I feel like I have two personalities, I’m not sure but it feels like it. I can live happily but sometimes I just got this strong urge to kill someone. It feels like something is dragging me into a void and just takes control of me. Nothing has happened so far but I am afraid that someday I might no longer be able to control it anymore. I also feel neither empathy nor guilt. I read that Psychopaths do not feel these two things as well but I on the other hand, can feel fear. Not that someone robs me or tries to kill me, Im not worried about those sorts of things. I am afraid of the reactions of my family since I pretended to be something Im not my whole life. I am also afraid to go see a Therapist, because they are professionals and Im not sure if I can keep the mask up or not. I do not want to spend the rest of my life in a mental hospital. I thought it would go away after a short while, but it seems the more time I ignore it, the stronger it gets. Please tell me I am not crazy.

A. This is a difficult question to answer without more information. For instance, what do you mean by two personalities? What are they like? Does only one personality have an urge to kill? How often do you feel this way and how strong are the urges?

The concept of multiple or split personalities has existed for centuries. People may believe in the separation of personality because it is difficult to comprehend how wildly disparate ideas and views can exist within one mind. It’s possible because we are complex beings.

You mentioned being afraid of the reactions of your family because you have been pretending. Are you faking emotions such as empathy or guilt? How do you know with certainty that you’ve never experienced empathy or guilt?

In general, if you’re worried about your mental health, then you should consult a professional who can determine if there’s a problem. You don’t have to worry about “keeping the mask up” because it’s important to be honest with your therapist. Otherwise, therapy doesn’t work. The therapist can’t help you if you don’t tell the truth. If you tell the therapist what you wrote in this letter, it will not shock them. Your thoughts and urges are not uncommon.

Your other concern is being hospitalized. In reality it is very, very difficult (did I say very?) to hospitalize someone against their will. Many people who should be hospitalized for their own good, to protect them, won’t be, because they don’t want to be.

Hospitalization only occurs in cases of imminent danger and this does not seem like one of those cases. Having thoughts and urges is generally not an emergency situation. Making plans to carry out homicidal or suicidal acts, however, are emergency situations and in those cases, hospitalization may be possible.

I also want to address your fear of being “crazy.” I received many letters about similar topics, suggesting that this is a relatively common line of thinking among the lay public, but therapists don’t think this way. They want to help and they will know what to do should you decide to seek help. Counseling is recommended and I hope you consider it. Please take care.

Dr. Kristina Randle