Part of this paper discusses James McAvoy’s character from the recent blockbuster Split.
James McAvoy plays a character names Kevin who has twenty-three distinct personalities “trapped” inside his mind. Everyone goes into the movie knowing it is about a man with a “split” personality, but “Kevin” displays these different personalities in very different manners. As the movie develops Kevin’s personalities manifest physically by changing his clothes, changing his personality (for instance, one personality is an agoraphobia, can cannot even stand a smudge on the mirror, one is a small child, who is excited to have a new person to talk to, one is a nurturing woman, one is a tough guy, who protects and guards, one is a gay man and fashion designer, and one has Type I Diabetes and needs medication), changing his medical needs, and changing his emotional state, as well as his physical appearance. Kevin also attends therapy. (I will not discuss the validity of DID in this paper, as I believe that DID is a real disorder.)
A psychologist uses, what is called, the four “D’s” to determine if a person has a psychological disorder. The four D’s include: deviance, dysfunction, distress, and danger (some consider a fifth D to be relevant in diagnosing psychological disorders; duration) (Davis, 2009). “Kevin” would certainly be diagnosed with DID if he was a real patient.
Deviance can best be described as a disruptive behavior that deviates from society’s norms, or standards of conduct (Davis, 2009). A person’s behavior can be described as deviant when it goes against societies norms, such as when Kevin kidnaps a person, and holds her prisoner, or when Kevin commits murder, multiple times.
Dysfunction can best be described as a behavior or multiple behaviors that interfere with a person’s life in a significant way (Davis, 2009). Kevin’s diagnosis of DID interferes with multiple faucets of his life. It is hard for him to interact with people socially, he has an Obsessive Compulsive disorder, and it affects his ability to maintain employment, friendships, and even his relationship with his therapist suffers over the course of the movie. Keven can be described as very dysfunctional.
Distress can best be described as the related stress the behaviors and dysfunctions have on the individual. A person can be very dysfunctional and not very distressed over those dysfunctions, or a person can have very little dysfunctions in life, and be very distressed over them anyway (Davis, 2009). It depends on the person, and the diagnosis one is looking at. Kevin experiences a high deal of distress, or at least some of his personalities do. The more dominant personalities have taken over Kevin’s physical body, the person who is normally in charge, a separate personality named Barry, has little control. Barry is very distressed by the actions of the other personalities, and he begins to call and email the therapist when he is in charge, trying to get assistance. Barry believes the other personalities will cause trouble or be dangerous, and he is right.
Danger is the fourth D, and it can best be described as the person’s ability or inclination, to harm either oneself or another person (Davis, 2009). The, normally, non-dominate personalities that have taken over Kevin’s physical body present a great deal of danger to others and to Kevin. They even run the risk of getting Kevin killed because of their actions; kidnapping, and murder.
Kevin has suffered from DID for many years, and has been, up until his non-dominate personalities decided to get revenge, a quiet, unobtrusive person who lives and works in the basement of some factory. The fifth D that psychologists look at is duration; how long has the person been suffering from these symptoms (Davis, 2009)? For Kevin, the answer is probably since child hood, as DID is a disorder usually brought about by severe childhood abuse and trauma.
Dissociative identity Disorder (DID) is a “…complex type of dissociation in which individuals are from time to time dominated by distinctly different, complex, highly integrated personalities (LeFrancois, 2016. Sec. 10.6, para. 23). The causes of DID are prolonged, severe, childhood abuse, with seventy-six percent of patients reporting a combination of mental, physical and sexual abuse; usually by a parent, or other close relative. Occasionally, the stressor of war can bring on a dissociative identity, as the identity of a person is still developing during childhood. Kevin has twenty-three distinct and separate personalities with their own psychological disorders to include OCD, and Generalized anxiety disorder. They have their own medical needs, and their own interests, and sexual preferences. Kevin has gone to many years of therapy to counter-react the effects of DID.
Treatment for DID mainly consists of talk therapy, but drug treatment may be necessary as well, especially if the patient presents with other psychological disorders, such as OCD, or anxiety.
Another form of treatment therapist may choose to employ for patients with DID is Cognitive Behavioral Therapy. Cognitive Behavioral Therapy is an approach to therapy that attempts to change behaviors and attitudes by changing the reward for these attitudes and behaviors (LeFrancois, 2016). Cognitive Behavioral Therapists believe that negative behavior can be unlearned and that acceptable behaviors can then replace those negative behaviors.
A more humanistic approach to therapy, one that has proven to be affective with treating DID, is Roger’s Client Centered Therapy (LeFrancois, 2016). Roger’s client centered therapy is perhaps the most well-known approach to therapy aside from Fraud’s psychoanalyst approach. Client centered therapy is built upon the premises that all people have a desire to self-actualize; to improve oneself. Client centered therapy focuses on providing the client with a safe environment in which to explore past trauma, and their feelings without a sense of judgment (LeFrancois, 2016). These are the therapists that asks such questions as, “how do you feel about that?” In this sense, the therapist helps the client to self-actualize, or improve upon oneself, by providing an environment where the client can grow and become of aware of their own coping mechanisms.
Because of the severe childhood trauma that accompanies a diagnosis of DID, often family therapy is recommended, if the patient is still in touch with their family. Family therapy aims to help families communicate better, as well as teach family members how to better understand the diagnosis (American Psychological Association: Society of Clinical Psychology, 2013).
DID, like all mental health diagnosis, can be complicated and hard to understand. However, treatment has been proven to be successful in that it has allowed most patients to carry on with their lives without too much dysfunction. Patients with DID often suffer from a variety of comorbid disorders, as well as severe mental trauma from the abuse that they suffered. Because of the comorbidity of DID, a diagnosis is often not made until later in life, often after many years of suffering by the patient at the hands of psychologists who are doubtful the disorder exists. Some attribute the symptoms to Schizophrenia, however, schizophrenia and dissociative identity disorder are completely different, in that in DID, patients have two or more distinct personalities, whereas, in schizophrenia, patients have paranoid episodes where they may behave like a different person.
T Davis. Conceptualizing Psychiatric Disorders Using “Four D’s” of Diagnoses. The Internet
Journal of Psychiatry. 2009 Volume 1 Number 1.
LeFrancois, G. (2016). Psychology: The human puzzle (2nd ed.). [Electronic version]. Retrieved
American Psychological Association: Society of Clinical Psychology. (2013). Research-
Supported Psychological Treatments. [Website]. Retrieved from