Multiple Personality Deception: Sybil Exposed

Debbie Nathan, a writer, has exposed Sybil as a lie.

For those of you who don't know about Sybil, she had 16 different personalities, according to Flora Rheta Schreiber the woman who made her famous in the book Sybil.  Everyone in my generation watched the movie with Joanne Woodward and Sally Field. It was on TV.

Like watching the Three Faces of Eve, seeing what appeared to be real mental illness is scary.  As a kid you think, who could fake this?

Now along comes a journalist determined to find the real story, and like any good investigative reporter, she digs in and gets Shirley Mason's (Sybil) true modus operandi.

We thought Shirley had suffered a childhood trauma, developed "alters" to cope with her terrifying world, but lo and behold, her psychiatrist, with the help of a  writer, milked a case of pernicious amnesia to make a lot of money.  Anemia isn't nearly as sexy as Multiple Personality Disorder.

For the clinician, the study of personality development is always of interest.  How we behave, how we come to respond differently in different situations, why one person is extraverted, another shy, these questions drive research, make up the soul of therapy.

We all have alters, we all have multiple personalities, and most of us know it. Most of our behavior, including breathing and turning off the alarm clock, is unconscious. So why should acting the part of someone more competent, someone more sexy, someone more youthful, someone more distinguished, someone more angry, someone more manipulative, someone more talented, be such a stretch?

And there are so many more roles, so many facets of personality that we try on never thinking about it. Nobody used to say, Just saying, five years ago. Nobody used to say, It's not all about you. Our language is picked up unconsciously, half the time we're not sure from which television show. Indeed some psychologists feel that over ninety percent of what we do, what we say, is unconscious.  That should scare us all into watching what comes out of our mouths.

Why wouldn't personality vary, and vary dramatically? Why not have several personalities?  And under severe circumstances, behaving differently is the only choice, just saying.

But Carol Tavris's review indicates that Multiple Personality Disorder (MPD), or Dissociative Identity Disorder, as we refer to it now, is all a ruse! The story, and then the movie, inspired thousands of more fake stories!  And from this, a classification born.

Now that makes sense.  Thousands, not one or two, copy cats.  Read with me.

By 1980 so many psychiatrists had begun looking for sensational cases of MPD in their own troubled clients—and finding them—that for the first time it became an official diagnosis in the "Diagnostic and Statistical Manual of Mental Disorders." MPD was a growth industry; eminent hospitals, notably Rush Presbyterian in Chicago, opened MPD treatment centers. By the mid-1990s, according to some estimates, as many as 40,000 cases had been reported.

Yet Sybil's story, which started it all, was a complete fabrication. Sybil, whose real name was Shirley Mason, did not have a childhood trauma that caused her personality to fragment, and her "personalities" were largely generated in response to pressures, subtle and coercive, by her psychiatrist, Cornelia (Connnie) Wilbur, whom she wanted desperately to please.

All well and good, a fake exposed. But to toss out rigorous research, the underpinning of diagnostic classification with the swipe of a pen?  She doesn't stop there.

What, then, did Sybil suffer from? Is MPD "real"? Yes and no. MPD is what some psychiatrists call a culture-bound syndrome, a culturally permitted expression of extreme psychological distress, similar to an ataque de nervios (an episode of screaming, crying and agitation) in Hispanic cultures and "running amok" in Malaysia. . .

. . .the promulgators of MPD do not seem to have learned anything. They changed the label to "Dissociative Identity Disorder," but a skunk by any other name is still a skunk. 

Oh dear! Promulgators?  Now they're promulgators, not teams of mental health researchers rigorously investigating the presentation of a disorder.  And to compare Multiple Personality Disorder, or Dissociative Identity Disorder to ataque de nervios, a cultural (Hispanic) panic disorder, is a bastardization of the process, we call this the scientific method, behind the Diagnostic Statistical Manual of the American Psychiatric Association (DSM IV-TR). Call it what you will, and the DSM is under it's 5th revision, but each diagnosis is researched to be determined exclusive.  We don't rely upon case study, we frown upon idiopathic research, anecdotal data like the story of Sybil.

To jump from an individual presentation (be it ingenuous or not), to an entire class of mental illness, isn't how diagnostic classification happens.  There are no promulgators.  And to disseminate it at such is clearly sensationalism, fraud.  And to say that those who present with the features of Dissociative Identity Disorder (DID) or Multiple Personality Disorder (see my post) are faking it, is a total disrespect to the thousands who suffer the disorder.

