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A blind woman who switched personalities and could suddenly see (washingtonpost.com)
190 points by fahimulhaq on Nov 25, 2015 | hide | past | web | favorite | 65 comments



That's just another example of how little we know about our brains and how they interact with our bodies. We're at the stage where we see stars in the sky, rotating every night, and think they go around the earth. Or see people getting sick around others and thinking they're cursed.

DID offers us a rare insight into what's possible. When all your life you saw nothing but hills, the concept of a mountain is hard to wrap your mind around. Imagine your brain being able to shut down your pancreas. Then another part (personality) comes forward and your pancreas is suddenly fine. One minute you're diabetic, the other you're fine. This is an example of a mountain we have a hard time accepting.


Isn't Science all about letting data shine the light. Why would we have a hard time accepting?


Science is just as much abot politics as any other human endeavour; witness the time it took geologists to accept the idea of tectonic plates.


An interesting take on this is the concept of "ghosts" in Zen and the Art of Motorcycle Maintenance.


Your comment reminds me of the Allegory of the Cave. DID is fascinating, another area of study that I think is interesting is Evolutionary Psychology.


From my understanding, DID is not a well accepted diagnosis my psychologists. I can't comment about this person specifically, but in many cases people diagnosed with DID actually have borderline personality disorder. It's a condition characterized by an inability to regulate emotions. They tend to experience their emotions in the extreme, regard others as either entirely good or entirely bad, etc. People with this condition are also very emotionally fragile, and are very suggestible. If a doctor starts asks them a leading question about having multiple personalities, they may internalize that and act accordingly.

Source: my father, a clinical psychologist


BPD is very different to DID. They don't share any similar symptoms. Your suggestibility suggestion doesn't match any of the people I know with the diagnosis (and I know many people with the diagnosis). I guess it's possible, but not if you tie it to BPD.

Some nice descriptions of BPD are in "Meeting the Challenge, Making a Difference": http://www.emergenceplus.org.uk/news-from-emergence/507-meet...

I agree that DID is either unlikely or fantastically rare.


I think suggestibility wasn't exactly the right word for it. One of the primary characteristics of BPD is a poor sense of self. That is, they are often unsure of what their long term goals are and what their values and opinions are. I think the DSM refers to it as a "pattern of instability of self-image." The thing you linked to phrases it as "A difficult relationship to ‘self’ such as difficulties with identity, self-esteem, feeling ‘different’ to others, or a sense that they are failing in the world."

In the mild or moderate cases a person with unstable sense of self presents as someone who doesn't know what they want in life. In extreme cases, where the patient's view of themselves frequently changes, it would look a lot like DID.

I agree it's not the typical presentation of BPD.


I'm not qualified to have a strong opinion, but I know one very interesting criminal case. In fact, there are many. But there's a guy called Thomas Dee Huskey aka “Zoo Man (https://www.bizarrepedia.com/multiple-personality-disorder)

A serial killer who killed prostitutes. He was described as dumb as a box of rocks, but his other personality, who allegedly committed the crimes, was left-handed. It's extremely difficult to fake it, even if you have high IQ. The handwritings experts agreed they are handwritings of "two different persons". There were many other facts I can't remember right now, but even the prosecutor agreed this guy probably has DID. And that's rare...


Unfortunately, the fact that he is a psychopathic serial killer means that he's most likely faking it. It doesn't mean that Multiple Personality Disorder isn't real. It just means that he's just using Multiple Personality Disorder as an excuse.


The article mentions just that: yes, it is a controversial diagnosis among psychologists and psychiatrists.

However, the point of the article is that data is accumulating that shows that DID can manifest in ways we can measure on brain scans. It's not just that this woman says she can't see, the brain scans confirm her visual cortex is not active in some of her personalities.

That is strong evidence that the popular opinion about psychologists, that you mention, may be wrong.


