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| In ], '''Dissociative Identity Disorder''' ('''DID''') is the current name of the condition formerly listed in the ] as '''Multiple Personality Disorder''' and '''Multiple Personality Syndrome'''. The ] continues to list it as Multiple Personality Disorder. | In ], '''Dissociative Identity Disorder''' ('''DID''') is the current name of the condition formerly listed in the ] as '''Multiple Personality Disorder''' and '''Multiple Personality Syndrome'''. The ] continues to list it as Multiple Personality Disorder. | ||
| '''Multiplicity''' is often used to describe wider behaviours than DID—in other words, it includes the presence of separate selves which are not part of a psychiatric disorder. In the widest sense it may include concepts such as ] and ]s. Indeed, in several cases, doctors have resorted to ]s in order to treat DID. , | '''Multiplicity''' is often used to describe wider behaviours than DID—in other words, it includes the presence of separate selves which are not part of a psychiatric disorder. In the widest sense it may include concepts such as voluntary ] religions, ] and ]s. Indeed, in several cases, doctors have resorted to ]s in order to treat DID. , | ||
| The very existence of DID is questioned by some doctors and scientists. The growing consensus among most doctors and scientists is that DID exists, but that it is an ] ("caused by doctors") illness that is generally created by suggestion or self-suggestion. A few psychiatrists continue to claim that it is a severe illness that cannot be created in adult life, brought on by extreme abuse in childhood. | The very existence of DID is questioned by some doctors and scientists. The growing consensus among most doctors and scientists is that DID exists, but that it is an ] ("caused by doctors") illness that is generally created by suggestion or self-suggestion. A few psychiatrists continue to claim that it is a severe illness that cannot be created in adult life, brought on by extreme abuse in childhood. | ||
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| MPD or DID is most commonly diagnosed in people who are, typically in ], found to be the victims of severe repeated trauma (usually ]) very early in life. Whether this abuse (often claimed to be ritualistic, sometimes ]) actually happened in the majority of cases or whether ] were induced by the therapist is subject of much debate. | MPD or DID is most commonly diagnosed in people who are, typically in ], found to be the victims of severe repeated trauma (usually ]) very early in life. Whether this abuse (often claimed to be ritualistic, sometimes ]) actually happened in the majority of cases or whether ] were induced by the therapist is subject of much debate. | ||
| Modern study has shown that this abuse is often a combination of real and imagined. Many people with classical MPD have early-life (prior to age 7) hallucinations, which resolve later in life. The memories from these hallucinations still carry a haunting, realistic quality that may make them appear to be real memories. Therapy can easily convince one that these memories are real. Still, |
Modern study has shown that this abuse is often a combination of real and imagined. Many people with classical MPD have early-life (prior to age 7) hallucinations, which resolve later in life. The memories from these hallucinations still carry a haunting, realistic quality that may make them appear to be real memories. Therapy can easily convince one that these memories are real. Still, verifiable abuse is often reported as well. | ||
| DID therapists believe that in an effort to shield themselves from the trauma, patients have effectively split their mind into two parts—the person who was abused, and the rest of their self, who was dissociated from the traumatic event and protected from its effect. Over time, and with repeated traumas, they become adept at masking their true self. In effect they become human chameleons in an attempt to protect themselves from anything that might harm their ] further, and later, to keep anyone from discovering their secret. Presumably, the victims will suffer from various general symptoms (such as depressions, sleeplessness and headaches) in later life. The therapist then has to uncover the split personalities and the suppressed memories in order to restore balance. | DID therapists believe that in an effort to shield themselves from the trauma, patients have effectively split their mind into two parts—the person who was abused, and the rest of their self, who was dissociated from the traumatic event and protected from its effect. Over time, and with repeated traumas, they become adept at masking their true self. In effect they become human chameleons in an attempt to protect themselves from anything that might harm their ] further, and later, to keep anyone from discovering their secret. Presumably, the victims will suffer from various general symptoms (such as depressions, sleeplessness and headaches) in later life. The therapist then has to uncover the split personalities and the suppressed memories in order to restore balance. | ||