Those of us who treat mental illness do find cases of the disorder, and they are severe, and they usually have roots in childhood trauma.  Those who have been profoundly abused usually don't seek help, certainly can't afford the type of psychiatric care afforded to Shirley Mason.  They haven't the resources, their lives have been altered, and occasionally, their personalities, just like yours and mine are altered, but in a more pronounced fashion.  They are clearly mentally ill.

Call a skunk a skunk, I say.  But it isn't the psychiatric profession that stinks here.

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Bruce Ivins

Bruce E. Ivins, a microbiologist, killed himself on July 29 with an overdose of Tylenol. He had a history of mental illness. People blame his death on pressure from the FBI, accusations and "proofs" tying him to the 2001 anthrax murders. I blame it on mental illness.

Prior to 9/11, Dr. Ivins suffered what FBI court documents deemed "serious mental health issues." He had been in treatment and talked about it in emails that dated from 2000 to 2001. He wrote about his depression, his counseling, and his medication.

Reporting for the Wall Street Journal, Evan Perez, Siobhan Gorman, Gary Fields, and Elizabeth Williamson, paint a Chilling Portrait of Dr. Ivins.

In August 2000, he wrote,

"I get incredible paranoid, delusional thoughts at times, and there's nothing I can do until they go away, either by themselves or with drugs."

We hear that in late 2001, he emailed a series of short poems ruminating about what he called his split personality:

"Hickory dickory Doc - Doc Bruce ran up the clock

But something then happened in very strange rhythm

His other self went and exchanged places with him."

And then there's this one,

"I'm a little dream-self, short and stout,

I'm the other half of Bruce-when he lets me out.

When I get all steamed up, I don't pout.

I push Bruce aside, then I'm Free to run about!"

Sounds like Free is a name, does it not? The word is capitalized in the middle of the sentence. Free is another Bruce.

Dr. Ivins thought he had a split personality, but when we speak of such a thing, a split personality, we're really referring to at least two separate personalities, separate people within the same body that co-exist.

Each personality is whole, if not altogether well. Each personality may have multiple Axis I or Axis II disorders, or not.

This sounds like Dissociative Identity Disorder, what used to be called Multiple Personality Disorder. A person like Dr. Ivins, if he suffered from it, had at least one high functioning self, the doctor, the microbiologist who worked diligently for the United States government on a vaccine to immunize us against the deadly effects of Anthrax.

And he had a second personality, clearly disturbed, but also high functioning, one that escaped detection while under FBI investigation for three full years. He is the one referred to as Free.
Free could carry out destruction, wreak havoc without conscience. Free could even justify his atrocities, say to himself, If the government associates these deaths with a terrorist group, then surely I will have funding for my vaccine. The ends justify the means.

Perhaps he had a third self, the one who fell in love with a sorority girl and stalked her. With his counselor, Ivins discussed killing the young woman. From the Washington Post,

More than a year before the anthrax attacks that killed five people in 2001, Bruce E. Ivins told a counselor that he was interested in a young woman who lived out of town and that he had "mixed poison" that he took with him when he went to watch her play in a soccer match.

"If she lost, he was going to poison her," said the counselor, who treated Ivins at a Frederick clinic four or five times during the summer of 2000. She said Ivins emphasized that he was a skillful scientist who "knew how to do things without people finding out."

And yet a fourth, a religious Catholic:

. . . a churchgoing family man and volunteer whose mental health eroded -- culminating in suicide -- because of escalating pressure applied on him by federal investigators as they came to regard him as the prime suspect in the attacks.

Surely a troubled, angry, psychotic individual, a scientist who struggled against his admitted paranoia, depression, and mounting social and professional pressures, a man who lived with a voice in his head, a violent amoral voice.

That voice talked to him, I think.
I think Dr. Ivins heard Free, and that Free, as such, was a delusion, not a conscious perception of self, not him. But when the stress got the better of Ivins Free broke out. Ivins became his delusion. Then he had more than one self.

And when he looked back on what Free had done, assuming it is true that he is the man who committed the anthrax murders, he said to himself, This is the work of another person inside me, the bad me. I did all of that as Free. But the ends justified the means, and the FBI should have canonized me, not punished me.

Insanity reigned. People died.

So although it sounds like definitive Dissociative Identity Disorder, there is a second diagnosis, Schizophrenia.

I would bet that Free wasn't another self at all, not until he acted out. Until Ivins gave in, Free had been only a voice, one who mocked and scolded him for years. Then, when the time was right, when Ivins could take it no longer, he gave in to what he had been hearing for years, "Do it. And don't tell anyone about me."

Since he was a smart man, it is likely he knew about things like multiple personalities, perhaps from his treatment even. But he decided to not make mention of the voices to anyone, as is often the case in schizophrenia. He used his poetry to suggest that what he had was a split personality, for to him, schizophrenia, carried more stigma.

