A CASE OF MULTIPLE PERSONALITY DISORDER Thigpen & Cleckley (1954)

Sybil Sybil’s real name was Shirley Mason Her case made Personality Disorder famous (especially after the 1973 miniseries starring Sally field) Sybil had 16 separate personalities Her personality fragmented as a result of extreme child abuse She was treated by Dr. Cornelia Wilbur a Freudian Psychologist

According to the book "she probed the child's vagina with a knife and a buttonhook. She hung her upside down and, using an enema bag, filled her bladder with ice- cold water, then tied her to the family piano and forbade her to urinate while she, the mother, played Chopin." This, apparently, had caused Sybil to split into alters who were able to deal with various life situations on her behalf.

What is Multiple Personality Disorder? Now known as Disassociative Identity Disorder. It is not Schizophrenia. Essential feature is two or more distinct personalities within the same body. The core personality is unaware of the other personalities. Amnesia is another common symptom.

It’s a Controversial Disorder There is evidence that people can fake this disorder. Is it due to suggestion? Reporting of cases is sporadic. Reliability of diagnosis is poor. The above points are important since a diagnosis of DID can be used in a plea of NGRI.

The Aim To provide an account of the treatment of a 25 year old woman who was referred to Thigpen and Cleckley because of blinding headaches

The Study Case study of one woman Eve White Original presenting symptoms were anxiety, headaches, blackouts and general dissatisfaction with her stressful life.

Start of the Study The symptoms were headaches and subsequent blackouts. Increasing stress at home. Husband requests she sees therapist due to unusual behaviour. In a particular session she puts both hands to her head and switches into ‘alter’ personality Eve Black A bright voice says ‘Hi there Doc.’

Differences between Eve White and Eve Black Gestures Expressions Posture Eye brow tilting Eye movement Voice Language structure

Eve White Eve Black Demure • Party Girl Simple and conservative clothes Soft voice Passive/lacking initiative Industrious Limited spontaneity • Party Girl • Shrewd Childish Erotically mischievous No stress • Prankster • Taunting • Whim-like attitudes • Never contemplative

The letter Several days after the first session a letter appeared at the therapists office The letter was in Eve White’s usually writing, but at the bottom of the page there was a paragraph that looked like a child had written it Eve white remembered starting the letter but denied having sent it

The interviews Over the next 14 months they conduced 100 hours of interviews Information was also collected from Eve’s husband, parents, friends Eve Black could sometimes pop out during hypnosis After a few sessions therapists could ask to speak to Eve Black under hypnosis After more sessions hypnosis was no longer necessary

Birth of twin sisters, EW loves them, EB hates them Traumatic events Birth of twin sisters, EW loves them, EB hates them EW witnessed her mother cut her hand when she was a child and found the incident traumatic EW quit school to work and support her family, she sent home money to buy sisters overcoats, denying herself a watch she really wanted The money was spent on two wrist watches and EW reacted with repressed hostility This was seen by EW as rejection from family

Findings from the therapy sessions EB bought expensive dresses and two luxurious coats, EW’s husband lost his temper when he found out and abused his wife EB would go out and get drunk and EW would wake up with a hangover and not know why she felt so sick

Findings from the therapy sessions A distant relative insisted that before she met her husband a previous marriage had taken place EW had no memory of this After some pressure EB admitted she had been in control during this period and it was she that married and lived with another man

Findings from the therapy sessions EB claimed she had no desire for sex but enjoyed frustrating EW’s husband by denying him sex He savagely beat her as punishment and EB avoided the pain by ‘going in’ and letting EW take the blows

Eve Black Present since early childhood. Eve White had no knowledge of the alter (amnesia). In childhood Eve Black often got into trouble and Eve White was punished (later backed up by parents and husband) Eve Black was clever enough to conceal her identity from Eve White’s husband and her parents

Eve Black Eve Black denied being married to Eve White’s husband, and denied any relationship with Eve White’s Daughter During her long periods of being ‘OUT’ she avoided family and friends and spent time with strangers She could remain unrecognised by imitating Eve White

The information collected Interviews EEG – measuring brain activity Projective tests –Qualitative data Rorsarch Ink Blot test Drawing a Human Figure Psychometric tests – Quantitative data Wechsler-Bellevue intelligence test Wechsler memory scale