| Again, these theories have come under fire from modern information. In classical MPD, the original personality is shattered, usually forming a group of 5 archetypes, which are then further subdivided by later abuse. Late-onset DID usually involves a much simpler |
Again, these theories have come under fire from modern information. In classical MPD, the original personality is shattered, usually forming a group of 5 archetypes, which are then further subdivided by later abuse. Late-onset DID usually involves a much simpler separation of the primary personality into two or more subsets. The pattern formed by classical MPD involves the archetypes of Host, Defender, Child, ISH (Internal Self Helper) and Opposite, and appears to be consistant in enough cases to suggest something about the etiology. | ||
| == History of multiplicity == | == History of multiplicity == | ||
| The existence of multiplicity is currently a topic of much debate within the psychological community. Reports of individuals who seemed to display more than one discrete self date back to the ], and some have speculated that cases of ']' described in earlier centuries were actually cases of multiplicity. 'Dual personality' was closely associated with |
The existence of multiplicity is currently a topic of much debate within the psychological community. Reports of individuals who seemed to display more than one discrete self date back to the ], and some have speculated that cases of ']' described in earlier centuries were actually cases of multiplicity. 'Dual personality' was closely associated with ] ]ship in the 19th and early ], as some believed that the different selves were actually spirits who had taken up residence in the ]'s body. Early ] attempted to attribute multiple personality to a variety of causes, including manifestation of unconscious desires, head injuries (]), and the oppression of women (]). | ||
| Psychoanalyst ], who later published a book on his experiences in treating ], a multiple client, believed that multiplicity was due to the disintegration of an original, unified ] into separate pieces. He translated ''desaggregation,'' a word coined by the French analyst ], as 'dissociation,' and used it to refer to the process by which the original personality was supposed to break apart. Although he did not attempt to theorize on a universal cause for dissociation, he believed that multiplicity needed to be cured by integrating all the selves into the |
Psychoanalyst ], who later published a book on his experiences in treating ], a multiple client, believed that multiplicity was due to the disintegration of an original, unified ] into separate pieces. He translated ''desaggregation,'' a word coined by the French analyst ], as 'dissociation,' and used it to refer to the process by which the original personality was supposed to break apart. Although he did not attempt to theorize on a universal cause for dissociation, he believed that multiplicity needed to be cured by integrating all the selves into one personality, not necessarily the "original". In his work with Miss Beauchamp, he actually chose the personality he deemed the most pleasant as the "real" self, and worked with her to try to ''kill'' the other selves. Integration as death is a recurring theme in accounts by multiples about their own experiences in therapy. | ||
| Several popular accounts of multiplicity, most fictionalized to some degree, were published during the first half of the 20th century, the most famous being '']'' by ] and ]. Thigpen claimed to have integrated all the selves of 'Eve,' a multiple client, and the book was so popular it was later made into a movie. Several decades after the book's publication, the real 'Eve,' ], came forward to report that much of the book was a fabrication by Thigpen; although she really was multiple, by her own account, she had never actually integrated |
Several popular accounts of multiplicity, most fictionalized to some degree, were published during the first half of the 20th century, the most famous being '']'' by ] and ]. Thigpen claimed to have integrated all the selves of 'Eve,' a multiple client, and the book was so popular it was later made into a movie. Several decades after the book's publication, the real 'Eve,' ], came forward to report that much of the book was a fabrication by Thigpen; although she really was multiple, by her own account, she had never actually integrated until much later, working with a different therapist. | ||
| The actual diagnosis of 'Multiple Personality Disorder' did not exist until the 1970s, when '']'', the most famous modern account of multiplicity, was published. 'Sybil,' whose real name was ], was a patient of ] analyst ]. Wilbur treated Mason for over a decade and believed that her client's multiplicity had been caused by severe ] in childhood, which had caused her original personality to 'split off' separate selves, each of whom performed the function of enduring abuse for her. In Wilbur's view, all multiples consisted of an original, depleted self and the many personalities who had dissociated from it as a result of childhood trauma. In order to restore the patient's original self, it was necessary to remember all the childhood traumas which had caused the 'splits,' and then integrate all the personalities; only then could the patient live a full and productive life. | The actual diagnosis of 'Multiple Personality Disorder' did not exist until the 1970s, when '']'', the most famous modern account of multiplicity, was published. 