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 | "...it has been proven that different personalities manifest different physiological symptoms. Some alters are allergic to penicillin or certain foods, whereas the host personality is not." Lisa Scott 8 |
| "There was no credible scientific evidence for any of this: no evidence that people who had experienced years of abuse ever repressed it; no evidence that forgotten memories caused the symptoms experienced; no evidence that 'recovering' memories relieved symptoms." Dr. Elizabeth Loftus, commenting on DID. 9 |
| "...if you go to a therapist with an open mind to asking for help in resolving problems and he or she tells you something that seems ridiculous, it probably is: therapists, despite their training and potential gift for insight, have no special intellectual powers--merely more degrees." "Melanchthon" -- book reviewer on the Amazon.com web site, reviewing Reference 10. |
| "Sybil said: 'Well, do you want me to be Helen?' And I said, 'What do you mean?' And she said, 'Well, when I'm with Dr. Wilbur she wants me to be Helen.' I said, 'Who's Helen?' 'Well, that's a name Dr. Wilbur gave me for this feeling." 11 |
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Nature of the MPD / DID controversy:
MPD/DID is extremely controversial. As in the case of Recovered Memory Therapy (RMT) Satanic Ritual Abuse (SRA), beliefs about destructive and mind control cults, abuse during UFO abductions, etc., almost all experts in the field are deeply polarized into two groups, which we call:
| "Skeptics: - those who believe that MPD is a psychological fad. It is either non-existent or phenomenally rare in nature. It is a disorder that has an iatrogenic cause; it is unknowingly created by the therapist-patient interaction. Thousands of victims have been generated by bad therapy. | ||||||||
| "Believers" - those who see MPD as a very serious
public mental health problem affecting perhaps 1% of the population. These are further
divided into:
|
As in so many other therapeutic controversies, it is imperative that we reach a consensus on MPD quickly in order to minimize continuing harm to the public:
| If MPD is an iatrogenic (therapist caused) disorder which does not naturally appear in society, then it is important that exorcisms and MPD therapy be discontinued, to avoid creating additional victims. |
| If MPD is real, if alters exist, and if the disorder is caused by severe child abuse, then attempted exorcisms by religious believers could exacerbate the victims' suffering. Activities by skeptics could prevent victims from receiving proper therapy. |
| If MPD is real, occurs naturally, is not a disorder, and is unrelated to childhood abuse, then it should be appreciated and studied; persons with MPD should be valued, not treated. |
| If MPD is real and is caused by indwelling demonic spirits, then psychotherapy to integrate the alters could cause great harm. Attacks by skeptics could prevent victims from seeking release through exorcisms. |
History of MPD / DID:
There have been stories throughout history of people who have behaved strangely, and who later were unable to recall their actions. But the first medical studies of what we now call MPD/DID did not appear until the 1800s. It was regarded as a very rare medical curiosity until the mid 1950's. Dr. Bennett Braun reports that a 1944 "review of the literature by Taylor and Martin found only 76 documented cases of MPD" worldwide prior to that time. 1 Ofshe & Watters refer to a 1979 study which found "only two hundred cases of MPD in all recorded medical history." 2 The appearance of Recovered Memory Therapy (RMT) in the 1980s gave therapists a method which appeared to recover images of early childhood abuse. These images often coalesced over time into memories which the therapist and patient believe were the root cause of MPD. Beliefs in Satanic Ritual Abuse (SRA) became popular about the same time. This gave a rationale for therapists to expect high levels of MPD in the general population. "By 1984 the number of reported cases had jumped to a thousand, and by 1989 to four thousand." 11 During the 1990s, "some psychiatrists and psychologists specializing in the treatment of MPD ...estimated that twenty to thirty thousand people" suffered from the disorder. 11
A fictional novel, presented as a documentary, The Three Faces of Eve (1956), described a woman who was believed to have three personalities. 6 This was the first multiple personality book to catch the attention of the public. It was later made into a movie in 1957. It had a profound effect on the public, convincing many that multiple personalities were both possible and common. Joanne Woodward won an Academy Award and Golden Globe award for her portrayal of Eve.
