The first documented case of
dissociative identity disorder (DID)
was in 1584. Though not labeled such at the time, Jeanne Fery recorded
her exorcism in detail (with additional details provided in the records
of her exorcists), preserving documentation of symptoms that exactly
match those that are found in individuals with DID today. She had
multiple
alters, each with their own name, identity, and identifying features and had alters that would today be described as an
ISH, persecutory protectors, and
child alters. Her alters were associated with actions that ranged from helping her to heal to self harm and
disordered eating, were
audible inside her head, and could
take control of her body to allow for various actions,
conversion features, and changes in knowledge and skills. The alters resulted from
childhood physical and possibly sexual abuse.
Jeanne Fery was actually called ”the most perfect case” of
“dédoublement de la personnalité,” the most perfect case of DID, by
Bourneville, the man who reissued a book about her life in 1886 (van der
Hart, Lierens, Goodwin, 1996)
1.
Following Jeanne Fery in 1623 was Sister Benedetta, a woman who was
supposedly possessed by three angelic boys who would beat her to cause
chronic pain. When they took control of her body, each would speak with a
different dialect and tone of voice while using different facial
expressions. Benedetta had amnesia for some of their actions, including a
sexual relationship that they had initiated. Like Jeanne Fery, Sister
Benedetta suffered from self harm and disordered eating. Her parents had
also shown signs of dissociation and had been rumored to be possessed,
and one of the “angels” was frozen at age 9, the same age at which
Sister Benedetta’s father had died, her symptoms had become
uncontrollable, and she had been sent to the convent (van der Hart,
Lierens, Goodwin, 1996)
1.
DID has a history of being mistaken for possession. After such a view
was no longer acceptable, those with DID were seen as hysterics.
Hysteria was seen as primarily dissociative in nature and could involve
disturbances of memory, consciousness, affect, identity, and body
functions (van der Hart, Lierens, Goodwin, 1996)
1, the same symptoms today associated with
dissociative disorders and particularly with dissociative identity disorder.
The first person to be officially diagnosed with multiple personality
disorder (instead of double personality disorder as had eventually come
into use in France) was Louis Auguste Vivet in 1882. Louis was
physically abused and neglected as a child and had frequent “attacks of
hysteria.” One such attack occurred when he was 17 and bitten by a
snake. He lost use of his legs for almost one year, and when the use
returned after a 50 hour attack, he didn’t remember any of the
physicians who had been treating him in an asylum for the last month or
any of his fellow patients. His manner, morals, and appetite were
different as well. Following additional attacks, the next year, his
character would change from impulsive and dangerous to calm and gentle.
In 1884, he had another attack that left him gentle of manner but unable
to walk, and yet another attack returned the use of his legs but left
him quarrelsome and inclined to steal as he had done as a child in order
to survive. Amnesia for intervals spanning episodes was noted. By 1888,
he had been recorded as having 10 personality states, each of which
were different in character, memory, and somatic symptoms. In 1885,
integration of the youngest alters began (Faure, Kersten, Koopman, &
Van der Hart, 1997)
2.
Interestingly, the earliest reports by Louis’s treating physicians
acknowledged only two of his eventually discovered alters as having
presented while he was first hospitalized, though later examination of
the hospital reports clearly indicated the presence of at least three
alters. It is thought that Louis’s case was forced to fit the mold of
double personality disorder for as long as possible. The same had
happened to Azam’s patient Felida X. Though Azam recognized that Felida
had three personalities, he publically recognized only two in order to
make her case fit the only diagnosis he could give it (Faure, Kersten,
Koopman, & Van der Hart, 1997)
2.
There’s always been a history of professionals attempting to diagnose
DID as another more prominent disorder of the time, even if to do so
was to willingly ignore information. Even after DID became a valid
diagnosis, it was still often mistaken for other disorders. In 1918, it
was first acknowledged in the predecessor of the DSM under Hysterical
Psychoneuroses, a subgroup of Psychoneuroses and Neuroses that included
alternate states of consciousness acting on normally unknown desires,
amnesia, and sensory and motor disturbances (“Statistical Manual for the
use of Institutions for the Insane,” 1918)
3;
this again placed DID under a hysteria label. Additionally, in 1910,
Bleuler had introduced the term schizophrenia, and in 1927, the reported
number of cases for this disorder rose dramatically, matched by a
decrease in the diagnose of DID. One reason for this is that the
original description of schizophrenia actually included multiple
personalities! Many of those diagnosed and treated as having
schizophrenia should have been diagnosed as having DID, but because
schizophrenia was the more popular diagnosis, that was what was
officially recognized (Rosenbaum, 1980).
4
It wasn’t until Ferenczi’s “Confusion of Tongues” paper in 1932/1949
that dissociation and subsequent splitting of the personality were
explicitly linked to childhood abuse. However, at the time, any theory
involving the subconscious mind was unpopular, and few paid attention to
what Ferenczi had discovered. As well, the schizophrenia diagnosis
still included and dominated over the DID diagnosis at this time. It
wasn’t until shell shock was noted in soldiers and then recognized as
posttraumatic stress disorder (PTSD) in abused women and children that attention finally returned to dissociation. (Howell, 2011).
5
After this point, it was specific case studies that brought attention
to the disorder, starting with that of Clara Norton Fowler (“Christine
Beauchamp,” 1898-1904) and followed by that of
Chris Sizemore (Eve).
1 Van der Hart, O., Lierens,
R., & Goodwin, J. (1996). Jeanne Fery: A sixteen century case of
Dissociative Identity Disorder. The Journal of Psychohistory, 24(1).
2 Faure, H., Kersten, J.,
Koopman, D., & Van der Hart, O. (1997). The 19th century DID case of
Louis Vivet: New findings and re-evaluation. Dissociation, 2(2).
3 Statistical Manual for the
use of Institutions for the Insane. (1918). In Statistical manual for
the use of institutions for the insane. New York: American
medico-psychological association/National committee for mental hygiene.
4 Rosenbaum M. (1980). The
role of the term schizophrenia in the decline of diagnoses of multiple
personality [Abstract]. Archives of General Psychiatry, 37(12), 1383-5.
DOI: 10.1001/archpsyc.1980.01780250069008
5 Howell, E. (2011). The
Dynamic Unconscious and the Dissociative Structure of the Mind. In
Understanding and treating dissociative identity disorder: A relational
approach. New York: Routledge