'Sybil,' whose real name was ], was a patient of ] analyst ]. Wilbur treated Mason for over a decade and believed that her client's multiplicity had been caused by severe ] and ] in childhood, which had caused her original personality to 'split off' separate selves, each of whom performed the function of enduring abuse for her. In Wilbur's view, based on ]'s work, all multiples consisted of an original, depleted self and the many personalities who had dissociated from it as a result of childhood trauma. In order to restore the patient's original self, it was necessary to remember all the childhood traumas which had caused the 'splits,' and then integrate all the personalities; only then could the patient live a full and productive life. | ||
| Wilbur later went on to specialize in treating multiples, continuing to enforce her view that all multiples had a history of severe ] in childhood and could not live functionally without recovering their traumatic memories and becoming integrated. She believed that it was routine for multiples to lack a communal memory and to be unable to remember things done by other selves. The diagnosis Multiple Personality Disorder was added to the third edition of the Diagnostic and Statistical Manual of Mental Disorders, and several popular, often highly-embellished and fictionalized case histories of multiples were published throughout the 1980s, all after the model of 'Sybil.' | Wilbur later went on to specialize in treating multiples, continuing to enforce her view that all multiples had a history of severe ] in childhood and could not live functionally without recovering their traumatic memories and becoming integrated. She believed that it was routine for multiples to lack a communal memory and to be unable to remember things done by other selves. The diagnosis Multiple Personality Disorder was added to the third edition of the Diagnostic and Statistical Manual of Mental Disorders, and several popular, often highly-embellished and fictionalized case histories of multiples were published throughout the 1980s, all after the model of 'Sybil.' | ||
| Dr. Wilbur claimed repeated successes in integrating her flock of MPD clients. However, medical staff who worked with her at her Open Hospital for Multiple Personalities reported that her clients would often ''pretend'' to integrate because it was what they knew Dr. Wilbur wanted. A demanding, charismatic woman, Wilbur could be quite the termagant when crossed; one learned quickly to give her what she wanted, or else. She seems as well to have been deeply conflicted in the matter of Sybil's integration; she'd have liked to see her "healthy," but as a multiple, she'd continue to garner attention. Friends report that Sybil never really integrated and remained multiple until her death from ] in ]. | |||
| === Allegations of iatrogenesis === | === Allegations of iatrogenesis === | ||
| ] of the ] in 1998 examined tapes regarding the Mason case and came to the conclusion that the multiple personalities were induced in the patient by her therapist, who, in sessions which included the use of drugs, carved out personalities for the different emotions, while dismissing any attempt by the patient to deny her multiplicity. Critics charge that this allegation of "denial" is used to force patients to go along with a therapist's psychological model, be it satanic ritual abuse with subsequent dissociation or abduction by aliens (a similarly |
] of the ] in 1998 examined tapes regarding the Mason case and came to the conclusion that the multiple personalities were induced in the patient by her therapist, who, in sessions which included the use of drugs, carved out personalities for the different emotions, while dismissing any attempt by the patient to deny her multiplicity. Critics charge that this allegation of "denial" is used to force patients to go along with a therapist's psychological model, be it satanic ritual abuse with subsequent dissociation or abduction by aliens (a similarly widespread phenomenon). In Mason's case, memories of severe physical abuse were also "recovered": Her mother allegedly filled her bladder with ice-water to stop her from urinating, and then forced her to listen to her mother playing on the piano. In reality, no evidence for most of the reported abuse was ever found, although contemporaries recall Mason's mother as a bizarre woman, possibly schizophrenic, who kept Shirley in a "vise lock" and never allowed her any freedom . | ||
| Mason's other therapist, Dr. Herbert Spiegel, also concluded that Mason's multiplicity was induced: He noted that Mason was perfectly capable of expressing her emotions without using different "personalities", and that the idea to use these personalities came primarily from Wilbur, not from Mason. | Mason's other therapist, Dr. Herbert Spiegel, also concluded that Mason's multiplicity was induced: He noted that Mason was perfectly capable of expressing her emotions without using different "personalities", and that the idea to use these personalities came primarily from Wilbur, not from Mason. | ||
