Billy Milligan: DID/MPD and Criminal Defense

Biography and Crimes

Billy Milligan is perhaps the most famous multiple charged with major crimes. Milligan, who claimed to have 24 personalities, committed several felonies including armed robbery, he was arrested for three rapes on the Ohio State University campus in Athens, Ohio and whose defense was that he wasn’t the perpetrator; rather it was one of his alters. His lawyers pleaded insanity. Incredibly, he became the first person acquitted of major crimes by this reason, instead of spending a decade in mental hospitals.

Milligan claimed he had been asleep for 7 years during the crime spree. When he awoke in jail,in 1977, arrested for the kidnapping and rape of three women,he was a shattered, frightened man who had no idea what he had done. Or what his personalities had done. Psychiatrists who interviewed with Milligan at the time of his trial diagnosed him with the disorder.

Milligan’s alters had distinctly different personalities and existed to serve different purposes. One alter named April, sought to kill Milligan’s stepfather. Another, a lesbian named Bad Lana, was responsible for the rapes that led to his arrest. Kevin dealt drugs and planned a robbery. Dana was the 8-year-old Keeper of Pain. Ragan was a thief. Christopher, a happy, earnest 13-year-old with a British accent liked to play the harmonica.  Tommy was a hostile 16-year-old teenager. Christine, who loved candy, learned to answer to the name Billy. Cathy, a toddler, was still learning how to walk. There were boys named Shawn, Philip, Jimbo and Arthur. There were Undesirables, whom Arthur, who was supposed to be a protector, “sent away” when they were “no longer functional.” The Teacher was the sole personality who “was able to put them all together.”

At times, Billy felt hurt if he felt his doctor was “sending him away.” Christine emerged to relay an incident in school many years before, where she had no idea where to sit. Two students warned her away from their seats. Her teacher, Mrs. Roth, had to help Christine find her seat. Christine left and when Billy emerged he was astounded to find himself in a classroom. Mrs. Roth thanked Billy for bringing her an apple, which confused him since he had no recollection of the incident. Arthur awoke in his place to find himself wearing two different coloured socks. Billy awoke and was startled to discover he had written a math test.

Milligan was considered “strange”. He often had trances that other people noticed.. Milligan decided he must be insane.

Film

Leonardo DiCaprio who is preparing to portray Milligan in the film The Crowded Room.  Before he finally agreed to play the part, DiCaprio considered starring in the role for 20 years.

While preparing for the role, DiCaprio asked Milligan what being a multiple was like. Milligan’s reply was “imagine you are reaching for a glass in a cupboard then suddenly you are standing in a park with no idea how you got there.”

Childhood

Milligan was allegedly abused by his stepfather, Chalmer Milligan. There was a great deal of instability in Milligan’s childhood; his mother, Dorothy Milligan, married 2 different men, the first being Dick Jonas. She had children with both of her husbands, and a common-law boyfriend. Dorothy divorced Jonas, re-married him, then divorced him one year later. Dorothy also lived with Billy’s biological father, a married man who was severely alcoholic and committed suicide when Billy was 4 years old. She then met and married the allegedly abusive Chalmer in 1973, when Billy was 8 years old. All in all it was not a pleasant childhood.

Milligan recalled an incident where Chalmer brought him outside near a tree and forced him to dig a shallow grave. He then sexually assaulted Milligan and told him if he told anyone, he would bury him alive. He buried Milligan and stuck a pipe in his mouth for air. Naturally the odd, abused boy was bullied by neighbourhood boys. Tommy, one of Milligan’s alters recalled an episode where he awoke in a pit and discovered a gang of boys hurling rocks at him. Ragan emerged and furiously climbed out of the pit with a switchblade, ready to stab anyone who tried to hurt him. When Chalmers heard of the incident, he beat the boy.

Years later, Dorothy recalled that Milligan would often appear to sleepwalk as he wandered away from home or school. She had to drive downtown when someone called her to retrieve Milligan and bring him home. Dorothy stated the school tried to tell her that his behavior was drug-related but “I knew it wasn’t.” Yet Dorothy never protected her son from Chalmer. She claimed she didn’t know her husband was abusing her son.

Artwork

Milligan drew and painted a number of work, including a beautifully depicted landscape.  Milligan also painted seven of his alters, including a woman and a little girl. He named them Allen, Tommy, Arthur, Adalana, Christene, Ragen, and Kevin.

Death

Life remained unstable for Milligan after the trial. He was incarcerated for a time at the Athens Mental Hospital located in what was known as the Athens Lunatic Asylum. It is now named “The Ridges.” The centre core of the building has been transformed into the Kennedy Art Museum.Milligan died of cancer in the Massillon Mental Hospital on December 12, 2014, at the age of 59.

Iatrogenesis – Sybil Exposed

There is a body of psychiatrists who believe that DID is actually manufactured, whether intentionally or unintentionally, by the therapist. This phenomenon, known as iatrogenesis, sheds considerable doubt upon the existence of DID. It is speculated that some very famous cases of MPD/DID have been created by therapists. Debbie Nathan’s work, Sybil Exposed, explored the likelihood that Shirley Ardell Mason’s psychiatrist, Dr. Connie Wilbur, had induced false memories in Mason in order to create a best-selling “non-fiction” about multiple personality disorder, as it was then known.

Shirley Ardell Mason (Sybil)
Sally Fields made Mason (Sybil) a household name when she starred in the 1978 mini-series “Sybil.” Her portrayal of the many different alters that supposedly shared one body, as well as the supposedly non-fiction publication entitled “Sybil” became the “bible” for people who believed they suffered from MPD. Fields displayed a range of colorful characters including an infant, a child whose role was to accept physical and sexual abuse, a religious alter, an alter who replaced Sybil’s grandmother upon her death and numerous others. Patients who believed they possessed MPD diligently mimicked Fields and displayed extremely unique alters.

Dr Connie Wilbur, Mason’s psychiatrist has been accused of manufacturing not only Mason’s personas, but also her childhood trauma at her mother’s hands. Wilbur informed Mason she had no interest in treating Mason unless she possessed the disorder. Accordingly Mason informed the good doctor she did indeed possess several personalities, all of which were the result of childhood abuse.

Debbie Nathan, author of Sybil Exposed, strongly believes Wilbur and Mason invented the account, although their motives were very different: Sybil wished to retain Wilbur’s services and Wilbur was on a quest to become the first recognized American psychiatrist in psychiatric publications to treat a full-blown multiple. Wilbur encouraged her client to read about MPD. Moreover, Wilbur fed Mason with drugs that were prescribed for women during that era: tranquilizers for the sexually frustrated housewife. Dexenol, also known as speed, was another common prescribed medication.Wilbur used the drugs so Mason could “remember” her childhood trauma.

