"Multiple Personality Disorder" Probably Doesn't Exist, And There Certainly Hasn't Been an Explosion of It Among the Youth

TikTok culture can be incredibly toxic, but those on the left refuse to ever condemn it for fear of echoing conservatives

The technical name is dissociative identity disorder, but it’s more commonly referred to as multiple personality disorder. It’s been in a thousand cheesy cop shows and legal dramas, too many novels written in MFA programs, and untold freshman Into to Psychology textbooks. M. Night Shyamalan’s films Split and Glass are typical of pop culture portrayals of the disorder as a lurid and impossibly dramatic disorder, with clear and distinct switches between entirely separate personalities that occur at the most narratively convenient times. And in recent years there’s been an explosion of interest and claims of diagnosis of the disorder, coincident with the rise of Tumblr and TikTok, where there are thriving communities of adolescents who claim to have dozens of “alters” and who refer to themselves as “systems,” along with a whole boutique identity vocabulary that they’ve developed. The number of views of videos tagged with #DID on TikTok is in the billions.

And yet.

And yet dissociative identity disorder is probably not even real. Its presence in the DSM has proven to be persistently and deeply controversial. Diagnostic criteria and standards are perceived by many to be highly impressionistic and unacceptably subject to the biases of the evaluator. The disorder reflects a cinematic and exaggerated vision of what mental illness looks like, which may make it more attractive to people looking for a diagnosis. DID is often presented as a kind of get-of-accountability-free card, as someone who claims to have it can always say that past bad behavior was caused by another personality and is thus not their responsibility. Many high-profile cases have been revealed to be frauds or, at least, the product of a therapist or doctor forcing patients to think they have it. The most famous DID patient, Chris Costner Sizemore of The Three Faces of Eve, claimed that her alters were not the product of childhood trauma but that she was born with multiple selves with fully-formed personalities, which completely contradicts the established etiology for the disorder.

Some who have claimed to have it have done so only after being accused of a crime. (An embezzler’s sole defense in a trial in the early 1980s was that an alter stole the money.) Diagnosis often involves the use of “recovered memories” and hypnosis, both of which are controversial if not outright discredited. And claiming to have it does not even require conscious dishonesty, just an active imagination and too much awareness of DID’s presence in culture. Regardless, the mere existence of the disorder provokes angry disagreement in a way that simply does not exist for other major psychiatric conditions like schizophrenia or bipolar disorder. Even proponents of the prevalence of DID acknowledge major overlapping symptoms with schizophrenia and major difficulties in diagnosis.

As the psychologist Joel Paris wrote in 2012, the trauma memories that therapists and psychologists say created multiple personalities in patients are most likely

fabrications shaped by therapists who insist that traumatic events must have happened and by patients who offer therapists what they want to hear…. The clinical features of DID may depend on role playing so that patients provide memories of trauma on demand… the number of alters has a troubling tendency to increase over time, possibly because of a wish to keep therapists interested.

A 2004 paper puts it even more starkly, just in the abstract:

The literature shows that 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 [that is, medical symptoms or harms caused by a doctor rather than by natural factors] appears in the practices of some of the disorder's proponents.

Even if we accept the disorder and are particularly generous in our criteria, the number of genuine cases from the past one hundred years is probably somewhere in the three digits. It’s that rare, if real. And its newfound prevalence among adolescents is particularly hard to understand, given that the condition has generally been identified among those in their 30s and 40s and is even rarer among the young. As stated in a 2011 lit review, “Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth.”

The people who have traditionally been treated for DID have suffered, greatly, and not in the cool arty time-to-dye-my-hair-again type of suffering common to social media performance, but actual, painful, pitiable suffering. Those patients who have been diagnosed in the past with the disorder, by doctors, and who have spent years and years dealing with the consequences, are often truly debilitated people, whether the disorder itself is real or not. They require intense therapy, are often medicated with powerful drugs, and are frequently subject to long-term hospitalization. They tend to live broken and pain-filled lives, like most people with serious mental illness.

