What if you felt that your sense of self slips from your control for hours without awareness? Or woke up one morning to find your house painted a new color you didn’t choose? What if you found yourself arguing with voices no one else could hear, or receiving commands from someone—or something—only visible to you?
These are not scenes from a thriller novel or a suspense movie, but real experiences endured by millions around the world who suffer from two commonly misunderstood mental health conditions in our societies: schizophrenia and dissociative identity disorder, formerly known as multiple personality disorder.
Among the bedtime stories my mother used to tell me, the story of Isaac remains etched in my memory. My mother insisted it was true and took place in her village, Deir Istiya—near Nablus—in the mid-20th century.
Isaac used to steal a chicken every day, justifying it by claiming that a fire spirit named Al-Sakouna threatened to burn the village if he didn’t. He would take villagers to a local shrine dedicated to a holy man named Sheikh Khater to show them the slaughtered chicken.
My mother said: “The village sheikh recited prayers over him after everyone agreed he was possessed by a jinn, but it didn’t help. He kept stealing and slaughtering chickens until he passed away.”
As a child, I trembled at the description of that spirit. Today, I see the story differently. I realize that Isaac might have been sincere—perhaps he truly saw what his mind dictated to him.
And although medicine has advanced significantly compared to what it was seventy years ago—when Isaac's story took place—many concepts related to mental health remain shrouded in mystery, confusion, and dangerous oversimplification.
One of the most prevalent misconceptions is confusing schizophrenia with dissociative identity disorder (DID).
Dr. Maya Bizri, a psychiatrist at Cleveland Clinic, explains to the BBC that "schizophrenia is a psychotic disorder characterized by a loss of the ability to distinguish between reality and imagination. It manifests as hallucinations, delusions, and disorganized thinking, along with negative symptoms such as social withdrawal and lack of motivation."
Hallucinations involve seeing or hearing things that do not exist (like Isaac's spirit), while delusions are fixed false beliefs that remain unshaken even in the face of contradictory evidence.
In contrast, dissociative identity disorder is not a psychotic disorder but rather a psychological response to trauma, marked by the presence of multiple distinct identities within a person. These identities do not lose touch with reality—as in schizophrenia—but rather shift or alternate.
This distinction is not merely a medical detail, but an essential gateway to understanding the difference between two very distinct conditions that people often confuse.
The term “schizophrenia” comes from two Greek words: “schizo” meaning split, and “phren” meaning mind. This linguistic origin has likely contributed to the widespread misconception that schizophrenia means “split personality,” when in fact it is a completely different condition.
According to the World Health Organization, schizophrenia affects around 24 million people worldwide, or 1 in every 300 people—roughly 1 in 222 adults.
Dr. Bizri recounts an example from her practice: “One of my male patients, in his twenties, had just been admitted to the hospital. He believed that his neighbors were controlling his thoughts through satellites and monitoring him with cameras.” She adds: “These delusions are deeply disturbing for him and his family and can lead to dangerous behavior if the voices command him to harm himself or others.”
In addition to hallucinations and delusions, schizophrenia patients also suffer from “negative symptoms,” which may be less obvious but have a persistent impact on daily life.
These symptoms include social withdrawal, loss of motivation, emotional flatness, and lack of personal care, according to Dr. Bizri—traits that may explain Isaac’s disheveled appearance in my mother’s story.
Isaac died at the shrine of Sheikh Khater, where he had so often taken villagers to show them the slaughtered chickens. In his final days, he never relented, continuing to beg people to abandon their stinginess and appease the spirit. He told them: “It’s a shame to let the fire consume all the olive trees for just a few chickens.”
I don’t know if Isaac suffered from schizophrenia—I’m not qualified to diagnose him—but challenging the myth of "split personality"—not just as a linguistic error, but as a social mindset that reduces a human being to a diagnosis and turns suffering into stigma—can play a key role in supporting patients and promoting their inclusion.
source: BBC Arabic.