Flora Schreiber, the author of Sybil, had her own agenda. She was previously published with a number of non-fiction and fictions works but she hadn’t experienced financial success. Schreiber was in need of a literary breakthrough, one that would put her name on the map and earn her an income. It has been documented that Schreiber was unhappy about editing the book. She doubted Wilbur’s motives. At times Schreiber advised Wilbur that embellishing Mason’s childhood and changing stories wasn’t ethical. Wilbur’s response was that she would replace Shreiber if she refused to edit the account. Schreiber felt she had no choice but to acquiesce.

Wilbur went so far as to administer ECT, electro-convulsive therapy on Mason. Added to this, Wilbur gave Mason pentathol, an old drug from WWII that was used to help soldiers recover from shell-shock. At the time it was believed that pentathol was a type of truth serum that forced people to tell the truth but in reality the drug enables the user to experience fanasies.

Around this time Wilbur adopted the role of mother to Mason: she paid her rent, bought her clothes and made it clear she disliked Mattie Mason, Sybil’s maligned mother. Mason’s writings included a passage that stated: I idealize and idolize you. I believe whatever you say must be right. Wilbur and Mason decided to write a non-fiction book about Mason’s experiences. The author, Flora Schreiber suggested the book would be more interesting if the multitude of child alters Mason possessed were adults, so many child alters became adults in the book.

The Women’s Movement
In the 1970s, the women’s movement was at its peak. Many women wrote to Schreiber stating they had also experienced sexual and emotional abuse as children. Most women stated it was males in their histories, not a puzzling fact, considering the backlash against the predominantly patriarchal society. The diagnosis of MPD sky-rockted. women with eating disorders or anxiety disorders were now diagnosed as multiples. The ridiculous phenomenon of supposed Satanic cults abusing children became popular. In particular daycare centres became popular targets and innocent daycare workers spent time in jail for crimes they had never committed. This type of phenomenon is the result of what Nathan calls “junk science.”

Satanic Cults and Child Abuse
Finally too many women accused their elderly parents of Satanic abuse and the social tides began to turn away from the unlikely accusations. Along with the cynicism towards Satanic cults came a healthy skepticism toward the plethora of MPD diagnoses. The condition is still included in the DSM-5 but it is now listed as DID. The significant difference between the two is the belief that DID isn’t comprised of alters but rather the client is a victim of iatrogonesis who needs to be taught healthy ways to handle stress and trauma rather than relying upon the false belief that alters are needed to perform this function..The client isn’t a fake; rather is the result of unhealthy hypnosis. Quite like what happened to Shirley Ardell Mason.

Sexual Abuse and DID – Judith Machree

Many therapists believe that extreme sexual abuse is the cause of DID in children and teenagers. There may be some truth to this theory but many psychiatrists are skeptical about this claim. There is no scientific proof that sex abuse causes DID. There are no longitudinal studies on DID that could answer many questions about this profound disorder, including its causes. Reliving memories and experiencing the emotional responses, known as abreaction, doesn’t seem to heal the patient. This would suggest that sexual abuse may not be the cause since the therapeutic procedure isn’t healing the patient’s memories or history. Without a cure, it is very difficult to pinpoint the cause.

Author Judith Machree,(pictured left), herself an alleged former multiple and victim of childhood sexual abuse, claims otherwise. She cites a number of examples that alerted her to the fact that she was a multiple. These are some examples:

1. After Machree married a supportive man she claims kept her on “an even keel”, she became more aware of her confusion and breaks with reality. She offers an odd example “I could park my car and go into the mall and not be able to find my car at all. I had no idea where I parked it.” If that’s a legitimate example of DID then I might have reason to worry: I forget where I have parked my car on a regular basis. I have spent up to a minute or two searching for it. I don’t see that as a sign of trauma.
2. Machree cited a major depressive episode she had after her 17-year-old son left to join the military as a symptom of her DID. I doubt that claim. Many people have major depressive episodes, including when a family member leaves for an extended time period. It seems extreme, but as Machree explained, she was very close to her son and was quite dependent on him.
3.  Her therapist suspected she had been abused because she had several gaps in her memory about her father. I don’t know what she refers to as gaps. Does this mean she cannot remember years of interacting with her parent? Neither can most people. I have a general idea of my relationship with my parents over the years and some specific memories associated with them, but I certainly cannot recall in detail most of my interactions with them.
4.  As with most DID stories, Machree claims “the things that happened to me happened at such an early age.” Actually, those who believe in the phenomenon of DID claim that DID can occur at all ages in life, from early childhood to adulthood. Some people even claim that DID can be inherited. Ergo, children may be born with the disorder and it isn’t the result of childhood trauma.

Was Machree a victim of childhood sexual abuse? Who knows? Many women are, so that is entirely possible. Did she develop the extremely rare phenomenon known as dissociative identity disorder as a result? I find that hard to believe. Her story is so familiar it is practically an echo of all the published documentation of people’s experiences with DID. I have only read about one woman who claimed she was born with the condition. I have not read yet about people who developed DID in their teen years or in adulthood but this development is now identified in the DSM-5. Now that this information has been published, I expect that many people will suddenly come forward with stories of developing DID in their teens and later years. Trends often develop from suggestions about various disorders that are published in psychiatric manuals and journals.

 

 

 

The Abuser

I have referred to Dr. Sam Vaknin, video The Abuser’s Mind in researching this blog.Link is enclosed.

The Abuser’s Identity
Abusers are male or female, adults,senior citizens, teens or even children. They molest, rape, beat and starve their victims. They taunt them, insult them and tell the victim s/he has no escape and is worthless. In extreme cases, the victim is a sexual toy for the abuser and sometimes friends of the abuser. When physical torture is involved with sexual abuse, this is often the extreme that causes MPD.  Thankfully, it is rare but according to the accounts of MPD victims, it happens.

The Abuser’s History and M.O.
The abuser frequently hails from an abusive background. S/he was once an abuse victim and continues the cycle with his or her own children or other victim. The abuser usually offers a type of “split personality”: one is the respectable persona presented to the world outside the house; the other is the monster within the family. It is almost as though the abuser has a “mild form of multiple personality.” Sometimes the abuser is a respected member of the community, “a pillar of the community” so to speak. S/he is not a split personality of the DID/MPD variety. Rather, this person is in full control of his/her faculties and chooses to don a disguise when functioning in public. The abuser also has a choice in abusing the victim and is fully capable of seeking help, rather than creating an abuser-victim cycle in the home.

The Abuser’s Mind
At the abuser’s core is a very insecure individual with extremely low self-esteem. In order to feel important and powerful, the abuser needs to abuse and humiliate others. Often the abuser has made no significant accomplishments in his/her life. The victim is merely a 2-dimensional object. S/he doesn’t merit empathy. The victim doesn’t exist as a real person. Sometimes the victim doesn’t realize there is something wrong with the relationship and believes this lifestyle is normal.  Both the abuser and the victim suffer from disturbances in their sense of self-worth. This doesn’t apply to child victims. Vaknin refers to adults in this type of relationship.

