Talk:Dissociative identity disorder

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Use of the word "subconscious"

As far as I understood it, this isn't really a word that pops up in psychology literature. The article subconscious even claims that much too. —Preceding unsigned comment added by 68.103.111.70 (talk) 19:51, 1 January 2010 (UTC)

Request for the article to be edited to better meet Wikipedia neutrality guidelines

This is an important article containing a lot of information about a serious subject. Unfortunately this subject is one of apparent controversy but th have slipped into the page's content. I believe strongly that it is the responsibility of an editor to censor their personal opinion and maintain a neutral tone as best they can. Most of the content achieves this, but a few sections, especially the first one, could be re-written to be more neutral without subtracting any facts. Just in case anyone would like some guidelines on writing without bias heres a couple good pages to check out.

Wikipedia: Neutral point of view

NPOV_tutorial

I don't mean any offense to anyone by the way, and thanks for hearing me out.

Demono (talk) 11:49, 31 May 2009 (UTC)

O-kay, in what way do you thikng the first couple of sections are biased? Can you please elaborate? Casliber (talk · contribs) 13:13, 31 May 2009 (UTC)

This particular article has been the subject of some pretty extreme POV pushing in the past, so the editors here who have been through it and attempted to resolve those problems to the current version are well aware of the NPOV policy. DreamGuy (talk) 19:01, 31 May 2009 (UTC)

Demono, just whom is your request addressed to? You're as much an editor as anyone here. So if you see something that can be improved, improve it! -- Jmc (talk) 21:29, 31 May 2009 (UTC)

Of course if other people disagree with it, they'll undo it and expect you to discuss and get consensus on the talk page first from then on. That's just the way things work, so don't take offense if it happens. DreamGuy (talk) 21:59, 31 May 2009 (UTC)

Reference number 1 does not support the statement it follows. The abstract clearly states the opposite. "Dissociative disorders are clearly not only an American phenomenon." http://www.ncbi.nlm.nih.gov/pubmed/2006691 I will move this reference to the appropriate section. The first half of the sentence in lead "DID diagnoses appear to be almost entirely confined to the North American continent, is inaccurate, as the article itself in the "Epidemiology" section disproves this. I propose changing the statement to "Originally DID diagnoses appeared to be almost entirely confined to the North American continent."Ergito (talk) 22:43, 6 June 2009 (UTC)

Good pickup. Casliber (talk · contribs) 22:50, 6 June 2009 (UTC)

One source making a claim doesn't mean you can change the long-held consensus view on a topic which is well supported. DreamGuy (talk) 18:37, 14 June 2009 (UTC)

admittedly, the paper is 15 years old. alot can change in that time. Still, yet another article to review...Casliber (talk · contribs) 21:38, 14 June 2009 (UTC)

Sorry for not being clearer. These references in the article, showing varying incident rates from different countries (27 - 33, 67,70 and 71) back up the minor change to the article, making the statement accurate and updated.Ergito (talk) 18:09, 20 June 2009 (UTC)

That's not a "minor change to the article" and it's primarily written to push a highly controversial POV. The incident rates from the other countries don't come close to supporting the conclusion you want the article to make. DreamGuy (talk) 04:36, 21 June 2009 (UTC)

I did just that: edited the intro to the article removing several judgement calls and unprovable statements but leaving the content, references, links, etc. completely in-tact and someone did the Undo. So now I need to defend my position: "A great deal" of controversy -- "great deal" as compared to what? This is an opinion. There is also a "great deal" of evidence supporting the disorder. How do you weigh them against each other? The purpose of the statement is to show that there is controversy, it is not to make a judgement on how much controversy. If there is a publication that thoroughly and fairly weighs the evidence vs. the discrediting, then I will rescind my request to edit. --- "there are many COMMONLY DISPUTED" points vs. "QUITE VARIED" both of which are judgement calls with "many" "common" and "quite" in those statements -- and are there commonly repeated points or many varied points? I consider these to be opinionated statements because quantity of "many" is obscure, and the dichotomy of "common" vs. "varied" leaves these two statements in a quagmire of not lending any credence to the statements. It is more educational to consolidate this point with the following statements that actually illustrate a range of disputes, which I attempted to do in a neutral fashion. "DID diagnoses appear to be almost entirely confined to the North American continent,[1][2] adding to the possibility that DID may not be a legitimate diagnosis." This statement is inflammatory to the actual content of the article. Later the article shows that there are instances in other countries. If this statement must remain, the "almost entirely" should be replaced with something more factual, such as "a higher percentage of", however, I would simply combine this statement with others refuting the existence of DID as a legitimate diagnosis, the way I did in my edit and remove the judgement call "adding to the possibility that " which is a statement of opinion. It's not a "possibility" it's a statement of position by people attempting to discredit the diagnosis. Please keep people attempting to discredit the disorder from skewing the facts. I haven't had a chance to comb over the remainder of the article. I did not remove any facts, I cleaned up opinions and skewed comments, and I believe I improved the overall readability of the page. When I read the page, it does not sound encyclopedic to me as it stands. Someone please return my edits, or make similar edits to the page. The Crisses (talk) 14:49, 26 June 2009 (UTC)

Crisses, I do hope you aren't taking a revert too personally. Dreamguy's revert appears to have been made in good faith with the interest of improving the article. I believe your edit was a step in the right direction, and I generally agree with your arguments, but it still raised some concerns. For example, your edit caused the paragraph to end with the flat statement that DID may not be a valid diagnosis. I believe the intent of the original prefix "adding to the possibility..." was to show that the previous statement was being used by some as evidence to support the conclusion that it isn't a valid diagnosis (or whatever it says, too lazy to pull the quote). I'll take a look at the lead when I get a moment and see what I can do. -Verdatum (talk) 15:56, 26 June 2009 (UTC)

Take a breath and look at your actual edit, Crisses. On balance the previous version was better than your version, because your version fractures sentences and removed uncontroversial information. I am completely at a loss to how you can think that "commonly disputed" and "quite varied" are at all contradictory, as they focus on different points completely. For an example you might be able to follow better because it's more tangible, the types of fictional characters on TV shows are quite varied, and a wide variety of those are quite commonly found on TV shows. Different criticisms of DID (some of which disagree with each other, showing the variety) are offered (and in case you were unclear what they are they're summarized right there in the article), and they are not rarely offered but quite commonly. They are common in how often they happen but the arguments aren't always in common with each other. You are apparently confusing the two different meanings of the word in the English language. That could be clarified, but to insist that it's wrong isn't accurate.

As far as your "Please keep people attempting to discredit the disorder from skewing the facts" goes, no facts were skewed, and the people who disagree that the disorder exists are a valid POV that is fully sourced to reliable, expert opinions, so if you think that accurately including what they say somehow "skews" the facts then you don't understand our WP:NPOV policy. DreamGuy (talk) 16:10, 26 June 2009 (UTC)

I have no problem with people disagreeing with all of my edits, but to revert the entirety of my edits does not seem to take into account that words such as "common" and "varied" are relative not exact terms. What percentage of the psychologists/psychiatrists out there disagree with DID as a diagnosis? Not enough to vote on it being removed from the DSM. I don't know whether the boards that write the DSM or the ICD or the MeSH are completely neutral, but I would guess that the boards that write these manuals are not skewed particularly in or out of favor for DID itself. The disagreement with the diagnosis should be mentioned but not given weight as per "common" or how "varied" the disputing is. I believe it should be covered as a fact, an exact illustration of what the range of disagreement is is very fair. I strongly disagree with stating the disagreements are common or not; this is a relative term that confuses me if not any other readers as to just how disputed it is as a diagnosis. Until someone surveys a broad and unbiased range of practitioners, one cannot say how common or uncommon the disputes are. Just because the detractors are loud does not make them common. It just makes them vehement and, if they are professionals, it takes time away from their practices. Actually, how many people who dispute DID/MPD as a diagnosis are actually psychologists? If there's no statistics, the detractors are just people with a lot of hot air and wishful thinking. I don't have access to all the original article texts. How many of the references cited on the page are disputing DID/MPD, and is it enough to constitute a "great deal"? And why is that stated at the head of the article rather than in a subsection on disputes rather than at the top matter which should define MPD/DID itself rather than start off debunking it? Perhaps this article can be reviewed by a specialist in the field who has read these original sources, so it can be more factual. The Crisses (talk) 22:01, 30 June 2009 (UTC)

So you're claiming that I have not read the original sources? And why is it in the lead? Because the lead has to accurately summarize the article, and not having the fact that the diagnosis is disputed in the lead would frame the whole topic from only one POV, which is, again, a violation of NPOV policy. DreamGuy (talk) 13:05, 1 July 2009 (UTC)

Your profile doesn't even say your name, much less any letters or credentials associated with it, so why are you assuming that I'm discounting you when I'm saying maybe an expert who has read the source documents should review the article? Do you have any credentials? Your profile says you wrote a book, but not what the subject is. It says you're a senior editor, but not who you really are, what degrees you may have, etc. And it doesn't say you've read all the source articles noted on the DID article page. You defend NPOV, but allow subjective phrasing such as "great deal"? Kudos on your Wikipedia accomplishments, DreamGuy, but I don't know you from Adam. I still disagree with some of the phrasing on the article page, regardless of whomever you are and your estimable Wikipedia-only credentials. There was absolutely no personal attack here. I was making a very blunt statement: Maybe someone with knowledge of the field should review the articles and determine whether or not "great deal" and other such non-neutral language is warranted. It might require a statistician and some way of quantifying exactly what percentage a "great deal" constitutes -- obviously over 50%, correct? It might also require a psychologist and a review of all extant literature. If those are your credentials, and you've performed these reviews and can back them up, please list them so I don't have to have this discussion. Even if that's the case, doesn't "great deal" constitute speculation and original research? if it's a direct quote of a resource, it should be in quotes and the source noted. The Crisses (talk) 10:47, 10 July 2009 (UTC)

Removal of controversy section in lead

Moving this to the talk page, as it appears it does not accurately summarize the article. I have proposed a new version below as a starting point from which others can work on. version there now --- There is a great deal of controversy surrounding the topic. There are many commonly disputed points about DID. These viewpoints critical of DID can be quite varied, with some taking the position that DID does not actually exist as a valid medical diagnosis, and others who think that DID may exist but is either always or usually an adverse side effect of therapy. DID diagnoses appear to be almost entirely confined to the North American continent, adding to the possibility that DID may not be a legitimate diagnosis. Possible new version ---- There is controversy surrounding the topic of DID. Viewpoints of DID range from the position that DID has scientific evidence backing its existence and that it is created by early repeated trauma, that DID does not actually exist as a valid medical diagnosis and the theory that DID may exist but is either always or usually an adverse side effect of therapy. Originally in the 1980's, DID diagnoses appeared to be almost entirely confined to the North American continent,, adding to the possibility that DID may not have been a legitimate diagnosis, but in the last twenty years, several studies have shown varying prevalence rates around the world. Ergito (talk) 18:27, 28 June 2009 (UTC)