| The diagnosis, which had always been a subject of much debate, became highly controversial in the mid-1990s. After approximately a decade of popularity among therapists and talk-show hosts, the recovered memory movement fell into disrepute. Clients began to report in increasing numbers that they had been misdiagnosed with multiple personalities, and led to believe that they had experienced traumas in childhood which had never actually occurred, including ]. Many of the patients who remained in therapy continued to get worse instead of better, which led many psychologists to conclude that multiplicity was usually or always iatrogenically induced through a combination of social and therapeutic influences. The diagnosis MPD was changed to Dissociative Identity Disorder in the fourth edition of the DSM. | The diagnosis, which had always been a subject of much debate, became highly controversial in the mid-1990s. After approximately a decade of popularity among therapists and talk-show hosts, the recovered memory movement fell into disrepute. Clients began to report in increasing numbers that they had been misdiagnosed with multiple personalities, and led to believe that they had experienced traumas in childhood which had never actually occurred, particularly including ]. Many of the patients who remained in therapy continued to get worse instead of better, which led many psychologists to conclude that multiplicity was usually or always iatrogenically induced through a combination of social and therapeutic influences. The diagnosis MPD was changed to Dissociative Identity Disorder in the fourth edition of the DSM in an effort to rid the condition of the exotic, tabloidish ambience with which it had been imbued. The guidelines caution professionals not to respond to the different selves or address them by name, but to approach the client as a single, whole person who experiences herself as a set of splintered parts of a single consciousness, encouraging integration. | ||
| Another interpretation is merely that some people are inherently multiple and attempting to treat them with "Integration Therapy" is detrimental to their mental health. | Another interpretation is merely that some people are inherently multiple and attempting to treat them with "Integration Therapy" is detrimental to their mental health. Even some classic MPD multiples such as ] who believe they split due to abuse feel they now function more successfully as a group, and refuse integration, seeing it as a form of murder. Some professionals agree with their clients that functionality is more important than whether or not the client sees himself as multiple. Dr. David Caul, who treated ], said of multiplicity therapy "It seems to me that after treatment you want a functional unit, be it a corporation, a partnership, or a one-owner business." | ||
| A classic case of a questionable diagnosis was the ] case in the US. Kenneth Bianchi, an accused ] who allegedly strangled multiple women in ], was diagnosed at his court-ordered psychiatric evaluation as having MPD. However, later investigation showed that Bianchi's behavior was not in fact consistent with the MPD diagnosis. This is commonly attributed to the joint effects of suggestion (''iatrogenesis'' in clinical terms) and deliberate deception from Bianchi ('']''). | A classic case of a questionable diagnosis was the ] case in the US. Kenneth Bianchi, an accused ] who allegedly strangled multiple women in ], was diagnosed at his court-ordered psychiatric evaluation as having MPD. However, later investigation showed that Bianchi's behavior was not in fact consistent with the MPD diagnosis. This is commonly attributed to the joint effects of suggestion (''iatrogenesis'' in clinical terms) and deliberate deception from Bianchi ('']''). | ||
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| == Multiplicity as a social phenomenon == | == Multiplicity as a social phenomenon == | ||
| If Sybil-type MPD/DID is rare or iatrogenically induced, alleged multiplicity is still a phenomenon worth studying. The existence of, or belief in the existence of, more than one self in one body is as of yet not very well understood. With the advent of the ], increasing numbers of self-acknowledged multiples who have never been diagnosed or in therapy have come forward to report that they are living functionally without need of integration. Not all have a history of childhood sexual abuse; many report not only having clear memories of their childhood, but having been multiple for as long as they could remember. Since they do not suffer from severe depression, amnesia, or dangerous behavior, such multiples have rarely come to the attention of therapists, having had no need for their intervention. | If Sybil-type MPD/DID is rare or iatrogenically induced, alleged multiplicity is still a phenomenon worth studying. The existence of, or belief in the existence of, more than one self in one body is as of yet not very well understood. With the advent of the ], increasing numbers of self-acknowledged multiples who have never been diagnosed or in therapy have come forward to report that they are living functionally without need of integration. Not all have a history of childhood abuse, let alone sexual abuse; many report not only having clear memories of their childhood, but having been multiple for as long as they could remember. Since they do not suffer from severe depression, amnesia, or dangerous behavior, such multiples have rarely come to the attention of therapists, having had no need for their intervention. | ||