Abusers are narcissists. They “are steeped in grandiose fantasies about their own self-importance.” At the same time, the narcissist fears that he doesn’t “measure up” to society’s expectations. S/he enters a fantasy world of personal accomplishment and self-worth. The victim is well aware that his or her sense of important is false but the victim plays the role of a child and greatly fears abandonment, even by the abuser. The victim is known as “co-dependent” in an unhealthy relationship. The abuser punishes the victim whenever she attempts to establish her own boundaries and independent needs. The abuser is terrified that the victim will develop enough autonomy that he will one day leave the relationship.

Types of Psychological Abuse 

Patrician Evans lists a number of psychological abuses used by abusers:

1. Withholding – or the silent treatment. An abuser can ignore the victim for days.
2. Refuting the victim’s statements or actions.
3. Discounting or “putting down” the victim’s emotions, hopes and fears.
4. Sadistic and brutal humour which are insults poorly disguised as a joke. When the victim is injured, the abuser can claim innocence. “I was just kidding,” is a typical response.
5. Blocking or avoiding a meaningful exchange in conversation
6. The ruination of intimacy
7. Blaming/accusing – “if you didn’t get me so angry I wouldn’t have to hit you.”
8. Judging and criticizing.
9. Threatening
10. Name-calling
11. Denial – “I didn’t say that or do that”
12. Smothering – this one is covert at first and is very dangerous. The victim isn’t allowed contact with other friends or even family. This isolation is meant to isolate the victim and prevent her from seeking help and solace from the abuser.
13. Unrealistic expectations – these tend to be directed at children and youth. The abuser knows the expectations are unrealistic and controls the victim by “setting the bar too high.” When the victim fails to reach the unattainable goals, the abuser is victorious and has succeeded in degrading the victim.
14. Being unpredictable is a significant form of abuse. One day the household rules are firmly in place. The next day the household rules change and the victim is punished for trying to follow the rules. Over time the victim is so disoriented that s/he doesn’t know when to expect physical or emotional abuse for unpredictably incorrect behaviour.
15. Pretending s/he is victimized rather than being the abuser This type of tactic can be very convincing and can mislead people outside the family.

There are many more evil tactics an abuser uses with her victims. All of these tactics disarm and alienate the victim, rendering him or her helpless.

Social and Cultural Influences
Identifying unhealthy patterns between abuser and victim can depend on a close examination of prevailing social and cultural influences. Oftentimes, specific cultures belittle women and treat them as second-class citizens. When a woman attempts to distance herself from the abuse, her family and friends may abandon her. The community works hard to maintain the abusive cycle while pretending the abuse doesn’t exist. In this situation it is extremely difficult for the victim to seek help for herself. Once she crosses that line, there is no turning back and her entire community rejects her, leaving her alone in the world. This leads to an excruciating aftermath where the victim becomes isolated and very depressed, sometimes leading to suicide.

Working with social mores and beliefs is part of the complicated process of separating abuser and victim. It is also a barrier in supporting the victim in her own belief that the behaviour she receives isn’t deserved. On the one hand, she is unhappy living with an abuser. On the other, her family and friends live this way. It is a very confusing and complicated process to assist this victim in leaving the abuser. The abuser in this type of culture cannot be “cured.” He is supported by his cultural norms and this increases his sense of righteousness and his power over the victim.

 

 

3 Case Studies

Karen Overhill is a documented case of MPD by  Dr Richard Baer, a top Chicago psychiatrist. In 1990, Overhill began treatment with Baer for depression. She was married to a physically abusive husband and had a verbally abusive mother-in-law. She told Baer she often “lost time.” It was two frightening incidents that prompted her to get professional help. Once she awoke to find a knife beneath her pillow. After supposedly visiting a casino, Overhill won $25,000.00, with no knowledge of having been in the establishment. She gave birth to her first child and when her family arrived in the hospital she didn’t recognize her mother-in-law or her husband. Excerpts from her therapist’s text about her case are included in italics.

During the C-section birth, she began to scream in pain. The doctor barked orders at a nurse and Overhill was sent under general anesthetic. When she awoke she had no idea that she’d given birth or why she was in the hospital. She discovered that during the C-section she had vomited and the bile had run back down into her throat and reached her lungs. For that reason, she was kept in hospital until she was well.

Sometimes I’d pick up a novel and discover the bookmark had moved – yet I couldn’t remember reading the chapter. Once, I found a knife under my pillow that I couldn’t explain. After the birth of my second child, I began to lose more time and the occurrences left me almost suicidal. Crazy as it must sound, I could not remember marrying or making love to my husband. Nor could I remember anything about my life between the ages of six and 10.

History
Overhill’s story sounds like many other people’s who have MPD. She was routinely molested and physically abused by her father, grandfather and others from an early age. During this time, Overhill developed alters to take over her life during the abuse, and eventually during non-abusive experiences. As a baby, she was choked and thrown against a wall by her father. When she was a schoolgirl, her dad and grandfather would stick pins in her legs. Where was her mother during these incidents? Presumably she looked the other way. Baer found that the personalities living inside Overhill were male and female, black and white, and ranged in age from two to 34. Baer told Karen about his suspicions in November 1993, after receiving a letter that bore a scrawled note: “My name is Claire. I am seven years old. I live inside Karen.”

After one Friday night I wrote: “It’s 2am and I don’t know where I am or how I got here. I don’t know what city I’m in. There are no homes; it seems deserted. I don’t know what to do. Should I ask for help, or just keep driving until something seems familiar? “I can’t call my husband. He wouldn’t understand. I am alone and scared. I’m at a petrol station and there’s a lady inside. I’ll ask her. The lady was very helpful and now I know where I am. We will get home OK.”

The above account sounds suspiciously like the opening chapter in Sybil. Sybil finds herself in a “non-place” with “snow clinging to her legs.” She doesn’t know how she arrived at her location. it is nightfall and she has wandered away from her car in a quest to discover her whereabouts. She happens upon a gas station with a male attendant. She attempts to get help from him but he shakes his head and turns away from her. Perhaps dissociative fugues are common with MPDs and upon awakening, the core personality does seek help at gas stations. It is difficult to ascertain whether or not these accounts are truthful.

