I know I have been flooding your inboxes with some rather impersonal posts of late, so I decided to get up at 4 am (truthfully, I’ve had a med change and can’t sleep) and write about a topic that both worries and frustrates me.
There are two diagnoses I’d like to cover in this piece and to give my personal insights into what I have seen. First, malingering and second factitious disorder. Both play a huge role in why providers of mental health services have such a hard time believing accepting the diagnosis of DID as real.
This piece will start out a little dry as I explain two of the diagnoses that contribute to DID looking “fake” to providers, but later I will give you my opinions and how I feel about those who think or pretend to have DID.
After reading this piece there will be many who will be angry with me. However, if you are angry about me writing the truth than perhaps you need to reevaluate your diagnosis because anyone who lives with the debilitating disorder dissociative identity disorder will fully understand what I am about to say.
Malingering is the intentional production of false or over-exaggeration of physical or psychological symptoms or disorders.
Usually, the folks who malinger have some type of perceived reward in mind when doing so. These external rewards can involve avoiding military duty, getting the attention of the producers of a television or movie producer, or to get out of some type of legal conundrum.
Malingering is not in itself a mental health disorder. However, it is definitely part of some diagnosis such as Munchausen Syndrome by Proxy where a caregiver creates an illness in someone close to them for attention.
Unfortunately, there have been many documented cases where people have claimed being afflicted with dissociative identity disorder to get out of serving time for crimes, including murder. This gives fodder to those who would make movies and other forms of media presentations where people like me are demonized as horrible monsters who kill.
Although malingering could be a problem, factitious disorder is very destructive.
Factitious disorder is something I’ve seen over and again in my travels among survivors. It is a mental health disorder where a person acts like they have a mental or physical health disorder like, unfortunately, DID.
Factitious disorder is a severe mental health problem because people who have it are purposely pretending to be sick and are often given diagnostic testing or medications they do not need that can be harmful.
The problems these folks face when feigning DID are not knowing what living with DID is like and needing to pretend symptoms without all the information they need to be convincing.
To be clear, people who are pretending to have DID may know they are pretending, at least in the beginning, but can fall prey to their own deception. After a while, they may honestly come to believe they have DID.
What? Who Would Want DID?
The above question is one I ask myself every time I run into someone who is faking DID. What do they think they gain by pretending to have a disorder that ruins lives?
I have seen people who have not fit into society before want to pretend to have dissociative identity disorder so that they fit I somewhere or are treated as being special.
I know that is my reaction every time I meet someone like this. Dismay and shock.
I write on a website called Quora.com and have had many people ask me questions about how they could form DID because it sounds so cool!
I always give them the truth of what living with dissociative identity disorder is like and they respond they do not want to live this way.
A Few Examples of What I’m Talking About
Now, here is where I’m going to get into trouble, but I don’t care. When I see this type of thing happening it always pisses me off because factitious disorder behavior has cost me dearly.
I have met women who pretended to have DID but clearly did not because they hoped to gain the attention of television producers. How do I know it was fake? Because they exaggerated the switching of alters, acting and talking like a child.
Anyone who has DID knows that we are highly protective of child alters and would never allow them to front before strangers. Frankly, when I saw this person acting like a little girl and showing off her “switching” I was both enraged and scared. I hoped to hell the show wouldn’t fly and it did not.
Even television producers saw through the pretense.
I’m not saying that it is impossible for a multiple to have child alters front before strangers with exaggerated behaviors, but it is unlikely.
I have also sat across the table recently from someone who was feigning DID. She pretended to switch several times even going as far as to speak in foreign accents. She was rude and used loud obscenities in a public restaurant feigning an inability to control what her “alters” did.
To be honest, I called her on it. I asked some poignant questions and told her to stop being rude and take responsibility for the embarrassment she was causing those at the table with her and the people who worked at the restaurant.
She pulled her hood over her head and pretended to be a wounded child. She expected me to comfort her, but I just ignored her from that point on.
Speaking Up About Fictitious Disorder So Important
Why? Because we who truly do live with the diagnosis of dissociative identity disorder desperately need providers to recognize DID as a true diagnosis.
There is a ton of research available proving that dissociative identity disorder is real, but why would a provider even bother looking it up if they are convinced that all who walk through their doors with DID are faking?
I know the research exists because I just wrote a book that is over 500 pages long that included only a fraction of the research that is available.
My future and that of many of you depends on teaching providers to recognize not only people who have DID but also those who do not.
There will never be a definitively helpful treatment for DID so long as those who could treat it avoid doing so because they believe it to be unreal.
Another Reason Folks Want to Have Dissociative Identity Disorder
It may seem that I am referring to only those who want financial or legal gain when I describe faking DID. However, it goes much deeper than that.
Because of Hollywood depictions of DID such as Sybil, people have the idea that my disorder is an exotic and wonderful condition to have.
Like I said before, I’ve had people contact me desiring to form dissociative identity disorder, many elaborating on how cool it seems.
I write them back telling them of how debilitating and devastating DID is to live with and they usually change their tune.
If you watch the movie, Sybil, it looks like she is having a good time (except for the suicide scene of course) changing personas in Dr. Wilbur’s office. However, those who see only that in Sybil miss the chaos, fear, and grief that is also portrayed.
Who on earth would want to live their lives not remembering their actions, never knowing they might wake up next, or fearing the knock at the door may be the police?
Who would want to live with the realities of what happened to them as little children? The horror, the grief, and the pain are horrific!
No one who truly has dissociative disorder would, but someone who is faking it would.
I Will Leave You with These Parting Words
I help train crisis intervention officers from three counties here in south-central Illinois. When I do they always ask me what to expect if they meet someone who they think may have DID. They want to know how to tell if someone is faking or not.
I tell them that because they are not highly trained that it is not up to them to decide who is faking or not. They need to treat anyone who appears dissociated or behaving erratically because they claim to have DID as though they truly do have the diagnosis.
I tell them to never leave the person alone but to put them in their car and take them to the nearest hospital for treatment because someone perceived as dissociated is not safe and can become victims of crime.
Recently I had my psychiatrist announce to me that he would know if someone were faking.
I don’t believe him.
Anyway, I’m not accusing anyone of “faking” dissociative identity disorder, but if we don’t talk about people who have fictitious disorder pretending to have DID we will never be capable of changing its impact on the DID community.
“In a room where people unanimously maintain a conspiracy of silence, one word of truth sounds like a pistol shot.” ~ Czeslaw Milosz