This is a very interesting find, though there are alternative explanations. People "losing" their sight due to a psychological condition has been documented for a very long time. In fact, I believe Freud treated a women with so-called hysterical blindness. Hysteria (now called conversion disorder) has been documented to cause these kinds of symptoms, and often the symptoms are intermittent and are brought on by emotional stress. It's possible that this person has borderline personality disorder and conversion disorder. Though I don't know if there are any cases of someone having both, it makes some sense that they would be co-occurring.

All that said, is there really that much difference between a person who genuinely believes and acts like they have DID and someone who "really" has DID? If it looks like a duck, quacks like a duck, etc... I suppose the evidence that would really win me over would be someone designing a novel therapy or medication which helps people with DID, but is not effective on people with borderline personality disorder or similar conditions. Because at that point the label actually becomes useful.


I don't think hysterical blindness is an alternative explanation. It's what's going on here, but, it happens in just one personality. That the different personalities can have entirely separate conditions like hysterical blindness is very strong support for the separate identities being in fact separate.

In addition, the fact that brain scans confirm the psychological/hysterical blindness actually happens at a neurological level as well, proves this isn't a case of malingering or of a high-level psychological disorder. This is happening at the lowest brain level we are aware of.

Even with that evidence, I suppose one can still ask "but are they 'really' separate personalities"? And I think you're right that if it quacks like a duck and so forth, we might as well call it a duck. Another perspective: if we saw those personalities on different physical people - very distinct, both psychologically and neurologically - we would have no problem accepting them as different people. The only challenge here is that they occur in the same physical person. Perhaps that's not reason enough to dismiss them as separate.


You have it backwards: all of her personalities were blind, and then the sight returned for one of them. With therapy, now only two personalities still experience blindness. The fact that her episodes of hysterical blindness coincide with the so-called transition to specific personalities is interesting, but not definitive.

Even if we accept DID as a legitimate condition, that doesn't mean these separate personalities are real entities in their own right. On of the patients personalities is a 13 year old boy, with all the memories of a 13 year old boy. But these memories are completely false: they did not actually occur. People with DID don't have multiple selves, they have no self at all: their personality is shattered and stitched together by a patchwork of delusions and artificial personality traits.


> You have it backwards: all of her personalities were blind, and then the sight returned for one of them.

We are saying the same thing. Some of the personalities are neurologically (not just psychologically) blind, some are not. That's a fascinating result, and certainly suggests that the different personalities are distinct not just psychologically but also at a far deeper level.

> People with DID don't have multiple selves, they have no self at all

It's not clear that your description and the article's are not the same, except for a preference for calling the same state "multiple selves" vs "no self." Both descriptions agree that something "shattered", and both agree that neurologically the split shards/personalities are remarkably distinct, on every level. I don't think there is a disagreement here.


On a second reading, you're absolutely right. My bad!


+1 this is pretty much exactly the explanation I got from my psychiatrist relative.


They also crave attention.


It is well known that extreme physical problems like blindness and paralysis can have purely psychological origins. It is "all in the mind" yet the symptoms are completely real to the patient. Its causes are way more complicated than a cry for attention or other similar utterances of street smart "wisdom".

See Somatization disorder and Conversion disorder.


Aging?

We have tales of yogis and other "adepts" who could supposedly live much longer than the average life span for their times or who could self-cure disease, etc. While I don't take these stories at their miraculous face value, I do wonder if there might not be some kernel of truth in there somewhere -- perhaps certain patterns of thought can and do have an effect on aging, the immune system, etc. We do know that people who are happy or feel socially accepted by friends and loved ones have statistically significant increased odds of surviving deadly cancers and other serious diseases.

For years I've felt like I've casually observed a converse effect-- people who adopt a curmudgeonly "old" point of view in life often seem to have failing health. I have wondered which comes first. Could an "old" (in the negative sense) mentality actually age you?