| In addition, many healthy multiples have called into question the concept of integration of selves. Several people who knew Shirley Mason reported that despite the statements made in 'Sybil,' she, like Eve, remained multiple even after her supposed integration. Some believe that true integration is impossible, or at least impractical, for genuine multiples. It remains to be seen whether the scandals and lawsuits of the 1990s will prevent serious research from being done on functional self-identified multiples, or from non-Wilburian paradigms of multiplicity being studied and considered. | In addition, many healthy multiples have called into question the concept of integration of selves. Several people who knew Shirley Mason reported that despite the statements made in 'Sybil,' she, like Eve, remained multiple even after her supposed integration. Some believe that true integration is impossible, or at least impractical, for genuine multiples. It remains to be seen whether the scandals and lawsuits of the 1990s will prevent serious research from being done on functional self-identified multiples, or from non-Wilburian paradigms of multiplicity being studied and considered. | ||
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| Because such multiples do not experience their condition as disordered or sick in any way, some have proposed that the diagnosis of DID be removed from the DSM entirely, or revised to classify multiples who have difficulty communicating and sharing memories and/or wish to integrate. It has occasionally been suggested in these communities to move the diagnosis into the category of neurological, rather than psychological, reducing the emphasis on integration and normalization therapy and shifting the focus to helping them better interact in daily life. | Because such multiples do not experience their condition as disordered or sick in any way, some have proposed that the diagnosis of DID be removed from the DSM entirely, or revised to classify multiples who have difficulty communicating and sharing memories and/or wish to integrate. It has occasionally been suggested in these communities to move the diagnosis into the category of neurological, rather than psychological, reducing the emphasis on integration and normalization therapy and shifting the focus to helping them better interact in daily life. | ||
| Because of the known risks associated with |
Because of the known risks associated with classical, pathological MPD/DID, most critics demand that therapists who induce multiple personalities in patients by creating false memories and encouraging their patients to assign names and characters to their different emotional states should no longer be allowed to practice. Interestingly, critics of MPD/DID therapy and self-identified natural/functional multiples share many of the same criticisms of the traditional MPD/DID paradigm. These include the emphasis on recovering abuse memories which may or may not be real, the status associated with victimhood and dysfunctionality, and the blaming of "other personalities" for irresponsible or criminal behaviour. | ||
| == DID in fiction == | == DID in fiction == | ||
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| * (awareness taskforce for functional multiplicity) | * (awareness taskforce for functional multiplicity) | ||
| * of a relationship with a girl who suffered from ] | * of a relationship with a girl who suffered from ] | ||
| * Example of a healthy self-identified multiple group's co-signed agreement to maintain responsibility and functionality. | |||
| ] | ] | ||
Revision as of 05:20, 28 March 2004
In psychiatry, Dissociative Identity Disorder (DID) is the current name of the condition formerly listed in the Diagnostic and Statistical Manual of Mental Disorders as Multiple Personality Disorder and Multiple Personality Syndrome. The International Statistical Classification of Diseases and Related Health Problems continues to list it as Multiple Personality Disorder.
Multiplicity is often used to describe wider behaviours than DID—in other words, it includes the presence of separate selves which are not part of a psychiatric disorder. In the widest sense it may include concepts such as voluntary possession trance religions, demonic possession and two-spirits. Indeed, in several cases, doctors have resorted to exorcisms in order to treat DID. ,
The very existence of DID is questioned by some doctors and scientists. The growing consensus among most doctors and scientists is that DID exists, but that it is an iatrogenic ("caused by doctors") illness that is generally created by suggestion or self-suggestion. A few psychiatrists continue to claim that it is a severe illness that cannot be created in adult life, brought on by extreme abuse in childhood.
