The implication that the change in nomenclature from “Multiple Personality Disorder” to “Dissociative Identity Disorder” means the condition has been repudiated and “dropped” from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association is false and misleading. Many if not most diagnostic entities have been renamed or have had their names modified as psychiatry changes in its conceptualizations and classifications of mental illnesses. When the DSM decided to go with “Dissociative Identity Disorder” it put “(formerly multiple personality disorder)” right after the new name to signify that it was the same condition. It’s right there on page 526 of DSM-IV-R. There have been four different names for this condition in the DSMs over the course of my career. I was part of the group that developed and wrote successive descriptions and diagnostic criteria for this condition for DSM-III-R, DSM–IV, and DSM-IV-TR.While some patients have been hurt by the impact of material that proves to be inaccurate, there is no evidence that scientifically demonstrates the prevalence of such events. Most material alleged to be false has been disputed by someone, but has not been proven false.Finally, however intriguing the idea of encouraging forgetting troubling material may seem, there is no evidence that it is either effective or safe as a general approach to treatment. There is considerable belief that when such material is put out of mind, it creates symptoms indirectly, from “behind the scenes.” Ironically, such efforts purport to cure some dissociative phenomena by encouraging others, such as Dissociative Amnesia.
It was Freud's ambition to discover the cause of hysteria, the archetypal female neurosis of his time. In his early investigations, he gained the trust and confidence of many women, who revealed their troubles to him.Time after time, Freud's patients, women from prosperous, conventional families, unburdened painful memories of childhood sexual encounters with men they had trusted: family friends, relatives, and fathers. Freud initially believed his patients and recognized the significance of their confessions. In 1896, with the publication of two works, The Aetiology of Hysteria and Studies on Hysteria, he announced that he had solved the mystery of the female neurosis. At the origin of every case of hysteria, Freud asserted, was a childhood sexual trauma.But Freud was never comfortable with this discovery, because of what it implied about the behavior of respectable family men. If his patients' reports were true, incest was not a rare abuse, confined to the poor and the mentally defective, but was endemic to the patriarchal family. Recognizing the implicit challenge to patriarchal values, Freud refused to identify fathers publicly as sexual aggressors. Though in his private correspondence he cited "seduction by the father" as the "essential point" in hysteria, he was never able to bring himself to make this statement in public. Scrupulously honest and courageous in other respects, Freud falsified his incest cases. In The Aetiology of Hysteria, Freud implausibly identified governessss, nurses, maids, and children of both sexes as the offenders. In Studies in Hysteria, he managed to name an uncle as the seducer in two cases. Many years later, Freud acknowledged that the "uncles" who had molested Rosaslia and Katharina were in fact their fathers. Though he had shown little reluctance to shock prudish sensibilities in other matters, Freud claimed that "discretion" had led him to suppress this essential information. Even though Freud had gone to such lengths to avoid publicly inculpating fathers, he remained so distressed by his seduction theory that within a year he repudiated it entirely. He concluded that his patients' numerous reports of sexual abuse were untrue. This conclusion was based not on any new evidence from patients, but rather on Freud's own growing unwillingness to believe that licentious behavior on the part of fathers could be so widespread. His correspondence of the period revealed that he was particularly troubled by awareness of his own incestuous wishes toward his daughter, and by suspicions of his father, who had died recently.p9-10
Today, acknowledgement of the prevalence and harms of child sexual abuse is counterbalanced with cautionary tales about children and women who, under pressure from social workers and therapists, produce false allegations of ‘paedophile rings’, ‘cult abuse’ and ‘ritual abuse’. Child protection investigations or legal cases involving allegations of organised child sexual abuse are regularly invoked to illustrate the dangers of ‘false memories’, ‘moral panic’ and ‘community hysteria’. These cautionary tales effectively delimit the bounds of acceptable knowledge in relation to sexual abuse. They are circulated by those who locate themselves firmly within those bounds, characterising those beyond as ideologues and conspiracy theorists. However firmly these boundaries have been drawn, they have been persistently transgressed by substantiated disclosures of organised abuse that have led to child protection interventions and prosecutions. Throughout the 1990s, in a sustained effort to redraw these boundaries, investigations and prosecutions for organised abuse were widely labelled ‘miscarriages of justice’ and workers and therapists confronted with incidents of organised abuse were accused of fabricating or exaggerating the available evidence. These accusations have faded over time as evidence of organised abuse has accumulated, while investigatory procedures have become more standardised and less vulnerable to discrediting attacks. However, as the opening quotes to this introduction illustrate, the contemporary situation in relation to organised abuse is one of considerable ambiguity in which journalists and academics claim that organised abuse is a discredited ‘moral panic’ even as cases are being investigated and prosecuted.
