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Mikayla and Mackenzie discuss dissociative identity disorder (DID), also known as multiple personality disorder, and its role in the legal system. They discuss the symptoms and prevalence of DID, as well as the controversy surrounding its legitimacy. They also touch on the neuroscience of DID, including differences in brain structure and function. They mention the case of Billy Milligan, the first recognized case of DID in the court system, where his multiple personalities were used as a defense. Overall, they find the topic fascinating and acknowledge the need for more research and understanding in both the scientific and legal communities. Hi everyone, I'm Mikayla. I'm Mackenzie. So Mackenzie, before we get started, I wanted to ask you a question. What would you do if you found yourself in the middle of a murder trial for a murder that you have no memory of committing, that they have some pretty hard evidence that it was you, but they were saying that you were calling yourself some other name that you literally have never heard before? I mean, that would be a pretty scary and confusing time. Are there any people who actually deal with this in their lives? Yeah, there's a bunch of people who actually deal with this. So, going into that, we're going to be talking about dissociative identity disorder, also known as multiple personality disorder, and how it plays a role in the legal system. One thing to know is this might be super interesting because Mackenzie and I each have done our own research. We literally have no idea what the other person knows, but we're just going to have a conversation about it and just see what happens. So, Kendi, do you want to give a little bit more background on what DID even is? Yeah, I think you had a beautiful introduction. This is going to be a little random and spaced out, but it's going to be a fun and informational conversation. So, for starters, dissociative identity disorder, which was previously known as multiple personality disorder, is a condition in which a person has two or more personalities that they switch between, and these personalities can be super different from one another. They can vary in their demeanors and how they interact with other people, in their preferences. They can even have personalities that have different handedness. So, one is right-handed, one is left-handed. There's even personalities that have different allergies. And there's just a lot of varying symptoms within this disorder. It normally starts because a child has endured trauma or abuse, and they learn to dissociate from these events, almost like it's happening to somebody else, and that's how they cope with this. And these alters or personalities can develop to kind of protect and deal with those feelings during that trauma, and only about 1.5% of the population has DID. This disorder also affects women nine times more than men, and it's likely to be presented with anxiety, depression, suicidal tendencies, alcohol and drug abuse, confusion, headaches, flashbacks, eating disorders, and a loss of memory, actually. And a lot of people don't remember the experiences that they have when they're in different personalities, or different personalities have the quote-unquote spotlight. Mikayla, what else did you find about dissociative identity disorder? Yeah, so I found that most of the time people with this disorder, they have a dominant personality, which is referred to as the host. Most of the time they are in their host state. However, when the other personalities come out, those are called alters. And I think it can be a little confusing when we say most of the time they should be in their host state, because if you have, like, 42 different personalities, how much of the time are you really going to be spent in that state? Right. Another thing I think it's important to mention, especially when we get to, like, the legal side of things, is most of the time the host or the alters do not have communication with each other. So they don't know what's going on when someone else is in charge. It's like you wake up from your deepest sleep, and then you find out that you did all these things, and you have no idea that you did them. So let's maybe dive more into the neuroscience of DID. So, Kenzie, do you want to start off maybe talking just a little bit about what you found with the neuroscience? Sure. So I looked more so for, like, the neuroimaging of DID, and honestly there were not that many studies, which obviously in class we've learned about neuroimaging and the positives and negatives of it and how there still needs to be a lot more research done to perfect this science. But I only found a couple of studies that actually neuroimaged people with, like, diagnosed DID. And one study found that there were cortical and subcortical volumes in the hippocampus, amygdala, parietal structures, and the frontal lobe where all of those regions were smaller in volume in DID compared to, like, a neurotypical person. And these areas deal with perception and awareness and motor movement, which could explain the symptoms of DID. And if there's, you know, a lower volume in these regions, that could explain that. And this study also showed that there were larger white matter tracts in the patients with DID, and those white matter tracts are involved in, like, the communication within the brain. And specifically the tracts that were larger were in the somatosensory association areas, the basal ganglia, and the precuneus. And these regions could also correlate to some of the symptoms of dissociative identity disorder in terms of, like, the dissociation that they're feeling. And let's see. There were really only a couple of studies that I could find on this. And obviously, like, the