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Health

Are Multiple Personalities Always a Disorder?

Members of the multiplicity community insist that they're healthy, happy, and even normal—they just have up to hundreds of personalities contained within one body.

Photo by Flickr user Shardayyy

When Falah Liang was five, she began to sense the presence of a man named Lark in her mind. She could almost see him. His frame was birdlike, he had gray hair, and his company soothed her.

As Falah entered her teens, Lark's presence grew and solidified. He took on a name. He took on a voice. "I was well aware that it was unusual for those my age to continue having 'imaginary friends,'" she says, "so I kept him a secret, even as the two of us held thought-conversations throughout the day and explored elaborate mental worlds together. I knew he wasn't just an imaginary friend at that point, but I didn't know what exactly he was. Some words we tried and discarded: guardian angel, daemon, alter ego. Muse was the only one that felt right, and we still use it today. Only last year did we finally find the words for our experiences."

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What she found were words like system and multiple and fronting—the vocabulary of the multiplicity community, a group that formed during the mailing lists of the 1980s. These multiples, as they call themselves, see themselves as healthy and empowered rather than disordered and "inherently pathological," as Falah says. And they desperately want the rest of the world to see them that way, too.

Their vocabulary is extensive, but the most basic concepts are these: A "multiplicity system" refers to the group within the body itself (i.e., "I'm part of a multiplicity system"). The system might consist of two people, or it might consist of 200. The "outer world" is this physical plane that we're all stumbling around in, while "inner worlds" are the subjective realms where their system members spend time when they're not "fronting," or running the body in the outer world. When I speak to Falah, she is fronting, not Lark.

The multiplicity community insists on being seen as healthy—even normal. This is our reality, they argue. Why are you imposing your reality onto us? Dissociative Identity Disorder (DID)—and its controversial precursor, Multiple Personality Disorder—are terms roundly rejected by the community, and most of them don't feel that they belong in the Diagnostic and Statistical Manual (DSM) at all. It's not that they don't believe people can suffer from DID (or, more broadly, Dissociative Disorder Not Otherwise Specified [DDNOS]). They just don't accept that they suffer from it. To them, all those with DID/DDNOS are multiple, but not all multiples are DID/DDNOS. Contrary to what a DID/DDNOS diagnosis implies, multiples want everyone in their system to be seen as people. Not fragments, alters, or personalities, but distinct individuals who happen to be inhabiting the same physical body.

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About a year ago, Falah and Lark were joined by Steven and Rain; a few months later, Marcus, Santria, and Alyenor came along. "We are not openly multiple," she says. "All of us disguise our behavior under one mask, one public persona, in essence appearing non-multiple to the outside eye and to most people we interact with. We're able to share memories and communicate among ourselves internally, so it's easy for us. We wear the mask well and look like your standard non-multiple STEM student, but it can be tiring to wear the mask."

The multiplicity community disagrees with the way the community is portrayed in the media, as in the TV show United States of Tara

Multiples who wear the mask, so to speak, may still notice others looking at them strangely, aware of shifts in speech patterns and personality traits but unable to put their finger on what's happening. Miakoda Combies, a computer technician and member of a nine-person multiplicity system called the JC Klatch, noticed that clients grew nervous when they didn't understand that she was a multiple. "They would sense a change in personality, but they didn't have an explanation [for it]," she says. "I guess they figured that if we didn't know what was going on, they should worry."

But certain clients knew that Miakoda was part of a multiplicity system, and remained unfazed. "We actually had customers that would prefer one of us over another," she says. "There were a few who could tell us apart the moment we walked through the door." Being multiple also provided subtle comic relief from an insufferable boss. "During meetings, as he repeated the same stuff for the umpteenth time, we'd poke fun inside where he couldn't hear us," she says. But when a disorder of the inner ear forced Miakoda and her system to leave that job, her employer denied them unemployment benefits. "After working there for five years, he insisted that a multiple couldn't possibly hold a job," she says.

