From Abracadabra to Zombies
reader comments: multiple personality disorder
20 Feb 2010
Basic premise of MPD/DID contradicts itself.
- Minimal Self: the awareness of Self in the immediate here-and-now. The Minimal Self has two components;
- Sense of Self-agency, "I am the one doing this or that"
- Sense of Self-ownership, "I am the one experiencing this or that"
The basic assumptions, upon which conceptions of Multiple Personality/DID have been built, are:
- when a child experiences trauma/suffering that they cannot escape from, physically, they can still escape the trauma/suffering mentally – through a reflexive, involuntary dissociation process
- this dissociation process involves the "splitting off" of a secondary personality, who will "take over" and experience the trauma/suffering, retaining a memory of it, in the place of the original or master personality who may have no memory of it
The point of all this, is to ESCAPE SUFFERING. It makes sense that, if a child who was being raped could change their perception from "I am being raped" to " ‘some other person’ is being raped", that might alleviate some of their suffering. This would be a severe episode of dissociative depersonalization, where one component of the MInimal Self – the Sense of Self-ownership – has been disrupted, has 'collapsed' or become inactive.
Episodes of dissociative depersonalization – where the experience of "this is happening to me" (Self-ownership) fades out and is replaced by a sense of "this seems to be happening, not to me, but to ‘some other person’ " - are not that uncommon, when a person is "in shock" or under extreme stress.
This is NOT THE SAME phenomenon as "splitting off" a new personality, a new "I" or "switching to" a different personality, a different "I".
"I", whatever identity it carries, experiences Self-agency and Self-ownership.
"I-Bob" is being raped and the suffering is intolerable, so "I-Bob" collapses and Sense of Ownership is taken over by "I-Sam".
"I-Sam" is still being raped and possesses Sense of Ownership, so "I-Sam" is going to experience intolerable suffering. The suffering has not been escaped, or alleviated or mitigated in any way. A switch of identities can’t help the victim, if the Minimal Self – experiencing Sense of Agency and Sense of Ownership – remains functional.
Even if it was possible, "splitting off" a new personality couldn'’t help a victimized person escape their suffering, so that can’t be how or why alters come into being.
by Justin Sane (not my real name).
reply: Thanks for clearing this up, Mr. Sane. There is something inherently problematic about postulating that a victim of serious harm would create another person inside herself to be the scapegoat unless the scapegoat personality was truly masochistic and was created as someone who enjoys great pain and suffering. Maybe enjoys is the wrong word. How about invites pain and suffering as part of some grand scheme in which it elevates her status to some grand role such as benefactor of mankind or savior of the world. Even then, you wouldn't need to create another personality to be the savior. You could just as well be the savior yourself.
On the other hand, it would be simpler (Occam's razor simpler, that is) to displace the painful event and pretend that it's happening to someone else. The pretense is straightforward dissociation and doesn't involve all the machinations that maintaining another personality would involve. It would be even simpler (again, Occam's razor simpler) to suppress the memory of the painful event.
This discussion reminds of a god I once heard of. He created a huge universe with his magic wand. Some 9 billion years later things settled down enough on one small planet in an obscure galaxy (one of billions of billions) to produce conscious beings who created ways to distinguish themselves from each other. They developed a language with words that expressed their feelings, like I'm beautiful and you're ugly, or I'm normal and you're a freak, queer, pervert, sinner, vile, abominable, and thousands of other equally offensive terms. Eventually the whole planet became a chaotic place where the people who called themselves good and normal were drumming up all kinds of schemes to make those who didn't follow their program suffer. It got to the point where the good, normal people put it all down in a book and justified their despicable behavior by claiming that the one god of the universe, their god, had proclaimed that what they were doing was in accord with this god's eternal decrees.
Well, the god got so pissed off that he annihilated the people on the planet, except for a chosen few. It didn't matter, though, because in a few generations the survivors had split into the self-righteous and those that felt their wrath. The god annihilated most of them again, but to no avail. Finally, the god decided that the best way to deal with the pain and suffering he'd caused himself by his flawed universe was to create another personality within himself and let this other person do all the suffering. Nothing changed on the planet, of course, as one group of people aligned themselves with the god's alter ego once he took on human form and walked amongst them. This group anointed itself good and normal, and it's been persecuting anyone who rejects it rules and self-righteous beliefs ever since. The god, however, is at peace with himself and ignores his alter ego to this day. So the story goes.
Meanwhile, anybody who is different is either being persecuted or, what is worse, is being "helped" to become "normal" and "good" by the self-anointed pillars of society.
21 Nov 2009
I am commenting on your entry on Multiple Personality Disorder. I think that if this disorder exists, it is very rare, so much so that all or even most of the people on blogs and forums claiming to have it couldn't -- the odds are against it. One of the comments you posted for this entry was from a person who said she had two friends with the disorder - I mean really what is the chance of knowing two people that have alters?
Since it seems the alters appear spontaneously, wouldn't people notice this? For example, couldn't an alter appear when the person is at work? One person who writes a blog and who claims she has the disorder, has been a teacher for 12 years. I asked her if over these years haven't students, teachers etc. noticed when her alters come out? She said she has a different persona for different parts of her life. How convenient. Yet when she writes her blog she will use "we" instead of "I" because sometimes, according to her, there is more than one alter writing at that time. Ok? There are many instances she writes of where things she did were attributed to her (behaviors that were unacceptable) but she will insist it was an alter.
Or what about people who go on talk shows and their alter comes out at the right time on the show?
The point is, while these people obviously have mental issues, I really don't think having a bunch of personalities in one body is it. Some people who commented on your site said perhaps some of it is really borderline personality disorder. I kind of agree with that, because I have borderline personality disorder. I've never had multiple personalities, but I have done some pretty strange things to get attention.