limitations of neuroimaging in terms of, like, correlation does not equal causation. Like, when the researchers were looking at this data, was it necessarily indicative that these regions were responsible for the symptoms that these patients were feeling? And also, this study only looked at female patients. So this kind of brings in the G2I controversy of whether this group data really reflects an individual or others. So that was one study that I found. What did you find about the neuroscience of DID, Mikayla? Yeah, I totally read that same study that you read. Awesome. Which is awesome. What I found interesting is, like you said, there is not that many studies done about DID, and they almost seem to contradict each other. Like, I found one study that said there is no difference in structure, but there is difference in the function of the brain. And then they used some different tests to, like, there was – I think I found a couple studies that showed the differences in how function works, and they used some fMRI studies that had been done. They used a regional cerebral blood flow study, which also just determined, like, activity in that orbital frontal cortex with the person with DID. So I think this shows that while the studies definitely – there was maybe some controversy about the structure, a lot of them still have to do with, like, the orbital frontal cortex and how there's something not – there's something going on there. But I definitely think that, like, in the future there should be more studies done just so we can really nail down what it is, if neuroimaging can even really be helpful in diagnosing someone with DID or what. But I think also going off of, like, maybe the studies contradict each other, I think that also ties in that a lot of people don't believe in DID. And, like, even within the professional field, like psychologists, there's a split between those who do think it's real and those who think it's fake, which, again, I think it's important for not only, like, the neuroscience side of things, because I don't know if people don't think it's real if I do research on it, but then also, like, when it comes in the courtroom. Like, how can you convince juries that this person is suffering from this when you can't even get professionals to agree if a person is suffering from it? So I don't know. Anything to add about that, Kinsey? Yeah. You know, I saw a lot of that same controversy in a lot of the articles that I read. And, you know, there were even psychologists who were like, no, this is fake. And, you know, these people are just malingering, which, for those of you who don't know, malingering is basically faking something in order to get some sort of, like, outside gain. So we'll talk more about that in a legal sense. But then there's other psychologists who are all for, you know, doing more research on this disorder and just learning more about it, because it does affect a lot of people. And I think, you know, as science develops, as we change, as we get better with neuroimaging, we should definitely focus on people who struggle with mental health conditions, especially if it somehow drives them to be more likely to commit a crime or harm other people, you know? Yeah, for sure. I think this is a great time to start talking about how DID is affected in, like, the court system and what goes on with that. To me, this topic is just so fascinating because you have, you know, different people saying, yeah, they're faking it. Some people saying, no, this is real. And just, like, hearing the cases, reading the cases, it's just been wild. I think it's good to start with the first ever case that the courts have recognized DID as a mental disorder. So this was the Billy Milligan case, also known as the Ohio Rapist. So in 1978, Billy was arrested. He went to trial. And some of the things they kind of dug up here was he was originally diagnosed with 10 personalities, but as time went on, it actually grew to he had 14 different personalities. One of them was named Adelina, who was a 19-year-old female. She was classified as lonely. She cooked for the other alters. And she was actually the one who was responsible for the rapes on campus. So professionals believe, again, going back to the background, that Billy's personality began to split when he was 5 years old as a result of the physical and sexual abuse from his stepfather. And then in 1977 was when he actually raped three women in Ohio campus. And if you go back and you look up that court case and the women's testimonies, they'll say that they've heard him refer to himself as different people. He had different accents one of the time. It was wild. But in conclusion, the court declared Billy insane due to the lack of one integrated personality. So therefore, he cannot be capable of his crimes he committed. I think this is, while this was the first case, it's also very rare. Nowadays, and Kinsey, I don't know if you found this in your research, but nowadays it tends to be that courts don't consider DID as a reason to give someone the insanity plea. And a lot of the reason is because the justification is you have these identities, so they trial one identity as a separate individual person. So if one identity is found guilty but the other three aren't, that person is still guilty, and then you kind of get into the controversial topic that, like, oh, you're technically punishing three other innocent people too. But one of the biggest, like, reasons too is if you look at an identity and they're saying they completely know what they're doing, then you can't really give them the insanity plea because the identity did, in fact, know what they were doing and still did it. I think there's other reasons why the courts don't really favor on the side of DID. Kinsey, do you have