Assessment:

Paula has been diagnosed by her therapist, Dr. Harpin, as having a Dissociative Identity
Disorder (formerly referred to as Multiple Personality Disorder) and indeed had five alter egos.
Prior to that, the initial diagnosis on her was borderline personality disorder given her mood
swings, alcohol abuse and tumultuous relationships. The event leading to this discovery had
been prompted by her professor’s concern on her when she wrote a paper saying she had been
sexually abused by her father.
At 38, Paula had been taking night classes then at a local university while also working
as a secretary. During this time, she has already been divorced with her husband Roger who
fathered her two children. Theirs was an unhealthy relationship from the very beginning. He was
married at the time she got her pregnant. He divorced his first wife and married her when he
came home from his duty with the Air Force, two years after the birth of their first child.
However, since Roger went overseas again, Paula continued a sexual relationship with
a married man from her past named Cal. They previously met and engaged in an affair when he
was 31 years old and she was sixteen.
Paula has been physically abused by her mother and sexually abused by her father as a
child towards her adult life. Her parents were strict when it came to disciplining her. On one
hand, her mother would dip her hands in boiling water on a regular basis. Her father, on the
other, started molesting her when she was five years old by fondling her genitals when no one is
around. This continued until she turned eleven, and when he caught her kissing a boy, her
father forced her to have an intercourse with him. The worst came by the time she was fifteen
as her father raped her in front of a neighbor who also took his turn with her afterward.
With Paula’s traumatic past which lacked the necessary intervention early on, it is easy
to acknowledge the development of dysfunction within her. Her experiences with such violence
as a child left a great impact in the shaping of her personality later in life. Like most victims of
great abuse for a long time, she may still be suffering from its aftereffects which eventually
progressed into a case of Dissociative Identity Disorder.
Sigmund Freud’s Psychoanalytic Theory had four key concepts when it came to
analyzing the nature of human beings: the structure of personality, the layers of personality,
defense mechanisms and stages of development. As a subject of that kind of brutality, Paula
developed and relied on defense mechanisms such as repression, suppression, projection,
dissociation and the likes, in order for her to cope with her situation.
 Defense mechanisms, in Freudian psychoanalytic theory, “are psychological strategies
brought by the unconscious to manipulate, deny or even distort one’s reality to avoid anxiety
and other unacceptable impulses as well as to maintain one’s sense of self”. Even healthy,
normal persons use defense mechanisms throughout their lifetime. It only becomes pathological
and unhealthy when it causes maladaptive and damaging behaviors to form as well as cause
negative effects to arise on the physical and mental aspect of an individual.
Dissociative Identity Disorder is “a mental disorder characterized by at least two distinct
and relatively enduring identities or dissociated personality states that alternately control a
person’s behavior, and is accompanied by memory impairment for important information not
explained by ordinary forgetfulness”. Dissociative disorders such as DID have been attributed to
disruptions in memory caused by trauma and other forms of stress. It is said that DID is an
individual’s reaction to an occurrence of severe trauma that is too much to handle, detaching
him/her from reality. It is categorized along with PTSD. Dissociation as a defense mechanism is
one’s separation from reality.
With Paula, being exposed to that form of violence from an early age by her very own
parents who should have been her main protectors in the first place was a reality she could not
accept. The incidents in which her mother repeatedly submerged her hands into the boiling
water and her father’s continued sexual assault on her had been too much for her to process
especially at her young age back then. In the veracity of her dreadful situation, she had
unconsciously triggered the dissociation of some parts of herself in order to cope and carry on
with her life.
Aside from her “conscious” self, Paula had four other personalities or self states: Sherry
who seems to be the most dominant among the others, a strong woman who enabled her to
endure the sufferings she had on the hands of her tormentors; Janet who is an angry teenager
that manifested her deep urge to rebel from her parents, also causing her to rely to alcohol and
begin an extramarital affair with Cal; Caroline who appears to be a very depressed 5-year-old,
the child within her that absorbed all the agony that she had; and Heather who is the suicidal
one, the needy part of her who wanted Cal’s love to possibly address her longing to be wanted,
loved and cared for. All in all, they serve as her defense against the harms in her environment.
Another theory from Carl Rogers which emphasizes human potential could also explain
her condition. Though Rogers agreed with Abraham Maslow for the most part, he further added
that in order to "grow", people need an environment that will provide them with genuineness
(openness and self-disclosure), acceptance (being seen with unconditional positive regard), and
empathy (being listened to and understood). Without these, relationships and healthy
personalities will not develop as they should. Every person’s basic motive in life is self-
actualization and this only happens when he/she achieves his/her goals, wishes and desires in
life. In self-actualization, a person’s “ideal self” should be able to match his/her actual behavior
or self-image and the main determinant of whether an individual will become self-actualized is
his/her childhood experience.
Paula’s life as a child which is a very crucial phase in determining what a person will
become as he/she grows up proved to be very dangerous. Hence, the dysfunctional being she
had become. This also led her to have a problematic life as can be seen with the state of her
self-esteem, relationships and role performance. Though there had been a potential in her as
seen by her professor, she could not bring herself to truly develop and realize it. She is unable
to reach for further development as she was stuck in her own conflicts and lacked the needed
motivation. One of the major factors in her failure to self-actualize was the troubled childhood
that she had. It also hindered her ideal self from becoming congruent to her own self-image.
Self-actualizing people are self-aware, concerned with personal growth, less concerned with the
opinions of others, and interested in fulfilling their potentialities.