Please do not remove whole sections just to talk about them. Removal would be a colossal WP:NPOV violation and serves no practical purpose. And you already know that the core change you suggest does not have consensus per the above discussion, adn the summary you want to tack onto the end is obviously intended to make people think that the idea that it is not a valid diagnosis is 20 years out of date, which, I shouldn't need to point out, another major NPOV violation. DreamGuy (talk) 18:47, 28 June 2009 (UTC)

The version I put above seems to be more neutral and better summarizes the article. Perhaps another editor could weigh in on a rewrite for this section.Ergito (talk) 18:53, 28 June 2009 (UTC)

Agh, this is bad timing! Will try and have a look soon. I was planning on ferreting around for the latest review articles on it soonish. Casliber (talk · contribs) 21:00, 28 June 2009 (UTC)

Ergito, I like where you're going. I'd add a comma between valid diagnosis & the theory that it's caused by abuse -- those are two separate POVs in a list including the theories that it's fake. If you remove "early" from repeated trauma you even cover the folks citing ritual abuse. Note that there's a footnote including a twin study (unless it's been removed...): a predisposition to DID can also plausibly be an inherited trait. This is why I'd make caused by abuse a separate view than that it's a valid diagnosis. If you want a citation that not all people diagnosed DID or MPD believe it is a disorder, there's Internal Family Systems Theory (a book -- I can get the author), Plurality Theory, and others. The Crisses (talk) 00:58, 1 July 2009 (UTC)

When we discussed those in the past here it was decided that there are no reliable sources that support the existence of MPD as something that is not a disorder. That is generally considered a WP:FRINGE view, with all the limitations on covering them here that comes along with that. DreamGuy (talk) 13:11, 1 July 2009 (UTC)

You misread me. I didn't say anything about stating that in the article. I said simply to put a comma. I also mentioned resources, although I didn't attribute them because I wasn't asking them to be included. Jung (anima, animus, archetypes, shadow self), Freud (id, ego, superego, libido -- while they may not be explicitly named they do take control over one's behaviors in his theorem), Richard C. Schwartz (Internal Family Systems Therapy, 1995). I may be able to hunt down others. The theory that everyone consists of "parts" is prevalent in psychological literature. That's why memory loss and explicit identities who take over and have names are part of the criterion to push it into the classification of a "disorder". If you have one or the other, you may have multiple personalities, but it's DD:NOS not DID. i.e. You can have multiple personalities without a disorder. Now, back to changing the opening paragraph. I like what Ergito proposed, and would ask for the addition of the comma. In the text below it would specify the criteria for inclusion as DID/MPD. At the top, it's a list comparing a range of theories on the topic. The Crisses (talk) 14:27, 1 July 2009 (UTC)

Errr -- correction -- not all psychologists think it's a disorder re: Internal Family Systems Theory & Plurality Theory. One could also look at Freud, Jung et al re: different portions of the psyche that are recognized in early psychological literature. The Crisses (talk) 01:09, 1 July 2009 (UTC)

And that sounds like original research. Different "portions of the psyche" is not the same thing as multiple personalities, and we can't present them here as if they are. DreamGuy (talk) 13:11, 1 July 2009 (UTC)

Again -- I didn't say to add that. I just used it to explain why I think the comma at the top of the article is relevant. If you wish to make it an AND statement, put a footnote siting a source and make sure it's phrased in a way that the statement with the conjunction is clearly a single element in the list of range of theories. Is the "and ---" the end of the list? I prefer the comma because it does not rule out that both are required criteria for the label as a "disorder" it merely makes it clear that the 4 items listed are indeed a list entire. The Crisses (talk) 14:31, 1 July 2009 (UTC)

I think I'm not being clear enough, so I'll try to rephrase it to show what I mean: There is controversy surrounding the topic of DID. Viewpoints of DID range from the position that DID is a scientifically backed disorder created by repeated trauma that usually occurs early in childhood development, that DID does not actually exist as a valid medical diagnosis, and the theory that DID may exist but is either always or usually an adverse side effect of therapy. Originally in the 1980's, DID diagnoses appeared to be almost entirely confined to the North American continent,[1][2], adding to the possibility that DID may not have been a legitimate diagnosis, but in the last twenty years, several studies have shown varying prevalence rates around the world.The Crisses (talk) 14:34, 1 July 2009 (UTC)

I have added an adapted version of the above to the page. It is more accurate than the present version. It more correctly summarizes the page and the different positions around DID. Ergito (talk) 17:43, 3 July 2009 (UTC)

And someone else reverted you (not me this time). Per WP:BRD and WP:STATUSQUO, please do not make changes you know are controversial until you can demonstrate WP:CONSENSUS to do so. Simply insisting that you are right is unacceptable. DreamGuy (talk) 22:32, 3 July 2009 (UTC)

Attempting to make the lead accurate. It would be helpful if people worked toward this goal and not just erase all attempts to improve the lead. Ergito (talk) 16:15, 7 July 2009 (UTC)

The lead is already accurate. It would be helpful if you stopped presenting your POV as if it were some ultimate truth you could force onto the article without bothering to gain consensus to do so. DreamGuy (talk) 17:39, 7 July 2009 (UTC)

How is it "without bothering to gain consensus" when Ergito posted it for discussion? How does one gain consensus? I've made comments but overall I find my problems with the opening of the page satisfied by Ergito's suggestions. What are your problems with it? Let's derive a consensus. I find Ergito's suggestion to be much less opinionated in any direction, it does not contain judgement calls, it's concise and clear, and very neutral. It continues to cite sources. It continues to point out that there is controversy without weighting the reader towards believing either the diagnosis or the controversy surrounding it. Do we need more people to come here and complain about the opening paragraph to establish that it's a problem? I'm willing to write to experts in the field. The Crisses (talk) 11:06, 10 July 2009 (UTC)

What you sound like you want to do is violate our rules against meatpuppetry. Contacting people you know would support your POV in order to rewrite an article to reflect that POV is explicitly not allowed. Posting for discussion is good... that's how someone would work toward consensus. Going ahead and editing the article with a controversial change despite knowing that the discussion shows there is no consensus and people actively opposed is a violation of several policies. DreamGuy (talk) 17:01, 10 July 2009 (UTC)

I made a few changes to the edit in the spirit of compromise. Two editors agree with the change. One apparently does not. The one should work with the others here for a new version. And the lead was not accurate. It did not correctly summarize the article.Ergito (talk) —Preceding undated comment added 22:39, 11 July 2009 (UTC).

I changed the text to place slightly more emphasis on the appearance of DID on other continents, but re-reading the old lead, I'm not convinced it's necessarily an improvement. The rates are much, much higher in the US, sufficient to merit the "almost entirely confined to North America". I'm not too upset if the page is reverted to this version. Also, now that the recovered memory/hypnotherapy/truth serum approach to child abuse is out of fashion, I'd love to see what the newer sources say about incidence and prevalence. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:20, 11 July 2009 (UTC)

"In the spirit of compromise"?!?! There was no attempt to compromise in the slightest, you just put the exact same content there and made deceptive claims about it (which is the hallmark of an editor here who was permanently banned for POV pushing and using socks to get around the blocks, now that I think of it). The edit comment of "you don’t have consensus to undo the change, work on the talk page for a new version and stop deleting others changes unilaterally" seems to show a deliberate attempt to ignore the rules of WP:CONSENSUS, WP:STATUSQUO and WP:BRD. On top of that, pretending that the current state of matters is that "Two editors agree with the change. One apparently does not." is also highly deceptive, and probably intentionally so. User:Carl.bunderson also removed your edits with the comment of "rv unsourced changes to sourced content", User:Casliber above did not support your changes, and of course myself. Now User:WLU has stepped in to make the number of people opposed to your desires even stronger: You not only do not have onsensus to make changes, there is a full consensus (consisting of ALL the non-newbie accounts, by the way) that what was there previously (and there now) is better. Any future attempt to restore the POV-pushing content despite knowing full well that a strong consensus opposes it will be viewed as a violation of WP:POINT. DreamGuy (talk) 23:38, 11 July 2009 (UTC)

I back up DreamGuy's comment here. Clearly I side with him in this disagreement, having reverted your edits at least once, Ergito. Moreover, I think it is an important point that the well-established editors are on DreamGuys's side, while Ergito, you have fewer than 100 edits. Any future changes to the lead by Ergito should be minor and have clear consensus prior to being done. carl bunderson (talk) (contributions) 00:57, 12 July 2009 (UTC)

Originally, it was two against one. One editor deleted my edits due to no sources, which I added after. I did make a few changes to my original edit. Now it is three to two against the change. Ergito (talk) —Preceding undated comment added 22:12, 25 July 2009 (UTC).

When judging consensus decisions, you can't just choose to go with whatever a tiny group who happened to immediately participate on the talk page has to say if it goes against longstanding consensus. Saying it was two against one originally ignores that it was two new users without any history of contributing anything to the article appearing out of nowhere to try to argue against a consensus that was built up by a number of editors over time. Going straight by polling of the moment means anyone who can bring in a couple of newbies -- or sockpuppets -- can overthrow what many people put a lot of work into hammering out. DreamGuy (talk) 12:53, 7 August 2009 (UTC)

"Current medical classification"

As of this post, the article states, "The condition first appeared in current medical classification in the 1980 publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, as multiple personality disorder (MPD),"

I cannot remotely understand the intent of this sentence. What is "current medical classification"? And depending on the meaning of that phrase, what evidence is there that this was the first appearance? I think further clarification is needed, and citation through a secondary source (i.e. not the DSM) is strongly desired. -Verdatum (talk) 14:58, 22 June 2009 (UTC)

I know, the phrase was a bit shoddy and I was having trouble thinking of an alternative. It has asecondary source in hte body of the text (not the lede). Casliber (talk · contribs) 20:34, 22 June 2009 (UTC)

If it becomes "appeared as a medical classification" then the problem should be resolved. The Crisses (talk) 01:11, 1 July 2009 (UTC)

--large section with one source--

This section in the article confuses me. It comes from only one source and I am unsure if the last part comes from the source or was just added in. Perhaps it should be rewritten. Ergito (talk)

Over-representation in North America

Paris[39] in a review offered three possible causes for the sudden increase in people diagnosed with DID:

  1. The result of therapist suggestions to suggestible people, much as Charcot's hysterics acted in accordance with his expectations.
  2. Psychiatrists' past failure to recognize dissociation being redressed by new training and knowledge.
  3. Dissociative phenomena are actually increasing, but this increase only represents a new form of an old and protean entity: "hysteria".

Paris believes that the first possible cause is the most likely.

The debate over the validity of this condition, whether as a clinical diagnosis, a symptomatic presentation, a subjective misrepresentation on the part of the patient, or a case of unconscious collusion on the part of the patient and the professional is considerable. Unlike other diagnostic categorizations, there is very little in the way of objective, quantifiable evidence for describing the disorder.

The main points of disagreement are these:

  1. Whether DID is a real disorder or just a fad.
  2. If it is real, is the appearance of multiple personalities real or delusional?
  3. If it is real, whether it should it be defined in psychoanalytic terms.
  4. Whether it can, or should, be cured.
  5. Who should primarily define the experience—therapists, or those who believe that they have multiple personalities.  —Preceding unsigned comment added by Ergito (talk • contribs) 22:18, 25 July 2009 (UTC) 

I have attempt to clarify and shorten the section above. Comments are welcome.

