This article is written by Vedant Saxena, from Rajiv Gandhi National University of Law, Punjab. It delves into the question of whether a person could be held responsible for committing a crime under the influence of dissociative identity disorder.

Introduction

Look Away, one of the latest Hollywood flicks to feature the concept of dissociation, is centred around one Maria, a timid young girl who constantly is mocked and made fun of by her classmates. Living in an atmosphere of ceaseless trauma and stress, she develops an evil alter ego by the name of ‘Airam’, and exacts revenge on the people who ridiculed her.

Dissociative identity disorder (DID), previously referred to as Multiple personality disorder (MPD), is categorised as a condition when 2 or more distinct personalities are implicit within the same person. Each personality is complete, with its own memories, behaviour, and preferences; these may be in marked contrast to the single premorbid personality. In its most well well-known form, only one personality manifests itself at a particular time, unaware of the other alters. Dissociation is known to be an extreme outcome of severe depression or trauma. People who have been subject to frequent physical and sexual violence are more prone to developing such symptoms. There have been a number of cases reported across the globe, including the Indian subcontinent. 

The views of the courts

There exist a number of problems with the way DID is perceived by courts of law. One of the major ones is that there are no set guidelines laid out by the courts in determining when DID can be considered insanity. They generally turn to experts, which in turn brings in more ambiguity. Over the years, however, a few American courts have made certain views with regards to considering DID as insanity-

• The first view is that at the time of the commission of the crime if the host personality was subdued by the alter, the person would be considered not guilty on account of insanity. 
• The second view was made in a Tenth Circuit case, United States v. Denny-Shaffer. It says that if the host personality was aware of and in control of the commission of the offence, he shall not be allowed to take the defence of insanity. 

Inconsistency of the defence of insanity with DID

Most often, courts around the world base the insanity defence upon the following premise: if the person was aware of the commission of the offence, he shall be guilty. Section 84 of the IPC identifies an insane person as one ‘incapable of knowing’ the nature or consequences of his act. Therefore if it is proven that the accused was aware of the act, it is presumed that he was in control of the act too. This rule clearly seems inconsistent with DID, for the host personality may not always be in control of the alter’s act, in spite of being aware. Controlling one’s actions when one is in control of one’s body is different from controlling one’s actions when one is not. It would clearly be unjust to punish the person if the host personality was not in control of the acts of the alter, or if it could not prevent the act without putting itself in reasonable danger.

Moreover, a person cannot be considered entirely guilty of committing the offence if he himself does not commit it, in spite of being reasonably capable of preventing it from happening. Similarly, in the case of DID, even if the host personality was in reasonable control of the happening of the act, punishing it for the acts of the alter would still mean punishing an innocent.

Reasons behind why a person must not be considered liable for the acts of his alter

The host personality must not be considered liable for the acts of the alter, for 2 plausible reasons–

• Firstly, alters are distinct individuals, without separate bodies. Most people’s intuitions are that their memories, thoughts, and histories—not their bodies—make them who they are. If we adopt a psychological theory of personal identity, then many alters could be people.
• Secondly, alters seem to be distinct person-like centres of consciousness. Alters enjoy their individual experiences and believe that their experiences are their very own—and no one else’s. Moreover, all alters seem to be people by all criteria of personhood or moral agency, except for the fact that they lack separate vessels. 

However, medical practitioners generally hold a separate view in this regard. They consider alters to be non-person-like parts of complicated people. This basically means that alters must not be considered separate people. Rather, the person’s personality is split up into separate parts. These parts can share thoughts with each other at times and can be integrated into one. Each of these views has some plausibility, and it is premature to claim closure on this question. We need more empirical information and conceptual theorizing about personhood to answer this question.

Criminal liability if alters are persons

The host personality must not in any way be considered liable for the acts of the alter. It may be the same person committing the crime, but punishing the host personality would mean punishing the innocent, which the law condemns. For instance, in the case of conjoined twins, if one of the twins shoots a person against the wishes of the other twin, would it be correct to send the guilty twin to prison along with the innocent? 

An innocent life cannot be compromised, even though this would mean the guilty going free. It is practically impossible to punish only the alter. How do prison guards correctly identify when a guilty alter comes out, and, more importantly, how do they make that alter stay out to receive the punishment?