Theory of Dissociative Identity Disorder
The primary criterion for the diagnosis of DID is the presence of two or more separate selves within the same body, which may have very different ways of acting, thinking and speaking, and may be of different gender identities, ethnicities or sexual orientations. Depending on the severity of the condition, one personality may not recall incidents that happened when another personality was predominant. Generally, one or two personalities assume the role of "primary", performing most tasks outside, although this does not appear to indicate that they are especially more developed or more "real".
MPD or DID is most commonly diagnosed in people who are, typically in recovered memory therapy, found to be the victims of severe repeated trauma (usually child abuse) very early in life. Whether this abuse (often claimed to be ritualistic, sometimes satanic ritual abuse) actually happened in the majority of cases or whether false memories were induced by the therapist is subject of much debate.
Modern study has shown that this abuse is often a combination of real and imagined. Many people with classical MPD have early-life (prior to age 7) hallucinations, which resolve later in life. The memories from these hallucinations still carry a haunting, realistic quality that may make them appear to be real memories. Therapy can easily convince one that these memories are real. Still, verifiable abuse is often reported as well.
DID therapists believe that in an effort to shield themselves from the trauma, patients have effectively split their mind into two parts—the person who was abused, and the rest of their self, who was dissociated from the traumatic event and protected from its effect. Over time, and with repeated traumas, they become adept at masking their true self. In effect they become human chameleons in an attempt to protect themselves from anything that might harm their psyche further, and later, to keep anyone from discovering their secret. Presumably, the victims will suffer from various general symptoms (such as depressions, sleeplessness and headaches) in later life. The therapist then has to uncover the split personalities and the suppressed memories in order to restore balance.
Again, these theories have come under fire from modern information. In classical MPD, the original personality is shattered, usually forming a group of 5 archetypes, which are then further subdivided by later abuse. Late-onset DID usually involves a much simpler separation of the primary personality into two or more subsets. The pattern formed by classical MPD involves the archetypes of Host, Defender, Child, ISH (Internal Self Helper) and Opposite, and appears to be consistant in enough cases to suggest something about the etiology.
History of multiplicity
The existence of multiplicity is currently a topic of much debate within the psychological community. Reports of individuals who seemed to display more than one discrete self date back to the 19th century, and some have speculated that cases of 'possession' described in earlier centuries were actually cases of multiplicity. 'Dual personality' was closely associated with Spiritualist mediumship in the 19th and early 20th centuries, as some believed that the different selves were actually spirits who had taken up residence in the medium's body. Early psychoanalysts attempted to attribute multiple personality to a variety of causes, including manifestation of unconscious desires, head injuries (Boris Sidis), and the oppression of women (Dr. Theodore Fluornoy).
Psychoanalyst Morton Prince, who later published a book on his experiences in treating Sally Beauchamp, a multiple client, believed that multiplicity was due to the disintegration of an original, unified personality into separate pieces. He translated desaggregation, a word coined by the French analyst Pierre Janet, as 'dissociation,' and used it to refer to the process by which the original personality was supposed to break apart. Although he did not attempt to theorize on a universal cause for dissociation, he believed that multiplicity needed to be cured by integrating all the selves into one personality, not necessarily the "original". In his work with Miss Beauchamp, he actually chose the personality he deemed the most pleasant as the "real" self, and worked with her to try to kill the other selves. Integration as death is a recurring theme in accounts by multiples about their own experiences in therapy.
Several popular accounts of multiplicity, most fictionalized to some degree, were published during the first half of the 20th century, the most famous being The Three Faces of Eve by Corbett Thigpen and Harvey Cleckley. Thigpen claimed to have integrated all the selves of 'Eve,' a multiple client, and the book was so popular it was later made into a movie. Several decades after the book's publication, the real 'Eve,' Chris Costner-Sizemore, came forward to report that much of the book was a fabrication by Thigpen; although she really was multiple, by her own account, she had never actually integrated until much later, working with a different therapist.
