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Richard P. Kluft QUOTES

1 " The implication that the change in nomenclature from “Multiple Personality Disorder” to “Dissociative Identity Disorder” means the condition has been repudiated and “dropped” from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association is false and misleading. Many if not most diagnostic entities have been renamed or have had their names modified as psychiatry changes in its conceptualizations and classifications of mental illnesses. When the DSM decided to go with “Dissociative Identity Disorder” it put “(formerly multiple personality disorder)” right after the new name to signify that it was the same condition. It’s right there on page 526 of DSM-IV-R. There have been four different names for this condition in the DSMs over the course of my career. I was part of the group that developed and wrote successive descriptions and diagnostic criteria for this condition for DSM-III-R, DSM–IV, and DSM-IV-TR.
While some patients have been hurt by the impact of material that proves to be inaccurate, there is no evidence that scientifically demonstrates the prevalence of such events. Most material alleged to be false has been disputed by someone, but has not been proven false.
Finally, however intriguing the idea of encouraging forgetting troubling material may seem, there is no evidence that it is either effective or safe as a general approach to treatment. There is considerable belief that when such material is put out of mind, it creates symptoms indirectly, from “behind the scenes.” Ironically, such efforts purport to cure some dissociative phenomena by encouraging others, such as Dissociative Amnesia. "

Richard P. Kluft

5 " Several recent studies (Bliss, 1980; Boon & Draijer, 1993a; Coons & Milstein, 1986; Coons, Bowman, & Milstein, 1988; Putnam et al., 1986; Ross et al., 1989b) are largely consistent in terms of the general trends that they demonstrate. At the time of diagnosis (prior to exploration) approximately two to four personalities are in evidence. In the course of treatment an average of 13 to 15 are encountered, but this figure is deceptive. The mode in virtually all series is three, and median number of alters is eight to ten.
Complex cases, with 26 or more alters (described in Kluft, 1988), constitute 15-25% of such series and unduly inflate the mean. Series currently being studied in tertiary referral centers appear to be more complex still (Kluft, Fink, Brenner, & Fine, unpublished data). This is subject to a number of interpretations. It is likely that the complexity of the more difficult and demanding cases treated in such settings may be one aspect of what makes them require such specialized care. It is also possible that the staff of such centers is differentially sensitive to the need to probe for previously undiscovered complexity in their efforts to treat patients who have failed to improve elsewhere. However, it is also possible that patients unduly interested in their disorders and who generate factitious complexity enter such series differently, or that some factor in these units or in those who refer to them encourages such complexity or at least the subjective report thereof. "

Richard P. Kluft