Paris[39] in a review offered three possible causes for the sudden increase in people diagnosed with DID: 1) The result of therapist suggestions to suggestible people, 2) Psychiatrists' past failure to recognize dissociation being redressed by new training and knowledge and 3) Dissociative phenomena are actually increasing. Paris believes #1 is the most likely. Paris believes that there is a debate over the validity of the condition. Ergito (talk) 22:47, 8 August 2009 (UTC)

I have shortened the section as per my comment above after waiting over a week for any objections. Ergito (talk) 23:33, 17 August 2009 (UTC)

And I have reverted. Please get an actual consensus for changes before making them considering that you know that people have objected to your changes in the past and your changes are always of the same type. DreamGuy (talk) 14:00, 18 August 2009 (UTC)

I have made another attempt to clarify and make the section more concise, deleting a few lines that appear to have no source.Ergito (talk) 22:36, 10 October 2009 (UTC)

Paris' belief that therapist suggestions cause DID would be wrong: The purpose of DID is to prevent the sufferer from remembering trauma because it is not safe to do so. Thus when parts come out in normal life (as they frequently do) it is overwhelming, and would be seen as a mental breakdown. The majority of DID sufferers have had numerous breakdowns requiring compulsory hospitalization. One could argue that mental breakdowns should be interpreted within a framework that appreciates dissociation and capacity issues [kclehman]. Therapy provides a safe space, and relationship, in which parts can come out, and if the therapist is able to help resolve traumas the parts can begin to express themselves. It is not uncommon for parts to become apparent without any therapist in sight. The apparent increase of cases is easily explained, as listening therapies gain acceptance, the parts are becoming heard for the first time. Psychiatrists using the medical model treat symptoms, they don't listen with anywhere near the levels of trust and relationship needed for a frightened, abused 3 year old part to come out. Freudian Psychoanalysts don't listen to or believe their patients, since their model is based upon interpretations in terms of repressed sexual fantasies, rather than providing a safe space within which to find out what actually happened. The fact that N.America has the most cases simply indicates that they are further ahead in their use of listening therapies. Most UK Mental hospitals do not have any Psychologists, or counsellors on staff, and operate purely within the medical model. This simply hides DID behind the chemical cosh. Those who debate whether the patient may be unconsciously colluding, do so because some coping mechanisms are interpreted as manipulative or over needy. If they have any practical experience at all, they are unlikely to have had the opportunity to dealing with patients towards the end of their treatment. When trauma is resolved and all coping mechanisms, fits, outbursts, paranoia, manipulation etc are completely absent, but the dissociation and fully articulated parts remain. -- anon —Preceding unsigned comment added by 84.13.128.59 (talk) 05:11, 24 December 2009 (UTC)

Your personal opinions on the topic are not relevant to this article. This is an encyclopedia, and as such we go by what reliabkle sources have to say, not what an anonymous Internet poster thinks. DreamGuy (talk) 19:21, 20 February 2010 (UTC)

Healthy multiplicity

I believe the concept of healthy multiplicity — multiple identities cooperating to function, rather than exist in conflict — ought to be mentioned. The fact that it is controversial is not a reason not to. -- Stormwatch (talk) 07:07, 7 August 2009 (UTC)

It's not just controversial, it's WP:FRINGE, which is a reason not to mention it. You would need some pretty solid reliable sources from experts suggesting that the idea is plausible for it to be mentioned here. If you can find any academic sources (instead of just someperson's blog or personal site) please list them here. I tried looking for some a while back and couldn't find any that meets Wikipedia standards. DreamGuy (talk) 12:43, 7 August 2009 (UTC)

See if you can find anything good here. -- Stormwatch (talk) 03:39, 8 August 2009 (UTC)

Tricky, most of those have nothing to do with DID. The first three might have something in them but one would need to see the whole source. Casliber (talk · contribs) 03:52, 8 August 2009 (UTC)

Indeed, find a specific source that is reliable, an a text to accompany it. There is more of a place for this sort of thing in the history/society section of the page, as I don't believe it has much support in the medical literature that perforce the rest of the page is based on. WLU (t) (c) Wikipedia's rules:^simple/_complex 04:20, 8 August 2009 (UTC)

DreamGuy seems like a dick cheese —Preceding unsigned comment added by 68.105.145.248 (talk) 04:20, 1 November 2009 (UTC)

The practice of learning to live with your condition, though not something I agree with, since there is a cure available, is widely practiced for many mental disorders and conditions. So it does not really qualify as a fringe idea. You will find numerous books on living with schizophrenia, or living with depression, for example. For DID, when all trauma is resolved parts may be fully co-conscious, and therefore will naturally share experiences, and all begin writing on the same memory pages. After a while integration may occur naturally or as a result of specific spiritual experience [ http://www.safeplacefellowship.com/testimonies/mari/ONEMIND.HTM ]-- anon —Preceding unsigned comment added by 84.13.128.59 (talk) 05:33, 24 December 2009 (UTC)

Citation: from Diagnosis and Treatment of Multiple Personality Disorder by Frank W. Putnam (1989, Guilford Press, NY, p. 301). (If you need others, let me know.) "Although there is a general concensus among experienced therapists that complete integration of the alter personalities is a desirable goal, this simply may be unrealistic with many patients. Kluft (1985d) is the first to acknowledge, 'In a given case, it is hard to argue with Caul's pragmatism: "It seems to me that after treatment you want a functional unit, be it a corporation, a partnership, or a one-owner business"' (p. 3). It is a mistake to make integration the focus of therapy. Treatment should be aimed at replacing maladaptive behaviors and responses with more appropriate forms of coping. Ideally, integration of the alters will emerge from this process, but even if it does not, the therapy may well be termed a success if the patient has achieved a significant improvement in his or her level of functioning." The Crisses (talk) 17:49, 8 January 2010 (UTC)

Note the entire section of fusions in his book (i.e. integration) includes numerous mentions and sections on fusion failures, etc. which may have more information about alternatives. I don't want to re-read the entire book to talk about alternatives to integration therapy. I recently "uncovered" my DID/MPD library (perhaps 20 clinical books and others), and if need be I'll be able to research citations for information needed from these sources. I don't currently have access to a periodical library for current research however. The Crisses (talk) 17:57, 8 January 2010 (UTC)

This concept may not be recognised by doctors - perhaps some do, I don't know - but I have come across a number of people online who say that for them being multiple is normal and they cope fine with it and don't want to be cured of it. Perhaps in that respect it could even be argued that it's comparable to homosexuality, which was medically classified as a mental illness until the 70s or 80s (I forget the exact date). It seems a shame if Wikipedia has to expunge any mention of a point of view that is common among multiple people themselves just because it is not the current medical orthodoxy (and I have not specifically sought out contact with multiple people online). Orlando098 (talk) 20:53, 16 April 2010 (UTC)

Seen this? Critiquing the Requirement of Oneness Over Multiplicity by Kymbra Clayton, a psychologist in Sydney, Australia. This article examines some of the texts written by mental health professionals about multiplicity, and questions basic assumptions. --Bluejay Young (talk) 06:06, 22 March 2011 (UTC)

Non sequitur in the history section

The history section starts off talking about the nineteenth century and earlier, then has a sequence of paragraphs which refer, respectively, to:

• the late 19th century ;
• the early 20th century;
• 1910;
• period 1903 through 1978;
• period starting in about 1927; and
• the 1980s.

But this is then followed by:

The public, however, was exposed to psychological ideas which took their interest. Mary Shelley's Frankenstein, Robert Louis Stevenson's Strange Case of Dr Jekyll and Mr Hyde, and many short stories by Edgar Allan Poe, had a formidable impact.

Erm, what? All of these influences come from the nineteenth century. They are followed by a discussion of the possible effect of publicity surrounding books published in the 1950s through 1970s, which makes sense in context. But the sentence I have quoted does not. -- 202.63.39.58 (talk) 11:43, 27 September 2009 (UTC)

Drug use

If the symptoms are caused by drug use, does it really not count? Or is it just when the are temporarily caused by drug use. i.e. If I used to take drugs and they cause the symtoms of DID that I now get every day, surely I have DID. Yaris678 (talk) 11:35, 9 October 2009 (UTC)

Sorry, you really need to discuss this with a doctor who knows you personally. Casliber (talk · contribs) 22:44, 10 October 2009 (UTC)

I think you might be mis-reading the hypothetical situation I described above. Yaris678 (talk) 13:04, 11 October 2009 (UTC)

Schizophrenia is often (enough) caused by drug abuse. If symptoms persist even a week since drug use, it's pretty safe to assume that there's something wrong. "Dissociative identity disorder is diagnosed in a sizable minority of patients in drug abuse treatment facilities." "The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (e.g., complex partial seizures). In children, the symptoms are not attributable to imaginary playmates or other fantasy play." Memory loss, however, can be caused in the long-term by drug abuse, and doesn't necessarily point to DID. MichaelExe (talk) 04:45, 11 October 2009 (UTC)

Sounds like I was right. I'll see how I can change the article to reflect this. Yaris678 (talk) 13:04, 11 October 2009 (UTC)

Done. Yaris678 (talk) 13:14, 11 October 2009 (UTC)

DISSOCIATION AND STATE-SPECIFIC PSYCHOPHYSIOLOGY DURING THE NINETEENTH CENTURY

by Carlos S . Alvarado, M .S. Some of the cases, like that reported by Despine (1838),were observed in patients that showed one of more personalities when hypnotized . For example, Lucie, a patient of Pierre Janet (1887), suffered from a variety of somatic problems, including absence of tactile and kinesthetic sensations. During hypnosis a personality named Adrienne communicated with Janet through automatic writing . When Janet pinched Lucie, Adrienne reported feeling sensations that Lucie did not feel. Similarly, under these conditions Adrienne was able to recognize objects by touch, a task Lucie was unable to accomplish. Janet measured the tactile sensibilityof his patient with an esthesiometer and found that while Adrienne 's sensation was normal, Lucie's was not.

The case of Blanche Witt, studied by Jules Janet (1888),showed similar phenomena . In her "primary" state Witt showed several sensory and motor deficiencies such as total anesthesia, lack of muscular sense, deafness in her left ear,color blindness in the left eye, restricted visual field, low visual acuity, and hysterogenic and erogenic points. Under hypnosis, however, Witt's secondary personality did not exhibit these problems. Finally, Bruce (1895) reported another case in which systematic tests were conducted . His patient, a 47 year old Welsh sailor showed two different states : one in which he spoke Welsh (was left handed, and had weak circulation and constipation), and another in which he spoke English (was right handed, and his circulation and bowel movements were normal) . According to Bruce : "Occasionally when changing from the Welsh to the English stage, or the reverse, this patient passes through an intermediate condition, in which he is ambidextrous, speaks a mixture of Welsh and English and understand both languages" (p . 62) . Additionally, the patient's pulse had a higher rate in the English state than in the Welsh state. The interpretation of these phenomena was problematic, Kazuba (talk) 03:25, 22 October 2009 (UTC)

The interpretation of some of these phenomena is obvious. The specific content of the specific memories and experiences of each part will effect physiological symptoms. Pulse rates may vary according to the relative anxiety levels in traumatic memories. The part with constipation will have had traumatic events relating to the subject. Bed wetting is another symptom commonly exhibited by only one part. Migraine like headaches may actually be memories of childhood illnesses as experienced by one part, but not another. -- anon —Preceding unsigned comment added by 84.13.128.59 (talk) 04:37, 24 December 2009 (UTC)

Memory loss what of short and long term memory is there a difference

I have D.I.D. and have an amazing long term memory and a good memory for sequenced numbers but my short term memory is very poor for more than 3 items.