The actual diagnosis of 'Multiple Personality Disorder' did not exist until the 1970s, when Sybil, the most famous modern account of multiplicity, was published. 'Sybil,' whose real name was Shirley Mason, was a patient of Freudian analyst Cornelia Wilbur. Wilbur treated Mason for over a decade and believed that her client's multiplicity had been caused by severe physical abuse and sexual abuse in childhood, which had caused her original personality to 'split off' separate selves, each of whom performed the function of enduring abuse for her. In Wilbur's view, based on Pierre Janet's work, all multiples consisted of an original, depleted self and the many personalities who had dissociated from it as a result of childhood trauma. In order to restore the patient's original self, it was necessary to remember all the childhood traumas which had caused the 'splits,' and then integrate all the personalities; only then could the patient live a full and productive life.
Wilbur later went on to specialize in treating multiples, continuing to enforce her view that all multiples had a history of severe trauma in childhood and could not live functionally without recovering their traumatic memories and becoming integrated. She believed that it was routine for multiples to lack a communal memory and to be unable to remember things done by other selves. The diagnosis Multiple Personality Disorder was added to the third edition of the Diagnostic and Statistical Manual of Mental Disorders, and several popular, often highly-embellished and fictionalized case histories of multiples were published throughout the 1980s, all after the model of 'Sybil.'
Dr. Wilbur claimed repeated successes in integrating her flock of MPD clients. However, medical staff who worked with her at her Open Hospital for Multiple Personalities reported that her clients would often pretend to integrate because it was what they knew Dr. Wilbur wanted. A demanding, charismatic woman, Wilbur could be quite the termagant when crossed; one learned quickly to give her what she wanted, or else. She seems as well to have been deeply conflicted in the matter of Sybil's integration; she'd have liked to see her "healthy," but as a multiple, she'd continue to garner attention. Friends report that Sybil never really integrated and remained multiple until her death from breast cancer in 1998.
Allegations of iatrogenesis
Robert Rieber of the John Jay College of Criminal Justice in 1998 examined tapes regarding the Mason case and came to the conclusion that the multiple personalities were induced in the patient by her therapist, who, in sessions which included the use of drugs, carved out personalities for the different emotions, while dismissing any attempt by the patient to deny her multiplicity. Critics charge that this allegation of "denial" is used to force patients to go along with a therapist's psychological model, be it satanic ritual abuse with subsequent dissociation or abduction by aliens (a similarly widespread phenomenon). In Mason's case, memories of severe physical abuse were also "recovered": Her mother allegedly filled her bladder with ice-water to stop her from urinating, and then forced her to listen to her mother playing on the piano. In reality, no evidence for most of the reported abuse was ever found, although contemporaries recall Mason's mother as a bizarre woman, possibly schizophrenic, who kept Shirley in a "vise lock" and never allowed her any freedom .
Mason's other therapist, Dr. Herbert Spiegel, also concluded that Mason's multiplicity was induced: He noted that Mason was perfectly capable of expressing her emotions without using different "personalities", and that the idea to use these personalities came primarily from Wilbur, not from Mason.
The diagnosis, which had always been a subject of much debate, became highly controversial in the mid-1990s. After approximately a decade of popularity among therapists and talk-show hosts, the recovered memory movement fell into disrepute. Clients began to report in increasing numbers that they had been misdiagnosed with multiple personalities, and led to believe that they had experienced traumas in childhood which had never actually occurred, particularly including satanic ritual abuse. Many of the patients who remained in therapy continued to get worse instead of better, which led many psychologists to conclude that multiplicity was usually or always iatrogenically induced through a combination of social and therapeutic influences. The diagnosis MPD was changed to Dissociative Identity Disorder in the fourth edition of the DSM in an effort to rid the condition of the exotic, tabloidish ambience with which it had been imbued. The International Society for the Study of Dissociation guidelines caution professionals not to respond to the different selves or address them by name, but to approach the client as a single, whole person who experiences herself as a set of splintered parts of a single consciousness, encouraging integration.
Another interpretation is merely that some people are inherently multiple and attempting to treat them with "Integration Therapy" is detrimental to their mental health. Even some classic MPD multiples such as Truddi Chase who believe they split due to abuse feel they now function more successfully as a group, and refuse integration, seeing it as a form of murder. Some professionals agree with their clients that functionality is more important than whether or not the client sees himself as multiple. Dr. David Caul, who treated Billy Milligan, said of multiplicity therapy "It seems to me that after treatment you want a functional unit, be it a corporation, a partnership, or a one-owner business."
