Iatrogenic Dissociative Identity Disorder—An Evaluation of the Scientific Evidence

Abstract

In recent years there has been a remarkable increase in malpractice suits in which a retractor-plaintiff alleges that a defendant therapist has suggestively implanted a false dissociative identity disorder (DID) diagnosis. A critical examination of the arguments used by plaintiff expert witnesses demonstrates that the scientific evidence is insufficient, consisting largely of anecdotal case reports, non-data-based pro-false-memory opinion papers, and several methodologically questionable laboratory studies. These sparse data fail to meet a minimal standard of scientific evidence justifying the claim that a major psychiatric diagnosis like dissociative identity disorder per se can be produced through suggestive influences in therapy. However, some scientific evidence exists to show that behavioral reinforcement can affect the frequency and type of alter behavior manifesting in patients who already have DID. Plaintiff expert witnesses have confused alter creation with alter shaping. Based on the available scientific evidence, it is doubtful whether such plaintiff complaints could meet a Frye-Daubert standard in a test of admissibility of such testimony. Furthermore, current malpractice claims based in iatrogenic DID fail to consider other plausible alternative explanations for plaintiff's retraction beliefs, such as the manufacture of retraction beliefs through systematic exposure to post-treatment pro-false-memory suggestive influences and/or deceptive, factitious behavior on the part of plaintiff.