It is not the mission here to make fun of people with debilitating mental disorders, or make light of those with serious problems. Fortunately, the two Tumblr species that most resemble popular media’s versions of abnormal psychology are happily free of anything but an overabundance of creativity and imagination, and usually only suffer from a tendency to get overly wrapped up in the mythology of their social circles.
Why should you care what I say? (Who the hell are you anyways?)
I have a BS in Psychology from a science-oriented university. As part of my degree process I worked on several projects with a researcher who is still at the forefront of the intersection of psychology and law, particularly jury behavior, eyewitness memory, and the use of psychological defenses at trial.
My particular area of interest was the use of psychological autopsies to determine proximate cause in ambiguous deaths. Part of that is determining whether “crazy” behavior leading up to a death is part of a legitimate disorder, or to intentionally obscure a suicide that would otherwise not provide financial benefits. Or whether what appears to be a suicide was actually an accident.
However I’ll try to provide enough accessible sources that you can check everything I claim yourself.
Tumblrite Type: Otherkin
Presumed Mental Illness: Schizophrenia
What are Otherkin:
Otherkin are people who believe that they are connected in some way to another being. This connection may be spiritual, ancestral, metaphysical or a belief that they are actually the other being, but mistakenly trapped in a human body.  The term Otherkin is typically applied to people with an affinity for something that is not an animal (such as an elf). A Therian has an animal identity. I’m going to use “Otherkin” for the entire group for simplicity’s sake.
The typical Otherkin has an affinity for a mythological creature, such as angels, fairies, demons, unicorns, etc, but also particular animals or combinations of animals such as an eagle, a wolf, a dolphin, or a wolf with dragon wings.
Otherkin believe that their “Other” side directly influences them. If they feel they have a wolf connection, they might be drawn to forested areas where wolves might live, and actives that mimic what they believe wolf pack behavior to be. An Otherkin who has a demon connection might feel that their demon side gives them special knowledge of the universe, or allows them to be spiritually attentive to the inner thoughts of others.
Some Otherkin claim that their “Other” side physically impacts them in the form of perception of body parts possessed by the Other, but not by their human self. The feeling that one has phantom wings is an example of this. The more magical type of this belief would be that not only does one feel as if they have phantom wings, but those phantom wings can physically interact with the world around them, like knocking things off tables, or causing gusts of wind.
The concept of Otherkin does have a historical basis. Many religions and traditions over practically all of human existence have concepts related to a spiritual connection with another creature, and many cultures have traditions in which humans can turn into animals, or be connected with animals or mythical creatures in some way.
The Maya had the Wayob  a human who transforms into an animal while they sleep, which is not much unlike the werewolf, which itself has been part of Indo-European tradition for millennia . And then there is of course the very wide group of spiritual beliefs systems that fall into the category of totemism, the connection of an individual or a group of people to a particular animal or natural object .
It is not at all a surprise that these types of beliefs have followed humans into the modern world, and now also incorporate “Others” that have more symbolic importance to our current culture, like robots, video game, TV, or movie characters, aliens, and other subjects of modern mythology.
Misrepresentation of Schizophrenia:
It is tempting, when first exposed to very earnest people declaring that they are actually a wolf ‘on the inside,’ to immediately assume they are suffering from a mental illness. In my experience schizophrenia is often the scapegoat. This conclusion is usually drawn from the way schizophrenia is portrayed in popular media, which is almost completely unlike how the disease actually presents.
The concepts of the ‘alter ego’ (See Tyler Durden in Fight Club) and the ‘split personality’ as part of a psychological disorder appear to have been invented by Hollywood during the Hitchcockian era of cinema. The only connection to actual schizophrenia seems to be that this character trope template often hears voices and may experience visual hallucinations, and some schizophrenics also hear voices and experience visual hallucinations.
The term schizophrenia was coined in 1910 by Paul Eugen Bleuler, and the etymology of the word is literally ‘schizo’ (split) and ‘phrenia’ (personality). The name stuck, and is unfortunately misrepresentative of the actual disorder. The intention was provide a distinctive label to a group of symptoms that involve a break from reality, rather than other disorders that involve a dysfunction of a normal emotional state.
