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SPEAKING FOR OUR SELVES By Nicholas Humphrey & Daniel
C. Dennett (From Raritan: A Quarterly Review, IX, 68-98, Summer 1989) "Thus play I in one person
many people, and none contented." – Richard II In the early 1960's when the laws
of Imagine now, thirty years later, a
commercial for an IBM computer. A poster on a tent announces, "The one
and only IBM PC becomes Great Information Processors of History". The
tent is dark. "WordStar!" shouts the showman, and the lights come
up on a desktop computer, displaying a characteristic menu of commands. The
lights go down. There is the sound of changing disks.
"Paintbrush!", and here is the computer displaying a different
menu. "Now, what you've all been waiting for, Lotus 123!"..
"But it's just a different program," says the schoolboy. Somewhere between these two
scenarios lies the phenomenon of multiple personality in human beings. And
somewhere between these two over-easy assessments of it lie we. One of us
(NH) is a theoretical psychologist, the other (DCD) is a philosopher, both
with a long-standing interest in the nature of personhood and of the self. We
have had the opportunity during the past year to meet several
"multiples," to talk with their therapists, and to savor the world
from which they come. We give here an outsider's inside view. * *
* * We had been at the conference on
Multiple Personality Disorder for two full days before someone made the
inevitable joke: "The problem with those who don't believe in MPD is
they've got Single Personality Disorder." In the mirror-world that we
had entered, almost no one laughed. The occasion was the 5th
International Conference on Multiple Personality/Dissociative States in The Movement or the Cause (as it
was called) of MPD has been undergoing an exponential growth. 200 cases of
multiplicity reported up till 1980, 1,000 known to be in treatment by 1984,
4,000 now. Women outnumber men by at least four to one, and there is reason
to believe that the vast majority - perhaps 95% - have been sexually or
physically abused as children. We heard it said there are currently more than
25,000 multiples in The accolade of "official
diagnosis" was granted in 1980, with an entry in the clinician's
handbook, DSM-III: Multiple Personality. 1. The existence within an
individual of two or more distinct personalities, each of which is dominant
at a particular time. 2. The personality that is dominant at any particular
time determines the individual's behavior. 3. Each individual personality is
complex and integrated with its own unique behavior patterns and social relationships.
Typically there is said to exist a
"host" personality, and several alternative personalities or
"alters". Usually, though not always, these personalities call
themselves by different names. They may talk with different accents, dress by
choice in different clothes, frequent different locales. None of the personalities is
emotionally well-rounded. The host is often emotionally flat, and different
alters express exaggerated moods: Anger, Nurturance, Childishness, Sexiness.
Because of their different affective competence, it falls to different alters
to handle different social situations. Thus one may come out for love-making,
another for playing with the kids, another for picking a fight and so on. The host personality is on stage
most of the time, but the alters cut in and displace the host when for one
reason or another the host cannot cope. The host is usually amnesic for those
episodes when an alter is in charge; hence the host is likely to have blank
spots or missing time. Although general knowledge is shared between them,
particular memories are not. The life experience of each alter
is formed primarily by the episodes when she or he is in control. Over time,
and many episodes, this experience is aggregated into a discordant view of
who he or she is - and hence a separate sense of self. The number of alters varies
greatly between patients, from just one (dual personality), to several dozen.
In the early literature most patients were reported to have two or three, but
there has been a steady increase, with a recent survey suggesting the median
number is eleven. When the family has grown this large, one or more of the
alters is likely to claim to be of different gender. Such at least is how we first
heard multiplicity described to us. It was not however until we were exposed
to particular case histories, that we ourselves began to have any feeling for
the human texture of the syndrome or for the analysis being put on it by MPD
professionals. Each case must be of course unique. But it is clear that
common themes are beginning to emerge, and that, based on their pooled
experience, therapists are beginning to think in terms of a "typical
case history". The case that follows, although in part a reconstruction,
is true to type (and life). * *
* * Mary, in her early thirties, has
been suffering from depression, confusional states and lapses of memory.
During the last few years she has been in and out of the hospital, where she
has been diagnosed variously as schizophrenic, borderline, and manic
depressive. Failing to respond to any kind of drug treatment, she has also
been suspected of malingering. She ends up eventually in the hands of Doctor
R, who specializes in treating dissociative disorders. More trusting of him
than of previous doctors, Mary comes out with the following tell-tale
information. Mary's father died when she was
two years old, and her mother almost immediately remarried. Her stepfather,
she says, was kind to her, although "he sometimes went too far".
Through childhood she suffered from sick-headaches. She had a poor appetite
and she remembers frequently being punished for not finishing her food. Her
teenage years were stormy, with dramatic swings in mood. She vaguely recalls
being suspended from her high school for a misdemeanor, but her memory for
her school years is patchy. In describing them she occasionally resorts -
without notice - to the third person ("She did this.. That happened to
her"), or sometimes the first person plural ("We [Mary] went to
Grandma's"). She is well informed in many areas, is artistically
creative and can play the guitar; but when asked where she learnt it, she
says she does not know and deflects attention to something else. She agrees that
she is "absent-minded" - "but aren't we all?": for
example, she might find there are clothes in her closet that she can't
remember buying, or she might find she has sent her niece two birthday cards.
She claims to have strong moral values; but other people, she admits, call
her a hypocrite and liar. She keeps a diary - "to keep up," she
says, "with where we're at". Dr. R (who already has four
multiples in treatment), is beginning to recognize a pattern. When, some
months into treatment, he sees Mary's diary and observes that the handwriting
varies from one entry to the next, as if written by several different people,
he decides (in his own words) "to go for gold". With Mary's
agreement, he suggests they should undertake an exploratory session of hypnosis.
He puts her into a light trance and requests that the "part of Mary that
hasn't yet come forward" should make herself known. A sea-change occurs
in the woman in front of him. Mary, until then a model of decorum, throws him
a flirtatious smile. "Hi, Doctor," she says, "I'm Sally.
Mary's a wimp. She thinks she knows it all, but I can tell you .. " But Sally does not tell him much,
at least not yet. In subsequent sessions (conducted now without hypnosis)
Sally comes and goes, almost as if she were playing games with Dr R. She
allows him glimpses of what she calls the "happy hours", and hints
at having a separate and exotic history unknown to Mary. But then with a toss
of the head she slips away - leaving Mary, apparently no party to the foregoing
conversation, to explain where she has been. Now Dr R starts seeing his patient
twice a week, for sessions that are several hours in length. In the course of
the next year he uncovers the existence not just of Sally but of a whole
family of alter personalities, each with their own characteristic style.
"Sally" is coquettish, "Hatey" is angry,
"Peggy" is young and malleable. Each has a story to tell about the
times when she is "out in front"; and each has her own set of special
memories. While each of the alters claims to know most of what goes on in
Mary's life, Mary herself denies anything but hearsay knowledge of their
roles. To begin with, the change-over
from one personality to another is unpredictable and apparently spontaneous.
The only clue that a switch is imminent is a sudden look of vacancy, marked
perhaps by Mary's rubbing her brow, or covering her eyes with her hand (as if
in momentary pain). But as their confidence grows, it becomes easier for Dr.
R to summon different alters "on demand". |