Bhool Bhulaiya is arguably one of the best psychological thrillers in Indian cinema. It centers its plot around a palace that is allegedly haunted by the spirits of two lovers who were torn apart by an evil king. The movie thrillingly captures the essence of Indian culture, a land where science meets spirituality. Avni, a new member of the family, is later revealed as the “ghost” that haunted the palace at night. After a psychiatrist intervenes, he diagnoses Avni with Dissociative Identity Disorder (DID). In this blog, we will be discussing and answering the questions we asked you in our video!
- Does Avni really have DID?
Dissociative Identity Disorder, according to the DSM-5, has five main diagnostic criteria. The first criterion states, “two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self” (Bhandari, 2020). We see two distinct identities/personality states in our patient, Avni. The first identity is Avni, and the split is Munjulika. Neither thinks or perceives the environment as the other personality. In fact, the contrast or the differences in perception of the self and their surroundings are enormous. Avni is married to Siddharth and is an archeologist by profession with an avid interest in history. Munjulika sees Siddharth as the evil king who murdered her lover which caused her to kill herself. Munjulika sees herself as a ghost, who is haunting the palace to find and kill Sidharth.
The second criterion states, “Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events” (Bhandari, 2020). We see this happening multiple times in the movie. The first incident was during the first night of disturbances, where the maid screams and wakes up all the family members. It was in fact Avni who was walking around the palace breaking cameras and pushing pillars. A notable example of this amnesia was during Nandini’s wedding when it looked like Sashidhar (the groom) was assaulting Avni. However, Avni was Munjulika at that time, who loved Sashidhar and was confused as to why he was rejecting her affection.
The third criterion states, “The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder” (Bhandari, 2020). The audience sees Avni’s considerable distress when Aditya tries to prove that the ghungroos are not antique but in fact a cheap imitation copy of what Munjulika adorned when she danced at court. Further, Avni becomes obsessed with trying to find out details of Munjulika’s life before her Mujulika personality fully forms. Avni wants to protect Siddharth from her disorder after she finds out she suffers from multiple personality disorders. Her split, Munjulika, wants to kill Siddharth because he is the evil king who killed her lover (Sashidhar) and propelled her to commit suicide to avoid a forced marriage. This causes significant distress in her marriage. We also soon see Avni transition to Munjulika very quickly and in front of Siddharth, which suggests Avni’s loss of control and Munjulika’s escalating pursuit to be the dominant personality till she is able to kill Siddharth.
“The disturbance is not part of normal cultural or religious practices” (Bhandari, 2020). The fourth criterion is interesting but tricky here, because Bhool Bhulaiya centers around the competing values of science versus spirituality, and then ends with science coming together with spirituality to manage Avni’s disorder and allow Munjulika to “leave” Avni’s body after she kills Siddharth. However, Munjulika’s behavior is clearly not consistent with normal or cultural norms, even in India.
Finally, “The symptoms cannot be due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures)” (Bhandari, 2020). Avni’s disorder is clearly not affected by any physiological effects because she is characterized as someone who does not indulge in substance abuse. She also does not have any symptoms of other general medical conditions but does show headache and amnesia after she has transitioned from Munjulika to Avni. This is a clear indication that Avni’s symptoms are focused only because of DID. “Dissociative identity disorder may include headache, amnesia, time loss, trances, and “out of body experiences” (Bhandari, 2020). Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). We see these symptoms and behaviors translate clearly in both Avni and Munjulika.
- How do we know Avni had DID and not Schizophrenia?
Schizophrenia and DID are quite easily confused with each other because of common misconceptions that say people suffering from Schizophrenia switch from personality to personality. That, however, is completely untrue. Individuals with Schizophrenia can have delusions, which include fixed false and unshakable beliefs (Morin & Gans, 2020). If Avni had Schizophrenia and delusions as a result, she would have believed Munjulika was communicating with her and trying to plot her husband’s death even though that is not true. However, because Avni had DID, she showed identity alteration. Avni altered her identity and split it with a new identity of Munjulika. She did not have delusions of Munjulika, but in fact, she identified as Munjulika. While her identity altered, she experienced distortions in space, time, and situation as seen in the scene where Siddharth forbids her to go shopping with Radha.