Treatment Options

The combination of 24/7 support, on demand therapy, and relaxed easy going community living with other non-survivors would be the ideal recovery framework. [1] Even with ideal conditions, support, and effective therapy, the process can take up to 10 years. Relapses and emotional breakdowns will occur, and providing this level of support is very challenging. Professional services rarely have the facilities or trained staff to offer this level of support, so treatment within lay-communities, with appropriate support and training is likely to be the most effective long term solution. Several organizations advocate this model. [2] [3]

Since DID sufferers are vulnerable to triggering, emotional overwhelm, and night terrors, the availability of support 24/7 is advised. Access to support helps prevent a small trigger spiraling into an emotional breakdown. A restful supported environment in which the the individual is able to find time and space to work on their issues will be needed for several years. Within a framework of emotional space with support, there are numerous therapy needs. 0) Safe environment and daily familiar routine 1) Resolution of trauma and lie based thinking 2) Resolution of strong truth based emotions: e.g. anger due to hurt and injustice 3) Re-parenting, close family-like relationships, and emotional development - Development of healthy nurturing relationships, and opportunuty to develop in emotional maturity (http://www.thelifemodel.org) 4) Occupational therapy, play and creative therapies 5) Caring and relationship development - i.e. Pet therapy 6) Celebrations and positive reinforcement, for birthdays, christmas, and any other excuse for a party 7) Empowerment and support for real life living and challenges 8) Regular listening sessions and normal conversations (4 times a day minimum) in order to enable natural emotional processing and to prevent headaches which are a symptom of built up stress or anxiety. 9) Memory work, good experiences, and successful therapy, should be scrapbook-ed and photo albums filled with images of good positive memories.

Items, 1 and 2 above - Resolution of Pain in memories. Specific therapy sessions are needed to investigate individual symptoms, beliefs and behaviors, with a view to resolving any underlying traumatic behaviors. "Theophostic Prayer Ministry" is acknowledged as being a pioneering technique in this field, with many derived methods applying fundamentally the same insights and techniques. e.g. [4] EMDR is discussed in this article is the best that conventional methods have available, and is not considered as effective. Effective therapy will be able to resolve a traumatic memory in a single session, and that topic will not need to be revisited again. Healing may require hundreds of similarly successful therapy sessions over several years.

Due to the complexities of helping an individual with DID, the most important success factor, is that of establishing communication with Jesus aka. God. This allows Jesus to explain things, outline specific strategies for specific problems, advising on therapy plans and to unentangle the emotional mess in a safe order. For example memory loss amy be a needed coping mechanism and should not be healed too soon. Secular practitioners have also identified a specific and possibly equivalent part known as the ISH "Inner Self Helper" [5], that maintains an objective position and is helpful in resolving disputes, and providing therapeutic direction, among other things. Given the complexities, successful treatment of DID without God's involvement would be a miracle indeed.

Dennis L: A Phenomenological Model For Therapeutic Exorcism For Dissociative Identity Disorder; Journal of Psychology & Theology; Summer2001; Vol. 29 Issue 2 - "It seems ironic that calling on a higher power is standard fare for work with patients who have addictions, yet it is frowned upon and somehow seen as illegitimate for other kinds of psychiatric disorders. If a Christian faith is already part of a patient s life, why not utilize it?"

Organisations reporting success in treating DID through to integration - THRIVE http://www.thrivetoday.org www.care1.org http://www.lifemodel.org/ - Dr. James Wilder et al - Residential fully supported programmes - "Immanuel Interventions" http://www.kclehman.com - Dr. Karl Lehman - "Theophostic Prayer Ministry" http://www.theophostic.com - Dr. Ed Smith - http://www.rcm-usa.org/What-is-DID.htm - Dr. Tom Hawkins - http://www.heartfortruth.org.uk - Carolyn Bramhall - http://www.safeplacefellowship.com - Phil Scovell - http://www.clinicfordissociativestudies.com/ Testimonies of Recovery - Carolyn Bramhall - http://www.amazon.co.uk/Am-I-Good-Girl-Yet/dp/1854247247

Many of the practitioners above write about how to treat demonization within the context of DID. Without an appreciation of this topic secular approaches are severely hindered, and will suffer frequent relapses, and conflicting behaviour. Typically a traumatic memory will contain up to 1-9 lie based beliefs, and each one may optionally have a spirit attached. This is trivially easy to handle with appropriate training.

It will take some effort to populate the main page with this information, collating references and attributions. Secular experts are charging £220 per hour for consultation in the UK, and keep much of their knowledge close to their chest. Case study material is extensive but is not publicly available due to confidentiality and is difficult to obtain and verify. Specific training courses which teach how to routinely work with DID have only been available for 15 years or so. Since recovery can take 10 years or more, papers, testimonials, publications and research is only just beginning to appear. In 30 years or so the situation will be much improved. Communicating the message that healing is possible and effective will accelerate the amount of data and research available in the public domain. This is not original research within the field, papers and articles are being written by experienced therapists [6]. Verification and statistically significant scientific analysis is limited due to the relatively small number of case studies in the public domain at this time. 84.13.128.59 (talk) 19:21, 24 December 2009 (UTC)

Bad Treatment Approaches

Group therapy is generally felt to be a bad thing, due to the overall vulnerability of the participants and the lack of safety in the group context. The likelyhood of triggering between participants, and the stresses of the situation are likely to halt progress in its tracks.

Therapists have various guidelines [7] (ref: The Code of Ethics of the Christian Society for the Healing of Dissociative Disorders (CSHDD, 1998)) which typically advise: Do not use hypnosis, guided visualization, counseling (advice or suggestions of any form). Medication is considered counter productive since DID is not caused by any chemical deficiency [8] . Compulsion in treatment, and or coercion is extremely negative inevitably leading to re-traumatization, and many are overwhelmed such that new parts are created just to cope with the trauma of hospitalization.

Therapists who choose only to respond to one part as a coercive or therapeutic tactic are causing further emotional damage. Dissociation is like looking into a house through different windows, each part is the same individual person seen from a different perspective. Each part is therefore a whole person, having needs, hurts, and fears and a desire to be heard and known. Parts should be related to in whatever manner is most helpful, friendly and safe to them.

Archetypal christian "Confrontational Deliverance ministry", or Exorcism [9] is used by some to treat DID. This is not a helpful process because it assumes a quick fix is possible without taking the time and the effort to understand, relate and love the person. This form of deliverance may be abusive and defiling to the individual, particularly if spirits are allowed to talk or act out. The all too common practice of mistaking a hurt frightened internal child part for a demon is emotionally damaging for the child part concerned. Secondly is has been known for internal child parts to believe that they are a demon because that is what they were told by abusers or family members. Deliverance when needed should always be done after emotional healing has taken place, safe therapists will enable the individual to learn for themselves what to do, without offering and advice or teaching. When it occurs it is a low key process, achievable with one word, addressed to the entity perceived in the mind and no longer relevant, "go". 84.13.128.59 (talk) 19:26, 24 December 2009 (UTC)

I'm not combing this information for its suitability for the Wikipedia article page or otherwise -- but I would love for more information like this to be shared on my own DID/MPD wiki. Please contact me so I can give you information so you may contribute it elsewhere where we would welcome the information, opinions, with or without citations. The likelihood of retraumatization through Ritual abuse or Religious abuse is profound but I can't personally speak to it other than very abstractly. You seem to have something to offer on the topic and I would value it. The Crisses (talk) 18:07, 8 January 2010 (UTC)

Brain Imaging?

I'd read long ago that brain imaging studies (CAT scans) showed that different parts of the brain were active when different personalities were active. I'd be curious to read the latest in this area. The point being that brain imaging offers physical evidence that perhaps might help distinguish this from e.g. schizophrenia, etc. linas (talk) 03:00, 7 February 2010 (UTC)

Point to ponder

[10]. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:22, 3 March 2010 (UTC)

Certainly a very good source worth citing in the article, especially the statistics on overall acceptance (or lack thereof) of the diagnosis. DreamGuy (talk) 22:14, 10 March 2010 (UTC)

I'm guessing this page still gets it substantially wrong - I'm guessing it now faces a lot more skepticism, it's less accepted, it's less common, and the fading interest is mostly found with the hard-line proponents. I'll be intrigued to see what the new DSM says about it. Right now the biggest critical sources are Piper and Mersky, presumably there's more out there. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:37, 11 March 2010 (UTC)

Before the 19th century, people exhibiting symptoms similar to those were believed to be possessed.[13]

When? Where? By whom? One can only assume in Western Christian society, by The Church, etc. This just seems like a very baseless, childish statement. If nothing insightful can be stated here, let's just get rid of it. —Preceding unsigned comment added by 96.224.179.19 (talk) 05:39, 6 March 2010 (UTC)

Nope, it's sourced to a reliable publisher. At wikipedia the standard is verifiability, not truth. If you're really concerned about the statement, I would suggest tracking down the source and contextualizing it. WLU (t) (c) Wikipedia's rules:^simple/_complex 19:36, 6 March 2010 (UTC)

No idea what the objection is or why it is allegedly childish or lacking insight. Please try express yourself in a more articulate and meaningful way. DreamGuy (talk) 22:06, 10 March 2010 (UTC)

Copyright problems with diagnostic criteria

The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (Ticket:2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl ^(talk) 14:10, 11 March 2010 (UTC)

Removed reference to MKULTRA experiments, reasoning explained

The reference to documents released under FOIA, concerning MKULTRA experiments, either contradicted or was contradicted by other information on the page. The deleted reference linked to Colin Ross's book "Bluebird : Deliberate Creation of Multiple Personality by Psychiatrists". It is true that Ross claims the documents demonstrate "The major goal of the Cold War mind control programs was to create dissociative symptoms and disorders, including full multiple personality disorder", but if that is a fact then other information on the page becomes false.

The documents in question do demonstrate that experimenters funded by the CIA created in test subjects, through hypnosis, a belief that an invented identity was their true identity. However, there is no evidence in these documents of identities asserting themselves without the intervention of outside agencies or mechanisms, as required by the preliminary definition. There is no evidence that belief in the secondary identity was permanent, no documentation of how long this belief was capable of persisting without outside reinforcement. If such belief was not permanent, then the "multiple identity" was simply a temporary condition imposed by an outside agency which again violates the preliminary definition.

Furthermore, there is no evidence of any other symptoms associated with DID arising in these test subjects. Ross's assertion that these experimenters created "full multiple personality disorder" appears to be a deliberate exaggeration. Bennet Braun and Kluft, the godfathers of multiple personality disorder, insist that hypnosis cannot create the full-blown disorder:

"Kluft and Braun found that reports of the experimental creation of multiple personalities with hypnosis were rather overstated. Experimenters have created phenomena seen in association with and analogous to multiple personality, but did not create a case of clinical multiple personality...to be a personality, an ego state must have a range of emotion, consistent behavior, and a separate life history. Kluft and Braun show that none of the authors criticizing the use of hypnosis with multiple personality produced phenomena which met these criteria. It is widely known that ego state phenomena short of MPD can be evoked with or without hypnoses.

