Hi it's Jess from MultiplicityAndMe, a
channel dedicated to ending the myths of
D I D, otherwise known as dissociative
identity disorder
We're also professionally recommended now! (yay) how cool is that?!
big up to Dr. Lloyd, thank you ever so
much for recommending our channel, it's much
appreciated. On that note today's main
topic is all about malingering, we've
gotten asked many times over the years:
what are the signs that somebody is
faking DID?  And our answer has
always been the same: unless you are
actually that person, or that person's
mental health expert, or specialist in
the field, you're not gonna know, and I
guess that's the bottom line for this
entire video, from a personal and
professional perspective. Ok that's it
I'm done, bye!~ But let's be objective and
analytical for a second and explore the
research behind this.  There is a
checklist so to speak, to pick up on
these things, so don't just take our word
for it.  Most of this video will be
focused on the article presented by
Thomas in 2001 from the Journal of
trauma and dissociation and this is
where the checklist was first proposed
and then we will also wrap up with our
personal thoughts and experiences.  We
also felt like the article highlighted
good reason for concern, so it had like,
really good intentions such as the
importance of getting the right
treatment for DID versus pseudo DID, or
factitious disorder, because obviously
either way, the person, whether or not
they are faking, still needs some kind of
support. Treatment outcomes after all are
really important and they do affect
everyone's well-being.  The author of this
has also spent over 20 years in the
field of dissociative disorders and
trauma and they also specialized in
diagnosing and treating the disorders, so
again- really good kind of person to
listen to on what is and what isn't a
red flag.  They first state that factitious
and malingered dissociative identity
disorder are particularly hard to detect,
so this is really isn't to be decided by us
armchair psychiatrists that kind of only
get a glimpse of what somebody's like
online, and Thomas also notes that
malingering or fictitious DID is noted
by wanting to assume the sick role, with
or without an external incentives, such
as economic gain or avoidance of
responsibility. Specialists are required to
take these kind of checklists into
consideration, when making a diagnosis, to
rule out things like an iatrogenic
disorder- so that's one that's been
implanted by the therapist- or any kind
of externally influenced DID, so if not
done correctly, it can not only damage
the patient because of the treatment
outcomes, but also puts the diagnostician
in legal and moral dilemmas. I feel like
we also have to be careful within this
video not to delve too deeply into the
checklist and that's just in case
somebody out there--I doubt very much-- wants to use that to know what to say
or what not to say during a diagnostic
interview.  So I'm gonna try and balance
things and keep things vague, yet
informative: say some stuff but also miss
some of the details out. Our advice going
into any form of diagnosis is of course
that all you can do is report your
experiences as they happen, don't try and
fit into any boxes or you know, look at
WebMD and see what you should or
shouldn't be like to fit a certain
diagnostic criteria, regardless of what
the outcome is, the treatment is most
important for the symptoms you're
experiencing, and you don't necessarily
have to have a specific label for that.
So all you have to do is relax and tell
the truth.  So it's a 12-point checklist-
number one: differences in DES scores, the DES is a scoring test to help diagnose
the disorder, it's often used for
screening.  Anyone scoring over 60 or more
was said to be more than likely
malingering
and so obviously professionals would pay
extra attention when continuing to
diagnose if there were particularly high scores received on the DES. Number two:
reporting on dissociative symptoms.
Within the study, basically there were
differences between a recall and
descriptions of those with true amnesia
versus the pseudo group, and so that's
things like the depersonalization
derealization and dissociation.  People
with true DID were able to give
examples of these issues, and those with
the pseudo DID generally struggled.
Identity alteration was also exhibited
between real patients of DID
versus those without.  Number three:
Able to conceptualize and have a good
chronological idea of time.  That kind of
speaks for itself as DID does impact
memory. Personal self reference and
expression of affect: so this basically
means there was a lack of consistency
and some expressions didn't really make
sense in their placement with the
fictitious group. Number five: expression
of a very strong negative affect, this
means quite simply, that people with
pseudoDID really were able to strongly
convey their emotions, without
any inhibitors. Number six: objects
brought to the consultation. These can
say a lot, so some people were bringing
their diagnostic papers and other bits
and art and... whatever else! Although some of the items brought to the sessions
kind of overlapped between genuine and
disingenuous DID. Seven and eight kind
of overlap, so seven is self
disclosure of alleged abuse symptoms or
diagnosis to people, and number eight is
the disclosure of alleged abuse that
came up during the consultation.  So
people with genuine DID tended to only
volunteer general statement about what
happened to them: ie I went through
physical ab*se, I went through s*xu*l
ab*se or I was neglected... and an
inconsistent medical history was also
found within those with the fictitious
DID versus those with true DID. Number
nine is presence of shame and guilt and
suffering, so this paid importance to the
way that people presented and felt about
their past. The pseudo group essentially
didn't express these feelings in the
right way when discussing their history
and symptoms, so number ten is the
involvement in community and self-help
groups, which I find comes as quite a
shock really, I figured that most people
would kind of seek help and support
online, but again I can understand why
that shame and also again the amnesia
may prevent that from happening, so it
stated that a lot more people in the
fictitious group were a lot more
involved in the self-help groups. As this
study was back in 2001 as well, it would
be interesting to see if there are any
changes to this now, you know, there's
more awareness online, people talking
about it more...
but then again does that statement ring
true, because there's more awareness about it and more people kind of want to
get involved and... yeah. Number eleven is
the presence of post-traumatic symptoms.
