 Hello and welcome to MIP TV and for our usual special segment of MIP TV which is of course Bob Cook's book reviews. So welcome Bob and you've got a cracking book in this section haven't you? We've just been talking about it off air haven't we? Yeah it's a real favourite book of mine. It comes from 1989 so some time ago and it's called Diagnosis and Treatment of Multiple Personality Disorder. Wow. But Frank Clough, sorry my apologies, Frank Putnam, P-U-T-N-A-M, that's fine. Okay so a lot of people think multiple personalities you know and they may get some kind of ideas from horror films. It's usually the sort of thing that gets kind of quite ghoulish headlines but what is multiple personality disorder Bob? What is it? Well it's the old name really for what is called now dissociative identity disorder. So before they changed the classification I don't know how many years ago in the ICD-9 and the DSM-5 or 4 if you like it was called multiple personality disorder. Basically it's when the ego fragments into many different parts. So in other words we've got many discrete personalities which were often laid dormant and sometimes emerge but they control the individual's actions. Okay so for those for those perhaps we'll watch then I don't quite know what the ego is. The ego really is is the part of us that kind of exists in consciousness doesn't it? It kind of guides us along as opposed to the id which is the kind of child, the fiery child of the personality and the super ego which is like the super parents. So the ego is how we function in the world it's who we are really isn't it in a lot of theories yeah and what you're saying is is that in some cases and we may talk about what those cases are people fragment so they have you know they have different identities and how are those identities present Bob? Would it be really different from the person you initially meet? Oh yes so if we think of a honeycomb I've only picked up a honeycomb yeah there's many many many different pockets isn't it? Yeah and if we imagine that each of those pockets is like a separate ego or a person if you want to look at it that way then each one of those pockets has in ta terms would have a parent adult child. In other words they would be like a specific person and these fragmentations of the ego are split in reaction to trauma. Right. So if there's been a real traumatic occasion say like sexual abuse or a violation of a person's ego whether it be trauma at the level I've just talked about or not then in order to protect itself the ego in order to protect itself will how can I put it put it put it fragment and cut itself off to different parts of the consciousness or unconsciousness. So they hide so that that that person that particular time which has been so traumatized is hived off fragmented off and usually only accessible through therapy. Of course that part of that self can be triggered off in particular moments so for example let's say when they're having sex say someone's been sexually abused so it could be triggered off by a sexual moment in real time and that other alter or a nether alter which had been captured in time will present itself as a real person. Right so it would be to the to the lay person who wouldn't be trained this or it would it would look like and he's very kind of simplistic terms here and not wanting to be rude or judgmental but for someone who wasn't a therapist it would look like someone is playing many different parts. Correct very good that's that's a good way to look at it and let me give you an example of that. I've taken at least two people who've had many different identities and wanted to integrate those into identities into a whole have come to me for treatment for at least 10 or 11 years now I'm thinking of one person particularly who arrived through my waiting room and she had problems particularly in personal life in any sense of continuity or say she didn't remember time and sometimes she'd find herself in dangerous places or difficult scenarios or even different geographical places and she didn't know how she got there well have amnesia and she came to the the institute she knew me particularly in terms of my professional process and in the first session I was talking to a very bright energetic intellectual person in many ways and then she said do you know Bob and I said what she said I have 142 pairs of shoes good grief and I'm guessing from that that because each of those personalities would buy a pair of shoes yes and have made so each altar might have 20 different pairs of shoes and I knew which person she was by the shoes or the clothes that she wore how interesting how interesting well maybe we'll do a longer interview on that because that sounds really fascinating but in terms of this book by Frank Putnam how how does that help a clinician let me tell you yeah Putnam provides an organisational map of how to treat people suffering from multiple-person disorder I mean before that he talks about how to diagnose them as well but if we talk about the treatment he provides a map of how to work with the different parts of the MPD in other words if we look at this in terms of calling these different parts if you like the name we're going to use here's altars so each one of these people are called altars so he provides an organisational map of how to work with every particular altars and he puts them into classifications to the older altars the elder altars the younger altars and he talks about how do we actually meet them and talk to these different fragmented parts of the self yeah because I'm guessing if you have someone with 20 different personalities depending on what they present with potentially you could have 20 different clients couldn't you yeah that's exactly and you know what Putnam says and this is very true you have to go through what we call the host altar to actually talk to the other altars because in the organisational map that Putnam talks about the host altar that's the one in the here and now that is actually present more than any other altar okay knows about many of the other altars the younger ones the even the older ones or the ones cut off and frozen in time but they don't know so much about other altars so the host altar who knows most of the other altars is like a mediator for me to be able to talk to these different parts of the self it strikes me Bob and I may be naive in this response but it strikes me of an old kind of technique a lot support workers use working with people with schizophrenia to try and get the voices that people have to talk to each other yeah to be externalised yeah to be externalised so this book gives a map it's a clinician's book I'm presuming it's not a book that someone could just buy and then toddle off and treat people with multiple personalities or dissociative identities it's not one of those things one could read and say oh I could do this then oh no no no no you need to be pretty experienced I mean when I started working with my first multiple if you like I've been practicing for many many years and in some ways it was quite scary and scary in two or three ways one was the huge level of trauma all these the people present with and secondly as I started to talk to different altars I got quite scared at the amount of time they would spend in these altars and actually for one time would we ever get back to present day so no this is a book for a professional clinician and actually takes a lot of courage to be able to work with the types of people with severe dissociation in amnesia it sounds like a fascinating book a clinician's book for someone who's really specialised one last question Bob through the years this book was in 1986 is that right it first came out yeah is there any more revisions to it as any kind of opinion changed in the last 20 plus years yeah now we've got remember we've got a new diagnostic term for this particular term called dissociative identity disorder now dissociative identity disorder has a one-level daydreaming which we all do yeah and the other end fragmentation of the personality to a severe sense losing of identity at a fragmented process which is multiple personality disorder so you get many books that talks about the continuum and also get books that talks about how to work at the excessive continuum which I'm talking about here and how to talk work with the neurotic level so you have many specialisms but if we're just talking about the mpd side or the severe did side they will talk about how to deal with dissociation and amnesia the same way as put them taught how interesting how interesting so the the idea and the approach seem to remain intact it's just that the the classification and the language around the presentations altered through the years yeah yeah because you still need to talk to each fragmented part of the self and the cure is the same and that's full blown integration yes now of course very rarely do you get full blown uh you know full blown integration really the best you're going to get is helping them manage their lives more functionally yes yeah it sounds like a fascinating book it sounds like a fascinating topic bob and one that you might you know if you're up for all we could revisit it perhaps in the video all of its own yeah um but the book is called diagnosis and treatment of multiple personality disorders it's by frank putnam will put a picture of it up at the end and if you go to the the information bar below the video I'll put a link to the book or the latest incantation of it people can inspect it as always we always say this at the video bob isn't being paid this isn't a paid placement uh for bobs uh for for bob this is just bob sharing his passionate book so thank you so much bob cook thank you