Our discussion begins with a renewed word of caution. As noted above, one cannot "create" multiple personality, but the injudicious use of hypnosis (via pressure, shaping responses, and insensitivity to demand characteristics) may create a fragment or elicit an ego state which can be misinterpreted as a personality."

(Uses Of Hypnosis with Dissociative Identity Disorder Written by Bennett G. Braun, M.D. Nov 29, 2008)Bartlebee2010 (talk) 09:31, 14 July 2010 (UTC)

I see what you did there. You casually changed the subject from multiple personality disorder induced by torture to MPD induced by hypnosis. Not buying it. Putting the reference back.Jeremystalked _{T C} 20:55, 2 August 2010 (UTC)

However, I added a note indicating hypnosis was one of the techniques investigated, even though torture techniques were investigated as well.Jeremystalked_{(law 296)} 18:06, 3 August 2010 (UTC)

Neither Ross' book, nor the documents he cites, demonstrate that CIA funded researchers caused anyone to develop full-fledged Multiple Personality Disorder. There are references to "multiple personality" but what is described in relation to this term only constitutes belief in a false identity. There is nothing at all in those documents demonstrating attempts to induce Multiple Personality Disorder through torture, nor even awareness of that concept.Bartlebee2010 (talk) 10:26, 6 August 2010 (UTC)

I'm fairly reluctant to take Ross at his word, that's an extreme claim and Ross isn't exactly the best source - more of an axe-grinder. I definitely would want this attributed, and with minimal details. This is a fringe claim that needs stronger sources than this. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:40, 3 August 2010 (UTC)

I've relocated that bit of info and the source to the "controversy" section. Ross is pretty much a lone voice in the wilderness on that particular bit of information, it's certainly not seen by mainstream scholars as a cause of DID. This information is better placed on Project MKULTRA than here since it's a fringe theory and we give it a lot of weight (undue weight?) by placing it here - particularly in the "causes" section. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:56, 3 August 2010 (UTC)

I've replaced the Ross citation and claim in the controversy section. Clearly, deliberate torture by the CIA is not considered one of the key causes of DID. Also, did they succeed? What medically reliable sources substantiate this? What peer-reviewed literature supports it? FOIA requests are not peer-reviewed journals. What scholars believe Ross, cite his books and other work? Is Manitou Communications a reliable publisher? I've changed the wording to reflect the source a little better, but this should not be placed in the "causes" section. Does anyone but Ross believe this? If not, it's clearly an undue weight issue - to the point that it's worth talking about removing it completely. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:41, 9 August 2010 (UTC)

To avoid future edit wars; I am moving this here

"There is a great deal of controversy surrounding the topic {{citation needed}}. There are many commonly disputed points about DID. These viewpoints critical of DID can be quite varied, with some{{who?}} taking the position that DID does not actually exist as a valid medical diagnosis, and others{{who?}} who think that DID may exist but is either always or usually an adverse side effect of therapy. DID diagnoses appear to be almost entirely confined to the North American continent{{citation needed}}; reports from other continents are at significantly lower rates."

This is unattributed material, and as such is skeptical as being original research. Let me point out the most fundamental reason for moving this here (or perhaps deleting it altogether) is that it is inexplicably vague. I understand that it may be "true" that there is a great deal of controversy surrounding the issue of a psychiatric condition; however Wikipedia is adament about verifiablity over truth. Second, there is no support to back up the claims within the paragraph itself. Indeed it may occur later in the text, but this portion claims to hold support, and yet provides no evidence for the percieved support. Let me also point that the "who?" tag does not imply that it is necessary to provide for every reliable source that tailors to the suppositions. Instead, often this is cleared up if you provide one or two examples of "Who" with a simple "such as (so and so)... and (so and so)..." Third, a broad-based claim that "DID diagnoses appear to be almost entirely confined to the North American continent; reports from other continents are at significantly lower rates" should provide the information linked to the other continents. Which continents? Which reports? In other words, what were the publications that produced the reports? Fourthly, since some of the claims are reasserted with source material in text; eliminating this, reduces redundancy. Special:Contributions/165.138.95.59|165.138.95.59]] (talk) 14:33, 16 August 2010 (UTC)

No it is not. See WP:LEAD. It is not unattributed, it is the lead paragraph, which summarizes the section in the body where the citations are found. Is it an inaccurate citation of this section? The verification occurs in the body, not in the lead - citations are optional. I have replacedthe information and please do not remove it again. In fact, I plan on removing the citations after you read WP:LEAD and indicate you understand why there is a reason why the citations were not there. There is no original research, it is deliberately vague because it is a summary of numerous sections, the citations are in the body, there is widespread skepticism with attribution in the text and no need to attribute the statements to speicific people when they are so widespread. You misunderstand the purpose of the lead. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:44, 16 August 2010 (UTC)

I just want to make it clear; that the crux of my argument weighs not necessarily on the issue of whether these claims are verifiable... but rather that I believe that these sentences misrepresent the reliable sources that they claim to be attributed to, especially in regards to the summation sentence: "DID diagnoses appear to be almost entirely confined to the North American continent{{citation needed}}; reports from other continents are at significantly lower rates." For example: Consider; Do the developed countries in North America have more recources than other countries to handle and study mental health issues? Is it plausible that underveloped countries may not have the adequate resources to study this disorder in their region? Do other regions outside of the North American Continent concern themselves with Mental Health? (In other words, do they even care?) The "reports" from other countries, are they reputable and thourough? Are they academic, medical, psychological, governmental? Furthermore, the widespread nature of the statement is an issue in itself. When something is far too widespread, fact-checking (source-checking) becomes an obsticle. This is an oversimplification. It may be true that there is "widespread scepticism"... yet, this issue is resolved by providing verifible sources as examples that tailor to that issue. I understand the nature to be intentionally vague in a lede, however that often creates many issues. First, fact-checking is out the window if the sentence or paragraph is too vague. It opens up the usage of other vague terms. E.g. "There are many commonly disputed points about DID." How many is "many"? How common is "commonly"? Quarterly? Annually? Which of these points is said by whom? I read later in the article... some of these issues become more clear. However, this article doesn't need this paragraph. The first paragraph does a good job of explaining the nature of the disorder. Whether or not it has controversial elements is hardly a qualifier for determining the definition of the term. I am not suggesting to take out the section on conterversy... but I don't believe this paragraph in its current position, and current style is very encyclopedic. The article can stand alone without it. Incidentally, the section on Contraversy can be retained, though it too needs a litte clean-up.165.138.95.59 (talk) 14:23, 13 October 2010 (UTC)

From your comments above, it is you who are making your own judgments and engaging in WP:OR. We go by what the sources say, not by your trying to make rationalizations to explain away the evidence the experts use to make their conclusions. Furthermore, per WP:LEAD, any notable controversies MUST be mentioned in the lead. Removing it would also be a fairly substantial violation of WP:NPOV policy, by trying to hide an important fact. Any "clean-up" you propose to do will have to be approved by other editors here. DreamGuy (talk) 22:25, 24 October 2010 (UTC)

Epidemiology

There are two sets of figures, one for the population of people with mental illness (numbers ranging from 0.017% through to 10%) - there is then a set of 3 figures for the general population ranging from 0.4%-1.1% under the heading that "within the general population the variation is less".

This statement is patently false - the fact that only 0.17% of the mentally ill population in one country have the disorder means that the variation between that and the 1% figure would be huge - statement should be removed.

Also - why does this second table exist, there are only 3 figures in it - is it relevant or important? 130.216.91.176 (talk) 19:39, 27 September 2010 (UTC)

Inaccurate lede mischaracterizes DID critics

Professional critics of DID are not claiming that the disorder "does not exist"; they argue the etiology of the disorder is iatrogenic and/or sociocultural and that it is a form of somatoform or conversion disorder. This is in opposition to DID proponents who believe DID is a product of traumatic childhood abuse.

• Piper and Merskey (refs 2 and 4) say

"1) there is no proof for the claim that DID results from childhood trauma; 2) the condition cannot be reliably diagnosed; 3) contrary to theory, DID cases in children are almost never reported; and 4) consistent evidence of blatant iatrogenesis appears in the practices of some of the disorder’s proponents." They do not claim DID does not exist.

• Scott O. Lilienfeld and Steven Jay Lynn in _Science and Pseudoscience_ say

"The principle controversy of this disorder has often been framed in terms of whether this condition "exists"... There is little dispute that DID "exists," in that individuals with this condition exhibit multiple identity enactments (i.e. apparent alters)...The central question at stake is not DID's existence but rather its etiology...As we will learn shortly that some researchers contend that DID is a spontaneously occuring response to childhood trauma, whereas others contend that it emerges in response to suggestive therapist cueing, media influence and broader sociocultural expectations."

Lilienfield and Lynn define the controversy as a conflict between two etiological models of DID - the post-traumatic model (PTM) and the sociocultural model (CTM) (Science and Pseudoscience, 116).

• DID critic Paul R. McHugh has been widely quoted as saying

"Students often ask me whether multiple personality disorder really exists. I usually reply that the symptoms attributed to it are as genuine as hysterical paralysis and seizures."

• DSM IV contributors Allen Frances and Michael B. Firth in _Your mental health: a layman's guide to the psychiatrist's bible_ emphasize the effect of sociocultural trends and mass media on both patients and therapists:

"Many therapists feel that the popularity of Dissociative Identity Disorder represents a kind of social contagion. It is not so much that there are lots of personalities as that there are lots of people and lots of therapists who are very suggestible and willing to climb onto the bandwagon of this new fad diagnosis. As the idea of multiple personality pervades our popular culture, suggestible people coping with a chaotic current life and a severely traumatic past express discomfort and avoid responsibility by uncovering "hidden personalities" and giving each of them a voice. This is especially likely when there is a zealous therapist who finds multiple personality a fascinating topic of discussion and exploration."

I am going to change the lede and article to reflect this more accuracate characterizing of criticism of DID.

Factomancer (talk) 14:08, 13 October 2010 (UTC)

I think you are vastly mischaracterizing the actual meaning of the quotes above. Saying that the symptoms exist is not the same as arguing that a mental disorder really exists. That same logic could be used to claim that nobody says demonic possession does not exist. The symptoms described as indicating demonic possession exist, sure, but don't try to mislead people into thinking that means nobody says demonic possession doesn't exist. I see someone already reverted your changes, but if they had not I definitely would have, because your slant on what those quotes say are clearly out of line with what they actually mean and what they people who said them believe. DreamGuy (talk) 22:16, 24 October 2010 (UTC)

I haven't commented yet, and as the reverter, I should have. I would agree with DG's statement that the edits in question end up giving a less accurate summary of the authors' points, and is particularly problematic because they are constrained to the lead only rather than the body. The main point of the authors is one of iatrogenesis and false memory versus abuse rather than of "existence versus non". Symptoms may exist, but the crucial point made is that they may be caused by therapists, not abuse. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:09, 31 October 2010 (UTC)

Reversion: 19 Jan 2011

On 19 Jan 2011, I reverted the page to its previous version (edit date: 18 Jan 2011 01:10) after checking to make sure that the only change made in the new version (edit date: 19 Jan 2011 05:34) was an inappropriate edit to the introduction of the article which used profanity and was unconstructive. ClueBot NG had attempted to revert the page, but for some reason it was not reverted. ClueBot NG had also automatically posted a warning on the user's talk page (the user was an anonymous IP address). After reverting the article, I also posted a warning on the user's talk page, and an indication that the IP address is probably shared (having traced it using the site recommended by Wikipedia in the article Wikipedia:Vandalism ( http://en.wikipedia.org/wiki/Wikipedia:Vandalism )). Since a reversion doesn't give an option for an edit summary, I wanted to make note of my reversion here.