Overhill’s family subjected her to horrific rituals where she’d be shut into a coffin or strapped to a table and sexually assaulted. If memory serves (pun) I read some of Overhill’s account in Baer’s biography: A Life in Pieces: the Harrowing True Story of a Woman with Multiple Personality Disorder. I believe her father was an undertaker and hence the access to a coffin and a funeral home. I recall a memory where her father and a friend of his forced Overhill to touch a corpse that had died with an erection. “I had some awareness of it at the time,” she stated in an interview with a magazine called The Mirror. “I’d see bruises and cuts. I had bits and pieces of memories, but you don’t want to ask too many questions for fear of it leading to more abuse. Later, I asked questions of my mother and brothers in a round about way to try and confirm what had gone on. Sometimes I remembered horrible things, but I couldn’t remember feeling pain – the alters had taken it away. It wasn’t like today, where you mention abuse and everyone comes running. In those days people beat their children. I went to a Catholic school. If the teachers saw welts, they thought it was discipline. And I thought I was bad and deserved punishment, so I didn’t complain. My father and grandfather said that if I told anyone they’d kill me. So I put make-up over the wounds or wore long pants if I had bruises.

Overhill claimed she was taken to a funeral parlour in the night and made to lie naked on an embalming table. While strange men molested her, her father stabbed her repeatedly in the abdomen with needles. She also claimed she was taken to a factory and used as the centrepiece of an obscene religious ritual. Personally, that whole satanic cult accusation has never impressed me. I am not convinced that satanic cults even exist. If they do, why are there not more headlines about them? Why are they so “underground” as to be almost impossible to locate? Cults don’t tend to shy aware from public exposure They believe fully in their own purpose and usually recruit more members over time. Even Baer held serious doubts about Overhill’s claims of satanic abuse.

In 1993, the year Overhill sent the letter claiming to be Claire to Baer, her dad was convicted of 19 counts of sexually abusing her niece. The conviction was probably the catalyst that gave Overhill the courage to reveal her past to the doctor. It took 19 years of therapy before Overhill was fully integrated.

I began trying to identify the different voices I could hear, and came up with a list that I gave to Dr Baer.They included four children under ten (three girls and a boy), two teenage girls (Julie and Sandy), a 21-year-old woman, myself, a man and a woman aged 34 (Holdon and Katherine) and another very angry man.

Baer and Overhill agreed on integration as a solution. “Each integration was so exhausting. I was receiving all their memories. And there were physical issues, too. One alter would do things left-handed and the others right-handed. Lots of the alters had different walks. After integrating one of the child alters I didn’t know how to drive. That wasn’t a good day. I sideswiped a car coming out of the parking lot.”

After treatment ceased and Overhill was fully integrated she divorced her husband and moved to the mid-west. A review of Baer’s text offers an interesting insight into a comment Baer included in the foreword:  “As a practical matter for therapy,” [Baer] writes, “it matters less what actually happened… These are the images in Karen’s mind, and they, and the feelings associated with them, are real to her… I don’t have to decide exactly what happened; I just need to understand what Karen thinks and feels.”

The critic’s response was: This is a curious intellectual stance to adopt in a memoir with the subtitle a “harrowing true story”. Even from a purely therapeutic perspective, not all mental images are created equal. When a woman claims, for example, to have been the victim of a Satanic paedophile cult, I’d say it’s the facts and not just her feelings that matter.

I’m of a mind (pun) to agree with the critic. If a person is going to bring a lawsuit against an abuser, or even to allege abuse against a person, than “images” and “feelings” have to hold up to actual facts. I’m not stating Overhill lied to her doctor. What I am stating is that alleged abuse against a person is very serious and has long-term legal and social implications.The drawback for victims is that there are issues with determining proof. However a thorough, long-term police investigation usually reveals the truthfulness of allegations of abuse.

There was Jensen, for example, an 11-year-old boy, who was “born” in 1971 when I was 12 years old and was raped by my grandmother’s brother. I’d never told anyone about the abuse that I’d suffered for fear that my father would kill me – as he had threatened. Jensen fought back against the abuse and tried to bind my breasts flat to help me appear more masculine. He especially hated older men.

Recalling the Shirley Ardell Mason case (Sybil), Dr. Cornelia Wilbur is believed to have manufactured most of Mason’s personalities and memories, using sodium pentothal. Mason once stated to a psychiatrist who treated her when Wilbur was out-of-town that Wilbur preferred her to be a particular alter during their sessions. Mason also stated that Wilbur told her if she wasn’t a multiple, she wouldn’t treat Mason, since this was the disorder that interested the good doctor. This type of information, along with suggesting that it is the patient’s feelings and not whether or not the accounts of abuse are truthful, that are the most significant factor in treating MPD, that seriously detract from the validity of MPD and DID..

A college friend of Mason’s, Jean Lane, recalled studying art with Mason. She claimed that Mason was very thin and often very sick. She frequently blacked out throughout the day. Occasionally she went out “drinking and carousing” at bars. During the day “she would just simply become comatose.”  Mason and Lane argued one evening and a child’s voice emerged.Lane recalled that Mason’s mother was very protective and caring. Mason eventually took over her mother’s life as she was dying. Mattie was tall, very thin, pleasant, and discouraged Mason from keeping pet rats. Her father was “more distant.” When Mattie passed and the father got a girlfriend, Mason became unhinged and began seeking a mother figure. Lane was careful not to fill that role. Mason “demanded a great deal of care. She didn’t have the concept that there was more than one person, you see.”

Unless someone loaned Mason money, she went hungry. Mason seemed to find a way to get people to take care of her. Lane believed Mason wasn’t abused. If anything she was too sheltered and taken care of too well by her mother. Lane commented that “overly protective homes….where [people will] do your decisions keep you out of trouble give you support and tell you how wonderful you are…. that is a very comforting thing to have.” Lane did believe Mason had more than one personality.

It may seem bizarre that a human being can be organised in this way. It’s an alternative way of thinking and functioning, but it uses the same mental tools – the same brain – that we all have. If we all grew up under the same abusive circumstances as me, maybe we’d all operate in the way I did then.

The late Truddi Chase a striking blonde woman, was another extraordinary MPD case about a woman with 92 separate personalities. The first text she wrote “When Rabbit Howls” was written by her many alters, a major breakthrough in documenting DID at the time.The text revealed Chase’s extreme sexual and physical abuse by both her stepfather and her biological mother. I found several discrepancies in the text that prevented me from fully accepting all of her recollections.

For one, I felt the composite character who interacted with “Stanley,” (the nickname she coined for her doctor), was questionable. Why would she use a fictional character who supposedly assists Stanley in her treatment in an autobiography? The concept was to edit the text in length, since Stanley must have conferenced with many people, but the character detracts from the text’s authenticity.

She also included a strange delusion from an alter named Ean, who supposedly was as old as time and had existed long before Chase was born. He offered his odd depiction of a story whereby he rides upon a horse and collects a beautiful dark-haired woman en route to leave with him. Leave where, I don’t know.