any input on what maybe some of those reasons might be? Yeah. I mean, you did a good job with the overview of the case. Like Mikayla said, this was the first incident where in a courtroom a person was given this ruling that they were not guilty by reason of insanity due to DID. But now, like she said, the insanity plea is just like insanely difficult to actually not diagnose in people but to give to people. And if the personalities are, in fact, sane and they're coherent, it's kind of a weird situation in the courtroom where even though the personalities don't know what each other are doing, they are all sane and present and they know what they themselves are doing. And this is like another argument in terms of like the defenses of DID. So one, there's four major defenses in terms of like assessing DID in the courtroom. And one is, so these are all from Steinberg's Multiple Personality Disorder in the Law. And he says that the first one is, the defendant has no control over the actions of his or her secondary personalities and therefore cannot be held responsible for them. Two, the defendant does not remember the acts of secondary personalities and therefore cannot participate in his or her own defense. Three, by virtue of suffering from Multiple Personality Disorder, it is impossible for the defendant to conform his or her behaviors to the law or to know right from wrong. And four, like a sleepwalker, the defendant was unconscious of the alternate's behavior and hence cannot be held accountable for them. So given these arguments, you know, whether the person is competent enough to actually testify for themselves or like, you know, be able to defend themselves is a huge argument. And also the sanity aspect of this is super interesting because like I said, the identities are sane, they are present, and yet this person is still lost in a sense. They don't know what they have or have not done. So definitely being in this, having this condition and being in a situation in a courtroom, whether if it was a misdemeanor or a murder or, you know, if you were a serial rapist, like it's a very scary and odd time for this person who is struggling with this condition. Yeah, for sure. And I think like a good question to ask is like, is it even appropriate to sentence someone if they're so confused during trial because they literally, again, have no idea what's going on. Even during trial, they could be flipping in and out between personalities, so they might not even remember the full trial. So, again, is it appropriate to even sentence this person to a crime or what are maybe some other options that would be more appropriate? Right. You know, it's hard if a person has ten personalities and one is evil and guilty, but the other nine are innocent, you know, do you sentence that person or find them guilty just because one personality is? And this was a dispute in a lot of the articles that I found, and some people were like, yes, you know, the other personalities, even if they are innocent, they should have been able to gain control of the other personality to prevent them from doing a harmful act, which that I also have some personal debate on because I don't think it's as, you know, turn of a switch, flip of a switch as people think it is. These people don't have control as to what state that they're necessarily in. So, yeah, there's a lot of controversy in how a person should be sentenced if they do commit a crime, and I think, honestly, the best option for them is just to send them to a place where they can get help, and, you know, like a psychiatric hospital or something where they can get the adequate help that they need. Right, right. I totally agree. And I think it's important, too, going back to earlier about how maybe the studies contradicted each other, to also mention that a lot of the courtrooms won't even allow DID evidence into their courtroom because of the fact that it's not really the scientific evidence fails to meet the reliability standard because there's just so many different opinions and results and different tests done, and I still – people, I don't know, we don't have a good answer for it. We don't really know what's going on. So just because of that, it's hard to even get, like, evidence put into the courtroom that a person may have DID. Yeah, Kinsey, should we talk about some more cases that we found? Yeah, I was just about to ask that, actually. There's a lot of interesting ones out there. What are a couple of your favorite cases that you found, Mikayla? I don't know that I have favorites. If there can be one. I think one that we haven't – well, we haven't talked about any of them yet, but I think kind of an interesting one is the State v. Maxwell case. Have you heard about that one, Kinsey? I don't think I came across that one, actually. Okay. So in this case, Juanita Maxwell was a hotel maid in Florida, and in 1977 she was arrested after cops found blood on her shoe and a scratch. Going from there, it was discovered that Maxwell had six identities, one of which was called Wanda Weston. Wanda had brutally beaten, bitten, and choked to death one of the guests at the hotel. The court eventually found her not guilty and sent her to a psychiatric hospital. She spent eight years in the hospital, and then she was released, and a year later she was arrested for two bank robberies, both of which were also done by Wanda. Maxwell claimed it happened again due to not receiving proper treatment at the psychiatric hospital. She was sentenced to more jail time – well, not more, but she was sentenced to jail time and then eventually released for time served. What do you think about that, Kinsey? You know, just with the Maxwell case and the Billy Milligan case that we talked about earlier, like these invoked a lot of controversy