The case of a patient with dissociative identity disorder follows:Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis.Cindy had been well until 3 years before admission, when she developed depression, "voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen.Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life.Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged.At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters.
Cheryl was aided in her search by the Internet. Each time she remembered a name that seemed to be important in her life, she tried to look up that person on the World Wide Web. The names and pictures Cheryl found were at once familiar and yet not part of her conscious memory: Dr. Sidney Gottlieb, Dr. Louis 'Jolly' West, Dr. Ewen Cameron, Dr. Martin Orne and others had information by and about them on the Web. Soon, she began looking up sites related to childhood incest and found that some of the survivor sites mentioned the same names, though in the context of experiments performed on small children. Again, some names were familiar. Then Cheryl began remembering what turned out to be triggers from old programmes. 'The song, "The Green, Green Grass of home" kept running through my mind. I remembered that my father sang it as well. It all made no sense until I remembered that the last line of the song tells of being buried six feet under that green, green grass. Suddenly, it came to me that this was a suicide programme of the government. 'I went crazy. I felt that my body would explode unless I released some of the pressure I felt within, so I grabbed a [pair ofl scissors and cut myself with the blade so I bled. In my distracted state, I was certain that the bleeding would let the pressure out. I didn't know Lynn had felt the same way years earlier. I just knew I had to do it Cheryl says. She had some barbiturates and other medicine in the house. 'One particularly despondent night, I took several pills. It wasn't exactly a suicide try, though the pills could have killed me. Instead, I kept thinking that I would give myself a fifty-fifty chance of waking up the next morning. Maybe the pills would kill me. Maybe the dose would not be lethal. It was all up to God. I began taking pills each night. Each-morning I kept awakening.