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

2. Sybil Sybil’s real name was Shirley Mason
Her case made Personality Disorder famous (especially after the 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

3. 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.

5. 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.

6. 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.

7. 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

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

9. 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.’

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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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.

23. 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.

24. 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

25. 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

26. 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

27. 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

28. 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’

29. 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?

30. 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

31. 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

32. 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