I can't find it now but yes there was a study done a few years ago that had one group of elderly people play and act like children, and another do some "serious" adult activity for some period of time, and afterwards they took some markers of aging, and found it significantly diminished in the play group.

But I wonder what the aging effect of our obsession with control is. In other words, would playful thoughts motivated by a desire for control still net those results? (if indeed you can even be playful and controlling at the same time)

Based on what I know about psychology, I doubt it. Motivations matter, and letting go and accepting things as they are is one of the most psychologically healthy things we are capable of doing. I doubt if any of those yogis who achieved long life (if indeed they did) did so intentionally for the purpose of achieving a long life. Instead, it was likely a by-product - as so many of the best things are.


This dude seems to be able to prove "Superhuman" abilities in scientific environments based solely on mental fortitude and control http://www.icemanwimhof.com/innerfire


A bit unrelated but after reading the wiki pages for Somatization and Conversion disorder and then reading the suggested links I stumbled upon this gem, the Cat Nun hysteria of 1844:

https://en.wikipedia.org/wiki/Mass_hysteria#Cat_Nuns_.28Fran...

>A convent of nuns began to meow like cats and others followed until all would meow together at a certain time for several hours together. This continued until the surrounding village called soldiers to threaten the nuns to stop their singing.


Well, if Multiple Personality Disorder is real, then that means there's another person/personality/talking voice living inside your brain. And if that other person/personality/talking, who isn't you, takes over the area of your brain involve in sight, OR, if that person/personality/talking voice resides in the area in the brain involves in sight, and you/your personality/your talking voice do not reside in sight area of the brain, it would make sense that you will not be able to see, and only the personality residing in the sight area of the brain can see. OR... The personality/those other beings living inside you decide not to share the vision are of the brain with you, then your area of the brain would not be able to receive the visual information, and thus, you would be blind, but that other personality would not be.


I'm surprised more wasn't said on the history of the disease. Hippocrates actually first recoreded it, and Freud's very first patient in 1880, Anna O., had it (she was partially blind/deaf and paralyzed) and she eventually recovered. Then it was known as hysteria, and today it's categorized as a form of somatoform disorder. It used to be quite common, and may still be, although there is some controversy in this regard (1a).

There's little that can be said about this particular case, because so few details are included - other than that it's no surprise that it co-occurred with DID, for discrete mental illnesses rarely exist in the wild. They almost always come in bunches.

Predisposing factors for somataform include alexithymia and childhood trauma (1b) and it often co-occurs with anxiety and/or depression. Alexithymia (a little known condition involving a severe deficit in awareness of emotion and the body, and a focus on the external world) is usually a key factor in the etiology of the disease.

"Individuals with alexithymia tend to demonstrate an impoverished fantasy life and limited imagination, a diminished capacity for empathy, a penchant for impulsive behavior, and a propensity to experience emotions somatically" (2). The deficit in emotional processing is usually (at least originally) the result of a conscious effort to suppress/distract from unpleasant emotions (like this lady's trauma), which then express themselves in the body. Indeed, alexithymia-like symptoms are a common feature in a number of common mental illnesses such as depression, anxiety and panic disorder (3), and the more alexithyia-like characteristics these patients have, the worse their somatic symptoms (4).

Treatment of the disease is difficult because despite its psychological etiology, patients usually present well and emphatically deny that their psychology has anything to do with their symptoms (5). Interestingly, emerging findings on it tend to revolve around some of Freud's original ideas (6).

(1a) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235919/

(1b) http://jnnp.bmj.com/content/early/2014/03/07/jnnp-2013-30720... and http://www.sciencedirect.com/science/article/pii/S0022399913...

(2) http://journals.lww.com/hrpjournal/Fulltext/2014/05000/Chang...

(3) http://link.springer.com/article/10.1007/s11126-012-9246-y and http://www.sciencedirect.com/science/article/pii/S1053810009...

(4) https://www.researchgate.net/profile/Robert_Schoevers/public... and http://www.sciencedirect.com/science/article/pii/S0010440X14...

