The differential diagnosis of multiple personality disorder from borderline personality disorder

p. 041-046Considerable controversy surrounds the relationship between multiple personality disorder (MPD) and borderline personality disorder (BPD). Some authors argue that MPD is a variant of BPD, and most agree that the differential diagnosis of the two is often very difficult. In this article data are presented from a study comparing historical, demographic and psychological testing variables between the two groups. No statistically significant differences were found between the two groups on these variables. However, certain trends emerged which may serve as a catalyst for further research. The relationship between the disorders may be complex; clinicians may need to use more sophisticated research techniques and develop more sensitive diagnostic criteria before it is understood

Response to the centrality of relationship: what’s not being said

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Iatrogenic factors in the perpetuation of splitting and multiplicity

p. 092-098The purpose of this paper is to increase the awareness of clinicians who treat multiple personality disorder patients to the possibility that misuse of treatment techniques may perpetuate splitting and multiplicity, and thus contribute to chronicity in MPD patients. Many MPD patients tend to have rapidly dissociative switching from one ego-state to another. These trance-like states make the patients highly suggestible to outside influences which include the therapists' verbal and non-verbal communication. Some therapists may have an overinvestment in more alter- personalities, and thus ignore the needs of the whole person. Treating an adult patient who is in an age regressed ego-state, or alter personality, presents a particular challenge as to the patient's boundaries since violating those boundaries may too perpetuate splitting and multiplicity. The paper reviews and discusses such issues as therapeutic limit setting, the issue of trust, and counter-transference elements as they may contribute to the perpetuation of splitting and multiplicity in MPD patients. Case vignettes are used to illustrate the above points, and suggest ways to avoid potential pitfalls so that therapy will promote progress towards integration and improved functioning of the whole person