Of the dozens of high-follower DID accounts that I’ve seen, almost none are experiencing any of that. Plenty of them are in therapy, but judging from how they talk about it, it all seems to be of the customer service variety of therapy. Hardly any of them say they’re medicated, which I guess makes sense - every last one I’ve seen comes from the school that sees mental illness as some adorable personality quirk that makes them unique and high status, rather than as a source of great pain and personal destruction. They don’t take meds because they don’t think there’s anything to treat. And, indeed, they aren’t living debilitated lives.
On the contrary, they’re flourishing, going about self-actualized and successful lives, getting into Ivy League schools, bragging about their social media clout, being girlbosses. This is the status of mental illness in youth culture today, where we are expected to extend every accommodation to those who say they have mental illness even as they would seem to require no accommodation at all; they would like the laurel of victimhood without the actuality of being victimized.

Their disorders don’t make much sense, for the record. For example, it’s very popular on DID TikTok to do an “alter roll call” or similar, where you show off your various personalities, usually with an outfit change between each one to better show off the personality difference. But in order to even conceive of making such a video, you’d have to think that you could reliably control when you would switch to a given personality! In the classic conception of dissociative identity disorder, those who suffer from it are not in control of when they switch, and in fact are often not even aware that they have done so. It would be completely impossible to plan out a video where you could reliably be in the right personalities at the right time, in sequence, and also expect them to be amenable to putting on an outfit and participating in a video. It’s bullshit, transparent bullshit. You might also wonder how the next alter knows to participate in a TikTok video, given that traditionally one alter is not supposed to know what the next is doing. But don’t worry, the TikTokers have a word for it - it’s called “co-con,” co-conscious, and it helpfully explains away a very basic piece of evidence that all of this is bogus. They always have these little outs, these very convenient explanations for inconvenient discrepancies between their disorders and the facts of their lives.

You might very well ask how it could possibly be the case that a notoriously controversial and historically extremely rare disorder would suddenly bloom into epidemic proportions among teenagers with smartphones and a burning need to differentiate themselves. How could that happen? The standard line on these things is that expanding public consciousness about such illnesses reduces stigma and empowers more people to get diagnosed with conditions they already had. But with dissociative identity disorder, I can only ask… really? One of the rarest mental illnesses in the medical literature has had thousands of people walking around undiagnosed, despite the fact that it’s perhaps the single hardest psychiatric condition to hide? It’s one thing to say that there’s tons of, say, autistic people walking around who are undiagnosed because of stigma around the diagnosis. It’s another to say that thousands of people’s conditions have gone unnoticed when they experience the world as a number of distinct and incompatible personalities which they switch between in jarring and disorienting moments.

None of this is healthy. None of it will result in better treatment or results for those who have legitimate psychiatric disorders. Ideas core to the toxic mental health ideology that kids are absorbing on TikTok include

• That intense childhood trauma is universal or near-universal, despite the fact that it simply isn’t, and thank god

• That trauma is somehow ennobling, a maker of meaning, a creator of identity, a way to be unique and special, rather than something terrible we should do everything we can to prevent

• Correspondingly, that to be mentally healthy is undesirable, when it’s a condition we should aspire to secure for everyone

• That mental illness is an identity, the most important and central element of someone’s self, rather than an unfortunate detail, and that the right way to have a mental illness is to revel in it, celebrate it, fixate on it completely, act as though there’s nothing else interesting or meaningful about you than your mental illness

• That any critical thinking or questioning of their rhetoric about mental illness is inherently a matter of “stigma” and thus illegitimate, and that the job of doctors and therapists is always to affirm their self-diagnoses, not to act as independent and dispassionate agents

• That anything they feel is valid, that their emotions are a perfect guide to their reality, and that anything that contradicts their intuitions or their desires is by definition the hand of oppression.

