MPD became an official APA “diagnosis” with the publication of DSM-III in 1980. It has since been renamed as dissociative identity disorder. The criteria are:
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. (DSM-IV-TR, p 529)
The drive to include this so-called illness in the psychiatric classification system was spearheaded by Dr. Connie Wilbur, a New York psychiatrist. Dr. Wilbur collaborated with a journalist named Flora Schreiber in the production of a book named Sybil (1973). In the book, which purported to be factual, Dr. Wilbur diagnoses and treats a female patient (whom they named Sybil – her real name, as later disclosed, was Shirley Mason) for multiple personality disorder. The book became a best seller, was translated into several foreign languages, and was made into a movie and a TV program.
In the book and in the movie, Dr. Wilbur is presented as the tireless champion who works diligently to “cure” Sybil by helping the patient remember that she had been the victim of horrendous sexual abuse from her mother. The book also recounts the techniques used by Dr. Wilbur to help the patient “recover” these repressed memories.
Sybil is especially noteworthy in that it was the stimulus that sent a sizeable segment of the mental health profession down the multiple personality side-road, with its emphasis on “finding” and “identifying” increasing numbers of personalities within each client, and “recovering” the traumatic memories that “caused” the problem in the first place.
Both Connie Wilbur and Flora Schreiber kept very detailed records, and some of this material was archived and has now become available. Earlier this year, Free Press, a division of Simon and Schuster, published Sybil Exposed by Debbie Nathan, an award-winning journalist. The book is meticulous and painstaking, and highly credible. Here are some quotes.
p xviii “What I found was shocking but utterly absorbing. The papers revealed that Sybil’s sixteen personalities had not popped up spontaneously but were provoked over many years of rogue treatment that violated practically every ethical standard of practice for mental health professions.
Dr. Wilbur had approached Sybil’s health problems with a predetermined diagnosis that brooked no alternative explanations. In her therapy she had made extravagant, sadistic use of habit-forming, mind-bending drugs. And she had treated the patient day and night, on weekdays and weekends, inside her office and outside, making house calls and even taking Sybil with her to social events and on vacations. She fed Sybil, gave her money, and paid her rent. After years of this behavior, the archives revealed, the two women developed a slavish mutual dependency upon each other. Toward the end of their lives they ended up living together.”
p 88 “To treat these problems, Connie wrote prescriptions for powerful, habit-forming drugs, many of which had just been patented in the 1950s and were being aggressively marketed by pharmaceutical companies. To help her sleep, Shirley got tablets of Seconal, a highly addictive barbiturate. Taking it regularly and then trying to withdraw can cause anxiety, vivid dreams, and even hallucinations. Connie treated Shirley’s menstrual pains with Demerol, an opiate related to heroin. It is extremely habit-forming, with side effects that include light-headedness, confusion, and blacking out. Shirley also got Edrisal and Daprisal for her monthly pain. Both combined aspirin with amphetamines – now commonly known as speed, which if taken excessively can cause hallucinations and paranoia. Edrisal and Daprisal eventually proved so addictive that they were yanked from the market. But they were readily available in the 1950s, along with the narcotics and barbiturates Connie prescribed. Soon Shirley was in her second semester at Teachers College, still managing to attend classes and complete her school work. But she spent her free time half zonked on mind-bending medications.”
p 99 “When Shirley felt particularly depressed or anxious, she frequently doubled, even quintupled, her prescribed dosages of Daprisal, Demerol, Dexamyl, Edrisal, Equanil, and Seconal. And Connie added Serpatilin, a combination of a tranquilizer and the stimulant Ritalin, as well as Thorazine, a medicine originally prescribed to relieve nausea and the kind of pain Shirley experienced with her periods. Thorazine would later be recognized as a potent antipsychotic whose side effects, particularly at high doses, include restlessness, confusion, blackouts, and unusual thoughts and behaviors. With this powerful drug and all the uppers and downers, Connie also gave Shirley Phenobarbital, another barbiturate, on top of her regular, intravenous doses of Pentothal.”
In 1958 Shirley wrote Dr. Wilbur a letter recanting all the multiple personality material, including the alleged sexual assaults by her mother. Dr. Wilbur interpreted the letter as a major defensive maneuver which demonstrated that the client had indeed been sexually assaulted by her mother and needed further therapy!
I strongly recommend this book to anyone who has an interest in mental health matters.
It is clear from Sybil Exposed that Dr. Wilbur had an agenda. She wanted to establish multiple personality disorder as a legitimate “diagnosis,” and through leading questions and subtle encouragement elicited this kind of behavior from her client. Dr. Wilbur, of course, was an extreme case. But the same kind of thing goes on in psychiatric offices and clinics worldwide. Psychiatrists view their clients through the lens of DSM. And what do they find as the underlying cause of the client’s problem? A mental illness!
There are no mental illnesses. Understanding people involves a great deal more than assigning them labels.