In 1968, MPD was defined in the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders" (DSM-II) as a hysterical neuroses. It was redefined in DSM-III (1980), as one of four dissociative disorders. These disorders have in common "a sudden, temporary alteration in the normally integrative functions of consciousness, identity, or motor behavior." MPD is differentiated from other dissociative disorders by the following symptoms:
| The individual switches between two or more distinct personalities |
| Control of the individual is held by whichever personality is in control at a given time |
| "Each individual personality is complex and integrated with its own unique behavior patterns and social relationships." 3 |
A second book, also presented as a documentary, described a woman who was believed to be possessed by 16 personalities. This was Sybil (1973). 7 It also came out in a made-for-TV movie version in 1976. Sally Field on an Emmy for her performance as Sybil. Joanne Woodward played the role of Sybil's mother. The movie made a major contribution to the public's perception and acceptance of MPD.
Dr. Herbert Spiegel was Sybil's backup therapist when her main psychiatrist, Dr. Cornelia Wilbur, was out of town. He concluded that Sybil's "personalities" were artificially generated during therapy when Dr. Wilbur gave names to Sybil's various emotional states. He said that Sybil told him that Dr. Wilbur wanted her "to be Helen" when she discussed a specific past occurrence. Dr. Spiegel suggested that she talk about the event simply as Sybil. "Then she discovered she didn't have to act like Helen in order to talk about it." 11,12,13
Audio tapes of Sybil's original therapeutic sessions have emerged; they confirm that the personalities were artificially generated by the therapist. Dr. Robert Rieber of the John Jay College of Criminal Justice obtained a set of audio tapes of conversation between Sybil, her psychiatrist and the author of the book. In a paper delivered to the annual meeting of the American Psychological Association in 1998-AUG, he said that the tapes show that the three were "not totally unaware" that the story that they told was wrong. "Yet at the same time they wished to believe it, no matter what. I would prefer to believe that there was as much self-deception as deception of others. They were not malicious people." 4
This novel/movie first introduced the concept that abuse during early childhood was a cause of MPD. This belief has since gained near universal acceptance among MPD therapists.
The American Psychiatric Association renamed MPD as Dissociative Identity Disorder
(DID) in DSM-IV (1994).
As increasing numbers of therapists became active in the MPD field, new concepts were
introduced. Patients were no longer limited to only a few alters. The novel by
Robert Louis Stevenson (1850-1894) -- "The Strange Case of Dr. Jekyll and Mr.
Hyde (1866) -- described two alters. "Eve" in the 1950s had three; Sybil had 16.
More recently, therapists uncovered
dozens of alters - even hundreds, and eventually as many as 4,500 within some individuals.
Alters "may present themselves as differing from the body in age, appearance,
sex, language and even species. Some therapists claim to have uncovered vegetable and even
inanimate personalities." 3 Some alters
appear as
animals; others are inanimate objects, like clouds. 5
Different personalities exhibit different speech patterns, mannerisms, attitudes,
thoughts, and gender. Alters are said to differ in allergies, handedness, eyeglass prescription or
even the presence/absence of diabetes. "Some alters are allergic to
penicillin or certain foods, whereas the host personality is not." 8
According to the DSM, the client is under the control of one personality or alter at a time; she/he usually cannot recall events that happened when the other alters were in control.
During the 1980s and early 1990s, the number of people diagnosed with MPD increased enormously. 40,000 cases of MPD were diagnosed between 1985 and 1995. 10 In 1998, there were over two dozen clinics in North America which specialize in this disorder.