The physical shape of Mollies paralyses and contortions fit the pattern of late-nineteenth-century hysteria as well — in particular the phases of "grand hysteria" described by Jean-Martin Charcot, a French physician who became world-famous in the 1870s and 1880s for his studies of hysterics...""The hooplike spasm Mollie experienced sounds uncannily like what Charcot considered the ultimate grand movement, the arc de de cercle (also called arc-en-ciel), in which the patient arched her back, balancing on her heels and the top of her head...""One of his star patients, known to her audiences only as Louise, was a specialist in the arc de cercle — and had a background and hysterical manifestations quite similar to Mollie's. A small-town girl who made her way to Paris in her teens, Louise had had a disrupted childhood, replete with abandonment and sexual abuse.She entered Salpetriere in 1875, where while under Charcot's care she experienced partial paralysis and complete loss of sensation over the right side of her body, as well as a decrease in hearing, smell, taste, and vision. She had frequent violent, dramatic hysterical fits, alternating with hallucinations and trancelike phases during which she would "see" her mother and other people she knew standing before her (this symptom would manifest itself in Mollie). Although critics, at the time and since, have decried the sometime circus atmosphere of Charcot's lectures, and claimed that he, inadvertently or not, trained his patients how to be hysterical, he remains a key figure in understanding nineteenth-century hysteria.
As Mollie said to Dailey in the 1890s: "I am told that there are five other Mollie Fanchers, who together, make the whole of the one Mollie Fancher, known to the world; who they are and what they are I cannot tell or explain, I can only conjecture." Dailey described five distinct Mollies, each with a different name, each of whom he met (as did Aunt Susan and a family friend, George Sargent). According to Susan Crosby, the first additional personality appeared some three years after the after the nine-year trance, or around 1878. The dominant Mollie, the one who functioned most of the time and was known to everyone as Mollie Fancher, was designated Sunbeam (the names were devised by Sargent, as he met each of the personalities). The four other personalities came out only at night, after eleven, when Mollie would have her usual spasm and trance. The first to appear was always Idol, who shared Sunbeam's memories of childhood and adolescence but had no memory of the horsecar accident. Idol was very jealous of Sunbeam's accomplishments, and would sometimes unravel her embroidery or hide her work. Idol and Sunbeam wrote with different handwriting, and at times penned letters to each other.The next personality Sargent named Rosebud: "It was the sweetest little child's face," he described, "the voice and accent that of a little child." Rosebud said she was seven years old, and had Mollie's memories of early childhood: her first teacher's name, the streets on which she had lived, children's songs. She wrote with a child's handwriting, upper- and lowercase letters mixed. When Dailey questioned Rosebud about her mother, she answered that she was sick and had gone away, and that she did not know when she would be coming back. As to where she lived, she answered "Fulton Street," where the Fanchers had lived before moving to Gates Avenue.Pearl, the fourth personality, was evidently in her late teens. Sargent described her as very spiritual, sweet in expression, cultured and agreeable: "She remembers Professor West [principal of Brooklyn Heights Seminary], and her school days and friends up to about the sixteenth year in the life of Mollie Fancher. She pronounces her words with an accent peculiar to young ladies of about 1865." Ruby, the last Mollie, was vivacious, humorous, bright, witty. "She does everything with a dash," said Sargent. "What mystifies me about 'Ruby,' and distinguishes her from the others, is that she does not, in her conversations with me, go much into the life of Mollie Fancher. She has the air of knowing a good deal more than she tells.
