The Shocking Reason Why MPD was Changed to DID

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If you haven’t been introduced to Plural terminology, I recommend reading my article on that first.

Science is supposed to be unbiased and objective. The problem is that people are doing the science. And people are notoriously biased. Thus begins the saga of Dr. Allen Frances…

In 1994 Multiple Personality Disorder (MPD) was changed to Dissociative Identity Disorder (DID). This occurred between the third (III) and fourth (IV) versions of the DSM.

What likely should have caused a large scandal is the fact that Dr. Allen Frances -the Chair of the DSM IV Taskforce- didn’t even believe that MPD was a real disorder.

Having seen hundreds of patients who claimed to house multiple personalities, I have concluded that the diagnosis is always (or at least almost always) a fake, even though the patients claiming it are usually (but not always) sincere. (Source)

Yet he was trusted to be the chairman of the board that would decide the fate of MPD as a diagnosis. Even more shocking are some of his statements about why he chose to change MPD to DID,

My own inclination was to wise up dumb therapists and protect vulnerable patients by simply omitting MPD from the DSM…But my hands were tied. We had laid down strict rules requiring high evidentiary standards before any change could be made in DSM-IV…

I couldn’t rid DSM-IV of MPD because I had to follow my own rules and there was no compelling proof that MPD didn’t exist as a meaningful clinical entity. It was only my personal opinion- however certain I was. The best we could do to reduce the popularity of MPD and inspire caution in its diagnosis was to fill its text description with all the cogent arguments against it.

And so they renamed MPD to DID. “Personalities”, were reduced to, “Dissociative Identities”. This is readily apparent in the way the DSM’s description of each was changed. Especially in presence of the word “Integration” in the entry on MPD; and the absence of that term in the entry on DID. You should know that “Integration” is the opposite of “Dissociation”. (Here’s a quick primer on it)

DSM 3 MPD Description Highlighted.pngDSM 3 MPD Criteria Highlighted.pngHere is the DSM V version,

DSM 5 DID Criteria Highlighted.pngDSM 5 DID Description Highlighted.png

Also note the change from, “Personality” to, “Personality States” from the DSM 3 to the DSM V. This reflects the beliefs of Dr. Frances, who doesn’t think that DID headmates are people; but are merely the fantastical constructions of mentally ill patients. Here’s another quote from Dr. Frances that accurately sums up his opinion,

My best guess is that the labeling of ‘alters’ offers an appealing and dramatic metaphor, an idiom of distress. Under the influence, pressure, guidance, and modelling of external authority, suggestible individuals find in MPD a convenient way to describe, explain, and express their conflicting feelings and thoughts.

What does Dr. Frances believe about the origins of MPD, and by extension DID? Well…he seems to think that it is a memetic disease,

Multiple Personality Disorder has always been controversial and contagious. We are lucky that MPD is now in one of its quiescent phases, but it will almost certainly make a comeback before very long. Recurrent false epidemics have occurred several different times during the last century. The trigger is usually either the widespread copy-catting of a popular movie or book, or the fevered preachings of a charismatic MPD guru, or both.

Of course, he admits that his opinions are not evidence based.

I couldn’t rid DSM-IV of MPD because I had to follow my own rules and there was no compelling proof that MPD didn’t exist as a meaningful clinical entity. It was only my personal opinion- however certain I was. The best we could do to reduce the popularity of MPD and inspire caution in its diagnosis was to fill its text description with all the cogent arguments against it.

In summary, MPD was changed to DID because the chairman of the DSM IV Taskforce didn’t believe in MPD.

Further, there is evidence to suggest that Dr. Frances deliberately had, “integrated” changed to, “dissociative” in the description. This change in the text implies that headmates (or alters) are not fully separate and independent entities. Thus he avoided the uncomfortably humanizing label of “personalities” by substituting in, “dissociative identities.”

This inevitably resulted in a heightened stigma against both the existence, and the validity of Plural systems. In addition, headmates/alters no longer have the possibility of being viewed as people or even as “personalities.”

We have been, “unpersoned” by the medical system for being, “too controversial.”

Note 1: I used the DSM V because I couldn’t find a digital copy of the DSM IV. However the entry on DID has only been changed in a few minor ways. This shouldn’t affect my argument, but feel free to double check it if you like.

Note 2: Updated for clarity of understanding that the DSM IV was where MPD was changed to DID.

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