Schizophrenia vs.

Dissociative Identity
Disorder
How These Two Illnesses are Confused for Each Other
& Analysis of Which Disorder Norman Bates Demonstrates in the
Film, Psycho
11/01/04

The purpose of this paper is to clarify the similarities and differences between the two
psychological disorders schizophrenia and Dissociative Identity Disorder (also known as
Multiple Personality Disorder). In Alfred Hitchcocks film, Psycho, Norman Bates suffers from
one of these two psychoses. Most viewers would initially think that he has schizophrenia due to
societys misconceptions about this disorder. However, we will argue that it is more accurate to
diagnose Norman with Dissociative Identity Disorder (DID).

I. An Explanation of Schizophrenia and Dissociative Identity Disorder

Several subtypes of schizophrenia exist-each with distinctive characteristics (i.e. Catatonic
schizophrenia describes one who is in a catatonic state). General symptoms of schizophrenia
include delusions, auditory hallucinations (hearing voices), and incoherent, disorganized speech.
The patient may give continuous verbal commentary on their behavior or, they may even appear
to have a conversation with their self. Usually, they are extremely antisocial.
Several factors have been linked to schizophrenia which include neuropathological factors,
environmental factors, genetic predisposition, and even viral infections. Schizophrenia is
treatable with medication if it is taken consistently. The patient is then capable of thinking
clearly and living a relatively normal life.
DID, while seemingly similar to schizophrenia, is a totally different monster altogether.
Sufferers of this condition literally have alternate identities and are capable of switching between
them. The main personality is referred to as the host, while the other(s) are referred to as alters.
The host is usually not the persons original personality. In most cases (over 97%), the patient
has been a victim of repetitive, often torturous, sexual or physical abuse at a very young age.
Alternate personalities are thought to arise in response to this abuse as a means to escape the
brutal reality, but they remain unobservable. Later, something in the physical or social
environment will trigger the personalities to emerge. Therefore, most cases of DID are
diagnosed in adulthood. On average, a person with DID has 15 distinct personalities. In most
cases, there is at least a child personality (the original), an opposite gender personality, a self-
helper personality, and a persecutory personality (one that hurts others or themselves). Separate
identities may or may not be aware of each other. If they are not, the person will demonstrate
bouts of amnesia. When the personalities are aware of each other, termed co-consciousness, they
will carry on conversations with each other and even offer each other advice.
Physical changes in posture and voice are observed when alters emerge in a person with
DID. If the person is male and a female alter emerges, the pitch in his voice will change to the
higher pitch typical of a female. The handwriting may also be different because some patients
demonstrate the use of the non-dominant hand depending on which alter is in control. In the case
of transgender personalities, the person may also dress the part.
The current methods of treatment include hypnosis and therapy. A person with DID is
very easily hypnotized-more so than the average person. Hypnotism is highly criticized because
recollection of childhood trauma often does more harm than good. Therapy aims to increase the
level of co-consciousness to a point where the personalities are integrated and work together
cooperatively. Successful treatment is rare.

II. How Schizophrenia and Dissociative Identity Disorder are (Justifiably) Confused
Since DID is a rare disorder, it is not uncommon for doctors to misdiagnose their patients
with more prevalent disorders such as schizophrenia. Some symptoms associated with DID can
be misinterpreted as symptoms of schizophrenia. For instance, paranoid schizophrenia is marked
by delusions and auditory hallucinations. A person with DID may be misdiagnosed as a having
schizophrenia if their alternate identity is mistaken for merely a hallucination. The key
difference in distinguishing the two is to observe how the person carries on a conversation with
their self. A person with DID will usually have some physical changes to accompany the
different voices in the conversation, and the schizophrenic will not display any change in voice
or posture. However, it is sometimes difficult for highly skilled psychiatrists to recognize DID.
In fact, DID patients spend an average of 7 years in the mental health system before acquiring an
appropriate diagnosis.
Society holds its own misconceptions about schizophrenia which contribute to the
confusion. Many people believe that DID and schizophrenia are the same or related disorders.
Actually, DID is more closely related to post traumatic stress disorder than to schizophrenia.
One common misconception is that people with schizophrenia have a split-personality. While
the root words schizo and phreno mean split and mind, respectively, patients do not have two
different personalities. Instead, the term split mindrefers to the schizophrenics split from reality.
Again, a person with DID is one who suffers from a true split personality.