The decline of MPD/DID:
Faith in MPD/DID appeared to falter in the mid-1990s. According to a literature review by August Piper, & Harold Merskey:
| "Between 1993 and 1998, the principal dissociative disorders organization lost nearlyh one half of its members. |
| In 1998, Dissociation, the journal of the dissociative disorders field ceased publication. |
| A paper published in 2000 examined the weaknesses in the dissociative amnesia construct. 15 |
| Various dissociative disorder units in Canada and the US (for example, in Manitoba, Illinois, Pennsylvania, and Texas) have been closed down. |
| US appellate courts have repeatedly refused to accept dissociative amnesia as a valid entity. |
| Several ardent defenders of dissociative disorders faced criminal sanctions, malpractice lawsuits, and other serious legal difficulties." 16 |
The number of active cases declined precipitously as belief in MPD has become less common in North America and most or all of the MPD/DID clinics were shut down. Some causes of this decline were:
| A growing belief that recovered memory therapy is extremely unreliable and often creates images of abuse that are unrelated to real childhood events. |
| A growing belief that no abusive Satanic religious cults exist, which engage in ritual abuse or murder. |
| Some persons accused of criminal acts have attempted to escape responsibility for their actions, and blame it on MPD. They claimed that their dominant personalities were not responsible for the crimes - their alters did it. This has contributed to public suspicion about the reality of MPD |
| Alleged victim-survivors of MPD have appeared on many TV talk shows. Some have given unconvincing, artificial, often comic performances of alter switching. |
| Observation by some skeptics that MPD symptoms only appear after the beginning of therapy. These symptoms tend to dissipate after the patient terminates treatment and is isolated from their therapist. |
| Some insurance companies have become alarmed at the extremely high cost of the long-term treatment of patients in MPD clinics. Costs sometimes run over a million dollars per patient. |
| Malpractice lawsuits against MPD therapists, their clinics and affiliated hospitals have been launched in recent years. Some settlements have run into millions of dollars. |
| Many therapists specializing in MPD -- including some leading authorities in the field -- have had their licenses pulled by regulatory agencies. |
In 1998, when the MPD hoax had almost vanished, the National Institutes of Health sponsored a Science in the Cinema film festival. Mental health professionals watched the 1957 movie version of The Three Faces of Eve. Dr. Paul McHugh of Johns Hopkins University gave a presentation after the movie. He concluded that:
"...multiple personalities are always artificial productions, the product of the medical attention that they arouse.....Patients believe that they have multiple personalities. They really do believe and show that. As I say, they are not attempting to defraud you, but the patients in fact are troubled by a variety of other mental illnesses–co-morbid mental or physical illnesses, adjustment disorders to their life at the moment, personality troubles–but there is no specific pathology, no particular specific psychological or somatic condition or even any particular life experience that necessarily produces hysterical behavior. The patients really are responding to the socio-cultural prompts that specify both the forms and the explanations for hysterical presentations. They are prompted by the interest of doctors and by the things which are happening and the prevalence of hysteria waxes and wanes with cultural attitudes and belief systems." 17
Conclusions:
MPD/DID seems to have gone through a 15 year cycle like many past psychological fads. It rapidly grew in acceptance among a minority of therapists during the 1980's. It reached a plateau and then started to decline in popularity. One very crude way of tracking the popularity of MPD/DID diagnoses is by scanning the publishing dates and topics of books on the topic. On 2004-JUN, a search of the Amazon.com website using the topic "Multiple Personality Disorder" revealed the following numbers of books published from 1973 to the present time:
| Date range | Number of books on MPD |
| Before 1980 | 2 |
| 1980 - 1984 | 6 |
| 1985 - 1989 | 9 |
| 1990 - 1994 | 17 |
| 1995 - 1999 | 15 |
| 2000 - 2004 | 1 |
The peak year was 1994, when six books were published. None have been published since 2001. Amazon.com only listed one book on the topic "Dissociative Identity Disorder;" it was published in 1997.
If MPD/DID were a valid diagnosis, one would expect this type of therapy to become gradually more popular, and would expect the number of books on the topic to increase. By 2004, MPD/DID appears to have been almost abandoned by the therapeutic community.
