorder is real, and whether they are real. After all, it seems so far-fetched. 

  1. Randomly violent alters/parts have no purpose

People with DID are no more aggressive or dangerous than anybody else, yet Hollywood loves to portray us as evil murderers. It’s important to understand that the alters/parts within a person are each there for a purpose. We don’t form murdering parts – they have no function. Sadly, this misunderstanding has created a stigma so large that sufferers tend not to share their diagnosis with others. 

  1. DID cannot be cured

There aren’t any drugs that can treat DID. There’s also no cure. Treatment typically involves years of therapy. Some people with DID chose to integrate/merge some of their alters/parts. Integration is a hot topic and is no longer considered the gold-standard for treatment. 

But what does this exercise reveal, when considering the perspective of modern-day media. The answer is simple: mental health disorders are complex and misunderstood. There’s a reason why people are reluctant to disclose their mental health. There’s a reason why we hide. I’m hoping to change that. But just for fun, I’m going to plough my way through some movies and discuss their portrayal of my disorder. That’s right: my disorder. That means my input counts. 

Watch this space!