On the plus side, the “Troops” as the alters called themselves, spoke continually to one another throughout the text and the conversations are detailed and appear to support each other’s account of abuse. Although the abuse seems too extraordinary to believe, it is probably possible that there are people so evil as to abuse a child in this severe a manner. In Chase’s case she refused integration as a form of therapy.

The “integration” felt like I’d gone through major surgery, and it left me with serious doubts about ever doing it again. At home, my mind raced as if I were watching a movie in fast forward. As the memories of what had happened to me poured into me, I felt every pain associated with them – and even though each pain lasted only a few seconds, I just wanted these memories to stop. During the next week, I worked through all the memories the Julie character had, and gradually I started functioning again. I realised that having Julie had always been a form of protection from what had happened to me as a child – and now I was going to have to deal with the memories of the degradation myself.

The musician Quincy Jones, once stated it was important to “leave room for God to walk in the door“ when living life, contemplating possibilities, judging situations. Perhaps that’s key in determining the validity of MPD.

 

 

 

 

 

 

The Function of Alters

Alters are the basis of multiple personality disorder and dissociative identity disorder.They emerge from the core personality, or the original identity, that is born within the body and brain. When the patient experiences more trauma than s/he can withstand but there is no chance of physical escape, the patient develops an alter ego, or an alter personality state. This personality is constructed to accept and deal with the trauma as it happens. The patient then retreats somewhere inside her or his head and doesn’t emerge until the crisis is over. In one rare case of MPD, the initial trauma was so extreme that the original patient regressed into an infantile state and never re-emerged for the rest of her life.

DID is rare or it isn’t rare depending upon who you ask. The circumstances that generally accompany this disorder are so extreme and repetitive as to be very unlikely. Dr. Richard Baer, the psychiatrist who treated Karen Overhill, stated, you have to be very, very careful about suggesting things to a patient. I think these [multiple personality] patients are very, very rare because of the circumstances required to create them. It takes a significant amount of trauma to cause a person to start to disassociate from it and that trauma has to take place over a sustained period of time, bringing with it multiple disassociations that become established as “alters.”

Types of Trauma Trauma doesn’t only refer to abuse. There are many types of trauma that a person can suffer and many reactions can result from any of them. Dissociation is one of many psychological defenses that protect people from harm although it doesn’t happen to everyone who experiences great trauma.

Ritual Child Abuse Extreme sexual, emotional and physical ritual abuse in childhood is a common trait among people with MPD or DID. It is believed that this is a cause of MPD but there is a problem with this theory. Not everyone who has MPD has been sexually, emotionally or physically abused. To be sure, repetitive, extreme abuse has to have a long-term effect on the patient. Developing multiple egos to distance oneself from pain and fear is a highly successful reaction to this type of abuse. The original personality leaves the situation and another emerges to tolerate the abuse, leaving the original, the “owner” of the body, unaware that abuse exists.

Extreme Duress
In the biography The Three Faces of Eve and later in her own autobiography I Am Eve, Christine Sizemore discussed how she began her experience as a multiple. At the age of two Sizemore witnessed a terrible accident at a sawmill where her father worked; a man was severed in half. As Sizemore’s mother held her and ran toward the accident, she mumbled to herself that the men were “careless” and she worried aloud whether it was Sizemore’s father who had died. Sizemore remembered being at the side of the pit where the worker’s body lay and, becoming overwhelmed with fear, she looked across the pit to see another little red-haired girl who looked calmly down into the pit. Of course, the little girl wasn’t real. This was Sizemore’s first “split”, as it is often called.

Extreme duress could also include the experience of war veterans, children suffering from long-term disease or illness, chaotic households, and many other situations, although these are not known to elicit MPD. Why it is that one type of stressor and not another results in a dissociation of the mind hasn’t been fully explored. There is the suggestion that some people are more “resilient” and do not need to retreat somewhere else into the mind.

What Alters Do An alter steps forward to take the place of a person who is overwhelmed during a severe traumatic episode and maintains control over the body until the trauma has passed. This alter experiences the trauma but the original person doesn’t. There may be several alters who fulfill this function. Some may develop at the same time during an extremely stressful incident. Others may develop later in life. Although it was once thought that alters only developed in childhood up to the age of 10, it is now believed that alters can begin in adulthood.

Types of Alters Alters are as unique as the individuals who possess them. No two people have the exact same alter, anymore than a person without MPD is exactly the same as another person. There are similarities however and most multiples possess a general form of personality states who fulfill specific functions. These include:

Pain There is usually an alter has no “choice” in experiencing physical abuse and is made from sheer desperation by the original person. This alter emerges when danger is nearby. The original person disappears into the mind and the new alter suffers the abuse or trauma.There may be more than one alter who suffers physical abuse.

Information  There is almost always one alter who possesses significant information that is relayed to the therapist This alter generally knows how many alters the patient possesses, who they are, their names, and their functions. If anyone was considered an eavesdropper, this alter would be it. The alter never suffers abuse and has no memory of it.

Child  There is usually a regressed alter who hasn’t had the chance to mature into adulthood due to the repression of the childhood environment. The child alter stays carefully hidden during the patient’s youth and tends to emerge under safe circumstances, usually when the patient is older and typically is in therapy,

Sexual Alter  This alter emerges when the patient engages in sexual activity of any sort. This alter is the one who suffers sexual abuse, and particularly pleasure that has been taught during abuse. In that way, the guilt and shame of sexuality is visited upon the sexual alter and not the patient.

Suicidal Alter  Often there is a suicidal alter who simply cannot recover from the childhood and possibly teenage trauma. This personality state cannot cope and wishes to die however this alter has no concept of “killing” the others. S/he doesn’t understand that if s/he successfully commits suicide, all alters and the patient will die. Other alters rally around the suicidal alter when s/he/it emerges to prevent the suicide.

Opposite Gender Alter  Sometimes multiples have both men and women (or boys and girls) living within their minds. Sometimes these alters develop due to the admiration of a person of the opposite sex, or the erroneous belief that had s/he been born the opposite sex, the abuse would never have happened. Truddi Chase who wrote “When Rabbit Howls“, an autobiography of her life as a multiple, possessed a strong, black, male alter named Mean Joe Green. Green was a famous, professional football player when Chase was in her youth. She also saw him as a kind man. She personified him as an alter by his nickname and he functioned as a “protector” for the children.

Protector  This alter is always hovering in the wings in case danger emerges. This alter usually prevents danger by physically removing the patient from a situation before harm can happen. The protector may well be responsible for occasional fugue states when the patient travels a considerable distance under duress but has no idea how s/he arrived at the end destination. Strangely, the protector can function in a dual role and also commit self-harm against the patient.

