Alters with different disorders

The possibility of headmates from one system having different disorders, or even disabilities, is a very controversial topic in the plural community. Therefore, I decided to start gathering cases from scientific literature to show that among professionals studying dissociative identity disorder it's not controversial at all. However, it's important to remember that from legal, and oftentimes also from a medical perspective a system is regarded as one person. And one person may have a disorder or not, there's nothing in between. For that reason in the scientific literature you'll always read that symptoms of some disorders are only manifested by or “encapsulated in” one or several “personality states”. I have yet to find a study that is dedicated solely to this topic, but it is often mentioned in ones on pharmacotherapy for DID. Experts recommend to target with medications only symptoms manifested by majority of the system in such situation.^[1] Apart from that there are many reported cases of systems where some alters had disorders that didn't appear in the rest of the system. Searching for them is not that easy, since they often appear in articles dedicated to entirely different topic. If you know some that haven't appeared here, I would be grateful if you could send them to me via e-mail or Discord.

After thinking it through I decided to include studies that collected information by self-report surveys. I doubt they make a strong argument against people who believe that such systems are just lying in this regard, but they may still be valuable to those who just want to learn more about the topic. But I'm not focusing on examples of systems where different alters are experiencing symptoms of the same disorder in different ways, since there doesn't seem to be any controversy around that phenomenon in the community.

Conversion disorders

The most frequently documented in the literature are probably various dissociative neurological symptom disorders (or functional neurologic disorders in DSM-V, formerly known as conversion disorders), which are characterised by a loss of normal motor, sensory or cognitive functions that is not caused by neurological or physical disease, nor another psychiatric disorder.^[2] For example a person having double vision, despite the fact that their eyes and optic nerve are not damaged in any way that could cause it. Cases were described as early as in the XIX century – an alter of Mary Reynolds (one of the first MPD patients in United States) was blind and deaf, and one from a system from French literature appeared to be paralysed.^[3] Bristol describes a system where only one alter was hard of hearing and needed to use a hearing aid (and the problem persisted for the post-final-fusion person, who had problems with getting used to it).^[4] Bhuvaneswar and Spiegel describe a case where only a little didn't have nystagmus and in addition was able to see way better than the legally blind host.^[5]

And my favourite: Strasburger and Waldvogel report a case of a system who completely lost sight after an accident and started gradually regaining it on therapy thirteen years later.^[6] For some time some alters were able to see, while others remained blind. Researchers objectively confirmed these experiences by measuring visually evoked potentials – electrical signals that appear in the brain in response to visual stimuli. These were present in sighted alters, but absent in the blind ones. Authors hypothesise that mechanisms already present in the brain are used here, like mechanisms for suppression of visual signal active when images from both eyes differ or while focusing attention on specific part of the image.

Depression

Loewenstein describes a system where only the host met the diagnostic criteria for major depressive disorder.^[1] Prescribed medication completely relieved her symptoms, but another alter experienced numerous side-effects, although in reality the system didn't take even a single dose. A teenage alter took the pill away every time the host put it up to her mouth. Kluft describes a system where an alter who remembered the trauma and was devastated by it was responsible for most of the depression symptoms that resulted in a diagnosis being assigned to the system.^[7] Josh (the host) experienced it as made feelings that had no apparent connection to any cause. Other alters were also responsible for the panic attacks in triggering situations.

Several tulpas responding to Veissiere's questions states that they don't appear to have depressive symptoms present in the host.^[8] One says that they definitely aren't like the host in terms of mental illness. Although sometimes it's hard, they are happy, they have everything they could want. They feel they motivated the host to start therapy and are more engaged in it than her. Another says that as far as they know, they aren't depressed. Being here is the only thing they can do, and it seems to help. Next one states that they seem to have some autistic traits, but depression doesn't affect them much. Another one responds that they kind of understand it, but don't have this condition. They know that there's no real reason behind host's worse mood, but want to help her however they can.

