Dissociation and multiple-personality disorder in incarcerated women: Observations from the Washington, D.C. detention center. Jail 1987–1989

Between 1983 and 1989, the number of women in U.S. jails more than doubled and continues to increase. Most women behind bars have been victims of violence including childhood sexual abuse. This may lead to psychiatric dissociative disorders such as Complex Post-Traumatic Stress Disorder and Dissociative Identity Disorder (Multiple Personality Disorder.). It is difficult for clinicians to study these women. This article describes several severe dissociative disorders in the women in the Washington, D.C. Detention Center (“D.C. jail”) from September 1987 to September 1989. The author was able to live with them for more than 2 years. The author, a surgeon, kept a diary and frequently intervened in the episodes described here. Conditions in the co-ed jail were hostile and dangerous to the women inmates. The women's observed dissociative behaviors included Dissociative Identity Disorder (“DID”), prolonged screaming, and prolonged sexual self-abuse. Dissociative episodes could trigger ones in other women inmates or even in female jail “Officers.” The author suggests (i) that dissociation is likely to be common and severe among incarcerated women (ii) that at least one of its antecedents here is severe childhood sexual abuse and that (iii) judicial and correctional biases exacerbate these symptoms.