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This is a highly publicized and sensationalized disorder and the reported instances have dramatically increased, in spite of the fact that MPD is extremely difficult to diagnose. Nine times more women have this disorder than men. In the 70's, there were fewer than two hundred reported cases of Multiple Personality Disorder worldwide; now there are more than 6,000 new cases reported each year (Milstone, 1997). Many people remember the 1970's book and movie, Sybil, whose leading character suffered from Multiple Personality Disorder. Interestingly, Sybil was a realistic MPD individual possessing more than 16 distinct personalities with different moods and memories. This disorder is characterized by two or more relatively independent personalities appearing in one person. The relationships among these personalities are generally quite complex and typically only one personality is prominent at any one time. The other personalities usually produce periods of amnesia in the personality that has been displaced. All personalities may be aware of one another, however, and often report having experienced sexual abuse in childhood (Boon & Draijer, 1993; Coons, 1994).

I first met Nora (not real name) during my Internship. She was a very congenial and personable 52 year old female with immense artistic talent. She was an accomplished artist with original art creations that had been displayed in numerous exhibits in surrounding cities and in her hometown. Nora had several personalities and each one behaved differently-some were reserved and compliant; some were histrionic and exhibitionistic. At times, each personality would violently interact with the other personality.

Nora had been sexually abused when she was a young child. Her father was not present in the family home. She had been locked in a closet by her biological mother, and had been sexually abused by her older brothers and their adolescent friends (with her mother's knowledge.) Unlike many other individuals with Multiple Personality Disorder, Nora had a pretty detailed autobiographical recollection of her childhood but she did demonstrate depersonalization and detachment. In spite of this fact, Nora acted very 'normally' to most she would encounter. In fact, many of her artistic friends did not realize she had a history of sexual abuse, or had the dissociative identity disorder. Nora kept her secret hidden and functioned in a fairly normal way. Nora was not ashamed of her clinical history and was willing to share the details with people she trusted. She was a very intelligent and trusting individual. Nora actually seemed to be proud of the details of her past and wore these details of her young, sad history on her lapel like a war badge. It has been noted that many believe Multiple Personality Disorder is a 'fashionable' diagnosis. This recognition gave Nora much needed attention and fed her attention-seeking behavior. Nora was competitive when she interacted with others in her community who had other severe mental disorders (such as schizoid-affective disorder, bipolar disorder, borderline personality disorder.) Nora was impressed with status and strived to place herself in perfection in other's eyes.

Like many others with Multiple Personality Disorder, Nora reported being sexually abused very early in her childhood (age 5). Dissociative identity disorder tends to originate in children, with most cases reporting their first alternative personality before the age of twelve (Richardson, 1998). This disorder has been noted as early as 1800 (Goff and Simms, 1993) but the earlier cases have fewer personalities (three versus twelve).