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Abstract
There is reason to believe that multiple personality disorder (MPD) is as frequent in Europe as it is in North America and that the core symptoms are the same. Dissociation is a defence mobilized against the pain and helplessness caused by traumatic experiences. Trauma experienced by dissociative disorder patients is more severe and has started at earlier ages than among patients with other psychiatric disorders. Dissociative symptoms are often covert and have to be inquired for in a systematic fashion; otherwise they may go undetected. Several instruments have been developed to help clinicians diagnose dissociative disorders. The most widely spread ones are the Dissociative Experiences Scale (DES) and the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D). This article describes a case of multiple personality disorder. The patient had multiple sclerosis and a multitude of symptoms of somatization, posttraumatic stress, and dissociation. She was treated with hypnosis and ego-state therapy. The therapy has focused on loosening the dissociative barriers, integrating dissociated parts of the personality, and uncovering repressed memories of incest. Even though the therapy is still in progress, the patient has already made positive changes in her marital and social relations. However, caution must be exercised when diagnosing multiple personalities with therapeutic techniques based on including altered states of consciousness. The surfacing ego states are not necessarily dissociative states. A theoretical knowledge of dissociation and the use of diagnostic instruments will aid the clinician in detecting patients with dissociative disorders.