The phenomenology and treatment of extremely complex multiple personality disorder

p. 047-058Contemporary reports indicated that the average number of personalities in recently reported patients with multiple personality disorder (MPD) is larger than that reported in the older literature. A minority of these recent patients demonstrate extreme complexity. A group of 26 patients with 26 or more personalities and under observation for a minimum of three years was studied. Their presentations, the reasons that appeared to underlie their complexity, and their courses of treatment are reviewed. Findings indicate that this group of patients is diverse, with some proving readily treatable, and others proving quite refractory. Observations that appear constructive for the treatment of such patients are offered. The concept of personality is discussed and an alternative description is explored. The usefulness of the paradigms and metaphors of splitting and division as heuristics for the understanding of MPD is challenged, and a paradigm/metaphor of redoubling and reconfiguration is offered for further study