Incipient multiple personality in children. Four cases.

Despite extensive study of child abuse and increasing interest in multiple personality, there has been no way of identifying abused children who are potential multiples, and only rarely has multiple personality been diagnosed before adulthood. This article describes four cases where dual identity was claimed by the child and/or trance states were evident in response to questions or stimuli related to traumatic events. In addition, the three children who were treated according to a program developed to integrate multiple personalities in adults showed unification of consciousness and immediate disappearance of or reduction in symptoms, together with other positive personality changes. Improvements were maintained on follow-up. From behaviors noted in these children, together with symptoms found in published biographical and autobiographical accounts of the childhood of persons with multiple personality, a list of 20 behavioral signs was derived which should be of assistance in helping teachers and other professionals who have frequent contact with children to identify potential multiples. Six subjective items were also given to be used in interviewing suspected cases. Incidence of incipient multiple personality and approaches to differential diagnosis are discussed. Three levels of family pathology are described and treatment approaches are suggested for each category, together with cautions about the need for careful clinical judgment. Finally, a systematic play therapy approach to enable personality integration is detailed.