Fiction has mined the idea of multiple personalities for centuries, but it was only in the 1970s that science followed suit. But many argue that "multiple personality disorder" is not a real psychological ailment. What exactly is the science behind this disorder, and does it even exist? How does it work for people who are not going for their Oscar? Find out about the most cinematic of mental problems.
The first thing you need to know about multiple personality disorder is that that's not the proper nomenclature. If you walk into a room full of psychiatrists and ask what they think of multiple personality disorder, anticipate laughter. It's now called dissociative identity disorder (DID). This is not just a clarification of terminology or a different trend in popular jargon. Multiple personality disorder changed its name for the same reason corrupt corporations or recently-freed felons do. It wanted to shake a sordid past. In the early 1970s, Sybil was on the shelf of every armchair psychologist, and people were discovering personalities left, right, and center. By the time the 1990s rolled around, all that was left of the disorder was ruined careers and (arguably) ruined lives.
Split Personalities and Stolen Movie Rights
Sybil, the famous patient who had sixteen personalities and was "healed" by Dr. Cornelia Wilbur is the poster girl for the disorder today. When the book was published in the 1970s, she was just riding the coattails of an earlier case of "split personality disorder" — one that made several careers.
The film The Three Faces of Eve came out in 1957. It was a dramatization of the work of Dr. Corbett Thigpen. He found that his patient Eve had three alternate personalities: a "good," "bad," and integrated personality. His research showed that these personalities had split off from the girl after she had witnessed the deaths and several near-fatal accidents of family members as a child. He worked with her, re-integrated her various selves, wrote a book about it, and promptly sold her life rights to a movie company looking to cash in on the multiple personality "trend" kicked off by a popular novel.
The patient herself — who decades later revealed that her actual name was Chris Costner Sizemore — had something of her own to say. She wrote several books, starting with the wildly popular I'm Eve published in 1977. The book debuted after Sybil hit theaters. She followed these up with two more books, both about her experiences as a "split personality."
Each book put Thigpen's work in a new light. She was not "cured" at the end of Thigpen's therapy. She was merely frustrated by his assertion that she was healthy again. As time went on and she got new therapists, her list of personalities expanded to roughly twenty, which surfaced in twos and threes over certain periods of time. Sizemore also said that she did not believe that this was the result of a childhood trauma, but the effects of childhood trauma on a person who had legitimately been born inhabited by more than one "self." In the 1980s, when she discovered her life rights had been sold to Hollywood without her permission, she went to court and received a portion of the profits from the movie based on her life.
The fluctuating amount of personalities, the varying accounts as to whether "Eve" was sick or cured, and the commercialization of the entire process cast doubt on the idea of multiple personalities. It seemed the doctor and patient only agreed that it was always best to strike while the marketing iron was hot. But when money, fame, and mental illness meet, there are always going to be different stories. It was Sybil that built up and then tore down the idea of multiple personality disorder.
The Slowly-Unfolding Scandal of Sybil
The book Sybil was the work Flora Rheta Schreiber. Sybil, the "cured" woman who finally settled on one personality, was the result of eleven years of work and over 2,500 sessions with Dr. Cornelia Wilbur. Before the treatment was even completed, the doctor and the author had gotten a book contract. The book did not give Sybil's real name (which remained unknown for decades) but assured readers that all facts were checked and that other doctors had met Sybil and witnessed her many personalities.
Sybil's personalities started manifesting themselves during childhood as the result of horrific abuse. They had taken over for weeks at a time, causing her to "miss" school and to have trouble keeping her life together. Eventually sixteen different personalities manifested themselves, from the assertive Peggy, to boys, to a pre-verbal baby. After a decade of work with many psychiatrists, "The New Sybil" emerged, healthy once again.
The book was such a hit that the press went into a frenzy trying to find the real identity of this Sybil, with no success. The most Dr. Wilbur would say was that she was still alive. Then questions started popping up. The timeline wasn't right, according to some of the other doctors who had treated Sybil. In the book, a new personality named Peggy showed up quite early. Meanwhile colleagues were being called in to help treat Sybil's "schizophrenia," the first diagnosis Wilbur made, years after Wilbur had started treating the patient. But the shift in timeline could be ascribed to the need to cut out a long, fruitless early diagnosis from the book for the sake of the reader.
More troubling was the doctor's use of sodium pentathol and hypnosis to find Sybil's repressed memories of abuse. Sodium pentathol is addictive and has sometimes been shown — with the help of a therapist's coaching — to bring forward false memories as well as true ones. Most damningly, Herbert Spiegel, a hypnotherapist who worked with Sybil at Dr. Wilbur's request, reported that when Wilbur wasn't with them, Sybil would ask him who he "wanted her to be" in any given session.