(5) http://www.omicsonline.org/open-access/do-patients-with-soma...

(6) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744921/ and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396134/ and http://www.sciencedirect.com/science/article/pii/S0149763415...


Dissociative identity disorder makes me wonder about the nature of our identity. Which personality is the real person? Clearly at least some of these personalities are not central to the identify of the person -- clearly not the teenage boy. It stands to reason that one or even none of the personalities truly represent the person, and that they are simply projections of the mind. Then I start thinking about the normal case of one personality. Is the normal case somehow different? Is our mind-created identity really us, any more than B.T.'s several mind-created identities are really her? Or is it just a projection of our mind?

Put another way, is our personality a part of our identity, or is it merely an extension of us, in the same way an arm or leg is a part of us? If we cut off an arm, we are no less ourselves. If B.T. lost a few personalities, we would agree that B.T. is no less herself. If we lost our own personality, our "ego", would we be no less ourselves? Eastern philosophy says yes. I see the logic, but I'm having trouble accepting it.


>Which personality is the real person?

Well, that's easy. Your preference for the color blue is the real you. Your preference for big boobs is not you. The preference for big boobs is your gene's preference, not your personality's preference. Your short temper-ness, your aggressiveness, that's your genes, it's NOT the real you. Your liking computers, that's the real you. Your curiosity about computers and wanting-ness of the computer, that's your genes, not you. You wanting to do something great with a computer. That's your genes. The greatness that you created with a computer. That's the embodiment of you. Your preference for fighting people. That's your genes. Your niceness. That's the real you, the real personality of you, the you that is not controlled by the genes.

So you see, it's pretty easy to tell which part of you is controlled by the genes, and which part of you is the real you.

What? What do you mean it's hard to tell the difference? What do you mean you need me to explain it more? LOL.



Some soldiers in WWII would go blind temporarily from high anxiety. There are different forms of blindness, some are biological and others are psychological.


Wiki has some information about it: https://en.wikipedia.org/wiki/Conversion_disorder

It was a plot point in one of the "Band Of Brothers" episodes.


Truth is stranger than fiction. The idea of psychological shutting down of the senses was the premise of the Who's album Tommy in 1969. https://en.wikipedia.org/wiki/Tommy_(album)

I wonder if there were earlier reports of this kind of thing?


Not sure about earlier, but this 1986 work is one of the definitive popular books on such issues:

https://en.wikipedia.org/wiki/The_Man_Who_Mistook_His_Wife_f...


Do read the first few comments too. They seem to raise legitimate concerns regarding the methodology /misaligned interests in the research. Regardless, I'm skeptical of the skeptics' suggestions.


I wouldn't put much (if anything) in those comments. It's like an article about a weird light in the sky that brings out all the tinfoil people.


Maybe even more interesting:

"At first, B.T.’s renewed sight was restricted to recognizing whole words in that one identity. If asked, she couldn’t even see the individual letters that made up the words, just the words themselves. But it gradually expanded, first to higher-order visual processes (like reading), then to lower-level ones (like recognizing patterns) until most of her personalities were able to see most of the time."


I can't find a quick reference now, but is long known that when we read - at least the educated and well-read adults -, we don't actually go for each individual letter, but we read word shapes and recognize them faster. Fast readers can even compress this recognition for two, three or more words at a time, reading in like flashes.

It takes some training and there are somebooks that exploit this to make you a fast reader.


One great experimental demonstration is these chain letters going around with all the letters in each word but the first and the last scrambled up - you can still read it at a good fraction of normal speed.

What's interesting to me is that this high-level processing can make it into conscious awareness before the lower-level features involved (not letters, but at least shapes and colors - which came after reading in this case).


We know that trying to teach children to read using this method is pretty terrible.


But I never implied that this is for children. Once we reach a certain age, and we are/were avid readers we "skip" reading the letters. Children cannot yet do this, of course, it takes training.