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Being denied benefits is just one example of the negative consequences of open multiplicity. Julie, another member of the JC Klatch multiplicity system, writes on her website that the Klatch's childhood signs of multiplicity were mistaken for ADHD, and that they were put on a cocktail of medication— Ritalin, Dexadrine, Welibutrin, Zoloft, and more—that led to extreme health problems and affects their body negatively to this day. "Social services might take your kids away," says Jazz Abbottlane, another multiple. "And you might know the laws to get your kids back, but the damage is done. Your kids are like, Oh my God, they can do that to us?"

Jazz fought for disability rights (unrelated to multiplicity) for years, so she's well aware of the law and has "taken a lot of precautions" to insure that her rights won't be encroached on. She's a member of Oure Gaiya, a system so big that she "hasn't a clue of the total." Both her mother and her grandmother were multiple, though she says they didn't pass down their wisdom to Jazz. "We had very messed-up childhood," she says, and declined to elaborate. Today, Jazz runs a group she founded called Plural Activism, which provides support for multiples and pushes for non-biased representation in the media. They're currently trying to soften the negative impact that Leonardo DiCaprio's latest movie, The Crowded Room, will have on the multiple community, as it portrays the violent side of Billy Milligan, famously diagnosed with multiple personality disorder.

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For a long time, Jazz wasn't openly multiple, because the person fronting her system was a woman named Debbie. "Debbie was scared of the idea of multiplicity," says Jazz. "She didn't want to have anything to do with it. All she knew was what this society had been cramming down her throat for her entire life: That multiplicity is sick, horrible; that you can't be that way. And she just wasn't around long enough to learn differently." Eventually, Debbie died—one person inside a still-living body.

"There should not be one model of reality imposed upon everyone." –Anthony Temple

A multiplicity system named Astraea runs one of the oldest and most definitive guides to multiplicity on the internet: Astraea's Web, which started in 1995. As a group, Astraea is vocally political, and not just about multiplicity; they'll take up the flag for everything from free speech to LGBT rights to animal abuse. Despite being a figurehead of the movement, the system keeps their multiplicity a secret offline. "Only a handful of people know our actual identity and accept that we are a 'we,'" three of the members tell me.

"Any time that a multiple group lives in fear of the consequences of coming out of the closet, they are being denied their social rights," says Anthony Temple, a member of Astraea. "There should not be one model of reality imposed upon everyone. Society can and should change to accept those who are different, rather than enforcing a single standard of normality and punishing those who don't fit."

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The idea of different modes of reality is fascinating, troubling, and incredibly slippery. It's not exactly a banner that the psych community at large is particularly interested in carrying. I asked a psychologist who specializes in dissociative identity disorder if she thought we should be accepting of different realities, and she immediately answered, "Of course there aren't multiple people in one body."

Still, she admitted that multiplicity "is how it's experienced and that is the reality of how it feels," which begs the question: Where is the line between experience and reality? If you experience life as part of a multiplicity system, that is, at the very least, your reality, whether or not anyone else agrees with you. So it's not about whether multiplicity is real, because that's not necessarily the point here. Instead, we should be asking ourselves whether or not we should try to change someone if we disagree with their mode of reality. Is it our duty to make all realities conform to our own?

"The multiplicity community's history with the MPD/DID/DDNOS labels is complicated, and full of contention," says Falah Liang. "There's a lot of resentment towards psychiatry for pathologizing what is seen as simply a neurological difference like being left-handed, for painting multiplicity as freaks and invalids, and for pushing integration as a necessary 'cure' that all multiplicity must undergo." On the flip side, the anonymous psychologist I spoke to expressed mild resentment at the idea of healthy/empowered multiplicity distracting from people who actually need a DID diagnosis. "People with DID need to be recognized, as it's a genuine disorder," she said.

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Photo by Flickr user Holly Lay

To be diagnosed with DID, you must fit several criteria under the DSM-5. Here's one: "The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." This is the criterion that really annoys multiples. They'll readily admit that they have problems, whether they're anxious or depressed or just bad at responding to text messages, but they don't chalk those problems up to multiplicity. They chalk them up to being human.

They also dislike the diagnostic language of "identity" and "personality," which implies that their system members—who they consider full-fledged people—are just fragments of some truer, more real Self that will one day, ideally, be unified again. This is the thinking behind integration, a controversial and somewhat dated process wherein all the people in a multiple system fuse into one. Most multiples are understandably skeptical, especially since famous integrations, like the ones undergone by Billy Milligan, Chris Costner Sizemore (who was written about in The Three Faces of Eve), and Shirley Ardell Mason (whose experiences were documented in the bookSybil), were never actually permanent. In these integrations, the many fused into one, but eventually, the one splintered back into many.