Economicsgirl (talk) 07:57, 19 January 2011 (UTC)Economicsgirl

Undo

I just undid a series of edits. The references used in the lead are inadequate- one being a german abstract on pubmed and not the secondary source required by WP:MEDRS and the second being a webpage of unknown reliability. The ref tag was screwed up, and the abstract itself didn't seem to reference this idea (the full text may be more revealing, I'll see if I can get a copy). The see also section was deaphabetized and several unnecessary links were added since they were already in the body text (per WP:ALSO). WLU (t) (c) Wikipedia's rules:^simple/_complex 11:50, 19 January 2011 (UTC)

Qualifications for diagnosis:

Other mental health professionals,Licensed Clinical Social Workers or Licensed Professional Counselors can diagnose DID or any other diagnosis if licensed to do so in their jurisdictions. Other instruments other than the SCID-D can be used as well.Pemmett (talk) 21:29, 2 July 2011 (UTC)

China

I have removed this sentence fragment that was tacked on to the end of a sentence: "although in China with "virtually no popular or professional knowledge of DID (...)" where "contamination cannot exist" it has been concluded that "the findings are not consistent with (...) iatrogenic models (...)" I removed it because it does not make sense as written. It is either only incoherent or incoherent and irrelevant.Jamesia (talk) 23:51, 16 August 2011 (UTC)

Someone put it back, and I removed it again. The lead is supposed to summarize the article. This did not, it was only tacked onto the end of the lead after a period, and it made claims that were pretty outlandish (no possibility of contamination? that doesn't even sound like something a serious researcher would say). It was clearly giving WP:UNDUE weight in order to push a particular viewpoint. DreamGuy (talk) 13:39, 19 August 2011 (UTC)

Information needs to be updated to include the newest information

Overall this is an excellent page, but I still do not like how this fore part is worded. It gives too much credit to those who do not understand DID and therefore do not believe it occurs.

Here is an outline that might be of help. See books published in 2011 such as E. Howells book for more information.

From E. Howell's book: Once in a GREAT while a "bad therapist" can lead someone to create an temporary and extremely limited alter, but it is not like the real thing.

ANP - Apparently Normal Parts EP - Emotional Parts

Complex Dissociative Disorders

DDNOS-1 Dissociative Disorder-Not Otherwise Described - (One ANP and Two or more EP's)

DID - Dissociative Identity Disorder - (At least Two ANP's and Two or more EP's) 1. Time Loss. 2. There are at least 2 Apparently Normal Parts. 3. Epileptic-like seizures and somatic issues. (proposed additions in the DSV-V)

• Some parts might be fixated in traumatic memories (as in the Simple PTSD and C-PTSD) and are chronically aroused while others are hypo-aroused

Also of importance:

Secondary Structural Dissociation. (SSD) SSD - Includes DDNOS-1. This is characterized by dividedness of 2 or more defensive subsystems. For example, there may be different EP's who are devoted to flight, fight, freeze, total submission and so on.

Tertiary Structural Dissociation (TSD) This is DID. There ARE 2 or more ANP's who perform aspects of daily living, such as work in the workplace, child-rearing, and playing as well as 2 or more EP's.

I've never heard of this, and this is not what I understand to be proposed for the DSM-5. The proposed third criteria for DID is "Causes clinically significant distress or impairment in social, occupational, or other important areas of functioning." reference here It was added in an effort to acknowledge multiple personality in non-western cultural contexts. If "E. Howell" is a real doctor or psychiatric researcher, there's no reason his ideas can't be included. However this is pretty long and the article is already pretty long, so you might want to put in just a reference to the book at the end. --Bluejay Young (talk) 22:25, 4 October 2011 (UTC)

You mean her ideas. Elizabeth F. Howell, a psychoanalyst at NYU. They aren't particularly new claims, just newly printed books, so it's kind of cute that the person who brought it up presented her work as some new understanding that ultimately demolishes all criticism and everyone who disagrees is just out of touch. She's written and coauthored some books and papers. The critics of DID are already well aware of them. There's no reason the article would need to be rewritten in any way. DreamGuy (talk) 20:18, 9 October 2011 (UTC)

Correct, it has nothing to do with the proposed DSMV, and yes it is not new, it is however well excepted by many who study trauma and is another way to identify DID.

The Haunted Self is a book by the original researchers. The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization (Norton Series on Interpersonal Neurobiology) [Hardcover] Onno van der Hart (Author), Ellert R. S. Nijenhuis (Author), Kathy Steele (Author)

E. Howell discusses this subject in Chapter 3 of her 2011 book and that chapter can be found online in PDF format. Understanding and Treating Dissociative Identity Disorder: A Relational Approach (Relational Perspectives Book Series) Elizabeth F. Howell (Author) — Preceding unsigned comment added by Tylas (talk • contribs) 15:38, 15 October 2011 (UTC)

Strongly agree. So much so that I'm posting a separate section at the foot of this page about this and related matters. Thanks for your interest and concern, and I hope you've mounted up for a long ride!Tom Cloyd (talk) 02:28, 10 January 2012 (UTC)

Controversy Section Removal

I strongly suggest that the entire section on Controversy be eliminated. It can go elsewhere on Wikipedia, but it does not belong on this page. DID is a dissociative disorder, it is in the DSMIV and proposed to be in the newer DSMV. The topic might be a controversial pop culture topic, but as far as a mental health disorder it is not. — Preceding unsigned comment added by Tylas (talk • contribs) 20:53, 9 January 2012 (UTC)

I wholeheartedly agree. The emphasis given this minor issue (it is NOT an issue in mental health professional circles) in this article, is disproportionate to it triviality. It suggest that the article was written by individuals lacking adequate familiarity with the serious literature on this topic, where the controversiality of the diagnosis is simply not taken up - because it is no longer controversial.Tom Cloyd (talk) 02:04, 10 January 2012 (UTC)

There are a significant number of sources published in reliable journals and by respected publishing houses indicating that there is a strong belief that at least some DID patients had their symptoms produced iatrogenically through therapy. A lot of those sources are already included in the page. Sources are not removed because editors disagree with them. A lot of professionals apparently think, and publish their thoughts, that DID may not be real - this should remain on the page. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:16, 14 January 2012 (UTC)

Deletion of external links

I have had a couple of links that I added deleted as spam. http://www.dissociation.org.uk/ is a UK educational site for those affected by DID. The other http://www.firstpersonplural.org.uk/ is a UK charity for survivors of DID. I am not affiliated to either organisation. Neither are particularly controversial sites and both are helpful for anyone researching DID. I would like to put them back up, but will not if it can be explained to me why they are unsuitable for entry. petitvie (talk —Preceding undated comment added 05:33, 4 December 2011 (UTC).

External links are for encyclopedic-level sources of information, not advocacy groups or geographically-based organizations. If we were to include these we'd have to include every a ton of others, and there's no good reason for it. DreamGuy (talk) 22:32, 1 January 2012 (UTC)

---

DID should not be controversial

Hello, it's Tylas again. I hope you do not mind, but I would like to do some work on this page. The page is set up to explain DID as a controversial topic and it should not be in my opinion. ×tylas — Preceding unsigned comment added by Tylas (talk • contribs) 01:59, 9 January 2012 (UTC)

Mental health professional's first reactions to this article

Warm greetings to you all! I'm signing on as a new editor to this article. I'm not new to Wikipedia, having been here for a few years, during which I've had a variety of involvements, as my user page documents. Two things that might be notable about me, though: I'm a mental health professional who treats DID, and I'm a formalist when it comes to rhetoric in general and writing in particular. I have extensive formal training and experience in social science and psychology research. I value clear thinking, cogent writing, and good sourcing.

So...first reactions:

1. Copy editing and rhetoric - I see major problems here, and I'll deal with those first.

2. Sourcing - more current literature, including some of the recently published literature surveys, needs to be brought on board, and some of the older references dropped. There is a lot of archaic and simply misinformed literature in print and on the web re: DID. NONE of that should be referenced here, I would urge. We want the good stuff, and that comes from professionals. "DID" is a concept THEY invented, and they do the research and theory development on this topic.

3. Priorities - as a clinician and someone very concerned in community education re: major public health issues (and I consider dissociation and dissociative disorders to be such), I consider it our first obligation here to correctly and fairly represent the topics and assertions in the current professional literature on DID. In that area in particular, major work needs to be done on this article. All else (e.g., "controversy", should be dealt with later, if at all.

4. Article form - I think there are some improvements which could be made that would present the material in a more useful way. I'll make specific proposals, and ask for comments, in the future.

I do have other commitments, one of which is to the PTSD article, in which I have taken a major interest for several years. This means that I'll be proceeding here with deliberation and calmness, and that allows plenty of time for community discussion, which I invite, appreciate, and enjoy.

It may interest you to know that I have surveyed the major contributors to this article in the last 2.5 years. There are four. Two are self-identified multiples, one is a bit of a science nut like me (hello there WLU!), and the fourth, like the first three, also appears NOT to be a mental health professional. One thing that means is that there is a real chance that I can be helpful here, due to my training, experience, and perspective.

About editor/contributors who are multiples: I think it is particularly valuable to have involved here individuals who are living with DID. That they are doesn't make them experts, any more than my having a brain tumor (which I don't!) would make me a neural surgeon, but they do have a highly valuable perspective to offer, part of which is [a] their encounter with the gross misinformation about DID that continues to make it into popular culture AND [b] their experiences with various aspects of the health care delivery system in their locale, wherever that may be. We are fortunate to have some people with DID participating here. If there are other editors here who have not so identified themselves, consider doing so, if you are comfortable with this and see value in this action.

This topic is both complex and important. I'm showing up to make this article better for both clinical (multiples and clinicians) and non-clinical readers. We owe them no less, I think. And...I'm glad I'm not alone here! (Comments welcome!)

