Dissociative Identity Disorder in ‘Fight Club’ Movie

Released in 1999, ‘Fight Club’ is still to this day considered one of the most classic movies among cinema lovers. It depicts the story of a nameless office worker suffering from depression and insomnia. In an effort to improve his emotional state, he attends support group meetings for cancer survivors, where he meets a woman called Marla. His life takes a complete another turn after he encounters Tyler Durden, who is everything that the narrator is not. Together, they create a fight club, where men who yearn to free themselves from the fetters of modern life meet and fight with each other. However, things quickly start to get out of control. When the narrator is exposed to the hidden agenda of Tyler's fight club, he also founds out that they are actually one person. While at first glance, ‘Fight Club’ may just appear as an action movie, it actually includes a portrayal of Dissociative Identity Disorder (DID). This essay aims at describing and analyzing the symptoms of the illness in the movie as well as its diagnosis, treatments, and the brain parts affected by it.

Even though it is quite famous and has been used in plots for many years, Dissociative Personality Disorder is still widely misunderstood and romanticized. Indeed, it is characterized by the presence of two or more distinct identities that recurrently take control of the individual’s behavior. It also comes with the inability to recall important personal information (American Psychiatric Association, 2000, p.519). There are several factors that can affect the development of DID, but severe child abuse or childhood trauma are the most common ones. Often, the patient, to suppress the traumatic memories, creates another personality that did not suffer from abuse. In ‘Fight Club’, Tyler takes over every time the narrator is sleeping and achieves everything that the latter is unable to. He comes to realize that he and Tyler are the same person and manages to “kill” his alter-ego at the end. There are five major symptoms supporting the fact that the character has DID. Not only is he subject to anxiety and insomnia, but he is also unable to recall certain events, has some memory lapses throughout the movie, and lastly, repeatedly suffers from auditory hallucinations. The narrator attempts to treat his depression through consumerism while seeking fulfillment through sadomasochistic acts at the same time, but both fail to cure him until the end.

Overall, even though some aspects of the movie correspond to DID, the overall portrayal of the disease is rather unrealistic. One accurate depiction of DID is the fact that the character uses alternate identities as a coping mechanism and creates the persona of Tyler, who is more dominant and gives a purpose to the narrator’s life. Moreover, on several occasions, the narrator relays information but is unaware of how he acquired the knowledge. After explaining how a projection booth operates, he acknowledges: “I know this because Tyler knows this” (Palahniuk 26). According to Jennifer Radden’s look at DID in Divided Minds and Successive Selves, “Oneself may report hearing, or having heard, the voice(s) of (an)other self(ves) or may report talking with another”. Nevertheless, the use of violence to portray the disorder is quite unrealistic. In addition, DID requires the individual to have two separate personalities that take control, but the protagonist suffers only from one in the movie. Finally, no childhood trauma is mentioned; his anxiety and feelings of entrapment cause him to dissociate. In this sense, the movie makes a statement about the intensity of the psychological damage that is caused by such a materialistic culture. DID is used as a metaphor: everybody has this repressed anger against the structure of modern consumerist society, even though few will go as far as to construct a separate identity to fight it. The narrator believes that in a world where everyone is special, no one is. When Tyler comes around, he genuinely sees him as special and detaches from the normal world. This is part of his dissociation as well and is not accurate according to the actual disorder description.

Dissociative Identity Disorder has proven itself to be very hard to diagnose and treat, as many characteristics of it are commonly misunderstood either as an attention deficit disorder, anxiety, panic disorder, or simply depression. However, Dr. Gary Peterson managed to classify the different symptoms in order to help make an accurate diagnosis. First, inconsistency of the patient’s conscious mind could be the reflecting symptoms of fluctuating attentiveness, such as a trance state or blackouts. Second, the forgetfulness of the patient’s autobiography paired with the inconsistencies in accessing the information could be an indication of a disruption in the processing of memory during early childhood development. Third, self-regulation difficulties may be reflected in the form of mood swings and behavior fluctuations. Fourth, a disorganization of the development of a consistent self may be reflected in the belief in the alternate self or imaginary acquaintances. And fifth, the subjective experience of dissociation from the physical body, as well as the perception, may indicate derealization and depersonalization in the patient’s psyche. These assessments demonstrate detachment of primary personality and a subsequent rise in sub-personality.

There are several treatments that have been revealed to be effective to improve the patient’s condition. One of them is the Draw-A-Person (DAP) test. It allows the therapist to see the extent to which DID affects the structural perception of a human figure through drawings. It helps him identify the different identities, which is important to assess and treat the disorder. The most widespread treatment still remains psychotherapy, and more specifically the Dissociative Disorders Psychotherapy Program, based on a four-part model. The first step consists in making the patient aware of the behaviors and cognitions of the personality, which may cause frustration (Peterson, 2003, p.7). The next step is the confrontation and conflict between the identities, as switching personalities is often used as a defense mechanism. Then, the patient must learn to talk about his traumatic experiences as a form of therapy. It will teach them how to deal with these events and therefore avoid the dissociative process. Lastly, it is primordial to encourage autonomy through self-monitoring. The patient’s acquaintances must also play a role as they should be aware of the different personalities and know how to intervene in case of an emergency.

Despite several studies and findings about the neural system of the disorder, there is no certainty that all patients present these characteristics and its neurobiology is essentially unknown. Nonetheless, early stress has been found to be linked to structural changes in the hippocampus in both animal and human studies. The hippocampus plays an important role in memory, learning, and stress control. It has been reported that the hippocampal volume was smaller in several stress-related psychiatric disorders. The authors looked at the hippocampus and amygdala in patients with Dissociative Identity Disorder. Through magnetic resonance imaging, the authors measured the volume of the hippocampus and amygdala in 15 female patients with Dissociative Identity Disorder and 23 female patients without Dissociative Identity Disorder or other mental disorders. Volume measurements were compared for the two groups. As a result of this study, Hippocampal volume appeared to be 19.2 percent smaller and amygdala volume was 31.6 percent smaller compared to healthy subjects. The ratio of hippocampal volume to amygdala differed significantly from group to group. In another study, functional MRI was used to examine brain activation in PTSD patients in a dissociative state while re-experiencing traumatic memories; greater activation was found in the temporal, inferior, and medial frontal regions and in occipital, parietal, anterior cingulate, and medial prefrontal cortical regions.

The hippocampus is the targeted organ of glucocorticoids and is secreted during stressful experiences. A hypothesis has been raised that prolonged exposure to glucocorticoids could lead to a contraction of the hippocampus' progress. The smaller the hippocampus volume in DID, the more likely it may be associated with stress exposure, and the neurobiological finding that DID is shared with stress-related mental disorders such as Post-Traumatic Stress Disorder (PTSD). It often comes with Dissociative amnesia, characterized by the inability to remember important personal information that is too broad to be explained by forgetfulness.

The movie ‘Fight Club’ depicts more or less realistically the symptoms and development of Dissociative Personality Disorder. Indeed, the narrator uses the character of Tyler to cope with the harsh consumerist society he is living in. However, there are many controverted aspects in the movie as it does not give an accurate portrayal of the disease. Because it is often confused with other personality disorders, its diagnosis is hard to determine and even harder to cure, but psychotherapy seems to be effective in some cases. These difficulties in treating this illness also come from the fact that there is no clear evidence of its neurobiology, even though some possible relations have been established between DID and the size of the amygdala and hippocampus.

References

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