As mandatory reporting laws and community awareness drove an increase its child protection investigations throughout the 1980s, some children began to disclose premeditated, sadistic and organised abuse by their parents, relatives and other caregivers such as priests and teachers (Hechler 1988). Adults in psychotherapy described similar experiences. The dichotomies that had previously associated organised abuse with the dangerous, external ‘Other’ had been breached, and the incendiary debate that followed is an illustration of the depth of the collective desire to see them restored. Campbell (1988) noted the paradox that, whilst journalists and politicians often demand that the authorities respond more decisively in response to a ‘crisis’ of sexual abuse, the action that is taken is then subsequently construed as a ‘crisis’. There has been a particularly pronounced tendency of the public reception to allegations of organised abuse. The removal of children from their parents due to disclosures of organised abuse, the provision of mental health care to survivors of organised abuse, police investigations of allegations of organised abuse and the prosecution of alleged perpetrators of organised abuse have all generated their own controversies. These were disagreements that were cloaked in the vocabulary of science and objectivity but nonetheless were played out in sensationalised fashion on primetime television, glossy news magazines and populist books, drawing textual analysis. The role of therapy and social work in the construction of testimony of abuse and trauma. in particular, has come under sustained postmodern attack. Frosh (2002) has suggested that therapeutic spaces provide children and adults with the rare opportunity to articulate experiences that are otherwise excluded from the dominant symbolic order. However, since the 1990s, post-modern and post-structural theory has often been deployed in ways that attempt to ‘manage’ from; afar the perturbing disclosures of abuse and trauma that arise in therapeutic spaces (Frosh 2002). Nowhere is this clearer than in relation to organised abuse, where the testimony of girls and women has been deconstructed as symptoms of cultural hysteria (Showalter 1997) and the colonisation of women’s minds by therapeutic discourse (Hacking 1995). However, behind words and discourse, ‘a real world and real lives do exist, howsoever we interpret, construct and recycle accounts of these by a variety of symbolic means’ (Stanley 1993: 214). Summit (1994: 5) once described organised abuse as a ‘subject of smoke and mirrors’, observing the ways in which it has persistently defied conceptualisation or explanation.
Frosh (2002) has suggested that therapeutic spaces provide children and adults with the rare opportunity to articulate experiences that are otherwise excluded from the dominant symbolic order. However, since the 1990s, post-modern and post-structural theory has often been deployed in ways that attempt to ‘manage’ from; afar the perturbing disclosures of abuse and trauma that arise in therapeutic spaces (Frosh 2002). Nowhere is this clearer than in relation to organised abuse, where the testimony of girls and women has been deconstructed as symptoms of cultural hysteria (Showalter 1997) and the colonisation of women’s minds by therapeutic discourse (Hacking 1995). However, behind words and discourse, ‘a real world and real lives do exist, howsoever we interpret, construct and recycle accounts of these by a variety of symbolic means’ (Stanley 1993: 214). Summit (1994: 5) once described organised abuse as a ‘subject of smoke and mirrors’, observing the ways in which it has persistently defied conceptualisation or explanation. Explanations for serious or sadistic child sex offending have typically rested on psychiatric concepts of ‘paedophilia’ or particular psychological categories that have limited utility for the study of the cultures of sexual abuse that emerge in the families or institutions in which organised abuse takes pace. For those clinicians and researchers who take organised abuse seriously, their reliance upon individualistic rather than sociological explanations for child sexual abuse has left them unable to explain the emergence of coordinated, and often sadistic, multi—perpetrator sexual abuse in a range of contexts around the world.