These days with the internet people can get in contact with others who say they have multiple personalities, and the idea is then planted in their own minds, to fulfill some sort of need. And through all these forums and blogs, there is reinforcement. However, as you said these people certainly do deserve pity not disdain. Probably most of them need therapy, but not for having multiple personalities, but for wanting to believe they have multiple personalities.
17 July 2009
I always read your site with great enthusiasm and interest. I have many things to say about many topics but I will limit my thoughts to just one.
I recently reread the "Multiple Personality Disorder" topic and would like to share a bit of my story and some information that so far I have not seen researched by anyone who supports MPD or not.
I completely agree that MPD is a socially constructed disorder.
I had a very difficult youth. I was always a very odd child: intelligent, creative, gifted...but something was never quite right about me. I never did well in school because I wasn't interested and I never had any friends. I was very naive, lived in my own world, and didn't understand the world around me. Despite my intelligence I was placed in special ed and diagnosed with various learning disabilities.
At eleven I was finally taken to a therapist because of self-harm and severe depression. [The therapist] decided that my father had sexually abused me. This belief, that I must have been abused in some way, went on for about seven years. In the meantime, I was placed in institutions, hospitals, had various types of therapy, etc.
I NEVER believed that I had been abused. It never made any sense to me because I didn't remember it. My father was always kind to me and cared for me. But I didn't remember anything [abusive]. Wouldn't I remember something like that? No one could convince me that I had ever been abused in any way (except abuse by my therapists and the psychiatric system).
At nineteen a doctor ... told me that I had high-functioning autism. Finally, I knew what my problem was and that none of my symptoms were related to "abuse." I am now 21 and still recovering from my horrible therapeutic and psychiatric abuse.
I find the socially constructed theory of MPD particularly intriguing considering that I have autism. As you may or may not know people with autism have extreme difficulty understanding social situations: I cannot grasp "subtle" behavior, body language, facial expressions, tone of voice, etc. I lack empathy and have no "Theory of Mind," meaning, basically, that I think everyone knows what I know. I do not understand anything political or social, and so never follow any social "fad."
As you have read, I NEVER believed that I had been abused. No one could ever convince me. Could this be because I have autism, because I am not socially motivated in any way to "please" anyone? I would be very interested to know if people with autism could be "tricked" into having a mental disorder like MPD. (Of course, many people diagnosed with autism today don't have it, but the "epidemic" of autism is another story...)
I did a bit of research and found a study that stated that people with autism have increased discrimination in false memories.
I really do not find this surprising considering that "false memories" of any type, not just of abuse, seem to be socially motivated in some way or another: high functioning autistic people tend to be very logical and rigid, sticking to facts, rarely lie, and they are obviously not socially motivated.
Needless to say, I find this all very interesting. Since I had many therapists attempt to convince me of false memories for years and I never believed them, Is it because of my autism, the fact that I am not socially motivated/interested? Would other autistic individuals be able to be convinced that they had a mental disorder considering their severe social impairments?
I realize such a study could not be done due to ethical reasons, but the premise is interesting. I have not yet come across anyone else with autism who has had therapists attempt to plant false memories in them, so I try to share my story and information when I can.
(name withheld by request)
reply: It is known that patients often want to please their doctors and report falsehoods and errors to them in an effort, apparently, to please those providing treatment. This is sometimes referred to as "patient politeness or subordination" (the patient doesn’t want to disappoint the healer). It is certainly possible that not being disposed to want to please anyone would tend to make a patient less likely to go along with a therapist's claims that the patient was sexually abused by her father when she has no memory of such abuse.
As you note, however, an important element in your not believing that you were abused, despite your therapist's speculation that you were, is the fact that you have an excellent memory. The study you found, "Increased discrimination of 'false memories' in autism spectrum disorder" by David Q. Beversdorf et al., found that individuals with autism spectrum disorder (ASD) are able to discriminate false memory items from true items significantly better than are control subjects. Furthermore, their results also suggested that high-functioning ASD individuals have unusually high memory capacities.
On the other hand, many individuals who have not been diagnosed with ASD have been led to believe they have MPD by their therapists. It is certainly possible that some individuals with ASD might have been similarly misled.
18 Sep 2003
I am writing about your inclusion of MPD/DID, and treatment of the same in your dictionary. I tend, regarding most things to be a skeptic, but I am unfortunately a skeptic with DID. Your treatment of DID on your website, and, I believe, in your book does not properly address the condition at all, as anyone living with it would attest to.
You seem, in your writing to equate repressed memory with false memory. They are not at all one and the same. In my case, I have had numerous severe injuries, including two broken hips, proven by x-ray, of which I have no memory.
reply: I distinguish between repressed and false memories in my entries on memory (where I discuss traumas received while unconscious, among other things relevant to this issue), repressed memory, and repressed memory therapy. (Even in the false memory entry I write: "It is as unlikely that all recovered memories of childhood sexual abuse are false as that they are all true.") On the MPD page, I present the views of memory held by the MPD therapists and their critics. I do not treat the issue of false memory and repression per se in that entry. I do, however, conclude the online MPD entry with the statement: "It is possible, of course, that some cases of MPD emerge spontaneously without input from the MPD community...." This implies that the critics of MPD therapy could be right about many, if not most, cases of MPD, and yet there still be genuine cases where the memories are not false memories. I regret not having this statement in the Wiley version of the entry.
You do not address dissociation, which is the root causes of DID. You say that the memories cause the illness, where the trauma causes the illness.
reply: I believe the issue of dissociation is adequately covered in the first two paragraphs and in the long quote from Dennet in the MPD entry. I think I make it clear that the MPD therapists believe that childhood sexual trauma triggers the response of dissociation, which is described as the creation of alters as a mechanism for repressing the memories. I may be wrong in my understanding of dissociation, but I do address it.