Dr. Max Krucoff, a neurosurgery resident at Duke University Medical Center, would be the first to acknowledge the potential slipperiness of DSM diagnoses. "Most medical diagnoses are defined by a pathophysiology—something identifiable, anatomic," he says. "Psychiatric diagnoses have no known underlying cause. I can't take a biopsy of somebody's brain and look at it under a microscope and say, 'You have Multiple Personality Disorder.'"

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Still, the controversial term "disorder," he says, is a means to an end: effective treatment for those who want and/or need it. "If people aren't hurting anybody or dangerous to anybody or asking for help, there's no reason to go looking for them and treating them," he says. "Everybody's on a spectrum, and what's considered a psychiatric illness is often evolving. If you feel like you're sick, if you feel like you need help, then doctors may be able to label you with a disorder only so they can figure out a good way to treat and help you."

Other cultures, religions, and historical periods have been open to the idea of—well, maybe not multiplicity exactly, but similar phenomena, like muses, phantoms, and fluid "selves." In ancient Greece, Socrates had his daimon, a mysterious sort of influencer whose presence he chalked up to the gods' generosity. We see the idea of autonomous-but-bodiless consciousness in Tibetan Buddhists, who allegedly invented tulpamancy, where one meditates and conjures up imaginary beings that eventually become sentient. Spirit possession is ritualized in religions from Pentecostal Christianity to Haitian Vodou. Even Descartes's famous dictum, "I think, therefore I am" can be read in a multiplicity-hued light—if multiple beings inside one body are all thinking, don't they all "exist"?

Point is, multiplicity wasn't born on 1990s internet forums, or dreamed up by lonely gamers longing for imaginary friends. Aspects of it, at least, have been around for centuries.

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"We're not made-up, we're not characters, we're not role-playing, we're not identity disordered. We're people." – Samari of the Monokrom System

Studies about dissociative identity disorder have shown the following: First, a body diagnosed with DID can react differently to medicine depending on which person is fronting. Second, one body examined by doctors could see when certain people were fronting, but was blind when others fronted. And third, there are [distinct differences between the brain patterns](https://www.rcpsych.ac.uk/pdf/Laura Harrison Multiple Personality Disorder; an Alternative Theory.pdf) of those with DID and the brain patterns of actors who are simply taking on different personas.

This is all to say that though the shift in behavior that happens when multiples "switch," or change who's up front, may seem implausible or even fake to a layperson, the multiples aren't acting.

I watched a video made by six members of a system known as the Monokrom System, each answering questions like "What is your hair color?" and "What is your favorite quote?" If you had showed me the video without context, I would have assumed it was an acting reel, or maybe just the result of a bored day at home, because the female body onscreen never changed. She dressed differently, she spoke differently, she wore her hair up or down or braided, but she was always the same brown-haired girl with bangs. One body. And, by extension, I would have assumed, one mind.

The Monokrom System is so large that they think of themselves as a city, with both locals and visitors—tourists of the mind, you might say. I Skyped with Samari, one member of the system, whose voice and personality were consistent throughout our interview and consistent with what I'd seen of her in the previous video. I asked her about the hardest part of being multiple. "Making people understand that we're people, we're not made up, we're not characters, we're not role-playing, we're not identity disordered," she says.

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In the video, Samari says that her hair is "strawberry pink," though she speaks from a brown-haired girl's body. That's because while multiples exist within a body, but they don't always identify closely with it. A person within a multiplicity system might be a different age than the body's age. They might be a different gender. They could be covered in tattoos but living in a body untouched by needles.

"Like any nine people forced to live together, we have spats," says Miakoda from the JC Klatch system. These spats often center around the body, whether physically or spatially. "One of us wants a tattoo, the others disagree. Two want to dye the hair, but they disagree on color, and the rest disagree on dying it at all." At one point, she laughingly refers to the body as the "meat car." The nine members of her system simply take turns driving it around.