It's almost like training a recurrent neural network, you get the best results if you teach them letter-by-letter and let them work out the structure themselves.


Couldn't another possibility is that her blindness was indeed the result of physical damage to her brain and her regained vision was the result of using other neural pathways in the brain. I remember reading an article not too long ago where people clinically blind people from birth were able to recognize visual stimuli subconsciously. Similarly she may not be able to consciously see new things as much as have an intuition about what parts of her vision are still working.

The mind is really an amazing thing and this combination could bring to light discoveries about how both vision and various mental disorders affect the brain.


When human beings are extremely frightened, they may faint,blind or die, even there's no any physically contact. It looks psychological problem can be a physical problem temporarily or permanently.


The thing that I remind myself is that you can receive a phone call and get bad news. This will put your body into shock, a physical response such as low blood pressure or high heart rate. Not everything needs a physical impact to have a physical response.


How hard would it be to figure out if 'the phone call' could exist? The call that, upon hearing of it you drop dead or become insane. Sort of a real-world SnowCrash. After all, it's not too much of a stretch to imagine that someone already weakened would get a heart attack as a result of the effect you describe.

http://www.imdb.com/title/tt0081203/

'Murder by telephone', only then without a device, just a text.


This documentary proves the concept beyond reasonable doubt: https://www.youtube.com/watch?v=WwbnvkMRPKM


Hah, of course :) I won't spoil it so whoever clicks the link will surely die, especially if they understand German.


So if you hear only a single voice in your head, then you're normal. It's called being normal.

If you hear your voice, AND other voices that do NOT belong to you, in your head, BUT, they can NOT control your body, then it's called Schizophrenia.

And if you hear your voice, and hear other voices that do NOT belong to you, and these voices can sometimes take control your body from you, then it's called Multiple Personalities Disorder.

This begs the question. Doctors keep saying the voices that Schizophrenia hear are not real. Yet, they themselves know that the voices they hear are real. As real as their own voice in their head. As real as the voice you and I hear in our head. The only thing is, the voices they hear, they know does not belong to them.

In other word, Schizo has some kind of brain defects where instead of the brain creating only a single voice, a single entity, the brain creates multiple voices. So those voices Schizo hear are not hallucinations, but rather, real voices like your voice in your head right now. Only problem is, those voices has no control over the body, unlike your voice.

However, if a defect happen, where the voices can temporary take over the body, then maybe that's what Multiple Personality Disorder is.

This also make sense why she becomes blind. She takes control of her body, but they take control of her vision.


Mental health is no joke


As far as I know Multiple Personality Disorder is, to put it mildly, not very accepted by the mental health community.

I have no doubts at all that one can be truly blind for a variety of non-physical or partially physical reasons, I do not doubt that this woman experienced blindness. But this personality/identity stuff is very questionable indeed.


That's what makes this so interesting. The EEG readings showing lack of brain response to physical stimulus were correlated with different "personalities". I can't think of a better way of proving the existence of DID.

I don't know anything about the reliability of PsyCh Journal so it's hard to know if we can take this at face value or not.


There's actually the full text available here: http://www.ncbi.nlm.nih.gov/pubmed/17611729

(At least, I think. Maybe this isn't the updated one?)


I was kinda sceptical about the article until I saw the quotes advocating that DID is totally a real thing from the doctors.

Then I was very sceptical.


I think a part of her brain got damaged, so it started relying on other neural paths that were still functional.

It's still trying out different paths, hence the different personalities. A new vision-related path is in the works, but not ready for production right now.


I am short on time today and just don't have time to read through all the comments (or even the article at the moment, sigh -- I would love to read this), but I have something of a longstanding interest in multiple personality disorder and I have read of cases where physical things, like scars or moles, appeared and disappeared depending upon which personality was being expressed at the time.


His eyes can see

His ears can hear his lips speak

All the time the needles flick and rock.