Your analysis of DID, while cute, appealing to those who don't wish to understand the facts, and helpful in selling books is ultimately wrong, and does a grave disservice to those living with the disorder.
reply: no comment.
I had to live through a violent childhood. Much of what happened I do, and did remember (prior to therapy). My mind through DID spared me the most painful parts and I can, now as an adult, sort them through. This is incredibly difficult work, made more difficult by works such as yours.
reply: I understand that the critics of MPD and those who write sympathetically about them (like myself) would make it more difficult to deal with the disorder for someone with MPD who is aware of our work. However, there are other people to consider as well. I am referring to the many who have been misdiagnosed and maltreated by MPD therapists.
I did a good deal of writing of a technical nature. I did not write on subjects of which I was not qualified to do so. I would entreat you to do the same. You may have consulted persons whom you sought out that had controversial stances, but they are not regarded as experts in treating this painful and sometimes debilitating condition.
reply: I don't have to have MPD or be an MPD therapist to be qualified to write about MPD, any more than I have to be a baseball player to write about baseball or a soldier to write about war. Who qualifies as an expert here is a matter of opinion, but simply because someone disagrees with your opinion does not disqualify them either as an expert or as somebody who can recognize an expert in a given field.
Please consider the legal test, of looking for the preponderance of
the evidence, rather than your own opinion or the flawed opinions of others.
reply: Determining that a position is supported by a preponderance of the evidence is an opinion.
I ask you to read the following letter.
07 Sep 2003
I read with interest your article, 'multiple personality disorder [dissociative identity disorder]'
I come from two points of view, one, that of a therapist, and the other of a person with DID.
To begin, I will recall my personal history.
I was born in 1960. At about the age of 13 I began to experience 'problems', anxiety attacks, syncope, and fugue states. I had not previously been in any psychotherapy, and I found that there was something amiss. I began to seek, on my own, counseling at school, and through other venues.
The only way I could later, [in about 1981] explain the way I felt was, "it feels like I am a computer and my boards do not match and I have a parity check error". I had no reason to even think of multiple personalities, I hadn't even seen the movie, 'Sybil', or any other on the topic. My MPD/DID was formally diagnosed in 1991.
I began studying psychology in the hopes of figuring out what was wrong and fixing it. ( I have a Ph.D. in psychology from Trinity Univ.)
I agree with the precept that some practicing psychologists/psychiatrists have preyed on patients for their own personal gain. Unfortunately, I had this experience in 1983 (See Demke VS Mowry...CA Civil Court 1984) in that the Ph.D. I was seeing at this time discovered my DID, and not telling me of it, created and programmed alters for his pleasure.
In my case, the diagnosis in 1991 was not induced by 'the media', but rather by an astounding presentation of an alter personality to an appointment with my therapist in 1991. Many of my SRA (Satanic Ritual Abuse) memories have been validated.
In 1991, after the death of my father I began to experience intense symptoms I, personally related to socio-economic stressors and grief. I began to seek counsel. In the course of the therapy, one appointment date was 'kept' by an alter personality who in dress, deportment, and identity was not me. The therapist I was seeking counsel from at this time was did not work with, or believe in MPD/DID and I was referred out to another therapist.
One 'trauma flashback event' was precipitated by a news article on a compound in Juarez, MX. This compound was used for rituals, etc.
[I later found an earlier drawing I had done, (about 1985) in my 'papers' of this compound in Juarez.]
I later began work with a specialist in MPD/(DID) in Southern California.
In the course of this work, a series of memories began to come forth, that I, personally could not fathom. Geographically, it appeared impossible to me. I to the best of my knowing, had always been in California, these memories were of travel in Texas, Mexico, and surrounding areas. I began to do my own research.
One memory had me at the home of a childhood friend, who had moved to Oklahoma. I called there, spoke to her parents, who told me that I had indeed been there in Oklahoma at the time I had remembered. I also researched Juarez Mexico., and found that my memory of the town was correct, along with the memories of El Paso, TX, and a few other places.
From my research, interviewing of persons from my past, and old journals I found that the memories of Ritual Abuse and torture had foundation. (My desire was to completely debunk the memories as false.)
My point of communication is that, although some persons have perpetrated fraud on patients by suggestion and hypnosis creating fraudulent case studies, other well meaning, and informed therapists in the field of MPD/DID are genuine in intent.
Also, a person with DID may also have other disorders, or mental illness.
Some with DID may have BPD, bipolar disorder, etc. These also must be treated. In my practice, I have also found alter personalities that may have additional diagnoses. My personal opinion is that much more is to be learned in the field of psychology and MPD/DID. I have yet to find two clients that do not vary.
Each case must be taken on it's own merits.
Your article does have merit, and I did not see you personally 'taking sides', but rather presenting a broad view of the topic.
Some information on "who we are" can be found at: http://www.trpsters.com
(If reprinted, please with hold my name, as I do not publish to all my personal history)
15 Oct 2000
If you are serious about being open minded and examining evidence that may refute your position, you may find my experience a counter example to the social construction theory of DID. I was raped by my brothers and their friends when I was nine, and my brother repeated it numerous times. My memory of the first experience has been continuous, those for the subsequent ones more vague (but confirmed by my brother). This happened in 1960. In college I became aware that I was nearly totally amnesiac for the years from 9 to 14, and had extensive amnesia for many parts of the high school years; this became obvious to me when I realized how impoverished my personal memories were compared to those of friends.
