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Silver Screen Psychology: Looking into often inaccurate film depictions of dissociative identity disorder

(Courtesy of Universal Pictures)

By Alissa Evans

May 13, 2020 3:15 p.m.

Mental health is explored extensively in popular media, from unsettling character studies like “Joker” to lighthearted family flicks such as “Inside Out.” But while some portrayals successfully shine a light on mental health conditions, others merely perpetuate stigmas and stereotypes. Columnist Alissa Evans puts her cognitive science degree to use in Silver Screen Psychology, comparing movies and shows that boast accurate depictions of mental health to those that sacrifice authenticity for drama.

Warning: spoilers ahead.

Dissociative identity disorder can be so misunderstood in the mental health community that some believe it doesn’t exist.

Although DID is considered rare, Dr. Stephen Marmer, a psychiatrist and senior clinical faculty member in UCLA’s Department of Psychiatry, said he has treated patients with the disorder. Some nonbelievers claim DID symptoms are induced by therapists, but psychiatrists like Marmer – along with the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” – recognize DID as a valid disorder that is distinct from mental illnesses like schizophrenia, which it is often compared to. Despite DID’s low prevalence rates, however, the disorder remains prominent in popular films like “Psycho,” “Fight Club,” “Split” and “Glass.”

[Related: Silver Screen Psychology: While some films explore schizophrenia sensitively, others perpetuate stereotypes]

Characters like Kevin in “Split” – whose 24 distinct personality states range from a 9-year-old Kanye West fan to an adult fashion designer – exemplify such dramatization, with flagrant shifts between alternate identities that are more sensationalized than accurate. In reality, the differences between each alter are usually subtle, Marmer said, as DID often develops as a hidden coping mechanism for victims of severe childhood abuse.

“What they need to do is somehow imagine that it’s really not happening to them or to find a way to placate their abuser without feeling guilty about it,” Marmer said. “That dissociation is a survival defense … that helps them get through childhood.”

“Split” addresses childhood trauma both through flashbacks and conversations with Kevin’s therapist. But while “Split” and its sequel “Glass” correctly identify the most frequent cause of DID, the films’ portrayal of the disorder’s actual symptoms is hyperbolic at best and stigmatizing at worst. Kevin is a homicidal kidnapper with multiple violent and out-of-control personality states, perpetuating the common misconception that people with DID are prone to violence.

But M. Night Shyamalan’s trilogy is not the first to misrepresent the disorder, as the use of DID in “Psycho” as an explanation for Norman Bates’ murderous behavior is perhaps equally problematic. In actuality, people with DID are no more likely to commit crimes than the general population, and they are more likely to be revictimized. Bates’ homicidal tendencies and Kevin’s superhuman, people-eating identity called “The Beast” therefore feed into the myth that people with DID often possess an evil alter.

Yet such violent behavior is not the only sensationalized aspect of “The Beast.” It is very unlikely that someone with DID would have an identity so dramatically and outwardly different from the others, as only 5% to 6% of people with DID show overt presentations of their alters. When someone with DID switches between alters, they rarely exhibit a drastic shift in personality, and each alter is unlikely to have dramatically different preferences, accents or clothes. But despite some films’ inaccuracies, Marmer said he understands that hyperbole is a major part of filmmaking.

“(Filmmakers) are in the business of making a dramatic story and drama requires caricature and exaggeration, but it does give a wrong impression as to what (DID) is all about,” Marmer said.

Exaggeration pervades “Split” and “Glass,” as Kevin’s alters are not representative of how DID symptoms may typically be expressed. Nevertheless, Marmer said personality states can noticeably differ – some might be more depressed, some more reckless or some more sexual.

Such is the case in “Fight Club,” where Brad Pitt’s character is a reckless adrenaline seeker who diverts the narrator’s attention from the monotony of everyday life. Although the narrator is never explicitly diagnosed with DID, he has more than one personality state and experiences recurrent amnesia, which Marmer said are common symptoms of the disorder. But the narrator’s visual hallucinations and conversations with his alter are generally unusual symptoms for someone with untreated DID, Marmer said.

[Related: Movie review: Characters’ relationship makes ‘Extraction’ stand out among action movies]

People with DID may not receive immediate treatment because their alters are hidden, or because a therapist may only interact with one of the client’s personality states, Marmer said. On average, people with DID usually circulate within the mental health system for around seven years before receiving an accurate diagnosis. And since DID often develops as a defense mechanism in response to other variables, people frequently downplay the condition and conceal their alters.

However, if the subtlety of switching between alters was better understood, perhaps symptoms would be more easily recognizable, leading to quicker diagnosis and early effective treatments. Media can play a role in educating the public by finding novel ways to distinguish between a person’s alternate identities without overdramatizing the switching process.

Fewer exaggerated portrayals might also lessen the extent to which people with DID are othered in society. Although only a small percentage of the population will experience DID in their lifetime, Marmer said there is a degree of normal multiplicity – almost everyone has acted out of character or dissociated while completing a routine task. While such mild experiences are not comparable to a clinical disorder like DID, recognizing even the smallest connections can help mitigate the misperception that people with DID are different or other.

“We have these expressions in English like ‘I wasn’t myself today’ or ‘I lost my head,’” Marmer said. “We all have these little micro-moments from time to time when, especially under great stress, we do things that we normally wouldn’t do.”

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