III. How Normans Actions Could Be Described as Schizophrenic

Normans behavior could easily be described as symptoms of schizophrenia. Some
schizophrenics prefer to be socially isolated and have peculiar behavior. Norman lives like a
hermit and rarely interacts with anyone except an occasional guest of his hotel. His hobby is
stuffing birds, which is somewhat strange. He also has strange reactions to Marion. One minute
he is very nice and inviting to her; the next he is enraged when she suggests that he put his
mother someplace. He is definitely socially retarded.
Schizophrenics tend to believe that their thoughts (especially anger and sexual thoughts)
are controlled by external sources. Norman believes that his mother is insanely jealous of him,
and she controls his sexual urges (or thoughts) by killing the women of his desires.
Catatonic schizophrenics are mute and unresponsive. At the end of the film, Norman is
sitting in jail, and he appears to be catatonic. He is hearing his mothers voice in his head. The
viewer could mistake this as an auditory hallucination. Norman himself may have thought that
the mothers voice originated from her grave. His mothers voice was constantly commenting on
his behavior, especially with regard to women. This commentary on behavior is typical of
schizophrenics.
Given Normans social isolation, peculiar behavior, delusions, catatonic behavior, and
possible auditory hallucinations, it is easy to see why he may be justifiably misdiagnosed as
schizophrenic.
IV. Why Norman Has DID
The main reason that Norman should more appropriately be diagnosed with DID is with
regard to the hallucinations. When one analyzes the film, it becomes evident that Norman has
three distinct personalities that take control of him. In a few brief moments, viewers see him
dressed as his mother and talking in her voice. He has the personality of a little boy (the original
personality), Norman (host personality), and his mother (an alter personality).
One can infer that the little boy identity did exist although viewers did not directly observe
a childs voice. However, the audience gets a glimpse of his bedroom. The bedroom still
contains childrens toys and a small bed that he continued to sleep in. Considering that he still
sleeps in this bedroom, he probably plays with the toys, too. It is typical for a person with DID
to have at least one child personality, and this is usually the original personality that was abused.

Since 97% of DID patients suffered sexual or physical abuse, it is highly likely that
Norman was abused. No real evidence exists that he was physically abused as a child. However,
several innuendoes made throughout the film indicate that he was sexually abused. Given that
his father died when he was very young and he and his mother lived alone for so many years, his
mother was probably his perpetrator.
It is obvious that Norman is extremely disturbed by his sexuality. The psychiatrist, after
analyzing Normans condition, determined that he had an incestuously possessive and jealous
love for his mother. He also notes that Norman became seriously disturbed after his fathers
death. Perhaps Normans mother turned to her son for sexual gratification after her husbands
death. Norman and his mother lived alone for many years before she took a lover. Maybe
Norman was really in love with her and when she took up with someone else, it drove him to
murder. Norman even states that a son is a poor substitute for a lover. (Was he, in fact, a
substitute?)
As previously mentioned, alter personalities tend to emerge in adulthood when they are
triggered. When Norman kills his mother, he starts to act and dress like her. He wanted his
mother to be as jealous of him as he was of her. To fulfill his fantasies, he dressed as his mother
and stabbed the women that turned him on. Stabbing is symbolic of rape. When he dressed as
his mother, he did to others what she did to him. When he dressed up like her, he dressed very
matronly-unlike the way she probably really dressed. This was his way of creating the mother
that he wanted, needed, and deserved.
When Lila enters the house to talk to the mother, she discovers Normans bedroom. Not
only do we see boy and girl toys, we get a glimpse of a record on the record player. It is
Beethovens Er-o-ica Third Symphony. Interestingly, the title is one letter short of erotica. This
establishes that there is some connection between his early childhood and deviant sexual
behavior. Then, Lila and Sam expose the fact that Norman dresses up as his mother. At this
very moment, Norman begins writhing as if he is having an orgasm. Now that he has been
exposed, his sexual frustration can be acknowledged and released.
At the end of the film, the mother personality dominates. She says something to the effect
of I am not even going to swat that fly. They are probably watching me right now. They will
say, Why, she wouldnt even hurt a fly.This statement concludes that the mother is trying to hide
something. She is clearly guilty because she wants the authorities to think that she is harmless.
The sheer fact that Norman has several distinct personalities is what distinguishes his disorder as
DID and not schizophrenia.

Resources Discussed:
Hitchcock, Alfred. Psycho. 1960.

Other Suggested Sources to Consider:

The Diagnostic and Statistical Manual of Mental Disorders. Published by the American
Psychological Association.
Web site: http://pub94.ezboard.com/fasmallcornerfrm14.showNextMessage?topicID=87.topic.
This site contains information taken directly from the manual above, which explains these two
disorders in great detail.
Web site: http://www.emedicine.com/PED/topic2651.htm. This site contains pertinent
information connecting DID to child abuse/neglect.
Web site: http://web.tiscali.it/andrebalza/. This link takes you directly to The Psycho Home
Page. It contains cool information on Alfred Hitchcock and the film itself.

This Web Page Brought to You Courtesy of:

Jessica Dawsey
Amber Hess
Jude Martin
Jessica Smith