Criminal responsibility if alters are person-like centres of consciousness

Alters being person-like centres of consciousness means that the alters may not be entirely different persons, but are still distinct entities. Each alter enjoys his own separate experiences and considers his experiences to be only his, and nobody else’s. Law takes into account wrongful acts committed by people alone, and not disembodied entities. However, this would again mean punishing the guilty at the cost of the innocent. As far as pure guilt or innocence is concerned, a body must not be considered to make a difference. 

Criminal liability if alters are nonperson-like parts of complicated people

Even if alters are not separate persons or entities but merely fragments of a single personality, it would be unjust to punish the person. In order to justify this statement, consider the case of Re: Pappathi v. Unknown, the court held that if a person commits an act under the effect of somnambulism (sleep-walking), he shall be considered not guilty under Section 84. In cases of sleepwalking, epileptic episodes or hypnosis, a person is not overcome by an alter. Rather, there is “a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment”. If in such cases the accused is not considered guilty, there is no reason by which a person committing an act under the influence of an alter can be considered guilty. DID, the paradigm of dissociations, does indeed render a disruption in his usual integrated functions of consciousness. 

In cases of dissociation, significant parts of the self are not brought to bear on the act. Therefore, we do not, and should not, attribute the act to the actors in their capacity as practical reasoners.

When can the host personality be considered guilty?

While punishing a person for an act committed under the influence of an alter might mostly seem unjust, there are certain instances when he could be considered guilty. First, if the host personality was aware of, and in control of the commission of the act, he should be convicted. Second, when the host personality and the alters are organized to such an extent that it would be just to hold them responsible by virtue of corporate criminal liability. It must be made sure that all personalities or fragmented parts of the same personality act within the scope of their authority, and with an intent to benefit the whole. However, the punishment must be mitigated to some extent, for in such cases the host personality would not be entirely responsible for committing the offence. He must be held liable for an act of ‘negligent delegation’.

State v. Green (1998)

In State v. Green, a test was suggested which stated that if any part of the person’s mind knew that the act was wrong, he should not be allowed to take the defence of insanity. Mere knowledge is not sufficient for rendering a person guilty. The question of whether the person could reasonably prevent the act or not also needs to be taken into account. For instance, a person acting under posthypnotic suggestion is well aware that his conduct is wrongful. However, it would be unjust to make him liable, for split-off parts of the person’s personality are acting.

State v. Moore (1988)

In State v. Moore, Ms Moore was held accountable for terrorising a group of children and participating in an act of beating one of them to death. She contended that during the commission of the offence, she was overcome by her alter, Billy Joel. However, the host personality had not been unaware of the crime. She would place phone calls to herself pretending it was Billy Joel calling with the children’s daily instruction and discipline. And she deflected the police when under suspicion. Since both personalities had in some way participated in the commission of the offence, the defendant must be considered guilty. Even though in this case the punishment was mitigated on the grounds of mental illness of the accused, she had certainly not been excused on account of DID.

Practicality of incorporating DID within the ambit of insanity

No matter how unjust it may be to punish a person acting under the influence of an alter, recognizing DID as a category of insanity poses many problems. 

1. Firstly, diagnosing DID, one of the most complicated forms of mental illness, is far from easy. it is impossible to say what a personality is and to distinguish a personality from a personality state or a fragment. No mental illness, other than some organic mental disorders, can be diagnosed as reliably as cancer or bacterial infections. There is no blood test for mental disorders.
2. Secondly, experts argue that if DID were to be included within the ambit of insanity, a lot of people would employ it as an excuse to cover up their wrongdoings. Most of the mental disorders, leaving apart a few organic ones, are fairly easy to malinger. For instance, psychotic disorders could be faked on projective tests, even by subjects uninformed about the diagnosis. 
3. Thirdly, diagnosing DID might take an exorbitant amount of time. Determining innocence on the basis of DID would mean having to evaluate all alters; without which one may not know who is the host, and one may not know which alter committed and which participated in the crime. Moreover, even if it is proven that the alter was active at the time of the commission of the offence, how could it be proven that the host personality did not acquiesce in its commission?