Between then and now I became a scientist (currently a full professor at a big 10 university), had numerous episodes of depression (which went undiagnosed for a long time), married, divorced, remarried in 1982 and now have a family of two children and a wonderful husband. My depressive episodes always had a quality of "happening to someone else" about them; this is recorded in various journal entries I have made at different times. In 1997 during my last episode of depression I became aware of voices in my head arguing about things I was trying to do; the sensation was that an "observer I" was listening to a child's voice of whining helpless hopelessness, and a adult woman's voice trying to urge her to action and scold her.
In 1999 with the support of a family physician I began to learn more about the effects of incest and to come to terms with my brothers. In the course of reading I learned a great deal more about depression and with my physician's support designed a prevention program. I also for the first time came across the psychiatric definitions of dissociation and the various dissociative disorders. Among them I had the symptoms of dissociative amnesia (as I described above), dissociative fugues (short ones lasting one to two hours that have occurred at times of very intense stress; perhaps a total of eight to ten such episodes over the thirty years, the most recent in 1987), depersonalized experiences, mostly of intense natural beauty, and small time gaps (1-3 hours at a time where I could not remember what I had been doing). When I read the criteria for DID my reaction was, "That's odd! That could fit me - but I'm not messed up like the people who have that." I did not give serious thought to my having DID again.
This spring my physician asked me to undergo an evaluation by someone experienced in treating people with abuse so that if I have another episode of depression he would have recommendations on how to treat it, given my history. In the course of the initial meetings with the therapist, as I heard my self telling her these things and others, like not remembering writing my own articles (!), the possibility of DID re-emerged. With her support my therapy since then has used this model as an important component, namely my focussing on self-awareness, self-acceptance and self-regulation. Another part of it was consciously using the first person pronoun when I thought about myself, as I had become aware that I thought of myself as "you" or even "they" at particularly distressing times. Early on, I experienced what seemed to me like the integration of several child parts. After this, several things changed at once; a long standing knot of anxiety dissipated, a buzzing noise in the back of my thoughts stopped (I had not been aware of it until it stopped), difficulty orienting to the day of the week on waking stopped, my memory for daily life events improved, and the short time gaps diminished and now are gone. Daily activities became simpler and easier to do. There were no more episodes of "voices in my head." Several subsequent "integrations" or whatever you choose to think of them have also been followed by less distress and better function.
Please note several things: I have never been hypnotized. I have had continuous memory for the abuse. I had never read nor seen Sybil, the Three Faces of Eve, or any other MPD stories. I had no interest in the "recovered memory" movement of the eighties because my memory was continuous; I would rather have forgotten than remembered. I cannot see in my past any secondary gain whatsoever from what I interpret as DID. Several previous rounds with therapists did not relieve the symptoms or the distress, although they helped in most cases with other presenting problems. My therapist did not suggest the diagnosis; it was a matter of my recognizing in my own experiences the criteria of the DSM diagnosis. Nor was there ever any attempt to elicit from me any of the symptoms.
It is clear that there has been an overuse of DID and that it has been casually applied by people who have very little training or critical capacity. I don't know exactly what to make of the satanic ritual abuse stuff; it could be paranoid schizophrenia, BPD (as you suggest for DID) or some sort of folie a deux between the patient and the therapists, a mass hysteria like the Dutch tulip craze of the seventeenth century. There is in any case no objective evidence for any of it, as far as I am aware.
However, severe childhood sexual abuse (severe meaning involving intercourse or other penetration) is common; 5-8% of women have experienced it, based on several reputable, population based studies, most recently one in the current issue of Archives of General Psychiatry. Given its prevalence, I find wholly believable the population studies in several countries that suggest a prevalence of DID in the range of 0.5 - 1%, with the understanding that many of these people would be like myself: functional in many ways but in great interior distress. Just as for every person with depression that needs hospitalization there are five to ten in the community, more functional but still in significant distress, I believe that there are a similar proportion of people like myself who have struggled with this problem and managed to cope in the community.
It is good that bad therapeutic practices, ones likely to lead to
confabulated or false memories, are brought to light and seen as unwise or
damaging. It is tragic that blanket statements are leading to a second
season of silence, one in which actual deep human suffering is being
denied and forced into silence again. As a child I was told by my brother
that no one would believe me; it took nearly forty years to find the
interior strength to break fully free from that. Black and white
treatments of this troubled question, ones that deny even the possibility
of DID as a spontaneous, interior reaction to horrific childhood
experiences, threaten to silence millions of others. Please reconsider
your page and revise it; I would be happy to provide citations from
mainstream psychiatrists such as Richard Kluft, whose work with DID
predates the fad and involves none of the marginal ideology of the people
reply with responses in italics from the
You don't say specifically what it is about my position that you think I should reconsider, so I will have to guess here at what you are objecting to.
You seem to think that I think that the self is nothing but a social construct. That is not my position. I believe the self is in large part a social construct, but has a biological basis as well. Oliver Sacks and other neurologists have written about some interesting cases of brain damaged people who lose their sense of self. Part of the self is obviously connected to memory and if memories are lost, so is an essential element of one's self. Part of the self connects consciousness with one's body. That sense of connection has a neurological basis. Part of the self is obviously a developmental response to one's personal experiences. And part of the self is a matter of role-playing and social expectations.
What Spanos argued for, and the position I agree with, is the notion that multiple personality disorder as classically described is unlikely to be correct. That most cases of MPD are therapist induced.
This is exactly what I am disagreeing with; that there is no...socially constructed MPD.
reply: I'm afraid the evidence is against you here. Even Dr. Bennett Braun, the founder of the International Society for the Study of Multiple Personality Disorder, now known as The International Society for the Study of Dissociation, has been found guilty of inducing MPD in a patient. There are other cases as well; to find them just look through the lists of further readings in my entries on MPD, false memory, and repressed memory therapy.
