Schizophrenia vs. Dissociative Identity Disorder
How These Two Illnesses are Confused for Each Other
& Analysis of Which Disorder Norman Bates Demonstrates in the Film, Psycho
11/01/04
The purpose of this paper is to clarify the similarities and differences between the two psychological disorders schizophrenia and Dissociative Identity Disorder (also known as Multiple Personality Disorder). In Alfred Hitchcocks film, Psycho, Norman Bates suffers from one of these two psychoses. Most viewers would initially think that he has schizophrenia due to societys misconceptions about this disorder. However, we will argue that it is more accurate to diagnose Norman with Dissociative Identity Disorder (DID).
Several subtypes of schizophrenia exist-each with distinctive characteristics (i.e. Catatonic schizophrenia describes one who is in a catatonic state). General symptoms of schizophrenia include delusions, auditory hallucinations (hearing voices), and incoherent, disorganized speech. The patient may give continuous verbal commentary on their behavior or, they may even appear to have a conversation with their self. Usually, they are extremely antisocial.
Several factors have been linked to schizophrenia which include neuropathological factors, environmental factors, genetic predisposition, and even viral infections. Schizophrenia is treatable with medication if it is taken consistently. The patient is then capable of thinking clearly and living a relatively normal life.
DID, while seemingly similar to schizophrenia, is a totally different monster altogether. Sufferers of this condition literally have alternate identities and are capable of switching between them. The main personality is referred to as the host, while the other(s) are referred to as alters. The host is usually not the persons original personality. In most cases (over 97%), the patient has been a victim of repetitive, often torturous, sexual or physical abuse at a very young age. Alternate personalities are thought to arise in response to this abuse as a means to escape the brutal reality, but they remain unobservable. Later, something in the physical or social environment will trigger the personalities to emerge. Therefore, most cases of DID are diagnosed in adulthood. On average, a person with DID has 15 distinct personalities. In most cases, there is at least a child personality (the original), an opposite gender personality, a self-helper personality, and a persecutory personality (one that hurts others or themselves). Separate identities may or may not be aware of each other. If they are not, the person will demonstrate bouts of amnesia. When the personalities are aware of each other, termed co-consciousness, they will carry on conversations with each other and even offer each other advice.
Physical changes in posture and voice are observed when alters emerge in a person with DID. If the person is male and a female alter emerges, the pitch in his voice will change to the higher pitch typical of a female. The handwriting may also be different because some patients demonstrate the use of the non-dominant hand depending on which alter is in control. In the case of transgender personalities, the person may also dress the part.
The current methods of treatment include hypnosis and therapy. A person with DID is very easily hypnotized-more so than the average person. Hypnotism is highly criticized because recollection of childhood trauma often does more harm than good. Therapy aims to increase the level of co-consciousness to a point where the personalities are integrated and work together cooperatively. Successful treatment is rare.
Since DID is a rare disorder, it is not uncommon for doctors to misdiagnose their patients with more prevalent disorders such as schizophrenia. Some symptoms associated with DID can be misinterpreted as symptoms of schizophrenia. For instance, paranoid schizophrenia is marked by delusions and auditory hallucinations. A person with DID may be misdiagnosed as a having schizophrenia if their alternate identity is mistaken for merely a hallucination. The key difference in distinguishing the two is to observe how the person carries on a conversation with their self. A person with DID will usually have some physical changes to accompany the different voices in the conversation, and the schizophrenic will not display any change in voice or posture. However, it is sometimes difficult for highly skilled psychiatrists to recognize DID. In fact, DID patients spend an average of 7 years in the mental health system before acquiring an appropriate diagnosis.
Society holds its own misconceptions about schizophrenia which contribute to the confusion. Many people believe that DID and schizophrenia are the same or related disorders. Actually, DID is more closely related to post traumatic stress disorder than to schizophrenia. One common misconception is that people with schizophrenia have a split-personality. While the root words schizo and phreno mean split and mind, respectively, patients do not have two different personalities. Instead, the term split mind refers to the schizophrenics split from reality. Again, a person with DID is one who suffers from a true split personality.
Normans behavior could easily be described as symptoms of schizophrenia. Some schizophrenics prefer to be socially isolated and have peculiar behavior. Norman lives like a hermit and rarely interacts with anyone except an occasional guest of his hotel. His hobby is stuffing birds, which is somewhat strange. He also has strange reactions to Marion. One minute he is very nice and inviting to her; the next he is enraged when she suggests that he put his mother someplace. He is definitely socially retarded.
