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In 1955, a woman named Shirley Mason visited the psychotherapist she'd been seeing for a few months.
1955年，一位名叫雪莉·梅森的女士拜訪了她幾個月來一直在看的心理治療師。
When the therapist asked her how she was doing,
當治療師問她近況如何時，
she said, "I'm fine but Shirley isn't.
她說：“我很好，但雪莉不好。
She was so sick, she couldn't come, so I came instead...I'm Peggy!"
她生病了，來不了，所以我替她來了，我是佩吉！”
Through continued therapy,
在接下來的治療中，
the therapist discovered what seemed like 16 personalities living inside Shirley's mind.
治療師發現雪莉的精神里似乎住著16個人格。
She later wrote a now-famous book about Shirley, titled "Sybil",
她后來寫了一本關于雪莉的著名書籍，名叫《西比爾》，
using a different name to protect her patient's privacy.
用了不同的名字來保護病人隱私。
And that book put a rare syndrome, then called multiple personality disorder, on the map.
這本書出名的地方在于寫了一種罕見的綜合癥狀，叫做多重人格障礙。
Before Sybil, fewer than 100 cases had ever been reported,
在《西比爾》之前，被報告的此類病例不到100例，
but after the book came out, diagnoses exploded into the thousands.
但這本書出版后，成千上萬的人被診斷出患了此癥。
In a surprising twist, Shirley's specific case might not have been real,
令人驚訝的轉折是，雪莉的具體情況可能并不真實，
and she eventually wrote her therapist claiming she'd made it all up.
她最后給治療師寫信說這一切都是她編的。
But researchers are still looking into the disorder as a whole.
但研究人員仍在研究這種障礙的整體狀況。
Today, we call Shirley's diagnosis dissociative identity disorder, or DID.
如今，我們稱雪莉的診斷為分離性身份識別障礙（DID）。
It often occurs alongside other psychiatric disorders, making diagnosis very difficult.
它經常與其他精神疾病一起病發，讓診斷變得非常困難。
And it's still very controversial among psychologists and psychiatrists.
它在心理學家和精神病學家中間仍存在爭議。
But what's not controversial is that the way Hollywood portrays it is way off.
但沒有爭議的是，好萊塢的表演方式已經過時了。
To be diagnosed with DID, a patient needs to have two or more so-called "identities", or personality states.
要被確診患有DID，病人需要有兩個或多個所謂的“身份”，即人格狀態。
This doesn't necessarily mean a whole other person is living inside their mind.
這并不一定意味著他們的精神中住著另一個完整的人。
In many cases, it's more like their overall personality is fragmented,
在很多病例中，DID更像是病人的整個人格支離破碎，
and different parts of their history and self-image can take control.
他們過去和自我意象的不同分裂人格掌握控制權。
For example, only one personality state might be able to speak a language learned during a semester abroad in college,
比如，一種人格狀態在國外大學的一個學期學會了說一門外語，
while another doesn't remember that experience.
而另一種人格狀態卻不記得那段經歷。
Or if they'd previously been a very religious person,
或者如果他們以前是虔誠的教徒，
they might have one fragment of them that's devout, and another that isn't.
那么他們可能有一個分裂人格是虔誠的，另一分裂人格不虔誠。
Sometimes these fragments present themselves as multiple people with different ages or genders, but not always.
有時這些分裂人格會以多人的身份出現，且他們年齡性別均不同，但并非總如此。
And while these fragments can be complicated,
這些分裂人格可能很復雜，
with their own wants and aspirations, they aren't there to fulfill, like, evil or criminal desires.
但它們有了自己的愿望和渴望之后就不會滿足，比如邪惡或犯罪欲望。
So the idea that people with DID are ruled by the worst parts of themselves,
所以患有DID的人被最糟糕的分裂人格控制這一想法，
like in Fight Club or Split, is entirely fictional.
會像《搏擊俱樂部》或《分裂》一樣完全虛構。
The other major symptom is memory loss or amnesia.
另一個主要癥狀是失憶或健忘。
This could be missing personal information about themselves,
這種癥狀可能是忘記了他們自己的個人信息，
or missing memories from times when another personality fragment was in control.
或丟失了另一個人格分裂控制時的記憶。
Also, it doesn't count if the personality shift or memory loss are chemically-induced.
此外，如果人格轉移或記憶喪失是由化學因素引起的，不算數。
If everyone tells you that you turn into someone else when you're drunk,
如果人們說你喝醉了就變成了另一個人，
but you can't remember what you said or did …
但你不記得自己說過或做過什么...
you do not have dissociative identity disorder.
那么你沒有患分離性身份識別障礙。
And parents, imaginary friends? Totally cool.
那么父母、幻想朋友呢？它們太有趣了。
They're really common, like, 2/3 of kids have them,
這種現象很普遍，2/3的孩子都有，
and this is not a symptom of your child harboring another secret personality.