However, it is not unexpected that laymen who have not had exposure clinical schizophrenia outside of popular media jump to the conclusion that people who have an ‘Other’ side or self that objectively does not exist are schizophrenic. Very tragically, this perception is also supported by some psychological professionals who are at a loss to deal with the notion of Otherkin, or by Otherkin themselves who feel they need a scientific label to justify what is generally a spiritual experience.
What is Schizophrenia:
Schizophrenia is a combination of symptoms that fall into a recognizable pattern. The cause is hotly debated, but there appears to be a genetic link, as well as identifiable problems with glutamate and dopamine neurotransmitter pathways. Changes in brain structure and chemistry have been consistently observed in fMRI and PET studies of patients .
There are three groups of symptoms that may or may not be present in any individual suffering from schizophrenia   :
- Positive Symptoms:
- Delusions - Firmly held erroneous beliefs due to distortions of reasoning, such as, but not limited to, the certainty that one is being watched or followed
- Hallucinations – Hearing voices distinct from one’s own inner thoughts, seeing things that are not there
- Thought Disorder – Difficulty speaking or organizing thoughts, can result in a surprising uniformity of schizophrenic speech and writing patterns
- Disorganized Behavior – Such as unpredictable agitation or inappropriate childlike behavior. Inappropriate social behavior.
- Negative Symptoms:
- Lack of normal facial expressions, “blunted affect”
- Monotone and monosyllabic speech, loss of vocabulary
- Neglect of personal hygiene
- Reduced ability to plan or carry out activities
- Loss of interest in everyday activities
- Movement Disorders (in few cases) – Such as constant repetition of certain movements, or at the other extreme catatonia (lack of movement, does not respond to external stimuli, this is very rare with today’s treatments but was very prevalent in the past.)
- Cognitive Symptoms:
- Poor “Executive Functioning” – Reduced ability to understand information and/or use information to make decisions
- Poor “Working Memory” – Reduced ability to use information immediately after learning it.
- Difficulty paying attention
To reach a diagnosis of schizophrenia an individual must have at least two of the common symptoms of the disorder for a significant amount of time during one month, with symptoms persisting for at least six months. The symptoms must not be drug or trauma induced or better described as a different disorder. The individual must have significant impairment in the ability to work, attend school, or perform normal daily tasks.
Schizophrenia most commonly begins to present in the mid-teens or early twenties in otherwise normal individuals as a deterioration of their ability to function in normal daily life. Delusions or visual or auditory hallucinations, when present, often begin after the individual starts to exhibit issues with hygiene and organization. Keep in mind though, that being unhygienic or disorganized isn’t a symptom in itself, there needs to be a significant drop in such activities from a previous level.
The need for institutionalization of people with schizophrenia is usually based on their level of ability to safely care for themselves, not due to the presence of hallucinations or delusions. Incidentally, hallucinations and delusions are the EASIEST symptoms to treat. Schizophrenics, even paranoid schizophrenics, are typically not violent, and do not suddenly ‘snap.’ There will be a progressive worsening of symptoms and deterioration of functioning, which does not occur overnight.
The presentation of schizophrenia in the media is usually of an intelligent, organized individual who is violent under the command of auditory or visual hallucinations, or has delusions of grandeur more applicable to manic disorders, if not a completely dissociated personality (more on split personalities below) that they switch back and forth between.
The sad reality is that your typical untreated schizophrenic is more like the severely unkempt but harmless homeless man who lives under the overpass and yells unintelligibly at people that aren’t there. More organized but still affected schizophrenics can be like the one in my own family, who lives alone very successfully but shows up to formal events in wildly inappropriate outfits, and seems to communicate rationally until she tells you how gangs of men break into her house and rape her every night, and ATM machines are watching her and stealing her energy. A schizophrenic may not suffer from any hallucinations or delusions at all, but have severe impairment of their ability to speak and process information.
So, what's up with Otherkin?
The unshakable belief that one is an animal, or has the sprit of another creature, *may* be part of a schizophrenic delusion, but is not a diagnostic symptom on its own, nor is it a definitive symptom of any mental disorder, especially since there is a rich cultural history of this belief as part of many spiritual systems. It is an example of magical thinking, but engaging in magical thinking is something that practically all otherwise rational people do to some extent.