The author's personal comments:
I predicted in 2000-NOV, that by the year 2010 CE, MPD/DID will be relegated to the trash bucket of psychological fads, along with frontal lobotomy, recovered memory therapy, therapy to uncover memories of abuse in former lifetimes, and therapy related to abuse by LGM (little green men) onboard UFOs. This prediction seems to be on track. Remaining behind are tens of thousands of victims of MPD therapy who will continue to suffer emotional disability. They will slash themselves, attempt suicide and sometimes die as the result of incompetent therapy. Fortunately, most of the mental health practitioners who once specialized in MPD have moved on. Many are now performing Eye Movement Desensitization and Reprocessing (EMDR). 14 It also is junk therapy, but at least it does not have the potential for harm as MPD/DID did. By about 2015, it is probable that EMDR will be generally recognizes as worthless, and its therapists will move on to some new emerging therapy whose efficacy and safety will not have been tested. I can only hope that this new treatment will be as benign as EMDR.
References:
The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.
- Bennett G. Braun, Ed., "Treatment Of Multiple Personality Disorder" American Psychiatric Press, (1986) Read reviews or order this book safely from Amazon.com online book store
- R. Ofshe & E. Watters, "Making Monsters: False Memories, Psychotherapy and Sexual Hysteria," Schribners, New York, NY, (1994), Chapter 10, Pages 205 to 224.
- "Possession, multiple-personality disorder", at: http://www.physics.wisc.edu/~shalizi/notebooks/possession.html
- Malcolm Ritter, "Lost tapes challenge Sybil story: psychologist; Multiple personalities created during therapy?," Associated Press, 1998-AUG-17.
- Sidran Foundation, "Dissociative Identity Disorder (Multiple Personality Disorder)," essay © 1994 at: http://www.sidran.org/didbr.html
- C.H. Thigpen, H.M. Cleckley, "The Three Faces of Eve," (1956; Revised 1992) Read reviews or order this book
- F.R. Schreiber, "Sybil: the true story of a woman possesses by sixteen separate personalities," Warner Books, (1973; Reissued 1995). Read reviews or order this book.
- Lisa Scott, Member, International Society for the Study of Dissociation, letter to the editor of Psychology Today, 2001-FEB issue.
- Elizabeth Loftus, "The Most Dangerous Book You May Already Be Reading," Psychology Today, 2000-DEC.
- Joan Acocella, "Creating Hysteria: Women and the Myth of Multiple Personality Disorder." Jossey-Bass, (1999). Read reviews or order this book.
- Reinder Van Til, "Lost Daughters: Recovered Memory Therapy and the people it hurts," Eerdmand (1997), P. 178 to 182. This book deals mainly with the recovered memory therapy hoax which damaged hundreds of thousands of lives during the 1980s and 1990s. The author briefly discusses the case of Sybil.
- Mikkel Borch-Jacobsen, "Sybil -- The making of a disease," New York Review of Books, 1997-APR-24, Pages 61 & 62. This is an interview of Dr. Spiegel. See: http://www.astraeasweb.net/
- John Taylor, "The Lost Daughter" Esquire magazine, 1994-MAR.
- "EMDR," EMDR Institute, Inc., at: http://www.emdr.com/
- A. Piper A, et al., "Custer’s last stand: Brown, Scheflin, and Whitfield’s latest attempt to salvage 'dissociative amnesia'." J Psychiatry Law 2000;28:149–213.
- August Piper, & Harold Merskey, "The Persistence of Folly: A Critical Examination of Dissociative Identity Disorder. Part I. The Excesses of an Improbable Concept," Canadian Journal of Psychiatry, 2004-SEP; 49; Pages 592 to 6000. See: http://www.cpa-apc.org/ This is expected to be a temporary listing. Later, it should be available in the CJP archives at: http://www.cpa-apc.org/
- "The Three Faces of Eve," Science in the Cinema transcript, 1998-AUG-20, at: http://science-education.nih.gov/
Copyright © 1998 to 2006 by Ontario Consultants on
Religious Tolerance
Originally written: 1998-JAN-11
Last updated on 2006-JAN-31
Author: B.A. Robinson
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