但這不是孩子隱藏另一個秘密人格的癥狀。
But if a patient has multiple identities, their memory is shaky,
但是如果病人有多重身份、記憶不穩定，
and they're distressed or impaired by these symptoms,
并且這些癥狀會讓他們感到痛苦或受損，
then a psychiatrist might diagnose them with DID. Many, though, wouldn't.
那么精神科醫生可能會確診他們患有DID。不過，這種人不會很多。
It's not that their condition isn't real, there's no denying that patients have these symptoms.
這并不是說病人的情況不真實，也不能否認病人有這些癥狀。
But experts disagree on where the symptoms come from,
但是專家們不同意這些癥狀的來源，
whether DID is a stand-alone disorder, or whether it's better explained by other, well-established disorders.
不管DID是獨立癥狀，還是與其他癥狀并發，它都是得到確認的障礙。
Surveys of psychiatrists found that most agree it's a valid diagnosis,
精神科醫生調查發現，大多數人同意它是有效診斷，
but many think it's commonly misdiagnosed.
但仍很多人認為它是誤診。
That's partly because DID is so rare, most studies on it have very small samples.
部分原因是它非常罕見，大多數研究樣本都非常小。
But it's also because it's very unlikely that patients get just a DID diagnosis.
但還有部分原因是病人不太可能得到DID的單獨確診。
It's usually tacked on to other diagnoses,
它通常被附加到其他診斷上，
and this is one reason why many psychologists think
這也是許多心理學家認為
that it's better understood as an extreme version of other disorders.
它作為其他疾病的極端版本更容易被理解的原因。
For example, DID can look a lot like a dissociative fugue state.
例如，DID很像分離性神游狀態。
This is a kind of temporary memory loss where people behave impulsively,
后者是一種暫時性記憶缺失，表現為行為沖動，
leave their homes and wander around, and do things that they would never otherwise do.
離家四處游蕩，做那些他們永遠不會做的事情。
So it might seem like a shift in personality.
所以它看起來像是人格轉變。
These people also often lose their memories of who they are,
這些人也經常失憶，忘記自己是誰，
so they sometimes invent a new identity to fill in the gap.
所以他們有時會發明一種新身份來填補空缺。
And although a lot of these fugue cases are a bit of a mystery,
雖然很多神游癥的案例有點兒神秘，
some are explained by substance use or neurological conditions.
但有些可以通過藥物濫用或精神問題來解釋。
DID also overlaps a lot with post-traumatic stress disorder, or PTSD.
DID也與創傷后應激障礙(PTSD)有很多重合之處。
That's especially interesting, because the psychologists who most strongly believe DID is a distinct disorder
這一點尤為有趣，因為堅信DID是一種獨特障礙的心理學家
think it stems from childhood trauma or abuse, which could also cause PTSD.
認為它來源于童年創傷或虐待，這些也會導致創傷后應激障礙。
And DID similarly shares symptoms with borderline personality disorder,
DID也與邊緣性人格障礙有很多相似癥狀，
which is characterized by impulsive behavior, as well as unstable relationships and identity.
后者的特點是行為沖動、關系和身份不穩定。
One study of 33 patients in the 1980s found that
在20世紀80年代對33名患者進行的一項研究發現，
70% of patients with DID could have just as easily been diagnosed with borderline personality disorder instead.
70%患有DID的患者可以很容易被確診為邊緣性人格障礙。
But, the researchers concluded that because 30% of the cases were distinct,
但是，研究人員總結稱，因為30%的病例不同，
DID should be considered a stand-alone disorder.
DID應該被認為是一種獨立障礙。
DID is also controversial because many of the new diagnoses seem to be coming from just a few psychiatrists,
DID頗有爭議，這是因為很多新診斷似乎只來自于一些精神病醫生，
and some suggest these doctors may be overzealous because they're eager to find new cases.
一些人認為這些醫生可能過于熱心，因為他們急于找到新病例。
But the doctors themselves counter that by saying that
但是這些醫生們反駁說，
they're just better at seeing the signs and identifying the disorder.
他們只是更善于發現癥狀和識別疾病。
Regardless, the good news is that treatment for DID with tailored therapy,
不管怎樣，好消息是DID治療是量身定制的治療，
at least for the symptoms related to identity fragmentation is pretty effective.
至少對那些與人格分裂相關的癥狀相當有效。
Which is great, because although there's a lot of controversy surrounding the disorder,
這種現象很好，因為盡管DID有很多爭議，
psychiatrists all agree that real people are suffering and need help.
但精神科醫生都認為，真正受苦的人需要幫助。
And like anyone else, they should be shown compassion, and not made into movie monsters.
他們和其他人一樣，應該被給予同情，而不是被塑造成電影怪物。
Thanks for watching this episode of SciShow Psych.
感謝您收看本期的心理科學秀。
If you want to learn more about the psychology of trauma,
如果你想了解更多心理創傷的內容，
you might be interested in our episode on how trauma can be inherited.
可能會對創傷如何遺傳的那期節目感興趣。