I would personally make the argument that Otherkin, despite protestations, are fully aware that they are engaging in magical thinking. Note that symptoms of a mental illness are present despite the intentions of the affected person. Expressions of someone’s Otherkin identity most often do not arise in situations where it would impair that individual’s immediate goals.
For instance, take forms of Pentecostal worship, where religious adherents speak in tongues, and perform physical behaviors that are not socially acceptable outside their church gatherings. Although these behaviors are believed to come directly from spiritual sources and are not controlled by the recipient, it is extremely rare for these types of worshipers to begin speaking in tongues in situations outside a gathering of like-minded people who accept and support them.
This leads me to believe that in both cases the individual does control and understand their behaviors and impulses. In the case of a true mental illness, the behavior would be impossible or very difficult to consciously control despite the external surroundings.
My opinion is that being an Otherkin has three motivations:
- To explain interior thoughts and feelings that might be perceived as inconsistent with one’s personality
- To fit into a cultural group that validates the importance of one’s interior thoughts and feelings, and has a kind of historical tradition that provides continuity, rules, and value.
- To be special. Seriously, who doesn’t want to find out that they’re actually The Mother of Dragons, or the only person who can fly the giant robot, or get the letter from Hogwarts, or be one of God’s chosen few, or be the hero that has to carry the ring to Mordor and save the world?
Tumblrite Type: Multiple/Singlet Sytems, Headmates
Presumed Mental Illness: Dissociative Personality Disorder (Multiple Personalities)
What is a Multiple System, what are Headmates?
Someone who has a “headmate” believes that they have a completely separate individual personality sharing their body. This differs from Otherkin, as to an Otherkin the “other” is actually them, a large but hidden part of their own personality. A headmate is an individual different from the “host” personality. The host can communicate with the headmate and vice versa. The headmate may be an animal, a mythological creature, a fictional character, or any other perceived sentient being (notably including the entire universe in one case well known on TiA). 
“Multiple Systems” are individuals who believe they have multiple headmates. “Single Systems” or Singlets have only one additional personality. This is the most basic explanation of terminology. The vocabulary can get bizarre because there’s a tendency for some to combine all sorts of these concepts into additional subcategories and forms.
What you need to know though is that to Otherkin and Therians they *are* their other side (even if they have more than one). A headmate is an additional autonomous personality, which is theoretically not controlled by the original personality. And yes, there are Multiple Systems where their headmates are Otherkin, and recursive systems where the headmates have headmates.
People in Multiple Systems can also believe that one or more of these personalities can “front” or take control of the host body and behave and communicate with others autonomously.
An associated concept is that of the Tulpa  which is a being or object one creates through meditation and mental discipline, and which may take physical form. The word itself comes from an alleged Tibetian spiritual tradition in which an alternative personality is created by force of will . The available information on this tradition is questionable however, and mostly consists of new-age type websites referencing each other. (/r/Tulpas will be angry with me for that statement, but the fact remains.) I believe though that the concept is more similar to the creation of a Memory Palace  which is a complex mnemonic device, than it is with having an imaginary friend. It is intended to be a mental structure which one can use to refine ideas.
There is a somewhat internal battle between the Tumblr version of Multiple Systems and the Tulpa people. You will get a number of people insisting that their headmates are not a symptom of mental illness, and a number insisting that they have been (allegedly) diagnosed with Dissociative Identity Disorder. The Tulpa people will also insist that they’re engaging in a meditative/spiritual exercise and that it is no way a mental illness.
If nothing else the take home message here is that you need to be extremely skeptical when encountering any of these varied claims.
Here is the point at which you say to me “These people think they have autonomous alternate personalities and you’re going to tell me they’re not crazy? You’re crazy.”
Well, yes. They’re not crazy. I may be crazy, but my type of crazy is unrelated. Here we go:
Misinterpretation of Dissociative Personality Disorder (DID)
Just like schizophrenia has an evil Hollywood twin that is unfortunately the extent of what most laymen know about the disorder, so does the concept of “multiple personalities.”