No machine can give the kind of stimulation,

Needed to remove his inner block.


"A woman with display driver problems who had dualboot has intermittent issues with display"


Problem running the new Intel drivers on Windows 10. What a nightmare.


My favorite thing about stories like this is that the provide a lot of data for mental modeling:

Suppose you're attempting to build up a mental(/scientific) model of how the human brain works. You're trying to come up with a set of abstractions and rules for how those abstractions interact, with which you can intuit, without performing a full simulation, the answers to experimental questions. That is, your model should produce concrete predictions: if I prod the brain at A, B will happen; invisible effect C is correlated with visible effect D; nebulous phenomena E and F are well-defined instances of type G. A good model is more like a type system than a simulation; it gives you names and concepts that match (with some loss of fidelity) those used by reality. It lets you write valid programs (explanations) that match programs (physics) that are being executed by reality.

The report that a person had multiple personalities and some of them were blind, leads to the logical 'program':

Either

(this person has a brain structure that was so bizarre it isn't related to the rest of the species' brains) [assume this is false]

Or

(it is possible for humans to contain multiple personalities which are not equally able to interact with sensory organs)

Therefore =>

(it is possible for human brains to contain multiple personalities)

(sensory organs are wired into personalities)

(personalities can lose their wiring to sensory organs without physical damage to the organs)

That is, a single report cuts out a huge swathe of model-space. With a single example we are obliged to include in EVERY model concepts of personalities (or something, er, homomorphic to them), and a concept of a wiring to the sensory organs, and the ability to express that this wiring can become broken.

A perfect model must explain every example (or leave a place for as-yet-undiscovered mechanisms to explain them). New examples put new burdens on every existing explanation. They cut model-space down by, presumably, percentage chunks ("excise the subspace of model-space that doesn't model personalities and wiring personalities to sensory organs"). If you imagine that there are something like 2^N possible models at a given granularity, then, the cuts are approximately reducing us to 2^(N-1) each time. Our models with N degrees of freedom that has to explain E experiments has more like N-E degrees of freedom (disregarded 'covariance' between experimental results). What this means is that a random model is overwhelmingly likely to be wrong with each successive experiment. (In practice our models have large dark spots where we leave many degrees of freedom open - but even still, it's likely that any explicit modeling choice we make ends up being incorrect, and quickly.)

(This math is pretty made-up. We could do better with something akin to Kolgomorov complexity rather than degrees of freedom, since type systems should be discounted by how complex they are so that systems more complex than reality actually is end up contributing nothing to the total.)

Summary: I enjoy stories about weird neuroscience because they defy my mental model of "how brains work" almost every time, even if I keep revising it.


[dead]


It's not impossible. But the article does address this point:

> One explanation, that B.T. was “malingering,” or lying about her disability, was disproved by an EEG test. When B.T. was in her two blind states, her brain showed none of the electrical responses to visual stimuli that sighted people would display — even though B.T.’s eyes were open and she was looking right at them.


[flagged]


If you think psychiatry is a cult, consider how many competing approaches there are within the field and how often experimental evidence is used to throw out old ideas and form new ones. This is pretty much the opposite of a cult. Though, I think the problem is they have to assign names to things they don't quite understand yet, and that can be frustrating, since they're not terribly specific.


It's worse than just vagueness. There is a culture of pseudoscientific arrogance and condescension. Foucault's account of the history of psychiatry is a key text. Also, check out Richard Bentall's books.


Given the variety of things under the psychiatry umbrella, there is surely some of that, they don't seem much different from the larger pool of scientists, doctors, public health workers, etc. on the whole. But, there's nothing wrong with a healthy dose of skepticism!


Sounds like the kind of statement that should be backed by evidence.


I have a feeling that if you believed that for rational reasons, you would have listed them. If you don't believe it for rational reasons, why do you believe it?


Yeah, and MK Ultra never happened.




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