Schizophrenics tend to believe that their thoughts (especially anger and sexual thoughts) are controlled by external sources. Norman believes that his mother is insanely jealous of him, and she controls his sexual urges (or thoughts) by killing the women of his desires.
Catatonic schizophrenics are mute and unresponsive. At the end of the film, Norman is sitting in jail, and he appears to be catatonic. He is hearing his mothers voice in his head. The viewer could mistake this as an auditory hallucination. Norman himself may have thought that the mothers voice originated from her grave. His mothers voice was constantly commenting on his behavior, especially with regard to women. This commentary on behavior is typical of schizophrenics.
Given Normans social isolation, peculiar behavior, delusions, catatonic behavior, and possible auditory hallucinations, it is easy to see why he may be justifiably misdiagnosed as schizophrenic.
The main reason that Norman should more appropriately be diagnosed with DID is with regard to the hallucinations. When one analyzes the film, it becomes evident that Norman has three distinct personalities that take control of him. In a few brief moments, viewers see him dressed as his mother and talking in her voice. He has the personality of a little boy (the original personality), Norman (host personality), and his mother (an alter personality).
One can infer that the little boy identity did exist although viewers did not directly observe a childs voice. However, the audience gets a glimpse of his bedroom. The bedroom still contains childrens toys and a small bed that he continued to sleep in. Considering that he still sleeps in this bedroom, he probably plays with the toys, too. It is typical for a person with DID to have at least one child personality, and this is usually the original personality that was abused.
Since 97% of DID patients suffered sexual or physical abuse, it is highly likely that Norman was abused. No real evidence exists that he was physically abused as a child. However, several innuendoes made throughout the film indicate that he was sexually abused. Given that his father died when he was very young and he and his mother lived alone for so many years, his mother was probably his perpetrator.
It is obvious that Norman is extremely disturbed by his sexuality. The psychiatrist, after analyzing Normans condition, determined that he had an incestuously possessive and jealous love for his mother. He also notes that Norman became seriously disturbed after his fathers death. Perhaps Normans mother turned to her son for sexual gratification after her husbands death. Norman and his mother lived alone for many years before she took a lover. Maybe Norman was really in love with her and when she took up with someone else, it drove him to murder. Norman even states that a son is a poor substitute for a lover. (Was he, in fact, a substitute?)
As previously mentioned, alter personalities tend to emerge in adulthood when they are triggered. When Norman kills his mother, he starts to act and dress like her. He wanted his mother to be as jealous of him as he was of her. To fulfill his fantasies, he dressed as his mother and stabbed the women that turned him on. Stabbing is symbolic of rape. When he dressed as his mother, he did to others what she did to him. When he dressed up like her, he dressed very matronly-unlike the way she probably really dressed. This was his way of creating the mother that he wanted, needed, and deserved.
When Lila enters the house to talk to the mother, she discovers Normans bedroom. Not only do we see boy and girl toys, we get a glimpse of a record on the record player. It is Beethovens Er-o-ica Third Symphony. Interestingly, the title is one letter short of erotica. This establishes that there is some connection between his early childhood and deviant sexual behavior. Then, Lila and Sam expose the fact that Norman dresses up as his mother. At this very moment, Norman begins writhing as if he is having an orgasm. Now that he has been exposed, his sexual frustration can be acknowledged and released.
At the end of the film, the mother personality dominates. She says something to the effect of I am not even going to swat that fly. They are probably watching me right now. They will say, Why, she wouldnt even hurt a fly. This statement concludes that the mother is trying to hide something. She is clearly guilty because she wants the authorities to think that she is harmless. The sheer fact that Norman has several distinct personalities is what distinguishes his disorder as DID and not schizophrenia.
Resources Discussed:
Hitchcock, Alfred. Psycho. 1960.
Other Suggested Sources to Consider:
The Diagnostic and Statistical Manual of Mental Disorders. Published by the American Psychological Association.
Web site: http://pub94.ezboard.com/fasmallcornerfrm14.showNextMessage?topicID=87.topic. This site contains information taken directly from the manual above, which explains these two disorders in great detail.
Web site: http://www.emedicine.com/PED/topic2651.htm. This site contains pertinent information connecting DID to child abuse/neglect.
Web site: http://web.tiscali.it/andrebalza/. This link takes you directly to The Psycho Home Page. It contains cool information on Alfred Hitchcock and the film itself.
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