"Multiple Personality Disorder is an Individually and Socially Created Artifact" by Paul R. McHugh

Debating against the existence of the controversial issue of multiple personalities in the Journal of the American Academy of Child and Adolescent Psychology, 1995, author Paul McHugh concludes that the DSM’s (Diagnostic and Statistical Manual of Mental Disorders) current diagnosis of Multiple Personality Disorders (now referred to as Disassociative Identity Disorder) should not, and he predicts will not, survive long enough to make it into future editions.

McHugh’s major points of argument are that the DSM is flawed because Multiple Personality Disorder isn’t a legitimate disorder; rather it’s an “individually and socially created artifact”. He isn’t denying the existence of the patient’s emotional troubles, but he believes that they have been misdiagnosed and led down the wrong therapeutic path. McHugh urges us to learn from a past analogous historical example-Hysteria, and even goes as far as to challenge the contenders of Multiple Personality Disorder to test the null hypothesis, as did Babinski in the referenced historical example.

McHugh’s first major premise is the therapist’s responsibility regarding the power of labeling vulnerable and emotionally suggestible patients. The first subpremise is that patients such as these tend to live out the label; a phenomenon known as “The Pygmalion Effect”, in which people live out others expectations of them, especially expectations of them that are held by others in positions of authority. The second subpremise is that such an extreme diagnosis allows patients to assume and exploit the sick role for its potential benefits, such as special treatment, attention, and relief from responsibility. The third subpremise is that the mistaken diagnosis obscures the patient’s real problem and wastes the patient’s time and money.

McHugh’s second premise is that we shouldn’t waste the lesson that was learned nearly a century ago when Jean-Martin Charcot’s student, Joseph Babinski, brought the null hypothesis regarding Charcot’s misdiagnosis of Hysteria, asserting that the women in question instead had behavioral disorders. McHugh’s subpremise is the example of how Babinski found that once the women were removed from the conditions fostering the misdiagnosis, and treated with “isolation and countersuggestion”, their real problems could finally be addressed.

McHugh’s third premise, based on his own replication of Babinski’s “isolation and countersuggestion” technique at John Hopkins with Multiple Personality Disorder patients sent there as a last resort, is that we should apply what we learned from history and give up the psychological fad of multiple personalities. The first subpremise is to change the Multiple Personality Disorder label to “abnormal illness behavior”, remove the patients from therapy with prior Multiple Personality Disorder supportive therapists, and disregard attempts of communication by “alter” personalities. Only in this case can the patients genuine issues be treated. McHugh’s second subpremise is his challenge to Multiple Personality Disorder proponents to reject his null hypothesis.

McHugh makes valid and coherent observations in his argument that Multiple Personality Disorder, as a clinical diagnosis, is an individually and socially constructed phenomenon that is not helping the afflicted. The main premises interdependently relate to one and other, and the premises relate to and support the conclusion.

"Multiple Personality Disorder is an Individually and Socially Created Artifact" by Paul R. McHugh