Your case history does not seem to be a counter-example at all, but rather a supporting example. The classical model assume that MPD begins with sexual abuse of a child which is repressed. You note that the memory of your abuse has been continuous, not repressed. The classical model of MPD claims that the child creates alters to aid in the repression.
I'm not sure what you call "classic," but DSM IV does not require amnesia for the abuse as one of the diagnostic criteria. Follow-up studies of documented abuse found that over a third of those abused did not remember it; another third had had intermittent memories for it. Many of those treated for DID have continuous memories for the abuse in at least some aspects.
reply: The DSM-IV has removed "multiple personality disorder" altogether, but some influential therapists are still adhering to the description in DSM-III and do not agree with the American Psychiatric Association's that "dissociative identity disorder" covers all the bases. I believe you are correct about the DSM-IV diagnostic criteria, but therapists are not required to use those criteria and many do not.
What I did not elaborate on in my first note (as I had no idea whether you would read it seriously) is that key elements of the abuse memory were inaccessible until this spring; the part of the memory that I was finally able to recover was that I had enjoyed the experience (no physical violence had been used) and that that was the part of me that remained hidden or inaccessible, a child-like part that felt deep shame and guilt because of willingly participating. My "rational" self has known since fourteen that I was not guilty of anything; this hidden self still felt responsible, until I had access to this and could address it.
Here is an analogy, or a small example, of how I believe these things work. I am certain you have had this experience - you are trying to remember a name or a word and it escapes you for the moment. Hours, even days later, the sought for word forces itself into your awareness. It is as if we have small mental file clerks that can accept an assignment and circulate in our brains until that assignment is complete. I believe that this is an analogy, or even an example of, how dissociated parts operate, encapsulating a limited range of thought, feeling and action that are only expressed in limited contexts and that operate outside the domain of active awareness.
The kind of amnesia you refer to is common to many of us who have never been abused. I, too, have amnesia for most of my childhood, adolescence and a great part of adulthood. Compared to my wife of 32 years, who remembers vast amounts of details about our children and ourselves, I might as well not have experience 90% of those years, for I can't recall most of what happened during that time. I can't remember writing some of the entries in the Skeptic's Dictionary. Sometimes I can remember having written the entry but reading it after a few years is like seeing something for the first time. The kind of amnesia of the classical MPD patient is amnesia regarding the abuse or behavior engaged in which is abusive itself, such as raping women by night while practicing dentistry and attending PTA meetings by day, or murdering women while "Steve" and being a nice guy while "Ken."
Again, "classical" by what standards? I am not trying to defend every form of therapy for DID; I know that people like Braun or Allison have some strange ideas. But you don't seem to have read anything by Kluft, a thoughtful mainstream psychiatrist with none of their baggage. And I didn't tell you everything about my amnesia, either - would you, to a complete stranger? Do you routinely have several hours pass where as soon as they are gone, you have no idea of what happened? I did for a long time; that is quite different than a bad memory for children's birthday parties.
reply: Yes, the kind of amnesia you describe is not common and is symptomatic of a disorder of some kind. At the risk of sounding insensitive, however, I must ask how anyone could know that these fugue states are causally connected to the abuse you suffered?
Classical MPD posits alters that are mostly impenetrable and isolated. Feeling detached from oneself while depressed is quite different and, I suspect, quite common.
Actually, no; I learned a great deal about depression when I was designing a prevention plan with the help of my physician. The significant aspects of depression are affective (feeling sad, hopeless, helpless, bad), behavioral (inactive or agitated) and physiological (changes in sleep, eating, weight). "Feeling detached from oneself" or anything like that has never been listed as a common aspect of it, and believe me I have read a lot of it.
I have never been diagnosed with clinical depression but like many people I go through periods where I am pretty much indifferent to almost everything. I, too, feel detached from myself and feel like the "real" me will return soon. I don't doubt that seriously depressed people experience a much deeper dissociation that I do, but positing "alters" to explain these feelings is a bit much.
No, "hearing voices in the head" has a fairly short differential diagnosis. Besides DID, the list includes schizophrenia (doubtful that I would have become a full professor if I had that), psychotic depression (a form so severe that it usually requires hospitalization or ECT) and schizoaffective disorder (which mixes both). Frankly, I find it hopeful to have DID by comparison; people don't get better from schizophrenia.
reply: There is a professor at UC Davis who has schizophrenia. It is true that the disease does not go away but it is treatable and some people are able to function at very high levels despite the disorder. Because of the stigma associated with mental severe mental illness, those who are "survivors" and functioning at a high level usually do not choose to come out of the closet.
There is, by the way, a school of psychotherapy that posits that all people have parts, and that difficulties come from not having full and ready access to those parts or conflict between them - two schools, actually. The more recent American one is called internal family systems therapy and an older Italian one is called psychosynthesis. On these two models, DID is just an extreme form of a kind of self-unawareness that can be a problem for many people.
reply: It sounds like you have a reputable therapist who did not assume before you walked through the door that he or she knew either that you had a disorder or the cause of your disorder. I agree that the charges against so many therapists putting false memories in their patients can have a deleterious effect on those who truly were abused and who truly do suffer some depression and some degree of dissociation. But I believe the fault is not with those of us who expose bad therapies and therapists, but with those who practice those therapies, regardless of their intentions.
I hope that my writing will steer people away from the charlatans and towards responsible therapists.