Self-Abuse  This alter continues the punishment and hatred of the patient’s childhood abuser. The concept has been placed firmly in the patient’s mind that s/he was very “bad” as a child and deserved the abuse. Ergo, throughout adulthood the patient holds this same false belief and punishes him/herself by committing abusive acts against the body such as cutting and slashing with a razor, burning, attempting to “murder” the body. The self-abusing alter perpetuates the abuse cycle. The self-abuse alter often states that s/he hates the patient,

Mother  The patient mothers her own child but she may not be present during the birth due to the extreme pain of labour. The patient may regress inward and the alter who experiences pain births the infant. Ergo the patient has no memory of the birth or even parts of the pregnancy but is prepared to mother the child.Other alters emerge during child-rearing but usually they claim no “ownership” of the child, including the alter that has birthed it. There is usually a strong bond between the patient and child. Seldom does the patient abuse her own child.

The Abuser  This alter replaces the actual abuser, whether s/he is a parent, guardian, or another individual. The patient develops this alter as a sign of self-hatred. The abuser taunts and torments the alter. The cyclical abuse continues.

Pairs Sometimes two alters emerge as one. They fulfill the same purpose and even have separate names. They may not be the same race or gender. For whatever reason, these alters feel the need for their own alter in order to function.

Animal  It has been reported that some patients have an animal alter but I have never encountered such a case in my research and readings. Supposedly this alter replaces a childhood pet that was either abused to death by the abuser or ran away, or died of old age.

Relative Patients have alters who are representative of a relative in their family who has been kind to them, and has not been a threat. This alter tends to develop due to the death of this person. The death is too distressing for the patient and an alter develops who replaces the deceased loved one.

Employee – Someone has to work in order to earn a living. Sometimes an alter who can work with colleagues and if necessary the public fills this role. Sometimes it is the original personality. Sometimes there is a switching between the two or other alters may also materialize to maintain order and minimize stress during the course of the day.

Alters aren’t sketched in stone. Sometimes their functions may overlap. In one day, several alters may control the body, depending on the functions that are required. During this time, the patient seems to lose track of time. “Losing time” has long been thought to be a major characteristic of people with MPD or DID although this may not be true for everyone. MPD and DID have many different symptoms and not all of them can be listed in one blog, since many symptoms may not be public knowledge, or have even been discovered.

Characteristics of Alters Sometimes alters are unaware of each other. Sometimes some alters are aware of some alters but not others. These states are called amnesia, and there are different types.

Amnesia Barrier  Most patients claim they have no knowledge of their alters. Sometimes alters claim not to know about each other. This concept is being challenged in the psychiatric community. Lab experiments fail to locate an amnesia barrier.  The film The Three Faces of Eve demonstrated an alter named Eve Black who claimed “I know everything about her [the patient]”, but the knowledge wasn’t mutual.

Repression  Rather than amnesia, it is possible that patients experience repression of their alternate selves. There may be no “amnesia barrier”, but rather alters are repressed when the patient feels threatened. The implication is that the patient is aware of interactions with other people but s/he chooses to allow alters to take control over the body during the situation.

 

 

 

 

 

Multiple Personality Disorder (Hysterical Dissociative Disorder) and the DSM-II

DSM I (Diagnostic & Statistical Manual of Mental Disorders, Version I) was created after WWI to provide a framework for labeling post-war psychiatric causalities. DSM II was written after WWII for the same purpose. The texts were written in the USA by American psychiatrists. The International Code of Diseases (ICD) at that time through its present 9th edition has adopted these terms. MPD was listed as Hysterical Dissociative Disorder. As of the publication of the DSM-IV, psychiatric terminology distinguished two disorders that were once labelled ‘hysteria’: somatoform disorder and dissociative disorder.Patients with hysteria often experienced what has been termed as the Cassandra Effect. In Greek literature, Cassandra was a woman whom Apollo fell in love with and bestowed upon her the gift of prophecy. When she rebuffed his advances, he cursed her with the predicament of not being believed. Hysteria had been a favourite term with Victorian Era psychiatrists, especially that of Sigmund Freud. Hysteria was strictly a female phenomenon that included faintness, nervousness, sexual desire, insomnia, fluid retention, heaviness in the abdomen, and many other symptoms. One physician catalogued seventy-five pages of symptoms; by the time he was done, even a sneezing fit could fit the diagnosis. Doctors thought that stresses of modern life caused women to develop faulty reproductive tracts (a wandering uterus).

Josef Breuer – Anna O.
Anna O. (Berta Pappenheim) was a patient of Breuer’s in the early 20th century. He diagnosed Anna with hysteria due to symptoms that included “severe cough, paralysis of the extremities on the right side of her body, and disturbances of vision, hearing, and speech, as well as hallucination and loss of consciousness.” Breuer observed that she experienced ‘absences‘, a change of personality accompanied by confusion Breuer decided that Bertha Pappenheim‘s illness was caused by her father’s death. He died on 5 April 1881. At the time she became “rigid” and did not eat for days. Breuer’s treatment included force-feeding and chloral injections. .

He described Anna’s behaviour as follows:

She had two completely separate states of consciousness which alternated quite often and suddenly, and in the course of her illness became more and more distinct. In the one state she was sad and apprehensive, but relatively normal. In the other state she had hallucinations and “misbehaved”, that is, she swore, threw pillows at people.

Breuer thought she was deranged and hoped she would die to end her suffering. However, Anna disappointed him: she recovered and led a productive life. Anna’s symptoms fitted the definition of what was known at that time as “split personality.” 

In the DSM-II hysteria dissociative disorder was a minor condition in the manual. It lacked its own code number. The DSM-III gave “Dissociative Disorders” its own section. Experts decided which disorders should be listed in DSM-IV. Skeptics disagreed that MPD existed. Instead they concluded that patients believed they had more than one personality. The goal of therapy wasn’t integration but helping patients to overcome the belief that they had other personalities.Accordingly the name was changed to DID, dissociative identity disorder in the DSM-5.

What I don’t comprehend is how a patient would believe s/he had multiple personalities in the first place, thereby needing to be cured of this delusion. Who puts the idea into the patient’s head? If anything, multiples typically argue against the notion that they possess alters and initially refuse to accept the diagnosis and integration since they believe it isn’t needed. Joan Francis Casey, in her text “Flock: The Autobiography of a Multiple Personality” demonstrated great resistance in therapy about the diagnosis, to the point where she angered her doctor. Doctors who refute the diagnosis of MPD haven’t addressed this issue to the best of my knowledge.

 

Multiple Personality Disorder and the DSM-III

1980 saw the revision of the DSM-II by the American Psychiatric Association. Several changes were made to the publication in the DSM-III concerning different disorders. One of the changes in the DSM-III was a separate category for the dissociative disorders. This gave considerable credence to the disorder. Of course it must be remembered that this was the time when Sybil was still fresh in people’s minds. Also around that time, Christine Sizemore, the “Eve” in “The Three Faces of Eve“, released a second publication about her experience with multiplicity. It had the unique perspective of being written in the first person by an integrated person who had suffered and been healed from the disorder.Sybil and The Minds of Billy Milligan soon followed, a “true” third person account, first as a text, then as a film, about a man who raped three women and used multiplicity as a legal defense during his trial.