in the public, just with differing opinions of, you know, kind of what we've talked about today, but just whether it was fair or unfair. Because, you know, at first Juanita didn't get jail time. She was sent to a psychiatric ward, and people were like, yeah, but there's still somebody who was murdered. Like, that doesn't change that fact, so should she have still gone to jail? So I think the public opinion had a lot to say about cases of DID for sure. Right, right. And I'm glad you bring that up because I don't think we mentioned it earlier, but another reason why the courts actually don't favor on the side of DID is because of the public opinion and how they've just had such a very strong, they do not want someone off for that crime. So I think public opinion like it is very important to mention. And, yeah, that case definitely brought up a lot of questions about that. Kinsey, what other cases did you find? Actually, when I was looking into the history of DID, the quote-unquote first case of DID was not considered multiple personality disorder because this was back in 1584. Wow. Yeah. And basically a lady named Jean Ferry recorded her exorcism in detail, and she said that she just had a lot of symptoms that matched individuals that we see like in DID today. And she said that she had like multiple alters with like different names and identities and differing like features. So this was obviously like a long, long time ago before medicine had advanced to what it is today. So that could be a potential first case of DID. But another one was in 1623, a woman named Sister Benedetta. I apologize if I mispronounced that. But this woman was supposedly possessed by three angelic boys who would beat her to cause chronic pain, and they would take control of her body, and they would speak with different dialects and different tones of voice and use like different faces and stuff. But she would have like amnesia of these actions and just wouldn't recall any of these details. So that was also an interesting case. And, you know, these were a long time ago, so maybe these two women would have been diagnosed using today's medical advances and psychological help. But, yeah, I just thought those were really interesting. Yeah, so I'm assuming that exorcism did not work for the first case. You know, I don't think it did. So do you know what, like, are there any treatments to DID? Like not treatments, but I guess cures. Can we cure this? Or what do we kind of do for this? I mean, I wouldn't recommend exorcism, but I suppose one could try it if they were desperate enough. But in terms of other peer-reviewed treatments and medically accepted treatments, psychotherapy and hypnosis is primarily what I found in order to kind of unify all of the alters and the personalities to try and make it one whole person and just kind of better the communication between those personalities. I don't know if you found similar things. Yeah. Yeah? Yeah, and then I just found that sometimes they can use, like, medicines to help the symptoms, too. Because, like, if you know somebody with DID, like, it's best to, like, be their friend and be supportive because it's, like, obviously a confusing time for them. Like, they could have multiple times throughout the day where they just, like, black out and they don't remember what happened. And, you know, if they go through some sort of personality switch, just to reintroduce yourself. The other personality may not know you, so. Yeah. I think we have a couple more minutes to talk about maybe a few more cases. Sure. I think it would be a huge disservice if we did not at least talk about one case where the lady was, in fact, faking it, and then maybe one case where he wasn't necessarily the one with DID, but how someone with DID impacted him. The Andra versus Commonwealth case. So she killed her husband and claims it was self-defense after he came after her with a baseball bat and a knife. She shot him five times. So interesting. Yeah, I'll let you ponder that, if it's self-defense after that many times or not. Anyhoo. So it was later found out that she killed her husband and altered the crime scene. Really, she killed him because she figured out that he was cheating on her, and she even made a comment to his mom that she rather have him dead than let him cheat on her with another woman. Anyhoo. So some specialists agreed that she did have DID, but later on it was revealed that, one, she did alter that crime scene to make him hold the baseball bat and the knife, and two, she actually told her cellmate while she was in jail that she was exaggerating all this, making it up so she could get the insanity plea. Well, the courts found her guilty, and she was sentenced to 32 years in prison. Dang. So that's one case where someone was faking it. I mean, that really highlights that people try to use this disorder to malinger and get, like, a better sentencing or, you know, get sympathy or something. So it's really difficult to malinger DID just because there's so much effort that goes into it, and, like, you have to be consistent with, like, the personalities that you use and, like, the certain ways that they act and behave, and, like, it would take some serious skill to, like, get away with faking this. I literally could never because I could not write with my left hand or all of a sudden have an accent or, like, straight face act like I'm someone I'm not without totally laughing and, like, letting you know that I'm just messing around with you. Yeah. So I don't know. It's kind of like for the people who can fake it, it's almost impressive because, like, it takes a lot of effort. It's not something you can just do. Right. Okay, Kenzie, have you heard about the Mark Peterson case? No, I don't think I came across that one, actually. Okay, so