But then I wish you would also call attention to responsible therapists who treat DID! People with recurrent depression and DID classically have the depression recur until the DID is treated. I worked with several good therapists on various problems over the years; they helped (some) with the specific problems, but NOTHING like the relief and improvement in function that I have experienced with therapy specifically directed toward DID by someone experienced with it. I find quite believable the population surveys that suggest an incidence of DID in the range of 0.5 - 1%, if that is taken to mean people like myself, and they will not get relief from drugs or from non-specific therapies. The excessive scepticism, that claims that there is no spontaneous DID and that the iatrogenic form can be "cured" by ignoring people, will only make it that much harder for these people to find true and last help. You may well damage more people than you help if you solely focus on the bad therapists and deny the existence of responsible ones.
reply: I don't deny the existence of responsible therapists. If my writing steers just one budding therapist away from doing bad therapy and harming who knows how many patients, I will consider it worthwhile.
16 Sep 2000
I happened upon your website by accident and I can't bear to leave without telling you that MPD (now called DID) does exist. I know, I have lived it and, to some degree, I will continue to live with it for the rest of my life. No therapist prompted me, no one "suggested" anything to me.
You speak of something you know nothing about and with such arrogance. What do YOU think happens to children who are horribly abused? To be sure, some die of the trauma, others become mentally ill, others become sociopaths and SOME, under the right conditions, learn to "go to sleep" by burying the horror deep within the psyche. A substitute for the "sleeping" part is invented, and so the house of cards is built, part by part. The concept is at once simple and extremely complex.
reply: Are you claiming that you have discovered this on your own, without having read any of the literature on this subject, or having seen any of the films depicting people with multiple personalities?
With the eerie connotation of MPD, I can understand that some minds cannot grasp what they cannot see - cannot get past the "Sybilization" of it. If man's landing on the moon had not appeared on television, I'm certain those with the inability for abstract thought would categorize the achievement as a hoax. DID (I like this term because it is less scary to childlike minds) is primarily a terribly painful healing process. Reliving catastrophic stress at the child level is the heart of it. It is a coping mechanism that will allow the child to appear to be normal.
reply: Again I ask: are you claiming nobody suggested any of these notions to you? You came up with them all on your own?
I graduated from college, trained customers for IBM, sold Premarin
to doctors, taught at the community college level (after attaining a M.A.)
and sold packaging products very successfully before the "house of
cards" fell to pieces. I had no therapist who counted personalities.
I was always co-conscious. No part appeared terribly different from
another. There were no monsters or Mr. Hydes. Mostly, it has been just
PAIN. Walk a mile in my shoes.
reply: I think you have misunderstood what I have written. Suggestion can be subtle. It can occur without our even being aware of it. From your description of the causes and mechanism of your illness, it appears very obvious that the diagnosis and explanation of your illness have been suggested to you. This is no way implies a denial of your pain and suffering.
Mary Lu replies
17 Sep 2000
Making assumptions based on insufficient knowledge indicates, to me, poor reasoning ability. For the sake of brevity, I left out several hundred pages of evidence that would demonstrate that I realized there was more than one of me long before any therapist. I did not even know that it had a name, I just knew something had gone terribly wrong with me. I hope for the sake of mankind that you are not a researcher. I don't need to debate with you what I know I have suffered through for so many years -- no one can "suggest" the kind of psychological pain that is the major part of healing. You know naught of what you speak.
reply: You seem to think that I have diagnosed you incorrectly or have denied the existence of dissociation, neither of which is true. I've never diagnosed you, but I have presented a case for the position that the self, however it is construed, is a social construct. This is not to deny that biology or personal experience do not affect the self in profound ways. It is, however, my opinion that the arrogant ones are those therapists who assume before even meeting their patients that their patients have been sexually abused as children, have repressed all memories of the abuse, and that the job of therapy is to help the patient recover those memories before there is any hope of recovery.
There is ample evidence that therapists can and have suggested things to their patients which have caused the patients great psychological harm. See my entries on false memory, repressed memory therapy and satanic ritual abuse for examples. Read the news story on the MPD page about what Dr. Bennett Braun did to Patricia Burgus.
To the argument that some therapists never see MPD, I must tell you this brief story: Believing that if I could just find another antidepressant that would work safely with Parnate my world would return to normal, I consulted Dr. Uran, on the faculty at Oregon Health Sciences University. He did come up with the sought after antidepressant (although it made no difference). I saw him twice. The second time he said, "I didn't recognize you. You don't seem like the same person; in fact, you don't even look like the same person." My mind was saying "He thinks I'm the same one!" Later I learned that Dr. Uran and his colleagues on the hill deny the existence of MPD. If asked, I'm sure he would deny ever having seen a case of MPD and, he's right, he COULD NOT SEE IT.
I suspect that further communication is pointless. My experience has been that people who carve their beliefs in granite have a severe deficit in analytical ability.
reply: I agree. Of course it is impossible for someone to give a diagnosis of a disorder he or she does not believe exists. In itself, however, that fact is irrelevant to who is right about MPD.
Your comments have made me realize that my writing was not clear enough. I don't think Spanos' arguments imply that MPD does not exist, but that the explanation of its origin, and by consequence the appropriate treatment for it, are not justified. I have rewritten large parts of the MPD entry to try to clarify my position and what I think is Spanos' position.
I have also introduced some new views. Dr. Hughes thinks MPD does not exist. Dr. Allison thinks it does and that spirits and angels are involved in the process. Dr. Coons buys into the standard MPD paradigm (Sybil) hook line and sinker, adding that demonic possession was a forerunner of MPD.
The fact that the Sybil case is the paradigm and forerunner of modern MPD cases, and that the Sybil case seems most likely to have been contrived, strongly suggests that Dr. Coons is not on the right side of this argument. The fact that there are no cases to speak of involving adults who suffer tremendous torture, trauma, abuse, etc., who defend themselves by creating "alters" strongly suggests that this explanation is bogus. Adults who are kidnapped and made into sex slaves, prisoners of war, etc., have as much desire to survive as children do. If the dissociation tactic is open to children it ought to be open to adults, yet it does not seem to be one they take. Furthermore, all the research that has been done on trauma demonstrates that the more traumatic an experience the more likely one is to remember it, which contradicts the repression theory. This does not mean that no child has ever been abused or repressed the memory of it or that DID is not sometimes brought about by sexual abuse. But the evidence does strongly suggest that as a model of DID, the Sybil model is a profile likely to cause more harm than good.