Eating disorders

Two cases described by Torem were not diagnosed with a complex dissociative disorder, although the author talks about dissociative “ego states” and they are not different from those cases with confirmed DID/OSDD-1.^[9] In the first case a trauma holder, who split off in the age of seven, was responsible for binge eating episodes and self-induced vomiting. It was her way of punishing the host – episodes became more frequent after every successful attempt to gain more independence. She was discovered thanks to the fact that the host always felt dissociated during these episodes. Working on acceptance between them reduced the frequency of binge eating. In the second case the host couldn't remember such details as what food was she binging or how did she learn to self-induce vomiting. It turned out that two different alters were responsible for these mechanisms. They started repeating behaviours from their childhood when system's daughter reached the age they started experiencing abuse at. For the first one it was quickly devouring large quantities of food after they were starved by the mother as a punishment. For the second – inducing vomiting after they were forced to eat rotten food. The patient already received psychotherapy and pharmacological treatment from several specialists, but only working through trauma held by the two other alters successfully eliminated binge eating and vomiting episodes.

Allergies

I don't know if allergies can be regarded as a disorder, but it is a significant physiological difference that is worth discussing here. They are often mentioned in the literature, but only recently I managed to find an article including specific cases. Braun describes three systems in which some alters had an allergy that was not present in others.^[10] In the first one the whole systems apart from one alter was allergic to oranges. When this alter remained fronting for the whole time needed to metabolise the fruit, they didn't have any symptoms, but when they left the front too early, an itching rash often appeared. In another system one alter was “deathly allergic” to cats. In their presence she had runny nose, itching rash and wheezed. But another alter could play with a cat for a long time, including being scratched and licked by a cat, and had no noticeable response. In two other systems there were allergic reactions probably caused by associaton with trauma. In the first one the former host was allergic to smoke, and the second one was getting a rash from contact with a specific type of soap that was used during their abuse (it's not clear here whether the rash appeared only for the alter that held this trauma). Braun also mentions cases of singlets who had different intensity of allergic response in different periods of their life or whose allergy was successfully treated with hypnosis, to show that such changes are also possible outside of the context of dissociative identity disorder. He suggests that possibly this phenomenon occurs at the level of noticeable allergic symptoms, not antibodies response to antigens.

Others

Here I will be adding all cases that I have not gathered enough for a separate section, don't describe specific cases or only have ones that make a weak argument (self-report surveys or ones where a specific disorder can be suspected in a headmate, but wasn't explicitly confirmed by a psychiatrist).

In the system described by Kluft it seems only Josh (the host) had a problem with substance abuse disorder and insomniac sleep disorder.^[7] Both were caused by lack of control over the behaviour of other alters. He was escaping from awareness of this fact using alcohol and other psychoactive substances and he was afraid that falling asleep would cause him to lose control over the body.

Among the tulpas that answered Veissiere's questions there were a few reporting independence of host's condition also for other disorders apart from depression.^[8] One states that host's autism doesn't seem to directly influence them in any way. They think that autism spectrum disorders are a deeper problem than just “wrongly wired brain”. From their perspective it seems to result in another way of thinking. While their host thinks about things in black and white categories, in logical way, they are able to think in terms of empathy and emotions. Other similarly is of opinion that ADD is not hardwired in the brain, but rather a problem with focusing that can be fixed. They regard themself as mindful and self-aware person and they like meditation and other activities that require a lot of concentration, so they help the host with the symptoms. Another one says that they don't share host's obsessive-compulsive disorder. They are usually not anxious and are able to remain calm when she can't. Next one is not affected by the premenstrual dysphoric disorder that the host suffers from. One was sharing host's delusions for years, but they were able to snap out of it. Another two don't have two disorders affecting the host, but they don't state anything about the nature of these disorders.

Şar and Öztürk state that sometimes one alter has psychotic symptoms (delusions and hallucinations) while the host doesn't.^[11] They also mention that in rare cases psychosis may be encapsulated in the host, while other alters don't have the symptoms. In such cases psychosis may persist after the final fusion. They evoke Katan's theory, which over half a century ago concluded that people with schizophrenia have a part of personality that remains in the pre-psychotic state.

Ross states that in criminal cases persecutors may be “sadistic sex murderers”,^[12] which suggests sexual sadism disorder, although he does not give specific examples and it's impossible to conclude whether he meant their sexuality, or only committed acts. Hall describes a case of a system with an alter that she calls antisocial,^[13] but here it's also not clear whether he actually had a personality disorder, or if her choice of words results solely from the murder he committed.

