Handbook of Dissociation

pp 337-366

Dissociative Identity Disorder

  • Richard P. KluftAffiliated withDissociative Disorders Program, The Institute of Pennsylvania Hospital

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Dissociative identity disorder (DID), formerly known as multiple personality disorder (MPD), is a complex, chronic, posttraumatic dissociative psychopathology (Kluft, 1987a; Loewenstein, 1991) characterized by disturbances of memory and identity (Nemiah, 1980). It is distinguished from other mental disorders by the ongoing coexistence of relatively consistent but alternating subjectively separate identities and either recurrent episodes of memory disruption, frank amnesia, or both, and/or amnesia for a period of noncontemporary autobiographic memory. It almost invariably emerges as the sequela of overwhelming childhood experiences (Putnam, Guroff, Silberman, Barban, & Post, 1986; Spiegel, 1984, 1991). Its childhood form is often rather simple and its traumatic antecedents frequently can be documented with facility (e.g., Faganand & McMahan, 1984; Kluft, 1984a, 1985a; Hornstein & Putnam, 1992; Coons, 1994). However, it appears that in some adult cases, secondary autonomy of the defense of alter formation and function, the development of additional complexity, and a reworking of childhood experiences occur during adolescence. By virtue of this metamorphosis, the adult form often becomes rather intricate in its structure, and adult patients’ given histories demonstrate the interplay of historical events, fantasy, confabulation, postevent information, and the impact of many nontraumatic exogenous influences (Kluft, 1995, in press a).