In spite of multiple personality disorder’s inclusion in the DSM-III psychiatrists worldwide argued against its validity. At that time, MPD was almost completely an American phenomenon. It was very seldom reported by European physicians. It was and remains, an almost strictly a female phenomenon, with women being diagnosed as multiples approximately 8 times more often than men. Is that due to gender prejudice in the psychiatric system? Consider there is a listing in the DSM-5 for Hysteria, a disorder that defines women who display abnormal behaviour due to various stressors.

Since the publication of the Eve, Sybil and Milligan books, along with the inclusion of multiplicity in the DSM-III, there was a virtual explosion in the publication of psychiatric journals, books, biographical accounts, of accounts about patients with MPD. In 1980 there were a number of landmark publications about the disorder including E. L. Bliss’ study of fourteen patients, P. M. Coons systematic information about making a diagnosis, G. B. Greaves review article, B, G. Braun’s treatment recommendations and S. S. Marmer psychoanalytic study.  In 1989, Frank W. Putnam of the National Institutes of Mental Health published “Diagnosis and Treatment of Multiple Personality Disorder”. In 1989 Colin A. Ross, a researcher, published “Multiple Personality Disorder: Diagnosis, Clinical Features, and Treatment”.

In 1994 the DSM-IV renamed MPD as Dissociative Identity Disorder (DID) and the publication of “Guidelines for Treating Dissociative Identity Disorder In Adults” by the International Society for the Study of Dissociation. Screening instruments, diagnostic instruments, and a mental status exam were developed. There is increasing information to the general public. Yet the debate involving the existence of Dissociative Identity Disorder and Multiple Personality Disorder continues.
The evolving theory of thought about DID, that the patient needs to be cured of his or her belief that s/he possesses varying mental fragments, makes little sense to me personally. I wonder where the patient developed the idea that s/he was more than one person. If this diagnosis was given by a clinician who believes in MPD, but another clinician who does not insists the patient suffers from DID, who is right?

The History of Multiple Personality Disorder

MPD has been diagnosed very early in history. Some professionals believe that it was first “described” in the images of “shamans changed into animal forms” on cave walls during the Paleolithic Era. Throughout recorded history cases of demonic possession have been reported that many experts now believe are cases of of multiple personality. At that time, people interpreted these odd behaviours as best as they were able for such a primitive era.

Eberhardt Gmelin
Millenia later, in the 1800s, American psychiatrists began diagnosing what appeared to be cases of multiplicity. Eberhardt Gmelin’s 1791 account of “exchanged personality” is erroneously credited as being the first documented case of multiple personality.

Paracelsus 1646
However, in 1646, Paracelsus wrote of a woman who had “amnesia about an alternate personality who stole her money.” The case involved a 20-year-old woman living in Stuttgart who began speaking perfect French and speaking German with a French accent. Tellingly, this case took place the year the French Revolution began. During this time many French aristocrats left France and fled to Stuttgart for safety. When she was the “French Woman” she remembered everything she did while she was the “German Woman”, but while she was the “German Woman” she denied knowing anything of the “French Woman“. Gmelin could cause the personalities to switch with a movement of his hand. That sounds like therapist manipulation to me, and this is the grey area surrounding DID.

Benjamin Rush
Benjamin Rush, the “Father of American Psychiatry“, and chief surgeon of the Continental Army wrote the first text “Medical Inquiries and Observations Upon Diseases of the Mind.”  Rush included the concept of MPD and theorized the doubling of consciousness related to a disconnection between the two hemispheres of the brain.

The Strange Case of Mary Reynolds
Dr. Samuel Latham Mitchel in 1860, published an account entitled “The Strange Case of Mary Reynolds” in “Harper’s New Monthly Magazine“. Reynolds was born in England in 1785 and moved to Pennsylvania. The Reynolds household was strongly religious. During her childhood Reynolds was very melancholy and spent significant time in religious devotions. At 19, she became blind and deaf for six weeks, in what might have been a form of somatic disorder. Three months later she suddenly forgot things she had learned. Eventually she learned how to read and write although her penmanship was crude. Mitchel described new nature her as “buoyant, witty, fond of company and a lover of nature”. After five weeks, she suddenly returned to her prior self. The alter egos switched between each other for sixteen years Reynold reached her mid thirties, when she remained in her “buoyant, witty” ego until she died at 61.

Estelle 1840
Estelle was an 11-year-old Swiss girl in 1840 who seemed to have paralysis and was extremely sensitive to touch. It was believed that she developed a second personality who could walk and play. Tellingly, this alter could not tolerate her mother’s presence.  Her paralysis and sensitivity was probably a form of somatoform disorder and was embodied in an alter. It was quite probable that the mother was her abuser and the sensitivity to touch was a result of painful abuse from her parent. The child was supposedly cured the through various treatment methods, some of which are currently utilized in the psychiatric community.

Eugene Azam 1843
In the late 19th century, Eugene Azam, a surgeon and hypnotist, published reports of Felida X, an alleged case of multiple personality. Born in 1843, Felida X’s father died in her infancy. Felida X experienced a difficult childhood, meaning she was very abused. She exhibited three different personalities, The second personality manifested when Felida was 13 years old. Switching happened every day after a strong pain in the temple and a solid sleep for three minutes. The switching happened every 25 to 30 days and lasted a few hours. The third personality exhibited anxiety attacks and hallucinations. Eventually the first personality became pregnant and the second personality took responsibility for it.

Pierre Janet early 20th century
In the late19th century and early 20th century, Pierre Janet described the five cases of Leonie, Lucie, Rose, Marie and Marceline. Leonie had three or more personality states including a child named Nichette. Lucie, had three personality states with an alter named Adrienne who experienced flashbacks of a traumatic childhood event. Rose suffered from somnambulistic states. Sometimes she was paralyzed and sometimes she could walk. Often these symptoms are clustered under somatoform disorder, making this DID diagnosis a case of co-morbidity.

Mortin Prince 1906
Mortin Prince published the Christine Beauchamp case in “The Dissociation of a Personality“. Beauchamp allegedly had three personality states including one calling herself Sally who was childlike. Sally differed greatly from an alter called a very regressed alter called Idiot. Eventually MPD was declared “extinct” by E. Stengel in 1943. Months later Prince released a landmark paper of “The Journal of Abnormal Psychology” which “was the most quoted reference in the history of the illness“. After this documentation however no mentioned was made of MPD in the journal until Prince’s published famous account of Christine Costner Sizemore. In 1957 the case was made into a film starring Joanne Woodward playing the title role in The Three Faces of Eve. It was presented as extremely rare and bizarre although since then psychiatric communities who accept the DID diagnosis state it is not as rare as once thought.