In the case desribed by Blizzard we may have an alter with a pedophilic disorder. Satan's statements on the alter that he was abusing: “That's how I show her I want her. Everybody always pushed her away, so she felt like she wasn't a person, but when her father wanted her for sex, then she felt like she was somebody”, “That's what I have to do to keep her close to me. I don't want her going out. Men only want her for one thing and then they hurt her. She doesn't need anyone else but me”^[14] seem to point to something more than a platonic (shown in a very toxic way) care. But it's impossible to tell for sure. Blizzard, as most psychologists, assumes that inter-system violence is nothing more than a way to relive the trauma, so idea of asking for such matter as the sexual attraction probably never even crossed her mind. And another problem – it's not explicitly stated that Satan was created in their childhood and that Becca (abused alter) has later also stayed in the child age, like the alter who held positive aspects of the relationship with their father. I feel like this was the case, due to the emphasis on recreating the abuse and the fact that persecutors often split during trauma and that trauma holders often remain in the age that the body was when the abuse took place. But it can't be known for certain.

References

1. ↑ ^{a b} Rational Psychopharmacology in the Treatment of Multiple Personality Disorder, dr Richard J. Loewenstein, The Psychiatric Clinics of North America, 1991
2. ↑ Dissociative neurological symptom disorder | International Classification of Disease, World Health Organisation, 2018
3. ↑ Psychophysiologic Aspects of Multiple Personality Disorder, Philip M. Coons, Dissociation, 1988
4. ↑ Single personality disorder: The experience of dissociative identity disorder clients following personality unification, M. F. Bristol, master's thesis, 1997, as cited in The ambiguous loss of post-integration : a theoretical analysis of the effects of integration on clients with dissociative identity disorder, Elise A. Manning, master's thesis, 2013
5. ↑ An Eye for an I: A 35-Year-Old Woman With Fluctuating Oculomotor Deficits and Dissociative Identity Disorder, Chaya Bhuvaneswar and David Spiegel, International Journal of Clinical and Experimental Hypnosis, 2013
6. ↑ Sight and blindness in the same person: Gating in the visual system, Hans Strasburger and Bruno Waldvogel, PsyCh Journal, 2015
7. ↑ ^{a b} Clinical Presentations of Multiple Personality Disorder, dr Richard P. Kluft, Psychiatric Clinics of North America, str. 619, 1991
8. ↑ ^{a b} Varieties of Tulpa Experiences: The Hypnotic Nature of Human Sociality, Personhood, and Interphenomenality, Samuel Veissiere, appendix 2, in: Hypnosis and meditation: Towards an integrative science of conscious planes, Amir Raz i Michael Lifshitz, 2016
9. ↑ Dissociative States Presenting as an Eating Disorder, dr Moshe S. Torem, American Journal of Clinical Hypnosis, 2011
10. ↑ Psychophysiologic Phenomena in Multiple Personality and Hypnosis, dr Bennett G. Braun, American Journal of Clinical Hypnosis, 1983
11. ↑ Psychotic Presentations of Dissociative Identity Disorder, dr Vedat Şar and prof. Erdinç Öztürk, in: Psychosis, Trauma and Dissociation: Emerging Perspectives on Severe Psychopathology, p. 170, 2008
12. ↑ Multiple Personality Disorder: Diagnosis, Clinical Features and Treatment, dr Colin A. Ross, 1989, p. 259-260, as cited in Therapeutic alliance with abuser alters in DID: The paradox of attachment to the abuser, dr Ruth Blizzard, Dissociation: Progress in the Dissociative Disorders, 1997
13. ↑ Multiple personality disorder and homicide: Professional and legal issues, P. E. Hall, Dissociation: Progress in the Dissociative Disorders, 1989, p. 87, as cited in: Therapeutic alliance with abuser alters in DID: The paradox of attachment to the abuser, dr Ruth Blizzard, Dissociation: Progress in the Dissociative Disorders, 1997
14. ↑ Therapeutic alliance with abuser alters in DID: The paradox of attachment to the abuser, dr Ruth Blizzard, Dissociation: Progress in the Dissociative Disorders, 1997

Created: 01.11.2025
Translated: 16.11.2025