A classic case of a questionable diagnosis was the Hillside Strangler case in the US. Kenneth Bianchi, an accused serial killer who allegedly strangled multiple women in Los Angeles, was diagnosed at his court-ordered psychiatric evaluation as having MPD. However, later investigation showed that Bianchi's behavior was not in fact consistent with the MPD diagnosis. This is commonly attributed to the joint effects of suggestion (iatrogenesis in clinical terms) and deliberate deception from Bianchi (malingering).
Multiplicity as a social phenomenon
If Sybil-type MPD/DID is rare or iatrogenically induced, alleged multiplicity is still a phenomenon worth studying. The existence of, or belief in the existence of, more than one self in one body is as of yet not very well understood. With the advent of the Internet, increasing numbers of self-acknowledged multiples who have never been diagnosed or in therapy have come forward to report that they are living functionally without need of integration. Not all have a history of childhood abuse, let alone sexual abuse; many report not only having clear memories of their childhood, but having been multiple for as long as they could remember. Since they do not suffer from severe depression, amnesia, or dangerous behavior, such multiples have rarely come to the attention of therapists, having had no need for their intervention.
In addition, many healthy multiples have called into question the concept of integration of selves. Several people who knew Shirley Mason reported that despite the statements made in 'Sybil,' she, like Eve, remained multiple even after her supposed integration. Some believe that true integration is impossible, or at least impractical, for genuine multiples. It remains to be seen whether the scandals and lawsuits of the 1990s will prevent serious research from being done on functional self-identified multiples, or from non-Wilburian paradigms of multiplicity being studied and considered.
Because such multiples do not experience their condition as disordered or sick in any way, some have proposed that the diagnosis of DID be removed from the DSM entirely, or revised to classify multiples who have difficulty communicating and sharing memories and/or wish to integrate. It has occasionally been suggested in these communities to move the diagnosis into the category of neurological, rather than psychological, reducing the emphasis on integration and normalization therapy and shifting the focus to helping them better interact in daily life.
Because of the known risks associated with classical, pathological MPD/DID, most critics demand that therapists who induce multiple personalities in patients by creating false memories and encouraging their patients to assign names and characters to their different emotional states should no longer be allowed to practice. Interestingly, critics of MPD/DID therapy and self-identified natural/functional multiples share many of the same criticisms of the traditional MPD/DID paradigm. These include the emphasis on recovering abuse memories which may or may not be real, the status associated with victimhood and dysfunctionality, and the blaming of "other personalities" for irresponsible or criminal behaviour.
DID in fiction
The idea of multiple personalities has been popularized by many bestselling books and some movies. The first novel to feature multiple personality prominently was The Birds' Nest, in 1954, by Shirley Jackson, which was made into a forgettable 1957 movie called Lizzie. Interestingly, the movie version of Three Faces of Eve, starring Joanne Woodward-- which was released in the same year-- drew heavily on Jackson's work to a point where some consider Jackson to have been plagiarized. The book about Sybil was turned into a 1976 TV movie, the 1994 mystery Color of Night, starring Bruce Willis, the 1996 movie Primal Fear and the 2003 thriller Identity also feature multiple personalities in fictional crime scenarios and explore the idea of responsibility for another personality's actions. Various movies, including Never Talk to Strangers and Session 9, and episodes of popular TV shows such as X-Files and Judging Amy, have used the now-cliche idea of multiples with a hidden "killer personality" for cheap drama and thrills. Touched by an Angel goes so far as to imply that multiples are actually demon-possessed. These movies and shows pay little attention to the controversy surrounding the disorder, but the idea of multiplicity is a powerful storytelling device.
See also:
References and external links
- Multiple Identities and False Memories by Nicholas Spanos, 1996, ISBN 1-55798-340-2
- 1996 paper covering debate
- The Layman's Guide to Multiplicity (non-disordered multiplicity resource, written and edited by multiples)
- Pavilion (awareness taskforce for functional multiplicity)
- True story of a relationship with a girl who suffered from Dissociative Identity Disorder
- In Essence We Declare Example of a healthy self-identified multiple group's co-signed agreement to maintain responsibility and functionality.