The way that multiple personalities is portrayed in the media is, to me, one of the most heinous propagations of psychological misinformation in modern culture. You couldn’t do worse by convincing people that they’re being controlled by ancient alien slave ghosts. (Hi Scientologists! Please don’t sue me, I don’t have any money.)
I believe it has become inculcated into our culture so heavily that the media actually created a psychological disorder where one would not naturally exist.
As I wrote above, popular media has conflated schizophrenia to actually mean exactly what the name says – “split personality.” The name however is not in any way related to the symptoms of the disorder. What the media should be referring to, if anything, is dissociative identity disorder (DID).
The original term for this syndrome is “multiple personality disorder.” It is a hugely common trope, you’ve seen it in a number of movies, TV shows, comic books, you name it, it’s in there. This is the typical “The evil twin is the same person,” “Tyler Durden IS the narrator,” “Norman Bates’ mother IS Norman” thing.
Most people have never encountered DID outside the media, which is why multiple systems and other headmate activities end up being an almost exact representation of the Hollywood version of this disorder, not of the actual symptoms.
Complicating this is that DID is extremely controversial within the psychological and psychiatric professions, ranging from some practitioners that diagnose it for practically every patient, to those who believe the disorder doesn’t exist at all.
To me, a telling piece of information is that DID is almost never diagnosed or observed outside North America. There are two explanations for this: That other countries have not yet recognized this legitimate disorder, or that this is a North American cultural phenomenon such as other culturally-circumscribed disorders like Piblokto in the Inughuit people  and “fan death” in South Korea .
What is Dissociative Identity Disorder:
Dissociative Identity Disorder (DID, and previously called Multiple Personality Disorder) is one of four dissociative disorders recognized by the America Psychiatric Association, along with depersonalization disorder, dissociative amnesia, and dissociative fugue.
Common symptoms for all types of dissociative disorders are :
- Memory loss of certain time periods, events, and people
- Mental health problems including depression and anxiety
- A sense of being detached from yourself (depersonalization)
- A blurred sense of reality
“Dissociation” itself is a psychological term that is used along a continuum measuring an individual’s detachment from reality. This term is sometimes interchanged by laymen with the term “psychosis,” but is not the same thing. Dissociation is a disconnection from reality (but reality stays the same), where psychosis is a loss of reality, or perception in addition to reality. 
DID specifically means a dissociative disorder combined with the inclusion of an alternate personality. The diagnostic criteria include :
- Display of the presence of two or more distinct identities or personalities, each with its own relatively stable pattern of perceiving, relating to, and thinking about the world.
- At least two of these identities or personality states repeatedly take control of the individual’s behavior.
- The individual can’t recall important personal information that is too extensive to be explained by ordinary forgetfulness
- These symptoms are not due to the effects of a substance, or other medical condition (complex partial seizures for example)
- In children, symptoms are not due to imaginary playmates or fantasy play.
The upcoming version of the Diagnostic and Statistical Manual (more or less the psych bible) may include an additional requirement that the individual must experience significant impairment and distress resulting from their symptoms over a pre-determined period of time.
The fact that DID is included at all in the Diagnostic and Statistical Manual is still highly controversial in itself.
The alleged causes of DID are also greatly debated. One major theory is that both the dissociation and the formation of an alternate personality was a form of autohypnosis. During chronic exposure to extreme stress, such as (but not limited to) a child being sexually abused repeatedly, or an adult in a forced labor camp, a suggestible individual may create a fantasy personality who will take control and cope in place of the conscious core personality, while the core personality dissociates (becomes removed) from the immediate trauma. 
This theory, like PTSD, requires the sufferer have been exposed to a severe existential threat, to the extent that massive psychological coping mechanisms are activated to allow the organism to simply survive. Discomfort, unhappiness, or a generally sucky life would not be extreme enough to create this state. This is the psychological equivalent of an ejection seat. It saves the pilot (maybe) the expense of the plane.
Another theory takes note of the fact that almost all individuals diagnosed are highly suggestible, thus able to successfully self-hypnotize to create alternate personalities. Clinically, being suggestible means that along a continuum people with this trait are more likely to confirm overtly to expectations or the views of others, or to accept what other people suggest uncritically and internalize it into their own memories and experiences.
