During this hour in the waking streets I felt at ease, at peace; my body, which I despised, operated like a machine. I was spaced out, the catchphrase my friends at school used to describe their first experiments with marijuana and booze. This buzzword perfectly described a picture in my mind of me, Alice, hovering just below the ceiling like a balloon and looking down at my own small bed where a big man lay heavily on a little girl I couldn’t quite see or recognize. It wasn’t me. I was spaced out on the ceiling. I had that same spacey feeling when I cooked for my father, which I still did, though less often. I made omelettes, of course. I cracked a couple of eggs into a bowl, and as I reached for the butter dish, I always had an odd sensation in my hands and arms. My fingers prickled; it didn’t feel like me but someone else cutting off a great chunk of greasy butter and putting it into the pan. I’d add a large amount of salt — I knew what it did to your blood pressure, and I mumbled curses as I whisked the brew. When I poured the slop into the hot butter and shuffled the frying pan over the burner, it didn’t look like my hand holding the frying-pan handle and I am sure it was someone else’s eyes that watched the eggs bubble and brown. As I dropped two slices of wholemeal bread in the toaster, I would observe myself as if from across the room and, with tingling hands gripping the spatula, folded the omelette so it looked like an apple envelope. My alien hands would flip the omelette on to a plate and I’d spread the remainder of the butter on the toast when the two slices of bread leapt from the toaster. ‘Delicious,’ he’d say, commenting on the food before even trying it.
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.
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.
There were other strange signals and signs. Another day, suddenly felt an almost overwhelming urge to travel to Balitmore. I wanted to 'kidnap' a helicoper fly it there if I didn't drive the there', she explains. 'I had no idea where I was to go, only that I was certain I would know my destination as I encountered signs and certain landmarks along the way. I was not even certain who I was to meet, or what my mission was, but I felt I must go.' Beginning to heal by this time with Talbon's help, she resisted that urge. Yet she sensed she would be summoned for three more Cat Woman missions: two in 1999 and one in 2000.As for the code words for activating her, those had been erased from Cheryl's conscious memory. Buried deep in her unconscious mind, however, the words, when called up, cause her to react as her programmers want her to. Though she can't remember the activation codes, Cheryl knows her handlers said the same things every time. 'I'm working on unblocking the words in therapy. Once I know what the words are, I can learn how to stop their effect on me. I did it already when I learned the control code. Standing in front of a mirror, I said the control code words over and over until I was completely desensitised to them. That's what I have to do for the activation code words... but I have not been able to recall all of them as yet.' Dr. Talbon was struck by another very important thing. 'It all hung together. The stories Cheryl told - even though it was upsetting to think people could do stuff like that - they were not disjointed. They were not repetitive in terms of "I've heard this before". It was not just trying consciously or unconsciously to get attention. She'd really processed them out and was done with them. She didn't come up with it again [after telling the story once and dealing with it]. Once it was done, it was done. And I think that was probably the biggest factor for me in her believability. I got no sense that she was using these stories to make herself a really interesting person to me so I'd really want to work with her, or something.
Treating Abuse Today 3(4) pp. 26-33Freyd: The term "multiple personality" itself assumes that there is "single personality" and there is evidence that no one ever displays a single personality.TAT: The issue here is the extent of dissociation and amnesia and the extent to which these fragmentary aspects of personality can take executive control and control function. Sure, you and I have different parts to our mind, there's no doubt about that, but I don't lose time to mine they can't come out in the middle of a lecture and start acting 7 years old. I'm very much in the camp that says that we all are multi-minds, but the difference between you and me and a multiple is pretty tangible.Freyd: Those are clearly interesting questions, but that area and the clinical aspects of dissociation and multiple personalities is beyond anything the Foundation is actively...TAT: That's a real problem. Let me tell you why that's a problem. Many of the people that have been alleged to have "false memory syndrome" have diagnosed dissociative disorders. It seems to me the fact that you don't talk about dissociative disorders is a little dishonest, since many people whose lives have been impacted by this movement are MPD or have a dissociative disorder. To say, "Well, we ONLY know about repression but not about dissociation or multiple personalities" seems irresponsible.Freyd: Be that as it may, some of the scientific issues with memory are clear. So if we can just stick with some things for a moment; one is that memories are reconstructed and reinterpreted no matter how long ago or recent.TAT: You weigh the recollected testimony of an alleged perpetrator more than the alleged victim's. You're saying, basically, if the parents deny it, that's another notch for disbelief.Freyd: If it's denied, certainly one would want to check things. It would have to be one of many factors that are weighed -- and that's the problem with these issues -- they are not black and white, they're very complicated issues.