In the 1990s, it was later discovered that Sybil was a recently deceased woman named Shirley Mason. The unsealing of Wilbur's records in the 90s provided the final blow to the book's credibility. In the 1950s, Shirley had been lonely, young, had liked Wilbur, and had craved her attention. The Three Faces of Eve would have recently come out and have been on both their minds. Shirley came into her office one day, talked to Dr. Wilbur about blackouts and "coming to" in strange places, and "Peggy" being a more fun, freewheeling version of Sybil. All of these behaviors were shown in the movie. And the movie was a commercial and critical success. That wouldn't have escaped the notice of either the doctor or the patient.
Once the sodium pentathol came out — and Dr. Wilbur interpreted an early tonsillectomy as abuse — things got worse. Wilbur got a book contract and Shirley got hooked on the drugs. Wilbur gave presentations and Shirley got her rent paid. Detailed descriptions of abuse and new personalities multiplied. Each went in deeper. When at last Shirley Mason wrote a letter to her doctor that said, ""I do not really have any multiple personalities. I do not even have a double...I am all of them. I have been lying in my pretense of them," and the doctor dismissed it as an attempt to stop looking at painful memories. The terms of the arrangement were set. No one wanted to hear about anything that wasn't multiple personalities. Not for the next twenty years, at least.
Sybil's influence on society cannot be overstated. Aside from the massive amount of money the disorder made for Hollywood, hospitals opened up entire wings to treat a sudden influx of multiple personality patients. Some patients came to doctors believing the disorder put a name to what they already felt, some wanted to make a buck on the book deal, some wanted attention and care. Not all the interest came from the patient's end. Unscrupulous doctors went on the hunt for patients. Everyone wanted a multiple personality case to call their own.
Then came the debunking of the book and the bane of any cultural phenomenon: lawsuits. In the early 1990s patients started suing doctors for using drugs and threats of abandonment to coerce more personalities into showing up for their sessions. Then patients, some of whom had spent years in hospitals, started suing for misdiagnoses. Money and fame went out the door and bankruptcy and infamy strolled in. No one wanted to diagnose anyone with multiple personalities anymore.
It was in the mid-nineties that the name was changed to dissociative identity disorder.
So what is Dissociative Personality Disorder?
The powerful multiple personality disorder has been humbled and dismantled into four "dissociative disorders," each comprising part of the original idea. Dissociative amnesia is memory loss, especially of a traumatic event from childhood. Dissociative fugue is what happens when someone walks away, semi-deliberately, from their life and lives under a new identity for a few hours or a few months. The end of the fugue can bring on anything from complete lack of memory to "feeling out of sorts." Depersonalization disorder is the classic state of "watching life like it's a movie," and may come with a skewed perception of time and space. And finally there's dissociative identity disorder, which is characterized by switching between different personalities with different histories, mannerisms, and physicalities. Although this may be associated with dissociative amnesia, it's often more gentle than that. Often people feel a sense of multiple people living in their heads at once, and feel a sense of fragmentation between personalities, not complete divides.
That's if anyone believes it happens at all. Many psychiatrists think that this is a cultural behavior rather than a mental one. When Dr. Wilbur and Sybil were going through their sessions, they sometimes identified a pattern of behavior and then gave it a name. Others saw this and followed suit. We may have learned, as a a culture, to call someone's tendency to retreat into childishness as a way of dealing with stress, "Emily." Other people, at other times, might not feel that this tendency needs personification, and that it's just a poor way of dealing with a difficult situation. Still other people might not consider it a special tendency at all, and just group it in with a person's overall personality. Whether this syndrome is a separate personality or a tendency or just a person depends on who you're asking.
There is an uncontroversial way to treat dissociative identity disorder, and that's to treat the many other problems that most DID patients come in with. Sufferers of the disorder generally also have anxiety disorders, eating disorders, sleep disorders, and throw themselves into substance abuse. Since patients are most likely to "switch" under stressful conditions (and these other disorders invariably come with stress) treating those, along with talk therapy, is considered to be the best way to resolve dissociative identity disorder. Whatever anyone believes, the treatment is the same: talk and coping skills. And no sodium pentathol.
Top Image: Library of Congress. Three Faces of Eve Poster: Movie Poster Studio. Sybil Book Cover: The Excerpt. Via The New York Review of Books, The New York Times, NPR, Mayo Clinic, Psychology Today.