Mary Lu replies and bids us adios!
23 Sep 2000
In college the dept. chair was also my advisor. I took many classes from him. He was probably one of the worst teachers I've ever had, yet he was supposedly teaching us how to teach. He spent most of our valuable class time talking about the different points of view presented by his peers in the various business journals. Their "research" was so far removed from the real world that his ravings or rebuttals meant nothing to us and contributed nothing to our ability to leave that institution of higher learning and know what on earth to do in a classroom. Frankly, mostly I learned from my cooperating teacher and from good old OJT.
If you wonder why I told you that "parable", then just let it pass you by.
I could not find the first article you mentioned in your reply regarding false memories. I can only guess at what you said. If in it you suggested that some memories are false, you are partially right. Our subconscious (at least mine) doesn't seem to speak English especially well. However, I've noticed that it speaks symbolically. Any therapist who takes every detail of a memory literally is either inexperienced or not really up to the task of working with whatever name you want to put on it (MPD, Repressed Memory, DID, etc.) I get from you that everything must have an "either-or" to it. Be good or bad, black or white - that everything must be clearly defined. Frankly, I think most behavior, traced back to its roots, is a mish-mash and mostly in gray tones. Actually, I think any therapist who actually believes he/she can determine the total truth of a reported memory is a fool. The human mind is far too complicated. Furthermore, a "memory" might be a "feeling" which has worked its way into consciousness only after exhausting the conscious mind and the body through lack of sleep and extreme stress. The best word for this process is "AGONY." This kind of "memory" cannot be "planted" by a therapist. And this kind of "memory" is very real. There is no mistaking terror. The word should be in huge letters with every horrifying adjective imaginable preceding it.
Have you considered the possibility that one person might fall into all categories. In the very beginning of my nightmare, there were several very different whole personalities. No, they did not have names. I finally put names on them simply for reference sake. Mostly I named them for their most outstanding characteristic. There was teacher, mother, little girl, center and the severely handicapped Mary Lu (the core and the most debilitated). Eventually, they merged and when it happened. I had to hold on to the kitchen counter because my body shook. It was, in fact, a huge internal earthquake. That was a major turning point. There were a few others, one who only came out in sexual situations, one for rage, etc.
Oddly enough, the most painful part of the process is when the "feeling" memories finally make their way out. In every instance, so far, the feelings match up with actual memories I've always had of my childhood - I simply buried the feelings because, I suppose they were too painful to feel at the time. So far, you can say that I had MPD, DID and repressed memories. The main exception to this is the neglect as a baby and as a toddler. Those "event" memories came from "pictures" that kept popping into my mind, but it was my body's actions that finally made me understand what the pictures meant.. Too long and involved to explain here.
I did read the Coons article and I don't remember any statements about demonic possession being a forerunner of MPD. If I had the time and energy, I would explain to you how I believe people will often talk of Satan and God and battles between the two, but frankly, I think you would misinterpret what I was saying. Besides, it is too complex and I am not inclined to put forth the effort.
I agree that MPD has been "Sybilized" - but it was the mental health community that stuck the name on it. A doctor whom I trust and is well experienced told me that the vast majority of MPD cases are actually co-conscious (as was I). Maybe now by calling cases like mine DID, they can get around to the business of actually helping instead of worrying endlessly over labels. Actually, none of my therapists have ever labeled my condition. They didn't need to.
Finally, I want to ask. Who are you? What kind of training did you have in mental health? I ask this because I find it hard to believe that anyone, even a lay person who has read at least a few "self-help" books would know that children are not simply little adults. You said:
The fact that there are no cases to speak of involving adults who suffer tremendous torture, trauma, abuse, etc., who defend themselves by creating "alters" strongly suggests that this explanation is bogus. Adults who are kidnapped and made into sex slaves, prisoners of war, etc., have as much desire to survive as children do. If the dissociation tactic is open to children it ought to be open to adults, yet it does not seem to be one they take. Furthermore, all the research that has been done on trauma demonstrates that the more traumatic an experience the more likely one is to remember it, which contradicts the repression theory.
I would hope that any training in psychology would include some amount of information on child development. Very small children have capabilities they lose as they grow older. Surely there is ample evidence of the remarkable ability of small children to become bilingual very quickly. Conversely, small children would not have the coping ability of adults, or the sense of time or place. To a very small child, mother is the world. To an adult, the world is the world. To an adult, solitary confinement might be survivable by any number of coping mechanisms. How does, for example, a toddler survive day after day of solitary confinement? Maybe, just maybe, they simply escape the horror of it by simply "going to sleep" - in other words, burying the pain (and part of themselves) very deeply in their subconscious. When mother does retrieve the child, the original baby is deeply buried in "sleep". Mother doesn't notice because a "new" baby, nearly identical in personality is there to greet her. Using this method, the child can survive and appear to be perfectly normal. My understanding is that no one really knows why some children are capable of doing this "splitting off" and others are not. Some say intelligence and creatively are the critical factors. Also, it seems the child loses this ability after the approximate age of seven.
When those feelings, apparently secreted in one area of my psyche, finally merged into what is "me", I screamed and begged for mercy. I called my doctors repeatedly screaming for help. Eventually, I came to realize no one could help because it was inside my head. The choice for me was to develop a coping mechanism or commit suicide. I don't remember making a conscious choice or deciding on what to do. I just did what my mind and body led me to do. I drove to a mall parking lot (seeing people even at a distance) at least kept reminding my thinking brain that this was reality. I held tightly to the steering wheel to feel grounded, and let the unimaginable fear consume me again and again and again until, after truly torturous hours, my mind began to build an immunity from the onslaught. Even now, four years later, any slight sense of abandonment will jangle that fear again although the pain is far less intense and is short-lived.
