Psychology of 'Kill Me, Heal Me': Dissociative Identity Disorder

Image from dramafever.com

{I never know whether to include a spoiler alert for something like a 2 year old drama. Just in case...

Spoilers for Episodes 1-3}

Getting sucked into the world of Asian dramas has not been bad at all. Kill Me, Heal Me, for example, has been a real treat to both the psych nerd and the new Asian drama fangirl in me. I usually find myself disappointed with the representation of psychological disorders, especially dissociative disorders, in television and film. It is not usually done right and what we often get is a misinterpretation of a mental health problem for the sake of entertainment. That is why this South Korean drama from 2015 has truly surprised me with their presentation and understanding of various psychological disorders.




A more or less accurate understanding and representation of mental illness is seen almost throughout the first few episodes, including surprisingly satisfying scenes of a discussion of bipolar disorder, and of course discussions and the presentation of Dissociative Identity Disorder (DID) as represented by the lead male character, Cha Do Hyun. 

Dissociative Identity Disorder, which used to be referred to as Multiple Personality Disorder, is a mental health disorder that refers to having two or more distinct identities or personality states. The current understanding of the disorder is that the individual experiences a fragmentation of their identity rather than "multiple personalities." That is to say, it is not two or more different individuals within one body, although it can look and feel like that, but the expression of different aspects or different pieces of the identity of a person at different times (referred to as alters). While these different alters may "take the wheel" at different points, they represent expressions of the person that are not integrated. It is believed that DID most likely develops as a defense mechanism following severe trauma. People have different experiences of DID, as well as different ages of onset, and a diagnosis of DID is relatively rare.

7 Personality States. Image from enjoykoreawith.blogspot.com

As presented in Kill Me, Heal Me, Cha Do Hyun, a Vice President of an entertainment sector of a large company, experiences 7 different personality states, each of which is expressed when in times of significant stress. In the first episode we see a shift from the main personality state to an alter when he is physically beaten and witnesses someone he cares for being physically assaulted. At that moment, the stressor appears to be not only the physical beating, but the feeling of helplessness associated with being unable to rescue his friend. This same alter reappears later in the episode after again being physically beaten. In the second episode a shift, or "transformation," occurs again when he is under stress and physically beaten. It is important to note that that specific time, Do Hyun asked to be beaten up by his confidant with the purpose of drawing out a specific alter to deal with a situation that he felt ill equipped to deal with himself. This was noteworthy because it is a sign that he sees his different alters as having different functions, and though he doesn't control when a shift occurs, he knows more or less the triggers. However, this moment also shows he has no control over which alter presents themselves, and instead of the alter he intends to summon, another comes forth to deal with the situation in a way that may be better than whatever the intended alter would have done. This also points to the possibility that which alters are expressed depend on what the situation calls for, and reinforces the theory that they initially developed as defense mechanisms to protect the ego from a situation that was so traumatic it required fragmentation in order to survive. 

Shin Se Ki. Image from dramafever.com

Throughout the first episodes we also see Do Hyun and one of his alters, Shin Se Ki, consulting with a psychiatrist who has followed his case. During these consultations, the psychiatrist tells Do Hyun that his alter Se Ki is becoming stronger, possibly due to having encountered a reason to become the 'main personality' or the only personality. This reason is the woman he has become obsessed with, Dr. Oh Ri Jin, a first year psychiatry resident. I have yet to see what happens and whether it is possible that one of the alters become a main personality. As part of trying to take over, Shin Se Ki wants to find a way to kill off the other alters, which is also something that may be seen in a person with DID in real life. 

Another little aspect that I truly appreciate about this drama is that every time they mention a psychological disorder or concept, they include a small caption at the bottom explaining it. This is not translated in the English subtitles on the site where I watch, so I don't know how much information is provided. 

Oh Ri Jin. Image from kdramakisses.com

So, the premise of this drama is that this man with DID meets a woman who is a psychiatrist and she becomes his doctor. While this is interesting and I am very happy with what I have seen so far, I have to say I cringe at the idea that she will become his doctor (it has not occurred as of the third episode). The two people develop a chemistry between them before they become doctor and patient. In psychotherapy, this type of multiple relationships is unacceptable, unethical, illegal, and potentially abusive and exploitative. There are also aspects of DID as presented in the drama that are more fantasy/sci-fi in nature, such as the change of eye color, and the sudden appearance of tattoos, which is obviously more for dramatic effect and for the viewer to see that a transformation has taken place, and not to be taken as a true aspect of DID. Although neuroimaging has shown meaurable differences between alters, which can include the way they think and the way they perceive and interpret their environment, the changes are not to the level that they are presented in this drama. In this drama, the shift between alters is also physically painful, while this is not necessarily the case in real life. Nevertheless, it is an interesting story and the fact that they have treated mental health disorders in general with a measure of accuracy and respect keeps me interested.