Tom Cloyd (talk) 03:00, 10 January 2012 (UTC)

If you are going to be removing sources, you need to provide more current sources indicating why - particularly, indicating that the opinions of the professional field have changed. Your opinion of "what's current" is inadequate. Wikipedia is not a crystal ball, we normally lag several months to several years behind what is discussed during conferences. Please do not remove information unless you can indicate why, and verify this with a reliable source. Generally controversies are explored rather than eliminated. Accordingly, if these old sources have been criticized, please provide citations and summaries of these criticisms indicating the professional literature has changed. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:19, 14 January 2012 (UTC)

Re: changes made to heading levels and structure

Many people do not understand that headings in an article give it an outline structure, and in proper English, one can never subdivide a section of an outline into just ONE sub-section. First, that is illogical (dividing something must at least split it). Second, inasmuch as this rule is taught in all English classes of which I know, in the English speaking world, AND evidenced in every modern printed book and encyclopedia I've ever seen (and with a couple of masters degrees, I've seen a few!), disrespect of this rule makes the article appear illiterate. (Read the article linked to in the first sentence for a longer discussion of proper outline form.) Therefore, I have, by various means, corrected in this article all such singular subdivisions (if the phrase even makes sense, which it doesn't). Tom Cloyd (talk) 03:37, 10 January 2012 (UTC)

Wikipedia is bound by it's manual of style, which may differ from other professional standards. Please refer to the MOS when adjusting headings (see also WP:SECTION). WLU (t) (c) Wikipedia's rules:^simple/_complex 18:20, 14 January 2012 (UTC)

Reply to Tom Cloyd

Thank you Sir. Your services are greatly appreciated. I have DID and am interested in cleaning up this article as well. I found many things in it offensive. I do not know all the ins and outs of Wikipedia as you seem to, but I hope I can offer some insight from where I stand. ~ty 16:34, 10 January 2012 (UTC) — Preceding unsigned comment added by Tylas (talk • contribs)

Regarding my reversions of 2012.01.13 and 2012.01.14 concerning DID and "controversy"

Reason for reversions

"There is a great deal of controversy surrounding the topic of DID." Bunk. This lede paragraph, one of several addressing "controversy" and DID which were recently removed by an apparently well-read editor, were recently reverted by another. I have reversed these reversions. This material simply does not belong here. Much of this article clearly is coming from writers who are insufficiently familiar with both the professional literature on DID and the present state of the diagnosis in the professional community. "Multiple personality" is a lurid topic in some regions of the popular press, and those seeking the lurid (e.g., some journalists who write books on DID) can fan the flames forever. This doesn't make the topic controversial, nor does it qualify such writings for inclusion in this article about a clinical psychology/psychiatry diagnosis that is gravely disabling and challenging to treat. Pop culture does not belong here.

In the professional literature there is little or on controversy regarding the legitimacy of the diagnosis. There is certainly discussion about which model of its etiology is most accurate (excluding the model which suggests that it is created by the suggestion or manipulation of a therapist - an idea which has NO standing in the professional community). There is also difference of opinion about which treatment approach is best, and...about a number of other things. This discussion is normal, healthy, and is NOT in any way indicative of "controvery". All diagnoses in the consensus diagnostic protocols of the DSM-IV and OCD-10 receive such discussion.

The sheer column inches devoted in this article to the purported "controversial" nature of DID, when I arrived here a few days ago, was appalling to me. There has been a great struggle in the profession to delineate the nature, bounds, dynamics, and legitimacy of this diagnosis, and the struggle has led to its full legitimacy in the professional mental health community. Yes, you can find professionals who still dispute the diagnosis, but that is true of virtually every diagnosis in the DSM-IV and the ICD-9-10. There will always be such outliers. The clear consensus, however, is what is expressed in those same authoritative documents, where there is no suggestion that the diagnosis is questionable or controversial in any way. That settles it.

Why do I say that? Because "DID" is a term and concept OWNED by the professional mental health community. AND because it is our agree-upon obligation here at Wikipedia to summarize the best literature on any topic which is available. That means that the noise of the popular press, if it is relevant to this article at all, should get attended to ONLY after the professional literature receives full, fair, and adequate treatment here. The article as it presently stands does not meet this standard.

Lay opinion and should never trump professional literature on any mental health topic, and especially on the topic of Dissociative Identity Disorder. If this were not so, we should expect to see insertion in the Wikipedia article on lithic stratigraphy (OK, I don't know if this article exists, but the example stands) several column inches about the theories coming from some Biblical literalists that it was the Devil who laid down all those rock layers, to lead men to doubt the Word of God which clearly says (and it does NOT) that the world was created in 5000+ years ago. Oh...and those fossils which appear to show evolutionary progression - we must make very notable mention in various paleontology articles that they too are the work of the Devil!

We do not allow such nonsense because we have agreed that Wikipedia articles should present a synopsis of the best thought we have on any subject. That current best thought re: DID is summarized in the professional literature coming from the clinical psychology and psychiatry communities. I cannot recall ever seeing mention of "the DID controversy" in this literature - not in 3 years of graduate school and 25 years of clinical practice.

It is a matter of priorities, pure and simple. Material about "DID controversy" might belong in the article I understand exists on "DID in popular culture", because that's where the controversy lives on - popular culture. In the professional mental health conmunity, the consensus is clear, and expressed in the DSM-IV and OCD-10.

Justification of my position

Let's look at some major references on the topic:

• Merck (2010) - No mention of controversy at all. But Merck is always synoptic, and maybe there just wasn't room. Let's look further.
• Steinberg, M. (2001). The stranger in the mirror: dissociation - the hidden epidemic (316 pp.). This major work on dissociation and the disorders in which it is prominent, by the psychiatrist who developed the SCID-D diagnostic inventory, addresses the "controversy" in her ch. 3, under "Myth #6 - DID is not a real illness" (pp. 26-27). Her summary is that multiple scientific investigations have validated the reality of the disease and its symptoms, and that assertions to the contrary are based solely on anecdotal evidence and hearsay. She backs up her assertions with careful sourcing. But this was written over 10 years ago, and may need updating. Let's investigate further, after a brief digression...

One of the topics taken up in graduate program in clinical psychology/psychiatry is symptom faking (factitious disorders) and iatrogenic causality. Basically, we are advised always to be initially skeptical of a clients' symptom presentation, until we can reasonably rule out causes OTHER than legitimate etiology. Some diagnoses are more vulnerable to this problem than others, and several have unique problems associated with them. Then, too, there is the problem of differential diagnosis - e.g., depression due to a medication side-effect is not legitimately termed "clinical depression". The DSM formally addresses this problem in diagnosis after diagnosis, including the dissociative disorders.

If there is indeed a real problem with faked or iatrogenic symptoms relative to DID, serious professional literature on DID should validate this problem and address it. We already know that Steinberg (2001) does not. Let's next consider...

• Haddock, D.B. (2001). The dissociative identity disorder sourcebook. (311 pp.) Written for professionals and informed laypersons, this book was very highly praised when it was published, and is still an essential reference. Haddock writes (p. 129) of clients' possible rejection of a DID diagnosis (not all are ready to accept a diagnosis this grave), but not of any professional controversy about the concept. Her discussion of differential diagnosis (pp. 76-77) makes no mention of there being a problem with faked or iatrogenic symptoms.
• Spira, J. L., Yalom, I.D., eds. (1996). Treating dissociative identity disorder (388 pp). Note that this was published well before both Steinberg and Haddock, which simply means that it was written closer to the time when there WAS a debate in professional clinical psychology/psychiatry as to the legitimacy of the DID diagnosis. It is also a very notable publication because of the outstanding roster of contributors the editor rounded up, most of whom are still very prominent in the field today. However, we see here exactly what is seen in Haddock: possible client rejection of the diagnosis is addressed; professional controversy and iatrogenic or faked symptoms is not.

WHERE is the alleged "controversy"? Maybe it took a while for the profession to catch up with something the popular press already knew. Let's look at some more recent major publications...

• van der Hart, O., et al. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization (418 pp.). This extraordinary synoptic treatment of DID and other trauma-related disorders (PTSD, Borderline Personality Disorder, etc. is a major milestone in the history of thought about such disorders. It has received exceptional reviews by a number of luminaries in the field. In the book's detailed index, there are no main entries addressing conceptual controversy relative to DID, nor any for iatrogenic symptoms, symptom faking, or factitious symptoms. The entries in the index under "assessment" take up almost an entire column on a two-column page, and there is no mention under this subheading of any of these topics, either.
• Howell, E. F. (2011). Understanding and treating dissociative identity disorder (308 pp). This work, both articulate and scholarly, is one of my personal favorites. The author has previously authored a well-received book on the topic of dissociation, and here addresses treatment of dissociative disorders in a manner that is both accessible to educated laypersons and exceptionally valuable to professionals. The first rule of treatment is "get the diagnosis right". She devotes 18 pages to assessment, producing the most useful statement on the subject I've yet seen. Interestingly, she does address factitious disorders (pp. 159-160), and as is her treatment of many things in this book, her remarks are detailed, thorough, and very useful. But she does not suggest that this issue is a significant problem, or that it is due to iatrogenic causes.

There is one other reference I'd like to review - Dell, P.F. & O'Neil, J.A., eds. (2009). Dissociation and the Dissociative Disorders: DSM-V and beyond (898 pp). This award winning book is a review of the literature which aims to supplant all others. My copy is due to arrive any day. I'll add to this review what I find when it arrives, but I honestly don't expect to see a deviation from the pattern already established: Professionals don't take up the alleged controversy surrounding DID because there is none.

So, why should this article? It shouldn't. Readers should not be misled, nor be forced to wade through inches of summary of the irrelevant ruminations of idle journalists, people out to disparage clinical psychology/psychiatry in general, and others who simply haven't anything useful to say. Let's stick the good science we do have, and theories based on that science, and on actual clinical experience. We can do no better, and our readers deserve no less.

We do not shrink from controversy in professional mental health - witness the ongoing flap about (alleged) overuse of anti-psychotic and psycho-stimulant medications. That there is none to be seen regarding DID should be noted and respected. The controversy is over, and has been for years.

If someone can come up with a professional quality reference that treats this alleged controversy with any real seriousness, let's consider referencing it in the article. But, we still have to content with the fact that the vast majority of serious thinkers in this field simply see no need to address the topic. Why should we? I can think of no good reason to do so, other than in the history section, and there we should not let the material use up valuable article real estate which would better be used addressing topics like assessment, treatment, and outcome, all of which are presently given seriously inadequate coverage in this article. I, for one, intend to redress this.

I have taken some very real time to write this because I want to dispense with this issue once and for all. We have important things to do with this article. Rehashing old issues is surely not one of them.

Tom Cloyd (talk) 07:21, 14 January 2012 (UTC)

Only two of the books linked appear to be published by an academic publisher (Routledge). My preference is generally to draw from the published literature (i.e. journal articles), though of course books are also permissible. The fact that there are so many sources that actively criticize DID indicates that yes, at least historically there was a controversy. It may be ongoing, which also requires demonstration via sources. That'll take time to dig up. It's possible the field has polarized, with neither group citing or discussing the other. That still means there are at least two sides and a controversy. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:31, 14 January 2012 (UTC)

"References" - plural? Uh...no

This is a mistake an undergraduate might make. It would be distressing for a grad. student to make it. To wit: When you have a document with a single note or reference, the list itemizing such is singular, for it contains only ONE element. When there is more then one, the plural form is called for. WP:LAYOUT does NOT take a position on this, but discusses ONLY the later case (read it - carefully, please). Since it is not covered, the issue reverts to "common law", which in this case is "common practice". My knowledge of such practice derives from the fact of my seven years of grad. school, and my experience teaching, and grading research reports written in, undergrad. experimental psychology.