Dr. Cornelia Wilbur 1978
Most people are familiar with the famous case of “Sybil“ an alias for Shirley Ardell Mason, a woman Wilbur claimed possessed 16 personalities as a result of a traumatic and highly abusive childhood.Mason’s story first arrived as a best-selling book that was” ghost-written” by author Flora Shcreiber who told the story in the third person(s). It sold in the millions. Not long after the book’s release, Hollywood actress Sally Fields starred in the movie Sybil, along with Joanne Woodward as her psychiatrist.

The text has come under fire in recent years, significantly weakening the argument for MPD/DID. An author named Debbie Natham, released “Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case,” an account that disputes much of the information. She claims that Wilbur was a fraud and intentionally invented several of Mason’s so-called personalities using the hypnotic drug sodium pentothal. Wilbur’s method was to suggest abusive trauma to Mason, who agreed with Wilbur’s account. Medical records do not support Wilbur’s claims about Mason’s physical and sexual abuse at her mother’s hands. Mason herself once asked a different psychiatrist who temporarily treated while Wilbur was away, which alter he would like her to portray, stating the name of an alter Wilbur especially preferred. Mason also admitted that if she didn’t agree she had multiplicity Wilbur wouldn’t treat her. Wilbur herself admitted that if she didn’t use the term multiple personality disorder in the account, her publisher would not publish the text.

H. Ellenberger published a paper entitled “The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry” that focused on multiple personality disorder. Throughout the 1970s, a number of clinicians worked toward defining and establishing the legitimacy of the condition. Margareta Bowers along with six other contributors published “Therapy of Multiple Personality” in 1971. “Therapy of Multiple Personality” outlines rules for treating multiple personalities. Several psychiatrists in the 1970s and 1980s have written notable accounts of case studies and treatment methodology.

Cecil Adams 2003  The Straight Dope
Adams writes for an online publications called The Straight Dope, a site that is self-described as “fighting ignorance since 1973.” Adams answered a writer about the phenomenon of multiple personality disorder. In his view, the disorder resulted from nothing more than media influences, misguided clinical practices and mass hysteria. Adams emphasized that the disorder was manufactured  “under the influence of hypnosis and other techniques,” whereby patients were coaxed into “uncovering bloodcurdling stories of child abuse” or satanic cults. The whole satanic cult-thing has never appealed to me as especially legitimate. If so many of these abusive cults exist why aren’t more people being charged, arrested and thrown in prison for their abuse of children and youth?

The disagreement over the definition of personality also complicates the diagnosis of DID. Supposedly in DID is alters are independent of one another, but this is difficult to prove. Speech and behavior can be faked. In support of DID brain-wave patterns may vary although some doctors insist this is not due to a genuine personality switch.  In a study of DID, patients and their alters, different sets of words. When different personality states were asked whether a word was recognized, if it supposedly belonged to a different alter, patients hesitated. The implication was —I’m not supposed to know this. Were those alters truly independent? Obviously not.

My personal feeling is that it may be possible for a single ego not to form due to repetitive, extreme trauma but this is extremely rare. I believe the many currently diagnosed cases are false. DID is just one of those “disorders” that is nigh impossible to prove. It appears to be extremely difficult for therapists to produce legitimate, longitudinal studies about DID, unlike almost all other disorders and illnesses listed in the DSM-5. I doubt that any current clinicians go so far as to use sodium pentothal with their patients but I do believe there is room for error and the use of false memory syndrome. I don’t believe most patients or clinicians do this on purpose. Very few people gain “fame and fortune“ from this disorder anymore, ergo the extrinsic rewards are nil. There may be intrinsic rewards for the patient but none thus far have been documented. Unlike Wilbur’s deliberate, false account of Mason, I believe it is misguided belief in an interesting, unique phenomenon.

Problems with Assessment of DID/MPD

DSM-V defines DID/MPD as the presence of two or more distinct identities or personality states” that alternate control of the individual’s behavior, accompanied by the inability to recall personal information beyond what is expected through normal forgetfulness. In each individual, the behaviour varies and the level of functioning can change from severely impaired to adequate. Individuals with DID may experience distress from both the symptoms of DID (intrusive thoughts or emotions) as well as the consequences of the accompanying symptoms (dissociation rendering them unable to remember specific information).   Identities may be unaware of each other and compartmentalize knowledge and memories, resulting in chaotic personal lives. 

The primary identity, which usually has the patient’s birth name, is the original core, or the first personality the individual possesses. It is hypothesized that the person is born whole then “splits” into several alters due to ongoing, extreme trauma. The core personality is “passive, dependent, guilty and depressed“. The alters are “out” or active more often than the primary or core personality. They are usually more aggressive and tend to hold complete memories, something the core lacks. DID is a major change in the DSM-5. Heretofore, DID was listed as MPD (Multiple Personality Disorder). MPD itself was fraught with controversy. Across continents there has been considerable debate as to whether MPD/DID even exists. There are a number of valid reasons for this:

1. It is almost strictly a North American phenomenon – MPD is diagnosed more frequently in NA than anywhere else in the world.
2. Females are diagnosed 3 times more often than males.
3. It became extremely popular in psychiatry after the release of the boo Sybil, written by Flora Schreiber, and the release of the movie by the same name, Sybil, starring Sally Fields The story featured the supposed biography of Shirley Ardell Mason, although there has been much skepticism in the following decades about the validity of her account.
4. Diagnosis dropped considerably into the 1980s when the disorder was called into question for inclusion in the DSM-IV-TR.
5. MPD was linked with extreme sexual abuse but no scientific research has proven conclusively that this is true, particularly since a number of people who claim to have MPD have never been sexually or physically abused.
6. There is no scientific methodology to prove the existence of MPD/DID.
7. It is a disorder that many people have tried to fake for attention-seeking purposes and in some cases, for financial gain. This is co-morbid with a factitious disorder called malingering.
8. MPD can be co-morbid with another disorder and therefore be difficult to assess.
9. Psychiatrists have manufactured the existence of alternate personalities in patients.This is known as iatrogonesis.
10. There is no such thing as several people within one body and one brain.
11. No longitudinal studies have been conducted.
12. No epidemiological studies have been conducted.
13. Patients claim to have varying numbers of alters, yet there is no proof for these claims. The number of alters varies widely, with most patients identifying fewer than ten, though as many as 4,500 have been reported.The average number of alters has increased over the past few decades, from two or three to now an average of approximately 16.
14. DID/MPD has been diagnosed based on memory, a poor assessment tool.
15. Only a small cluster of clinicians accept and use the diagnosis.