Repressive, Showing obsessive compulsive traits Regressive, Eve White Eve Black IQ Test 110 104 Memory Test Superior Inferior Drawings Less healthy than EB Healthier than EW EEG 11 cycles per sec 12.5 cycles per sec Personality Repressive, Showing obsessive compulsive traits Regressive, Unable to deal with her hostility Hypnosis Easy Not Able Thigpen and Cleckley go to some lengths to prove that the personalities are different from each other and thus use more objective data to try to support this claim. The above chart summarises the methods used and their results

When Eve White became aware of Eve Black she became able to prevent her from ‘getting out’ Negotiation became necessary for Eve Black to get time out After 8 months Eve Black was making progress Her black outs had stopped and she was making good progress in her job.

Jane After a period of progress Eve White had increased headaches and blackouts. Eve black denied responsibility and claimed during these blackouts she too couldn’t remember what happened In a session focusing on early childhood traumas, Jane emerged. This personality is an approximate balance between the other two – assertive and mature.

Jane Jane showed compassion for EW’s daughter Jane had not found a way to displace EB or communicate through her Jane was aware of both Eves thoughts and behaviors but did not have full access to their memories before she appeared

Eve White Eve Black Jane IQ Test 110 104 N/A Memory Test Superior Inferior Drawings Less Healthy than EB Healthier than EW EEG 11 cycles per sec 12.5 cycles per sec Personality Repressive Regressive Hypnosis Easy Not Able Thigpen and Cleckley go to some lengths to prove that the personalities are different from each other and thus use more objective data to try to support this claim. The above chart summarises the methods used and their results

Results of tests There was a clear difference in the EEG tests between Eve Black and the other two personalities It was not clear if there was a difference between Eve White and Jane’s EEG’s

The conclusion Thigpen and Cleckley were convinced that they had witnessed a case of Multiple Personality Disorder They recognised that they could have been conned by a successful actress but believed that the performance could not have continued for so long They decided that if Jane took over that would be the most appropriate solution to the troubled mind

The case of Eve was made into a film In 1975 Eve revealed that she had experience other personalities after the therapy had ended In total she claimed she had a total of 22 different personalities In 1977 in a TV interview Eve revealed who she was, real name Christine Sizemore, and wrote the book ‘I’m Eve’

Evaluation Validity: The people interviewed could have mislead the researchers, or their memories may be inaccurate, the information collected was very subjective Reliability: Did the study have control? Could it be replicated with the same results? Generalisability: can the findings be generalized Ethics: Could Thigpen and Cleckley act effectively as both therapists and researchers? Was Eve treated as more of a subject than a patient? (Action research) A key point to note is that due to Thigpen and Cleckley being both researchers and therapists they are combining joint roles. This may cause problems in objectively investigating this case - as therapists they may have already come to the conclusion that Eve does have MPD but as researchers they need to be more skeptical. Can they do this effectively?

Bias P: The close relationship between researcher and therapist may introduce bias E: For example in this case study when Eve Black first appears and crosses her legs the therapist noted that there was something attractive about them, and this was the first time he had noticed this C: Therefore this may not be a change in her personality, but rather a change in the way he sees her

Advantages of a case study P: Case studies provide highly detailed and in depth data E: For example a great deal of information was collected from Eve, her husband, and also from their friends and family members, they collected both quantitative data with the psychometric tests and qualitative data with the projective tests on Eve, they also did EEG scans on all of the personalities C: Other superficial methods might not have this much detailed background information on participants P: a case study produces highly ecologically valid information E: For example C: The case study method is true to life and has mundane realism

Disadvantages of a case study P: Case studies have low generalisability E: For example we have no way of assessing how typical Eve is of other people with Multiple Personality Disorder C: Therefore the findings may be unique to one case and cannot be generalised to others with multiple personality disorder P: Case studies are impossible to replicate E: For example the information was all collected from Eve and her family recalling past events, their memory could be distorted and things could be remembered incorrectly, or they could deliberately mislead the researchers C: Therefore the case study method is very unreliable as it could not be replicated with similar results