He carried the shame honestly. The illness went undiagnosed in his family, Dr. Ivins said. Read this Washington Post excerpt:

"The skeletons are all out," he wrote in one GreekChat posting from 2006.

"I'm having a devil of a time rounding them back up. Let's see . . . how about mom who was an undiagnosed paranoid schizophrenic. . . . Is that bones enough?"

Dr. Ivins was delusional. He suffered from paranoid schizophrenia, like his mother. And ironically, the FBI actually did follow this poor man with schizophrenia.

At some point, when a mentally ill person takes his life, perhaps, diagnosis becomes moot. It's a so what? Dr. Ivans died. He left two children. Other people died, no matter what the diagnosis. (See the comments section for a more thoughtful discussion of how the two diagnoses are related).

He was a scientist who shouldn't have passed a background check. And much worse, he did not get sufficient treatment for his mental illness.

You can read all about this at WSJ, The New York Times, the Washington Post, everybody's telling the story, so I don't have to repeat the details here. Suffice it to say that Ivins spent late nights in the lab, ostensibly cooking up the anthrax for delivery the following week. He was one of the world's foremost anthrax experts, according to news reports. He fooled the FBI for three years, switching anthrax samples on them, deliberately hiding the flasks with mutations that would have made a direct match. When it became clear he would be charged for the crimes, he killed himself.

I imagine that Free told him to do that.

I looked for childhood history but so far, nothing. He did work for the government, so perhaps his history is top secret.

I feel that the people he worked for should have picked up on his suffering, his severe emotional stress. Why treat only depression? His counselors, his doctors must have known he had delusions. Anyone reading his poetry (maybe they didn't) should have said,

"Dude, take off a month. Get into a hospital. Get the proper doses of the right medication. Get well. Shake off Free."

That is the treatment in schizophrenia, shaking off the delusion, muting the voices, ending their tortuous reign, by using medication.

People who notice strangeness in co-workers should get closer, not move farther away. We should wonder, when a person is cooking up Anthrax, What is he doing with that?

I know, 20-20 hindsight.

Yet I have to wonder. Where were his people? Weren't there people watching him slide? He did have a previous suicide attempt.

But then I think, mental illness is masterful. It can hide itself pretty well.

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Dissociative Identity Disorder

Well, hopefully it doesn't apply to you,Dissociative Identity Disorder (D.I.D.)*

But it might. We used to call it Multiple Personality Disorder. Some people think this label applies to Schizophrenia, but because you read this blog, you know the difference.

People who suffer from Schizophrenia may hear voices, but they don't usually have multiple personalities. These are both Axis I disorders, by the way, not personality disorders (Axis II).

And this is not Depersonalization Disorder, either, which is getting some press because Adam Duritz of Counting Crows (a popular rock band) is said to have it. (Read Dr. Deb). Depersonalization Disorder features persistent or recurrent experiences of feeling detached from one's mind or body, as if watching the self as an outside observer.

I first came upon Dissociative Identity Disorder when I met a client who had been a victim of incest, we're talking about 1984. (If you're faint-hearted you may not want to read on. I'm changing all the details for you, so this is total fiction, and it's a quick read, but nevertheless. . .upsetting).

The patient, age 40 at the time, recalled being a child of about six years old laying helpless on a sofa while her father molested her in every way imaginable. She grabbed onto a lace tablecloth that covered an end table and twirled it in her hand while he did this, all the while imagining that she was someone else, another child, complete with alternative personality, looks, parents, name, toys, friends, etc.

She played her fantasy so well in her head that she didn't feel (as much as she might have otherwise) what was happening to her. You can see why she did it, tranced out like that. She came to like this other self, so much in fact, that she often referred to herself as the other girl, used the other's name.

The patient became the other girl, too, had multiple selves. After all, the other girl didn't exist except in her head. And as confusing as this sounds, she could switch off all the time, unconsciously or at will. She experienced reality at different times as two different people.

Since that time I've treated only two others with this disorder who described similar circumstances, one sexual abuse, the other physical abuse. This ability to dissociate, to separate the self or ego, from what is happening in "real" time, is obviously the ego's defense system operating in a most sophisticated fashion.

Sometimes a person develops several personalities, in which case they are called, multiples. One identity suffers, so it helps to have a few who do not. Understudies.

Treatment's remarkable.

Anyway, I thought you'd like to be able to diagnose this for real, just in case you sometimes wonder,

Am I? Is she? Is he?

Here you go. 300.14 Dissociative Identity Disorder

A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).

B. At least two of these identities or personality states recurrently take control of the person's behavior.

C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

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*You can read more about it in the Merck manual.