-Caveat Lector- http://www.telegraph.co.uk/et?ac=000343180237640&rtmo=0XbxX2sq&atmo=99999999 &pg=/et/99/9/23/ecfsplit23.html The crowd inside her head New research is helping scientists to understand split personalities, says Raj Persaud AFTER years of doubt and controversy, multiple personalities have been seen inhabiting the same brain for the first time in a study conducted by a team of American scientists. Using a brain scanner, a group of doctors, led by Prof Guochuan Tsai at Harvard Medical School, has performed the first in-depth imaging study of brain activity in multiple personality disorder. The disorder is one of the most dramatic and controversial diagnoses in psychiatry and was made famous by books and films such as The Three Faces of Eve and Sybil (who claimed 16 different personalities). Patients contend that totally different personalities inhabit their minds and can take over their bodies from time to time. These personalities might be of a different sex, age, skill, hand preference, motivation and emotional style from the usual persona. After a switch back to the base or core personality, the patient cannot remember the period during which the other personalities were in control. The theory is that in the face of some extreme trauma, often childhood sexual abuse, the mind deals with overwhelming stress by producing an alternative personality that experiences the shock, so protecting the core personality, for whom the terrible event never occurred. But British psychiatrists have always been more sceptical than their American counterparts. This cynicism follows the use of multiple personality disorder as a defence in several legal battles over heinous crimes, where perpetrators complained that another personality in their minds was guilty, not them. In the early 1980s, Ken Bianchi, an American serial killer nicknamed the Hillside Strangler, claimed it was another personality inhabiting his body who had committed a string of murders. But psychiatrists suspected he was faking his supposed two personalities, and told him that sufferers usually have at least three different personalities. Bianchi immediately produced another. Bianchi aside, is the phenomenon real? Most British psychiatrists suspect pretence is at the root of multiple personality disorder. At Harvard, Dr Tsai's team used functional Magnetic Resonance Imaging to highlight blood flow in the brain in the hope of revealing the underlying mechanism of personality switching. They asked each patient to switch to a third "pretend" personality as a control condition, providing a comparison for the activity of alternative personalities. The subjects would confirm the moment of a switch in personality by pressing a button in the scanner. When a patient was changing from her normal personality to the main alternative one, part of the brain now thought to code our memories of significant episodes from our pasts, the hippocampus, seemed to be inhibited - its activity was significantly decreased. When she switched back from her "alter" personality to her normal one, the hippocampus was more active than in the alter personality. These results throw new light on the science of where our sense of self is located. The hippocampus is the "antenna" of the brain, attuned to the environment and sensitive to the stresses of life. Many victims of abuse have hippocampal degeneration, as did the subject examined by Dr Tsai. Perhaps a compromised hippocampus is vulnerable to a personality switch. The work shows that who we are is strongly determined by memories of significant past events, as one would expect. It might even be that holding on to past turning points in our lives continues to define our outlook, and to change our personality we have to alter the focus of our memory of the past. These brain-scanning results also converge with the current therapy for multiple personality disorder. This is to encourage the patient to recall and perhaps even relive the traumatic early event that first produced the switch to another personality. It is striking that when the person is returning from their "alter" personality to their base, or core, the activation occurs in their right hippocampus. It is this right side that is hypothesised to be implicated in more emotional experiences. So it could be that recalling especially emotional memories is vital to our sense of self, and denying them renders us prone to forgetting who we really are. But perhaps the most revolutionary finding in this research is the fact that a brain structure was identified as a switch of multiple personalities, but that this switch is not active when the patient is instructed to pretend to shift to a feigned personality. This means the new technique of functional MRI brain scanning could begin to persuade British psychiatry to regard multiple personality disorder as a brain dysfunction. A redrawing of the map of disorders previously attributed to malingering and other dubious motivations could now be heralded by this study. For these brain-scanning techniques allow clinicians to look past the pretence and directly into the brain. Dr Raj Persaud is a consultant psychiatrist at the Maudsley Hospital, London ======================= Robert F. Tatman Computer Help Desk Desktop & LAN Services Systems Department Philadelphia Newspapers, Inc. 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