On Sunday, Natalie Portman is expected to take home the naked statuette for her portrayal of Nina, the ballerina who confronts her dark Ukranian sitcom-star side in Black Swan. While the disease known as Movie Multiple Personality Disorder has been a staple of films and soap operas for years, never before has it been so well honored: Halle Berry got a Golden Globe nomination for playing a stripper with dueling personalities — one of whom is a white Southern racist — in the “based on a true story” film Frankie and Alice. And Toni Collette collected an Emmy this past fall for her multiple-personality mama in Showtime’s United States of Tara. In their portrayals of MMPD, these actresses, like Joanne Woodward and Sally Field before them, distinguish their different “alters” with accents, wardrobe changes, and occasional violent showdowns. But how do these symptoms compare with people who suffer from actual Dissociative Identity Disorder (the preferred term for Multiple Personality Disorder)? To find out, we called Dr. Marlene Steinberg, author of the book The Stranger in the Mirror, who has done groundbreaking work in the field of DID, demonstrating that the disorder is both more common and less extreme than we’ve been led to believe. We went through all of the symptoms that we’ve seen in movies like Sybil, Fight Club and Black Swan and engaged her in a vigorous round of fact-checking.
Many people associate Dissociative Identity Disorder with the cases in movies like Sybil and The Three Faces of Eve. What are the most misleading ideas that we’ve gotten from those movies?
In real life, the symptoms are very subtle. Patients in real life are concealing the symptoms because it was an elaborate way that they could survive. And so often, they are unaware that they’re suffering from multiple personalities. In the movies, the most common symptom is they’re switching from one personality to another. Well, that’s the least common symptom that people ever present with. That’s not a complaint that people are aware of. They complain of having mood changes; they complain of feeling very depressed; they complain of feeling anxious or panic-stricken. So that’s really a very large misconception that results in misdiagnosis.
Natalie Portman’s character in Black Swan has signs of dissociative identity disorder, but the other personality doesn’t emerge until she’s in her twenties. Is it possible for a second personality to come out that late in life, as a result of intense stress?
Yes — that is, assuming she was predisposed to dissociating when under stress. If she had split into alters as a child, she would be at increased risk of creating new alters as an adult when under severe stress. The “good girl” versus “bad girl” struggle is common in D.I.D.
Portman and Mila Kunis have possibly hallucinatory sex in the movie. Could one personality believe that it has intimate or romantic relations with another?
This is absolutely possible! People with dissociative disorders are extremely creative. I had a male patient with D.I.D. who reported that he had a female alter inside of him who functioned as his girlfriend. His inner girlfriend would get jealous whenever he dated other women.
In The Three Faces of Eve, there’s a famous scene where one of Eve’s three personalities does a nightclub act. Could one personality just decide to go into show business?
It certainly is possible that different personalities take over for different talents or skills — a musical talent, a writing skill. But only 5 percent of cases have different personalities that have dramatically different appearances or talents. It’s usually much more subtle.
Also in that film, the origin of Joanne Woodward’s disorder is that she was forced to kiss her dead grandmother at an open-casket funeral. That seems like it couldn’t actually be that traumatic, right?
That would seem rather mild compared to the kinds of history I usually see. Usually it’s a chronic history of some sort of traumatic event, whether it’s emotional abuse, physical abuse, or high family dysfunction involving alcoholism and severe boundary violations.
The soap opera One Life to Live had a character with multiple personalities who passed her condition onto her daughter. Is that even vaguely possible?
You know, I think we’re at a very early stage of determining whether it would test genetically or not. But certainly, if a child is raised by a mother who is experiencing uncontrollable mood changes or memory gaps that lead to abuse, one could argue that it’s environmental. If the parent was not abusive, then it would be unlikely that the child would suffer D.I.D.
On The United States of Tara, the main character is a mother with four personalities. It is possible for people with D.I.D. to be good parents?
Absolutely, especially if they have sought out treatment and are aware of what’s going on. The amnesia that you see in the movies, where one personality is not aware of the other personalities, is something I see only in people who are unaware that they have D.I.D. This is a disorder that can respond very well to appropriate treatment.
Another variation that we see a lot in movies is one personality trying to kill the other personalities. Could that happen, where the alters are at war with each other?
Actually, it’s very common that they’re at war with one another. This is a disorder that was developed in a child that was very young in the face of overwhelming abuse and trauma. It’s typical that there might be one part that identifies with their perpetrator. Obviously that perpetrator, or self-destructive part, would be at war with the part that wants to survive. So you get people who self-mutilate, or who are suicidal.
So does it ever happen that the part that identifies with the perpetrator takes over?
It certainly could happen.
Looking at movie and TV characters with D.I.D., I noticed that many of the alternate personalities seem to fall into similar categories: scared little girl, tough-talking guy with a New York accent, sexy Southern vamp, proper lady. Are those common archetypes?
You know, omitting the different accents, what is commonly seen is that the personalities can be the individual themselves at different ages. So: a scared child, an adolescent, a mature adult.
Are there ever different regional accents between different alters?
It is possible for alters to have different regional accents. More commonly, the alters have slight variations in speech patterns or may demonstrate mood swings that may be noticeable only to persons who are close to them.
In the movie Sybil, at one point, Sybil says, “There are sixteen of us.” How many patients would have that level of awareness?
When they first present? Zero. At the time they first present, most people are not aware even of the existence of different personalities. They’re aware of having mood changes that are not in their control. They’re aware that they go from feeling very depressed to being very up, or they’re aware of being capable of getting many jobs but not being able to hold a job. They’re aware of not being able to maintain an intimate relationship. Alcohol and drug abuse is an extremely common way that people come into treatment. They’re not complaining about M.P., but they have a dissociative disorder underneath.
One Hollywood convention is a person talking to a different identity in a mirror. What does a person with D.I.D. see when they look in a mirror?
That’s why I titled my book The Stranger in the Mirror: I hear from one patient after another, they look in the mirror and they don’t know who they’re seeing. Sometimes they don’t see themselves; they don’t see anything. And if they see a face, they don’t connect to it. One of the most common symptoms of D.I.D. is the symptom of depersonalization: people feeling disconnected from themselves, as if they were going through life as a robot.
Could the frustrations of ordinary life cause D.I.D., as it did to Ed Norton In Fight Club?
Just from the general frustrations in life? It’s unlikely. This is something that starts in childhood, because of longstanding abuse. But there’s actually something on the Internet that looks at how the central character in Fight Club suffers from dissociation, and how the symptoms I describe in my book are manifest throughout the film.
In your work, you encourage people to see dissociation as something that’s relatively common. Can you think of a movie that expresses that more realistic kind of dissociation?
The Lovely Bones is told from the point of view of a dissociated person looking down at their life from heaven. Alice Sebold also wrote Lucky, an autobiographical account of her own experience of being attacked and raped in college, and was actually writing about her dissociative experiences. The movie Precious, which depicted a young woman who was emotionally, physically, and sexually abused, showed her dissociating when she was abused: She would imagine herself as a famous person or a daughter that had a loving parent. That would be an example. But it’s quite prevalent all over, and it’s not necessarily pointed out.
Editor’s note: Some small tweaks were made to clarify some quotes since the original posting.