A Controversial Diagnosis for Herschel Walker

"I have treated individuals with DID who are psychiatrists, lawyers, corporate executives, politicians and TV news reporters, among others," Loewenstein said. "Because the disorder is subtle, hidden and symptoms are covert, unlike the typical media depiction, co-workers, friends, even family, may be unaware of the person's disorder. When the diagnosis is made, family members typically say, 'now everything makes sense' about what has seemed like a confusing, often contradictory person."

"DID is one of the most controversial and difficult psychiatric conditions to treat," Dr. Ira Brenner, clinical professor of psychiatry at Jefferson Medical College in Philadelphia and author of two books on the subject of dissociation. "The issue of 'false memories' and the possible alibi for those accused of crimes who use a DID diagnosis as a defense in court add to the controversy over the condition."

Dr. Bessel van der Kolk, founder and medical director of the Trauma Center at the Justice Resource Institute in Boston and author of "Psychological Trauma," said the "condition has been very well documented since the 1880s, and we now also have very good neuroimaging pictures that demonstrate how different self-states are reflected in activation in different parts of the brain."

Walker's Impact

Mental health experts also had different views about the impact of Walker's revelation.

"Walker's coming forward is a mixed situation," Loewenstein said. "Public and media fascination with high-profile cases tends to turn off clinicians and others who are unfamiliar with the extensive research on diagnosis and treatment of DID."

In addition, he said, it "contributed to the public and professional confusion that surrounds this disorder."

Casada, at the University of Texas Health Science Center, agreed. "I am concerned that with increased exposure more patients will come to believe that they have DID when they do not and that some practitioners will be encouraged to diagnose DID rather than more common and easily treatable illnesses."

Others believe Walker's announcement will have a positive impact. "Mr. Walker's revelation about his diagnosis is courageous. ... It may empower others to come forth with stories," Brenner, at Jefferson Medical College, said.

Rachel Yehuda, a professor of psychiatry at Mount Sinai School of Medicine in New York, said she hopes the announcement about such a successful athlete "can reduce stigma. It also flies in the face of the stereotype that psychiatric illness happens to the physically weak."

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