Psychiatrist Dr. Garrett Marie Deckel received an email last week from a patient with multiple personalities, a condition known as dissociative identity disorder, or DID. “There’s a new movie out about a person with DID. It’s a thriller/horror movie,” her patient wrote, referring to M. Night Shyamalan’s latest movie. “Do I ever scare you?”
Hollywood has a fascination with split personalities; from movies like “Sybil,” which was around the time Multiple Personality Disorder was introduced in the DSM-III, to the very recent sci-fi film “Split” directed and written by M. Night Shyamalan that mixes mental health and horror. Though these films are primarily for entertainment purposes, when mixing components of mental health, the two movies took very different approaches.
The DSM-III called it Multiple Personality Disorder, but since the DSM-IV, we’ve referred to the disorder as Dissociative Identity Disorder (DID). The disorder is characterized by two or more distinct personality states or an experience of possession. This disruption of identity can be identified by discontinuity in sense of self, along with altercations in effect, behavior, memory, consciousness, perception, cognition, and/or sensory-motor functioning. The symptoms are often accompanied by dissociative amnesia, where the individual will not be able to recall events, occurrences, or information from one state to another. This psychiatric disorder is not attributed to the use or effects or a substance, nor is it a part of cultural or religious practice.
Sometimes, the dissociating is an adaptive response to a trauma or overwhelming circumstance. The theory is that childhood trauma will result in an individual‘s psyche dissociating in order to cope with the trauma or stressors. Dissociating allows circumstances to be repressed until a later point in life where the individual is able to properly cope with past occurrences. The movie Sybil (2007), based on the book Sybil by Flora Rheta Schreiber, is based on real-life accounts of Shirley Ardell Mason. According to Schreiber’s accounts, Mason had 16 personalities or dissociative states, as a response to various traumas in her life; death of a family member, as well as physical, emotional, and sexual abuse at the hands of her mother. The movie and book are both based on the account of a real woman named Shirley Mason, who was treated by the psychiatrist Cornelia B Wilbur. The controversy that surrounds this movie is based on the potential fabrication around Mason’s diagnosis for the sake of financial and professional gain. Some argue that Mason did not enact multiple personalities until she sought treatment from Dr. Wilbur, and that Mason’s symptoms emerged after suggestion on the part of her therapist. There was also a “bogus confession of Mason’s father that her deceased mother had been diagnosed with schizophrenia”.
The damage that media sensationalizing does for DID results in misconceptions about the disorder itself as well as the treatment. In Sybil, we see clearly distinct and recognizable states; however, often time these states are not as distinct. It is not as exaggerated as displayed in Sybil. “DID is much more subtle than any Hollywood portrayal,” says Bethany Brand, Ph.D., a professor of Psychology at Towson University. Often individuals with DID will have comorbid disorders that make it harder to identify the disorder. Individuals will struggle with treatment-resistant depression, posttraumatic stress disorder (PTSD), eating disorders and substance abuse; but because the standard treatment for these disorders does not treat DID itself, these individuals often don’t get much better.. The film shows the psychiatrists use of hypnosis to bring these 16 states of Mason together. Effective treatment of DID does not involve hypnosis as a means of “retrieving” repressed memories, as it can cause a false recollection in some clients who are susceptible to producing memories that did not occur. Dr. Brand claims that most individuals with DID “do not forget episodes or aspects of some of their trauma…but it’s fairly rare not to remember any trauma at all and suddenly recover memories of chronic childhood abuse.” Hypnosis is typically used to help patients find a calm state to work through anxiety and other emotions.
In a more recent film, Split (2016), we see mental health exaggerated to the point of thriller/horror. The film sensationalizes the diagnosis as a villain with 24 personalities who abducts and torments 3 girls in a windowless bunker. The surprise 25th personality, called the Beast, physically transforms the individual into a monster that kills and eats the two friends of the lead protagonist. Its opening weekend brought in over $40 million in domestic sales. Bethany Brand was also contacted in late 2014 by M. Night Shyamalan in order to learn more about DID. Once trailers were released, Brand emailed Shyamalan to express concern. “The trailer for Split is causing outrage among trauma and general therapists,” she wrote in emails, “Do you plan to do anything to help the patients you are portraying as dangerous?” Shyamalan responded that both he and Universal Pictures would be promoting information about the illness as well as support for those who suffer from the disorder, claiming that when the film opens “we will work..together to raise awareness.”
“And then, crickets…there was nothing”
A large part of combating stigma is knowledge and awareness. By portraying mental illness as a dramatic, body altering horror movie; we are doing a disservice to those who live with the illness. By altering details and real life accounts of an individual’s struggle with the illness for personal gain; we are doing a disservice to ourselves, those who come across the book/movie, and those who struggle with the disorder. In misrepresenting mental illness in the media, we are inaccurately portraying mental illness to the general public, who, unless they have some sort of educational background in psychology or medicine- will receive the bulk of information about disorders and mental health from the media. The media’s representation of how mental health looks (in terms of individuals, severity of illnesses, violent tendencies), as well as treatment (side-effects of medications, psychiatric hospitals doing patient’s harm, limited possibilities for recovery) impact preconceived notions of mental illness, as well as impact an individual’s willingness to seek treatment. By doing our part to try and make the media more responsible, we can impact the outcome of views and perceptions of mental illness.
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Diagnostic and statistical manual of mental disorders DSM-5. (2013). Arlington, VA: American Psychiatric Association.
Fawcett, K. (2015, April 16). How Mental Illness is Misrepresented in the Media. Retrieved from http://health.usnews.com/health-news/health-wellness/articles/2015/04/16/how-mental-illness-is-misrepresented-in-the-media
Nedelman, M. (2017, January 23). What Shyamalan’s ‘Split’ gets wrong. Retrieved from http://www.cnn.com/2017/01/23/health/shyamalan-split-movie-dissociative-identity-disorder/