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The Sixth Sense is a movie about a nine-year-old boy, Cole, who sees ghosts. They are scary ghosts, ghosts who frighten him, get him into trouble, and make him feel like a freak. But the truth is, there are no ghosts. The only ghosts that exist are the ones inside our minds. For most of us, these ghosts, the ones inside us, can be understood as the internalized self and object representations we have taken in, projected, and reinternalized over the course of our lives. We are haunted by many of these specters. They criticize us, taunt us, humiliate us. They also frighten us by the intensity of their impulses, which threaten to erupt at any moment. Fortunately, many of us have more benign ghosts as well, those that soothe, comfort, or provide an encouraging word. For others, however, because of a confluence of external trauma and internal capacities, these ghosts become dissociated self states, each with their own structure, autonomy, and investment in separateness. Cole can be understood in this light, not as a child who possesses the extraordinary albeit frightening capability of seeing and talking to ghosts, but rather as a severely traumatized child who has responded to his trauma by dissociating into relatively stable, enduring parts. Each of the ghosts in the movie, including the psychologist, Dr. Malcolm Crowe, represent different personality states or alters of the child identified as Cole. Cole is not a freak. He is a child with dissociative identity disorder.
DESCRIPTION AND ETIOLOGY
Dissociative identity disorder (DID), formerly known as multiple personality disorder, can be defined in various ways. The descriptive Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV; American Psychiatric Association 1994) approach indicates the essential feature of DID as the presence of two or more distinct identities or personality states that alternately take control of the person's behavior, along with the presence of amnesia. Hilgard (1986) defines dissociation as "a special form of consciousness such that events that would ordinarily be connected are divided from one another" (p. 80). Using an information processing model, West (Putnam, 1997) defines dissociation as "a psychophysiological process whereby information-incoming, stored or outgoing-is actively deflected from integration with its usual or expected associations" (p. 7). Davies and Frawley...