it happened in 1990. He had intercourse with a woman who had DID where her 20-year-old, so he was 29, her 20-year-old identity consented to it, but she had a 6-year-old identity who was watching from a different perspective. So he, Mark, was charged with second-degree sexual assault because it is illegal to have intercourse with someone who is mentally ill. He was never actually tried for the crime, but I think this brings up a huge point. Like, what do you do? Because some of these people, you may never know they have DID. Right. Because they might always be in the same personality around you, so you would have no idea that they have it. So if they consent to you, and you're thinking, yeah, they're of age, yeah, she consented, but mentally she could have been a 6-year-old, that's kind of crazy. Wow. Yeah, so I don't know. I feel like that brings in a whole different topic. And I think there's actually a documentary out about someone who does have DID, and she, like, talked about her, you know, did interviews about her life with a different person that came out. And if I recall correctly, one of the identities has a boyfriend. But the others don't? Well, I think they all kind of end up dating him in the end because he's there. But it's just wild to think that, like, you want people with DID to still have these relationships and still want to make sure that, you know, they have these friends, they have support. But, like, what do you do? Are they not allowed to have relationships? Like, is it illegal to have relationships? Interesting. I mean, I feel like that goes back to, like, whether people with DID are truly competent or not. That's true. Because if the other personalities are aware, then I don't think it's a problem, you know? Yeah. But kind of in the case of, like, the woman who also had the alter personality of a 6-year-old, like, obviously that's a little bit of a situation. So, yeah, I don't know. It's a slippery slope. Yeah. But speaking of documentaries, there are a lot of misconceptions in the media of DID. One TV show is actually about Billy Milligan and the murders and rapes that or just the rapes, sorry, in his time at Ohio State. And this TV show actually stars Tom Holland. And while it is obviously dramatized a little bit for the media and the sake of Hollywood, a lot of it does go into the struggles that he had and just how he was assessed with DID. And another film, which I actually watched the other week, is Split, which I don't know if you guys have heard about this, but this story was also loosely based on Billy Milligan's actions. And this is a story about a man with DID who has, like, 24 personalities, kidnaps two girls, or three girls, sorry, with the intent of killing them. But as he's kind of switching throughout his personalities, these girls are trying to figure out what the heck is going on and am I going to die, am I not? And while the film was wildly exaggerated, it was still interesting to see kind of the internal turmoil that a person with DID may have and how one personality could just be drastically different from another. So I highly recommend, you know, checking out these two films or TV shows just about DID, just to kind of see how the media portrays them. But I do want to ask you, Mikayla, how do you think people with DID in the real world feel about these portrayals of them in films and movies and TV shows? Right. I don't know. I think it kind of depends on the TV show and the movie and how accurate it is, right? Split, how accurate is it really, you know? And I feel like Split and the documentary you mentioned with Tom Holland, they might be super interesting, but it almost places a huge fear factor in people, that they have to be afraid of people with DID. I feel like if that's all we're ever seeing, a person who might have DID might be super offended and just, again, I feel like they would feel like the world was against them at that point. Right. On the other hand, if there's a doc, like the one, I watched it a few years ago, and she was just saying what her life was like every single day. It was totally real, totally how it happened. I think that was very educational, and that doesn't make you, like, afraid of her. It just is like, oh, interesting. Like, I had no idea that this is what your life could be like. I think those documentaries are educational and fun, but I think the Hollywood movies, I think that someone with DID could easily be offended by that. Right. I don't know. I feel like I would be offended by it if I had it. Yeah, no kidding. I don't know. Yeah. To wrap up this podcast, I think just some closing messages from my perspective is we just need more research on DID. You know, it's obviously something that's happening in the world, and we should better understand it, not only from a neuroscience perspective, but also in the law. Like, while it may not be super common, there are cases where people with DID find themselves in trouble, and we need to figure out how to better assess them in their situation and, you know, offer them help. And, yeah, overall, just research this. Get the word out there and, you know, do better, really. Yeah, I totally agree. It is up to everyone to do better with this, honestly. But I would just love to be able to, in a few years, be like, oh, wow, neuroscience was used in this court case to help someone with DID, to help, like, prove their diagnosis or whatever. Or just help everyone understand it more, I guess. So that's something I would really love to see. Other than that, thanks for tuning in, everyone. Yes, thank you for listening. And if you have any questions or comments, be sure to respond on the little YO Courses thread. And with that, we will see you guys later. Bye. Bye.

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