Also, it's just common sense. If you have one, don't refer to it in plural!

Tom Cloyd (talk) 08:06, 14 January 2012 (UTC)

It'd be simpler to call the "Footnotes" section "References" (for that is what they are and any scientific/medical journal will call them this) and include the single item listed as "reference" in them. WP:LAYOUT specifically excludes "reference" (it clearly takes a position on this: "With the exception of "Bibliography", the heading should be plural even if it lists only a single item"), because articles are supposed to have multiple sources. "Reference" is discouraged, because it will become inappropriate as soon as some other editor adds another one. And: yes, I have seen that "Sadock 2002" (which properly should be "Sadock and Sadock 2002", think) occurs twice in the "Footnotes", but with two almost adjacent pages (681 and 683). Either merge the two ("681-683") or, if page 682 really is completely inappropriate to include, just make two separate references. Makes things simpler and less dissociated... Apart from this (in the end rather minor) quibble: kudos for vastly improving this article! --Guillaume2303 (talk) 09:03, 14 January 2012 (UTC)

Ha! I yield on the "References" matter - how could I have missed that in WP:LAYOUT? But I did. I still think my line of thought makes more sense, and I KNOW it to be the practice at least some of the time, but I don't know what the style sheet of a random sample of peer-reviewed journals would say. Interesting question, but we do have bigger fish to fight than this (I just love mixing metaphors!). Glad you like the rest of what I've done. It's early in the day, and others have yet to be heard from.

Haven't considered the format of the article's end-material, as I've been too busy being annoyed by the main article content, although surely not by all of it. Some is quite acceptable, or even better, I'd say.

I don't yet have access to my copy of Sadock (which I think is actually "Sadock, Sadock, and Kaplan") - I just moved. So, I can't respond to your comment there. I didn't add the original reference. Thanks for your comments. Tom Cloyd (talk) 11:58, 14 January 2012 (UTC)

Controversy and History sections - in need of a major re-write

"Controversy"

First problem: It's way too long. The topic, if addressed at all, is properly seen only as historic, and minor mention may be made of it in the history section. It's simply unbalanced to give it this much space. It suggest lack of familiarity with the professional literature.

Second problem: That it appears at all! The existence of a FEW professional papers arguing that the diagnosis is illegitimate, etc., etc., is far outweighed by the clear consensus in the profession that the diagnosis is legitimate, period. DID is controversial ONLY in non-professional circles, and certainly not always there, either. This article should not read like a tabloid presentation of this topic.

That this is taken up here at all cannot be justified by NPOV (see quoted lede sentence below), which does NOT require that we bring into the article every hair-brained idea in print. If so, then I want to see a major section on my favorite bogus DID etiological model: space aliens have implanted their children in various people's brains, and the kids won't shut up. I read it on the Internet, so it must be true!

"Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and as far as possible without bias, all significant views that have been published by reliable sources."

Significant is the key term here. I have demonstrated in my section above re: "Controversy" that this topic is not currently significant, and hasn't been for a long time.Tom Cloyd (talk) 08:24, 14 January 2012 (UTC)

Wow. Just wow. Your opinion on this topic is so strong you falsely believe that an opinion you disagree with must be "hare-brained" and "insignificant". Claiming it's not currently significant is just nonsense, as there are more and more books, articles and other reports coming out supporting that idea that DID/MPD is either nonexistent or hugely misdiagnosed coming out all the time. You simply are either not familiar with these works (and ignored the references made to them in this article) or dislike them so much you want to ignore them. That's your own personal POV. That cannot be made to take over the article. DreamGuy (talk) 17:52, 14 January 2012 (UTC)

Update: about my edits in the "Controversy" section

I HAVE decided to dive into this section and try to fix a number of problems. I've tried to document my changes carefully.Tom Cloyd (talk) 08:24, 14 January 2012 (UTC)

Is it "controversy" or is it "professional ignorance"?

This "controversy" topic is a great example of the reason why we need professional involvement in this article. As a mental health professional, I can offer a couple of relevant facts I'm aware of which well may not be common knowledge:

1. Clinicians are casual, to put it mildly, about keeping up on research literature. Many are 15 or more years behind (depending upon when they left graduate school). As a class, they are very busy with practice management (their business), clinical activities (their clients), and families. Many never cared much about research to begin with, which is why they went into clinical practice rather than academia. Even academics have trouble keeping up with the research journals; clinicians usually just give up, unless, like me, they're a bit fanatical (and unmarried, which really helps). THUS, it is likely that as a group clinicians, most of whom do NOT treat trauma or dissociative disorders, are NOT up to date about the scientific status of these topical areas. A couple of studies cited in the first paragraph of this Controversy section reflect this, although the studies do have some serious methodological issues (small samples, in the face of consider parametric variance, coupled with significant subject non-response).

This doesn't mean there is controversy about DID. It means there is ignorance. The two are hardly the same, and to call one the other is to completely mis-characterize the problem. Why am I so confident? Read on...

2. Very little mention is made, even in professional clinical circles, of the science behind the diagnostic categories published in the DSM-IV. Behind this well known tome there is a published set of research reports (multiple volumes, I'm told) documenting the research done SPECIFICALLY to validate these categories. The diagnostic categories do not make it into print until adequate validity is achieved in a clinical setting. When there are problems, the categories are re-conceived, and the research is done again. THIS IS THE REASON WHY THE DSM-V HAS BEEN DELAYED FOR YEARS - they are working to tighten up some of the diagnostic categories.

Conclusion: If it appears in the DSM, it has demonstrated diagnostic validity.

This doesn't mean that clinicians, much less the general public, knows or appreciates this. Nevertheless, it's fact. This demonstrated validity is a major, major development in the history of clinical practice, and it all began with the DSM-III. Again, not common knowledge, but a fact nevertheless.

So, again, don't mistake ignorance for controversy. I can find people who still think the earth is flat. Does that mean that we have controversy on our hands? I'll let you decide...Tom Cloyd (talk) 08:24, 14 January 2012 (UTC)

Yet more personal opinions being presented as fact. As far as point one goes, lots of people are behind on current research, many decades behind, yet you seem to want to believe that only those people who do not support DID/MPD are behind and those who do support it must be up to date. Many people would argue just the opposite. As far as point 2, lots of things in the DSM have been controversial. Homosexuality was in there as a disorder for a while, for example. This article is not supposed to be the mouthpiece of the DSM. Similarly, the DSM is very very slow to be changed to meet consensus of the outside world of professionals, and those professionals themselves are slow in changing their minds. By the time the DSM is finally released it reflects already very old ideas. DreamGuy (talk) 17:57, 14 January 2012 (UTC)

Deletion of paragraph beginning "It is suggested that on rare occasion symptoms that mimick (sic) DID can be created iatrogenically..."

This paragraph is simply incoherent, and concludes with citation (including quotes) of a study that has NO bearing whatsoever. If there is an argument actually asserted here, it escapes me. I refuse to attempt to turn a sow's ear into a silk purse. "Out, damned spot..." And so it came to be. Good riddance.Tom Cloyd (talk) 08:24, 14 January 2012 (UTC)

"History"

This contains much interesting material, but some of it is off-topic, and the narrative flow is jumbled in spots, such that the article would benefit from a significant rewrite. I do appreciate the meticulous sourcing in evidence here, though. Someone put some real work into this section. I respect that.

There are some interesting sources used, but I fear that some are more cherry-picked than representative of the literature. Some also look suspiciously likely to have been mis-characterized. I have elected to leave this mostly alone for now, until I can acquire the sources (some of which are due to arrive in my office very soon). I can then do the rewrite with the proper materials in hand.Tom Cloyd (talk) 08:24, 14 January 2012 (UTC)

Regarding my removal of "Sybil" material from "History" section

This is not relevant to the history of this diagnosis. No detailed history of the concept of dissociation, or of the dissociative disorders, that I have yet been exposed to takes up this materials. We should follow this model and omit mention of it here.

The implication that the book about Sybil had influence upon the mental health profession is unlikely, and in any case this assertion is the opinion of the writer - no citation for it is given. It is more reasonable to assume that the case arose, was treated, and was written about because of the growing professional interest in the subject, which began in the 19th century with Janet, than to assert that some trade press book had a magical influence upon academic, research, and clinical psychotherapists, psychologists, and psychiatrists.

In any case, this is a popular culture topic, and irrelevant to the development of thinking and practice relative to the diagnosis of DID. It can be treated in an article on DID and pop. culture, or DID and literature, or whatever.

Tom Cloyd (talk) 08:24, 14 January 2012 (UTC)

It's very relevant to the history of the diagnosis, as described in several books of the topic. Only someone trying to whitewash the history of it could possibly make such a statement. Plenty of citations were given for its inclusion here. DreamGuy (talk) 17:45, 14 January 2012 (UTC)

Reply to Tom Cloyd II

Impressive Sir! Thank you for bringing this article to a state that Wikipedia can be proud of. I enjoy your writing style, your knowledge on the subject of Dissociative Identity Disorder and your knowledge of Wikipedia itself. I have been looking at your work on Wikipedia and I am impressed. Thank you for taking DID seriously. It's difficult when so many see this as interesting so they want to fuel the media and mis information. Thank you for bringing science to this page.

tylas raine 13:33, 14 January 2012 (UTC) — Preceding unsigned comment added by Tylas (talk • contribs)

I don't ever edit anything on wikipedia i find it all too intimidating but i wanted second Tylas's thank you. I am very impressed. Thank you very much. -Bug — Preceding unsigned comment added by 76.126.178.225 (talk) 17:24, 14 January 2012 (UTC)

Reverted back to consensus version

While Wikipedia appreciates new input from editors, editors new to a topic should refrain from making massive and controversial changes to an article that has been written and rewritten following a long standing discussion of several points through a consensus building process. This is especially important as above comments make it clear that these changes were made to push a specific POV and to minimize another well documented POV. Calling the controversy based upon ignorance may be the opinion of the editor who made the changes, but Wikipedia does not take sides.

In the upcoming days I will try to go through each edit one by one to restore any individual changes that might be good, but the changes as a whole simply will not stand. Another editor besides myself already removed them, and I would caution the editor who made them to try to find consensus for any changes before making them again. Wikipedia is not a battleground. DreamGuy (talk) 17:44, 14 January 2012 (UTC)

Re: editor Tomcloyd's possible "conflict of interest" here

It has been suggested on my user account talk page that my edits to the DID article may violate Wikipedia's COI guidelines. Anyone suspicious of this should now make that argument, here. Vague allegations annoy me. Stand up where I can see you.Tom Cloyd (talk) 21:53, 14 January 2012 (UTC)

Tom, of course you have a COI. You're a bloody expert, you want to make this article correct and let it reflect the current state of knowledge... That's absolutely improper and the fact that you care about this subject is especially damning. You should know by now that "experts" are, by definition, COI editors and cannot edit an article without any POV. Please leave here and let those who know how to maintain NPOV edit this. --Guillaume2303 (talk) 22:08, 14 January 2012 (UTC)

PS And the fact that you tried to explain your edits at length here on the talk page make things even worse, why couldn't you just be BOLD. --Guillaume2303 (talk) 22:10, 14 January 2012 (UTC)