Chapter 1. Dissociative Disorder in the Modern Era (7)

Let us look at a fact. If we compare the diagnostic criteria of DID and BPD, there are many items in common. According to Marmer (Marmer, et al. 1994), items such as identity disorder, unstable emotional control, self-destructive behaviors, impulse control problems, interpersonal disorders are included both criteria. So long as they have so many common features, likelihood of their co-existence within an individual should be very high. In the United States, comorbidity of DID and BPD has been well documented. According to one study, 35~71 % of DID patients meet the criteria for BPD (Gleaves, 1996).
However, some of the characteristics of DID and BPD are very different from each other, typically the way the mechanism of dissociation is used. It is frequent and abundant in DID patients whereas in BPD, it is seen only partially as a defense mechanism or some aspects of their symptoms. Marmer states that whereas BPD uses “low-tech” dissociation whereas DID patients use quite exquisite mechanism of dissociation.
In my view, there is another factor which is playing a significant role in the misdiagnosis of DID with BPD. It is the possibility that clinicians who are dismayed and confused by the kaleidoscopic manifestations of the dissociative symptoms tend to attribute their symptoms to the patients’ manipulativeness, characteristic of BPD.