Position in India

Dissociative disorders are primarily caused on account of severe stress or trauma. Most of the DID patients around the world were proven to be victims of sexual or physical abuse. In 2005, a girl who was presented before the Department of Psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS), showed symptoms of DID. At certain intervals, she began referring to herself as Mr S. She dressed like a male, did not seem to recognize her parents, cousins, relatives, etc, and was unable to recount her personal information. Upon research, it was discovered that she had been living amid a strained parental relationship. This had arisen on account of her mother not bearing a boy. The girl lived in constant stress, and eventually began acquiring alter states recurrently after a dissociative convulsion, and was unable to recall important personal information. 

According to Vikram Kirtikar (Psychologist & Outreach Associate, Mpower – The Foundation), “Dissociative disorders in India usually have a cultural context. They are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.” In some rural areas in North India, having a boy is still considered way more desirable than having a girl. Failure of a mother to bear a male child often results in separation, divorce and remarriages of male partners. This generally has a devastating effect on the girl child. On account of an exorbitant amount of stress, they start showing symptoms of dissociation. This also explains a major reason why DID is not diagnosed effectively in India: it mostly occurs in villages and rural areas which usually have seldom access to healthcare facilities. 

Figures

In 2009, a study had been conducted by Santosh K. Chaturvedi (Department of Psychiatry, National Institute of Mental Health and Neurosciences, NIMHANS, Bangalore, India), Geetha Desai (Department of Psychiatry, National Institute of Mental Health and Neurosciences, NIMHANS, Bangalore, India) and Deepika Shaligram (St Elizabeth’s Medical Center, 736 Cambridge Street, Boston, MA, USA). The aim of the study was to examine patterns of dissociative disorders among subjects attending psychiatric services, over the past decade (1999-2008). A total of 893 patients had been diagnosed with the dissociative disorder: 591 (66%) were outpatients and 302 (34%) were inpatients. The proportion of patients diagnosed with dissociative disorders ranged between 1.5 and 15.0 per 1,000 for outpatients and between 1.5 and 11.6 per 1,000 for inpatients. The majority of patients were diagnosed with dissociative motor disorder (43.3% outpatients, 37.7% inpatients), followed by dissociative convulsions (23% outpatients, 27.8% inpatients). This study clearly shows the effective diagnosis of DID by Indian psychiatrists is still lacking. 

The Mental Healthcare Act, 2017

This Act was passed with an aim of promoting mental health care facilities across the country and ensuring that the patients’ rights are protected during the delivery of mental health care and services. Though there are quite a few positives, it still has its share of grey areas, particularly with regards to personality disorders. 

The Act defines mental illness as “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs.” Flaws are clearly evident in this definition. Firstly, only serious mental disorders are considered mental illnesses. Secondly, going entirely by this definition, personality disorders are excluded from it. 

With regards to DID, this definition is fairly restrictive. Since DID involves switching of personalities, it is clearly not a conventional mental illness. While the host personality might meet this definition, his alter would not. Moreover, the person may have more than one alter, each of which could be considered a separate person/entity. 

Conclusion

With the rise in the cases of DID across the globe, certain changes need to be made within the laws. It is incumbent that the courts follow the proposed standards to prevent the unjust conviction of the innocent host. However, it is also important to note that incorporating DID within the laws would be far from easy. While the Mental Healthcare Act, 2017 does try to improve healthcare facilities and encourage therapy, it still fails to include DID. The dissociative disorder requires long term treatment by a mental health expert who tries to stitch the two different personalities while healing the core issue. It may also include cognitive and creative therapies.

References

• https://www.researchgate.net/publication/266235027_Multiple_Personality_Disorder_-_A_Case_Report_From_Northern_India
• https://journals.sagepub.com/doi/10.1177/0020764009347335
• https://www.cambridge.org/core/journals/bjpsych-advances/article/dissociative-id enti t y-disorder-validity-and-use-in-the-criminal-justice-system/C1C27EE973 1782 5 7 0 E1 3 76A3EDA48CE4
• https://openscholarship.wustl.edu/cgi/viewcontent.cgi?article=1130&context=law _u rba nlaw
• https://gould.usc.edu/why/students/orgs/ilj/assets/docs/10-2%20Saks_Intro.pdf
• https://gould.usc.edu/why/students/orgs/ilj/assets/docs/10-2%20Saks_Article.pdf 

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