Even when the pseudo group described
their symptoms of PTSD, basically their
symptoms didn't fit and didn't marry up
with the diagnosis, it was like that lack
of consistency whereas for the genuine
group, the re-experiencing of trauma sort
of came up again and again, and with the
certain comorbidities that then
reflected the true representation of
PTSD, which is found within DID, obviously
So number twelve
finally, is motivation for consultation.
So I'll read this to you guys: so this is
what it says about the pseudo group:
three people appear to use DID diagnoses
to avoid responsibility,
two people have their identity and
social network wrapped up entirely in
being part of a multiple personality
group or a survivor support group in
their respective communities, both are
referred because their therapist felt
stuck in therapy, and as a previous
trainee psychotherapist  like, to me, that
would also be an indicator that the
treatment is incorrect
it doesn't fit that diagnosis, it also
says another developed symptoms after
being in close proximity with someone
with DID, and another few needed to
maintain long term disability benefits,
and therefore were... after the label... that
sounds horrible doesn't it?  There were
however different motivations for those
with the genuine disorder of course, that
speaks for itself when you go on to read
the discussion of the article, basically
authenticity and consistency appear to be
the overarching theme, and also a push to
prove legitimacy of somebody having the
disorder, is not within the normal realms
of someone apparently with genuine DID
it also says quite a high amount of
people do not have genuine DID... so they
say around ten percent of those seeking
a second opinion of a diagnosis have
simulated DID.  Out of these twelve a
person needs to demonstrate eight or
more out of 12 to be considered
factitious DID and it says then that the
genuine cases often tick around three of
those boxes, and while the paper itself
draws some really strong conclusions, the
main downside
is the small and selective population
that was interviewed overall. So, two very
important questions: one can you spot a
faker and two what do you do if you feel
like you're faking? So I'll say again,
unless you are that person or you're in
that specialist field, the answer is
probably not, but what can you do about it
if you're adamant somebody's faking, what
can you do? My personal opinion is to
separate yourself and create that
boundary and that distance to not reward
their actions, you might be right, you
might be wrong, but at the end of the day
you can't do anything about their
actions, and your comfortability is the
most important thing, and if that person
makes you feel awkward, you can take a
step back.  It'd be lying if I didn't say
we've come across people in our time
that come across as either disingenuous
with their disorder or, who quite frankly
seem to roleplay it, and yeah you know I
think that to me has been quite
offensive, but then again that person is
only showing a side that they want to
show online that may not necessarily
reflect how they are in person 24/7. For
that reason alone, I would never call
somebody out for it because I'm not in
their head, I don't see them 24/7 and I
am NOT their therapist.  We can still have
those thoughts and feelings about
somebody else that is a valid way to
feel, but in regards to actions, it's not
okay to shame either and for some of the
research that's done on sort of pseudo
and fictitious disorders, it says
actually, that confronting a person
aggressively or shamefully actually
makes matters worse,
you need to gently state that it's okay
and regardless of whether or not someone
has it - of course it could be played up
for gain.  Support and validation seeking
are legitimate human occurrences, so it's
not unheard of to play up your symptoms.
We're all human.  So - what do you do if
you feel like you're faking? I'd say be
honest with yourself: do you have a game
or do you feel like you're doing or
saying
some things to fit in and feel a part of
a community?  Have you or are you receiving
treatment? or if there a reason perhaps
you're avoiding treatment? those are the
questions you kind of have to be honest
with yourself about - sometimes as well,
like I know full well that that mixture
of dissociation, derealization,
depersonalization, amnesia, kind of all
mix together and kind of create this
wall between 'I experienced this and I
don't remember experiencing this...'
'yesterday was a lie, my whole life is
a lie...' and that's also genuine and fine
some parts may not acknowledge they have the disorder, whilst other parts do
sometimes it flip-flops, and again that's
fine. In those times I would say to kind
of bear with those feelings until it
passes or speak to you mental health
professional who may be able to kind of
guide you and help you rationalize
Equally, if you're watching this and you
feel like you need permission to own
your truth or own your reality and kind
of accept those feelings, then
yeah, it's okay! Here's your permission.
It's okay to have that reality that
perhaps this disorder doesn't encompass
what you've actually experienced, I know
the boys have been saying a lot lately,
"you can't fit a square peg in a round
hole" - if it doesn't fit, if your symptoms
don't fit, don't try and make it fit, just
be you and that's all you can be. The
most important thing, is to be true to
you.  And that is another puzzle pieced
together! so what have we learned? One: that
there is a checklist that exists of
course for all specialists to make and
ensure that they are going to diagnose
somebody correctly. Two: some people bypass
that but evidently people should
not be shamed for it, because whatever
they're experiencing, is clearly
something. Three: either gently approach
someone or distance yourself from that
person if you feel uncomfortable about
their displays of DID.  Four: it's okay to
be honest and it's okay to get help and
regardless of whether or not you have DID, Five: we are not in somebody's head, we are
not their specialists, and therefore it
is wrong for us to judge or call anyone out.
anyway, thank you guys so much for
watching, I hope you keeping well and
keeping safe in these very strange times.
okay guys, speak soon - bye!!!