If you take this sense of disconnect too far, the ethics get a little murky. You run into cases like Billy Milligan's: He raped three women but used a successful insanity defense, saying that others in his system had committed the crimes without Billy being aware of them. In other words, the body committed the crimes, but Billy's detachment from the body made him innocent.

Interestingly enough, many multiples disagree with Milligan's insanity defense. They take full responsibility for the body, no matter how disconnected to it they otherwise feel. According to Astraea's Web, "The multiple personality defense should be abolished; if one person in a system commits a crime… the body goes to jail. Period."

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"I see that people are abused by the medical and psychiatric profession simply because they are not like me." –Jim Bunkelman

A person with one mind inside one body is a "singlet," according to multiple's terminology, and Jim Bunkelman is what they call a "singlet ally." His story is typical, at first: Jim met Rhonda at a production company, where she was the office manager and he was a freelancer. Then one day, when the two of them were hanging out with Rhonda's sister, the sister alluded to Rhonda's multiplicity.

"Rhonda didn't seem nervous about it, but she was," says Jim. "She didn't know if it would scare me off or not." It didn't faze him at all, a fact he chalks up to a curious personality, an open-minded upbringing, and a degree in physics, which taught him that you can never be sure you're totally right. "I've always felt that the universe and the human mind are amazing and the possibilities within each are endless," he says. Plus, Rhonda was a total catch. "She was such a lovable and good being that everyone loved her and accepted her and her system," he says. "If you knew Rhonda and spent time with her and the people in her system, you could not be skeptical."

Jim and Rhonda married, and eventually, Jim met 70 other members of Rhonda's system. He even fell in love with another one of them, Gloria, and the two of them had a wedding in his and Rhonda's backyard. "The others were my friends, my companions, and my kids," he says. "I had an entire family of Rhonda. It was the most wonderful experience of my life."

Jim and Rhonda Bunkelman

After 15 happy years of marriage, Rhonda Bunkelman passed away. A grieving Jim went online, searching for some way to perpetuate her memory. He stumbled across Plural Activism, the group run by Jazz Abbottlane, and has been an active member ever since. "I have no investment in this group other than the fact that I have lived with a multiple and I see that people are abused by the medical and psychiatric profession simply because they are not like me," he says.

"There's this whole evolving understanding of how the actual physical brain interfaces with the mind, and how we identify the self and consciousness—when you say 'I am this,' what that actually means as far as the physical substrate of the brain," says Dr. Krucoff. "It's hard for anybody to say what's really a disorder versus a variant of normal."

Jim created a memorial for Rhonda in Los Angeles with three columns that listed the names of everyone in her system. He says over 5,000 people attended the event. "There are so many things we do not know," he says. "To declare them not possible solely because we have not experienced them is incredibly foolish to me."

"Where does consciousness reside? Where does the brain end and the mind begin?" –Dr. Max Krucoff

I sat outside at a coffee shop the other day and tried to retreat within my own mind. I identify with my physical self so closely: my eyes, my fingers, my annoying hair. I wanted to see if I could imagine others milling around inside my body, but instead, I was overwhelmed by a sense of single occupancy. It felt like my mind, my selfhood, was occupying every square inch of my frame, pressing against the inside of my skull and furling out to the tips of my fingers. I waited for a voice to step out from the shadows and say hello, but there was no room for anyone else.

The self is an infinitely complicated topic. Personal reality? So subjective. The brain? A mysterious organ, its surface barely scratched by neuroscience. Consciousness? A living phantom, still impossible to pin down. "When you start digging deep into neuroscience," says Dr. Krucoff, "you start digging into the question: Where does consciousness reside? Where does the brain end and the mind begin? What's the chicken and what's the egg? When you have a spontaneous thought, is it because neurons fired and you had the thought or because you had the thought and neurons fired?" And later: "We're not even close [to understanding the brain] in some regard."

It can be beautiful to dwell a little in mystery, to inhabit our own unknowing. Maybe admitting that we don't understand everything is a vital stance for all of us: for those asking to help and medicate and "fix," for those who say they don't need help or medication or fixing, and for those of us on the sidelines, unsure of our role in the complicated realm of the mind.

Follow Tori Telfer on Twitter.