Individuals with Schizophrenia can also hallucinate, and see, hear, or smell things that no one else can. Avni is never seen hallucinating, as it is not characteristic of DID patients to hallucinate. Furthermore, it is characteristic of Schizophrenia to present a disorganized speech. Individuals may use made-up words or phrases that only have meaning to the individual, repeat the same words or statements, use meaningless rhyming words together, or jump from topic to topic without being able to hold a conversation (Morin & Gans, 2020). Avni and Munjulika have clear, succinct speech with no room for confusion on their intent or aim in every conversation because DID patients do not suffer from disorganized speech. Instead, DID patients go through “derealization,” or “depersonalization”, a feeling that the world is not real or looking foggy or far away or a sense of being detached from one’s body and is often referred to as an “out-of-body” experience (Bhandari, 2020). Avni briefly suffers from this feeling when she enters the third floor and goes about exploring and taking in the historical significance.
Lastly, individuals with Schizophrenia may exhibit grossly disorganized or catatonic behavior. This means that they may exhibit bizarre bodily behavior that interferes with their ability to function, for example., maintaining a single body position for hours at end. Individuals with catatonic behavior may appear unresponsive even though they are awake (Morin & Gans, 2020). Avni never shows these symptoms and is awake and responsive, and is never bizarre with the exception of Munjulika manifesting in what people think is still Avni. Also, individuals with schizophrenia may not display or even feel certain types of emotional reactions that we expect from people, also called “blunting of affect” (Morin & Gans, 2020). Avni is very sociable, picks up on social cues, and reacts in an expected manner to good news and bad news. Avni’s primary seemingly bizarre behavior is her dissociative amnesia, a result of DID, and is seen when Avni rips her own saree after Nandini’s wedding (when the audience finds about Avni’s disorder) and does not remember who ripped it. It is clear, through these various explanations of Avni’s symptoms, that she had DID and not Schizophrenia.
- Are all DID patients violent or do movies only highlight one of the possible character traits?
DID patients are no more likely to be violent than any other person, and in fact, violence among DID patients is an unfortunately popular myth. There are very few documented cases linking the tendency of criminal activities to DID. The idea of an ‘evil’ alter is not true (Australia, 2021). While the idea of DID violent alters has frequently been the premise of horror movies (Bhool Bhulaiya), it is not supported by what is known about DID. There is no link between increased criminal activity and DID. The false belief that people with DID are violent is dangerous because it increases unnecessary fear further stigmatizing and isolating people who have a serious mental illness (Hull, 2020).
- Epidemiology of DID (includes answers about the average number of personalities, gender most affected, and age)
DID is most likely to occur in women than in men, and affects roughly 1% of the general population. However, some studies have found a diagnosis of DID in as many as 6% of patients in clinical settings with highly traumatized patients (Brand et al., 2016). A clinical description of DID is as follows - “The typical patient who is diagnosed with DID is a woman, about age 30. A retrospective review of that patient’s history typically will reveal the onset of dissociative symptoms at ages 5 to 10, with the emergence of alters at about the age of 6. Typically by the time they are adults, DID patients report up to 16 alters (adolescents report about 24), but most of these will fade quickly once treatment is begun. There generally is a reported history of childhood abuse, with the frequency of sexual abuse being higher than the frequency of physical abuse. Patients who have been diagnosed with DID frequently report chronic suicidal feelings with some attempts.” (Gillig, P. M et al., 2009, )
References
Bhandari, S. (2020, January 22). Dissociative Identity Disorder (Multiple Personality Disorder): Signs, Symptoms, Treatment. WebMD. https://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder#:~:text=The%20DSM%2D5%20provides%20the,about%20the%20environment%20and%20self.
Morin, A., & Gans, S. (2020, December 9). What Is Dissociative Disorder? Verywell Mind. https://www.verywellmind.com/dissociative-disorder-vs-schizophrenia-4160180.
Australia, S. A. N. E. (2021, March 23). Dissociative identity disorder (DID). SANE Australia. https://www.sane.org/information-stories/facts-and-guides/dissociative-identity-disorder#:~:text=For%20the%20vast%20majority%20of,cases%20linking%20crime%20to%20DID.
Hull, M. (2020, December 31). 7 Myths About Dissociative Identity Disorder: The Recovery Village. The Recovery Village Drug and Alcohol Rehab. https://www.therecoveryvillage.com/mental-health/dissociative-identity-disorder/related/did-myths/.
Brand, B. L., Sar, V., Stavropoulos, P., Krüger, C., Korzekwa, M., Martínez-Taboas, A., & Middleton, W. (2016). Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder. Harvard Review of Psychiatry, 24(4), 257–270. https://doi.org/10.1097/hrp.0000000000000100
Gillig, P. M. (2009). Dissociative identity disorder: A controversial diagnosis. Psychiatry (Edgmont), 6(3), 24.