Multiple Personality Disorder and One Analyst's Paradigm Shift

LAMENTABLY, RECENT DISCUSSIONS of multiple personality disorder (MPD) reflect sharp polarizations between those who accept the existence of this disorder as a genuine clinical entity (e.g., Putnam, 1989; Kluft, 1996) and those who believe it is either rare or iatrogenic, the joint creation of gullible therapists and suggestible patients (e.g., Merskey, 1992; Simpson, 1995). Until several years ago, I shared the opinion of the latter group. But more recently, my own clinical experience led me to change my mind (see also Waugaman, 1998, 1999, and Imperio, 1999). In this article, I will discuss this shift in my thinking about MPD. In my title, I borrow the concept of a paradigm shift with respect to MPD from the excellent article by Loewenstein and Ross (1992), who, in turn, borrowed the term from Thomas Kuhn (1970). I have found their discussion of the paradigm change involved in current theories of dissociative disorders to be a very useful way of understanding not only the evolution of my own thinking about MPD, but also then reaction of colleagues to these phenomena. In my own experience, some analytically trained colleagues can be especially self-assured in their insistence that MPD does not exist or is iatrogenic or is an incorrect diagnosis for some patients who actually have border-line