I don't know why I am bothering to tell this to you, some faceless person whose credentials may be questionable and whose mind appears to be set on fine lines rather than the broad picture. Why do you write what you do? What motivates you? Have you any training in the mental health field or are you a "wannabe". Maybe your heart went out to some controlling bastard who managed to convince you that his daughter's insistence of incest was "planted" by some stupid psychologist. I won't disagree there are good and bad in every profession. I am sure there are some therapists who began to see sexual abuse in every client. I am just as sure there are parents who will go to any extreme to cover the horror of their actions. By the way, who invented the term "false memories?"
reply: Adios. No mas, no mas!
24 Dec 1999
I just finished reading your entry on MPD, and I couldn't agree more. I am a master's level social worker, and my graduate training took place on an inpatient psychiatric unit. During my internship, I was fortunate enough to actually see a case of dissociative identity disorder.
The patient was a young woman who claimed to have about five different personalities. At first, the staff at the hospital took her claim at face value. Then we began to notice a pattern in her behavior: whenever she wasn't the center of attention, she suddenly switched personalities. During one of her supposed personality changes, she threw herself on the floor and began to have a temper tantrum like a five year old child. My supervisor instructed the staff to ignore her instead of fawning over her, and the result was quite interesting. She suddenly stood up and screamed, "You people don't know a damn thing about multiples!!!" She then stormed out of the room. She didn't switch personalities again for the remainder of her stay in the hospital.
It is my opinion that most patients who present with "MPD" should really receive a DSM-IV Axis II diagnosis of borderline personality disorder. People with BPD are notorious for trying to hook their therapists into a long, drawn out "therapeutic" relationship for the sole purpose of gaining attention. They will give the therapist exactly what s/he wants if they think it will prolong the therapeutic relationship.
Thanks for your informative web site. I would like to discuss other pseudoscientific "diagnoses" that abound in the mental health field. If you are interested, please feel to e-mail me. Also, please do not include my name if you choose to post this letter under the "readers' comments" section. I don't want to inadvertently violate patient confidentiality.
25 May 1999
I have a very close friend who has a multiple personality disorder. Through her I have started to see this disorder a lot more frequently.
I have seen quite a bit of evidence that counters your (admittedly on the surface convincing) argument that multiple personalities are always constructed by psychotherapists.
reply: I don't claim that all cases of dissociation are caused by therapists. I claim that "multiple personality disorder" has been largely created by therapists, books, movies, etc.
For one, after knowing her for about ten months, one of my friends revealed other personalities to her lover. She has never been in psychotherapy and now, two years later, she has got to the point where her alters are somewhat spontaneously re-merging into a whole. Still without ever seeing a psychiatrist.
She did not remember the abuse but the other personalities told her lover about the abuse. There was no hypnosis, no coercion, she merely finally trusted someone enough to tell them of this. Now that I am friends with the two of them they are sharing with me the process as she reintegrates. It is very touching.
People with multiple personalities aren't insane. They are quite functional and often never go to a psychologist at all. They hide their switches as best they can. I have another friend who has multiple personalities and still denies it. I have spoken to two of them and they deny they are her but I know they are her from other evidence.
reply: You spoke to two of your friend's personalities, each of whom denied identity with your friend, but you know these personalities are her "from other evidence"? Why would you need other evidence? Can't you tell by looking at the person who it is?
Also, 'insane' is not a useful word. Being "functional" is not a sufficient condition for not being "mentally ill," i.e., having a brain or biochemical disorder that affects thoughts, feelings, and behavior.
There is a circular illogic in your theory and it is this: you don't accept evidence except from scientific sources such as a psychiatric diagnosis; yet you then say that all cases are caused by psychiatric "iatrogenic" type function.
reply: I will accept evidence from any source. I've already clarified my position on the role of therapists in the diagnosis of MPD.
There is a reason some therapists see tons of MPD and others see none: the ones who see none don't believe in it. How many cases of a disease you don't believe exists will you see? *grin*
reply: Yes, that much is obvious.
I do believe that it is possible to induce MPD through hypnosis. Also to insert memories artificially. For this reason you are right about the cases you cite more than likely. That doesn't preclude the existence of real cases however. In fact, the fact it can be induced means it probably occurs naturally as well.
reply: What is the evidence that hypnosis alone has ever induced a single case of MPD? The process of suggesting memories is altogether different. As for the relationship between being induced and occurring naturally, I would say that at least something like MPD occurs naturally, and that it is not a mental disorder requiring psychiatric treatment. Some day we will learn to think of psychiatric disorders as matters of degree.
Your friend's developing symptoms of MPD without seeing a therapist is not unusual. After the movie Sybil was aired there was a dramatic increase in MPD cases. This wasn't because therapists saw the movie, read the book, etc., and then started seeing MPD in every patient. No, the patients assimilated the symptoms. I wonder if your friend took a psychology class where MPD was discussed, read a book or saw a film on MPD, and then started to show her symptoms. Maybe she has been playing a role. No doubt it got her lots of attention, and perhaps that is what she craved. Maybe she is tiring of the role she's been playing. Who knows? But you misread the entry on MPD if you think I claim that every case of MPD has been induced by therapists.
I sincerely hope my friend was not a case of induced. However I don't know any way to
tell. She is who she is now and I deal with that as best I can. No matter who inflicted
the trauma though, it is just as real.
reply: You are right, even if the trauma is self-inflicted and delusional.