And the core point here is that the people who are being hurt by this are these kids themselves. Sucking up scarce mental health resources with fictitious conditions is irresponsible, yes, and pretending to be sick for clout is untoward. But setting that aside, self-diagnosis is dangerous. Playacting a serious mental illness is harmful to your actual mental health. Fixating on the most broken part of yourself is contrary to best medical practices and to living a fulfilled life. Defining yourself by dysfunction is a great way to stay dysfunctional. And everything about mental illness that seems cool and deep and intense when you’re 18 becomes sad and pathetic and self-destructive and ugly by the time you’re 40. Take it from me. These kids are hurting themselves. I don’t want to ridicule them. I’m not even angry at them. I’m angry at their adult enablers. That includes the vast edifice of woowoo self-help bullshit Instagram self-actualization yoga winemom feel-good consumerist tell-me-I’m-special psychiatric medicine, and a media that loves the prurient thrills of multiple personalities and never saw a vulnerability that it couldn’t exploit.

Most of these young people will probably just move on as they get older, realizing that keeping up this pretense is exhausting and pointless, and go on to live (I hope) normal healthy lives. But some of them are no doubt using these popular and trendy diagnoses as a way to avoid what’s really wrong with them, far more prosaic and thus unsexy personal problems, whether mental illnesses or not. And all of this, the enabling and the humoring and the patronizing, will really hurt them in the long run. Adults who play into it should be ashamed.

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Here’s the problem: under current conditions, there’s no way I can talk about any of this in a way that liberals and leftists will listen to. They’ll see that I’m criticizing Zoomers on TikTok who are engaging under the broad umbrella of “identity” and they’ll declare me a reactionary. No matter how right I am. Ruy Texeira calls it the Fox News Fallacy: “if Fox News (substitute here the conservative bête noire of your choice if you prefer) criticizes the Democrats for X then there must be absolutely nothing to X and the job of Democrats is to assert that loudly and often.”

The specific way that lefties will dismiss this problem will be to say, hey, who cares, it’s just adolescents on TikTok. They won’t affirmatively say that it’s good that thousands of teenagers claim to have spontaneously developed an extremely rare and very punishing mental illness, because that’s stupid, so they’ll say it just doesn’t matter, and really it’s weird that you’re paying attention to this. I’ve already established why I care - I believe that this behavior, and the broader suite of 21st century progressive attitudes towards mental health, are doing immense damage to vulnerable young people. But also we’ve seen this movie before.

People pretend that this never happened, now, but in the early and mid-2010s, the stock lefty response to woke insanity at college was not to say that the kids were right and their politics were good. That was a rarely-encountered defense. No, the sneering and haughty response to complaints about, say, incredibly broad trigger warning policies that would effectively give students the option to skip any material they wanted to was, “hey, it’s just college! They’re crazy kids, who cares? Why are you paying so much attention?” Of course, first it was just elite liberal arts colleges, tiny little places, who cares about what happens there. And then it was just college. And then it was just college and Tumblr, and then college and Tumblr and Twitter, and then it was media and the arts, and then all the think tanks and nonprofits, and when it had reached a certain saturation point the defense changed: now it was good. Just like that, overnight, the “it doesn’t matter if that’s happening” sneering defense switched to the “yes that’s happening and it’s good that is’s happening” sneering defense. From an argument of irrelevancy to an argument of affirmation in no time at all, and absolutely no acknowledgment that what they were dismissing as meaningless the day before they were now defending on the merits.

And I’m fairly certain that’s what will happen with all of this “alters” shit and various other bits of identity madness. If you think we won’t have mainstream media liberals rabidly defending these self-diagnoses as “valid” and the “personal truth” of a generation of internet-addled kids, wait awhile. Wait. You’ll see. The cool types may not feel great about what’s happening, but they’re doggedly attached to never seeming to echo conservative complaints and are very invested in a self-conception of being above it all. So they won’t rock the boat and this ideology will bubble along in the background and eventually questioning it will result in instant excommunication. Meanwhile a lot of kids will get hurt.

I will inevitably be accused of a lack of sympathy for those with mental illnesses. But I have very deep sympathy for everyone who genuinely struggles with the human devastation of mental illness. What I have always demanded is that this sympathy be extended with an unsparing and viciously honest dedication to grasping their true, ugly, and profoundly unsexy reality. None of this stuff is honest, and none of it is healthy, and I think the cul de sac of rigidly-enforced identity politics is a ruinous development for psychiatric medicine. I am truly worried for online youth culture, and for that I’ll be called a reactionary.