The suggestibility aspect is further combined with the fact DID is highly comorbid (diagnosed along with) and has overlapping symptoms with rapid-cycling bipolar disorder, borderline personality disorder, and Aspergers syndrome, all which may emerge as attention-seeking behavior, lack of or misunderstanding of social boundaries, and other symptoms which may mask the true nature of what the patient is suffering.
DID is also strongly comorbid with the group of factitious disorders that are particularly described by their attention-seeking aspects, and underdeveloped sense of self. Factitious disorders include Munchhausen syndrome, and the well-known Muchhausen syndrome by proxy, in which suffers harm either themselves or an individual they have access to in order to gain attention and sympathy. The term "factitious" refers to the behavior of the individual being artificial, not that the disorder is fake.
The issue here occurs when a highly suggestible individual who may or may not be highly attention seeking, who likely also has other mental conditions and a history of abuse collides with a psychological professional eager to diagnose DID. The therapist, most likely with the best of intentions and perhaps unconsciously, will “lead” the patient into displaying the symptoms of the suspected disorder. The suggestible patient may internalize this leading and basically play along, even coming to believe they have multiple personalities, and display the symptoms they think will please the therapist.
It sounds bizarre, but psychologist-induced behavior is in reality a major problem in the psychological fields from couch therapy to pure research neuropsychiatry.
For an extremely interesting case, in fact the very case that basically started the multiple personality disorder craze in the US, see the book and film “Sybil” about Shirley Ardell Mason. Her psychologist, Cornelia B. Wilber, has been highly criticized for manipulating her patient to display the correct symptoms and engaged in unprofessional behavior throughout the course of treatment in order to gain exposure and fame.
In short, it is a controversial diagnosis, overrepresented and incorrectly represented in the media, and may have sprung entirely from a fame-seeking psychologist’s fictionalized novel.
If nothing else, DID has some serious unsolved problems.
So, what does this mean for headmates?
Not much really, except that they’re not a symptom of a disorder.
If someone is claiming to have alternate personalities with whom they actively communicate, exchange information with, who talk to each other, and take control of activities while the core personality is still conscious, the worst thing I’m going to accuse them of is having a very active and rich imagination.
The point of an alternate personality in DID is the dissociation piece. It is a coping mechanism, and is more or less out of the control of the individual. The core identity is removed from the traumatic stimulation and does not remember what happened while an "alter" was engaged.
You’ll notice the vast majority of the multiple systems on TiA do not lose consciousness, or experience lost time. They are aware of what’s going on at all times. When they have blogs and such for each headmate their writing styles, thoughts, and general nature are suspiciously similar to the core personality’s, even if they’re supposed to be a different sex, demons, or entire universes.
The most telling point is the one I also mentioned for schizophrenia – Their headmates do not manifest in behavior that prevents them from achieving their immediate goals. If it was an uncontrollable mental condition, it would manifest in incredibly inconvenient ways at least occasionally. In fact, in case studies of DID the sufferer often doesn’t realize they have a problem at all, even fail to notice loss of time, people close to them notice their bizarre behavior first.
So what is this? In my opinion, a complex game of make believe, driven by the following motivation:
- Foremost a misperception of internal states. As individuals we can have widely varying emotions, thoughts, and desires to act. Because a shy demure librarian has a sudden desire to go dance topless on a bar doesn’t mean she has a separate personality. You can feel like a warrior in the morning, and
a mouse in the afternoon and still be the same person. No metaphysical or psychological explanation is required.
- As above, attention, the feeling of being separate and different. Having something that causes you distress can bring satisfying attention just as well as a positive aspect of one’s personality.
- Inclusion in a cultural group that embraces their inner thoughts and feelings and encourages further imagining and refining of their internal story.
Even if you disagree with me on everything else, please let me encourage you to maintain compassionate skepticism when confronted with people who claim to have a formal diagnosis of DID. It is not diagnosed a fraction as often as it is claimed, and even some of those few actual diagnoses may be invalid.
 www.docstoc.com/docs/15057478/Hollywood-schizophrenia (PDF)
Edit: 06/08/13 10:26am - Spelling errors.