Newsgroups: bit.listserv.psycgrad
Date:         Tue, 29 Sep 1992 10:33:47 -0700
              <PSYCGRAD@UOTTAWA.BITNET>
From:         MaryAnne Murray <murray@SEATTLEU.EDU>
Subject:      MPD (warning: long posting!)

I have been reading with interest these postings on dissociation and
Multiple Personality Disorder. There are a number of issues I want to
respond to, but will have to do so in several postings as time allows.

I have been interested in dissociative disorders for several years and
have read as much as I could find on the subject, plus I have attended
several professional trainings on MPD. Also, for a couple of years I
lived with a person who has MPD, so I have understanding of it that
goes far beyond what can be told in books.

I am a graduate student in a program granting an MS in Community
(Agency) Counseling. Already I hold a masters degree in Pastoral
Ministry (essentially, practical theology) and Basic and Advanced
Certificates in Chemical Dependency Counseling. I work as a counselor
at an alcohol and drug treatment center. Some of the persons who come
to us for treatment are persons who have MPD.

Much of what has already been written recently on Psycgrad regarding
PTSD fits with what I know of MPD. PTSD results from severe trauma in
which the person believes s/he is in danger or death. The flashbacks
of PTSD are common to persons with MPD, and often a person with MPD
gets his/her first real clues about MPD from the flashbacks.
Usually--but not always--persons with MPD are amnestic for much or all
of childhood, and in a sense, the flashbacks are childhood memories
"leaking through" their considerable defenses.

Most persons with MPD have this condition as a result of severe
childhood abuse--I think current researchers (Richard Kluft, Colin
Ross, Frank Putnam, Walter Young, and Eugene Bliss are some of the Big
Names in this field of study) are saying that about 92% of the persons
they have studied have documentable histories of severe childhood
abuse, including physical and sexual abuse. It is important to note
that NOT ALL persons with MP have such histories, but rather that
there is ALWAYS history of trauma. Chris Costner Sizemore, for
example, who is the famous Eve whose case was made public in Thigpen
and Cleckley's _The_Three_Faces_of_Eve_ and who has since written
several books on her own experience, is a person who evidently was NOT
abused as a child. Her dissociation reportedly was a result of a
number of losses (if memory serves, she had 5 deaths in her family in
a short period of time, including her beloved grandmother) when she
was 6 or so, and she also witnessed a devastating airplane crash
during the same time period.

OK, a note about childhood sexual abuse. From what I have read and
been taught in recent coursework, I understand that it is not so much
the severity and/or nature of the actual abuse which is a deciding
factor on the outcome, as it is the assistance or lack thereof which
is provided the child victim to process the trauma. So, a child who is
raped and beaten by a stranger may recover well if s/he has parents
who will get medical and psychological help for the child and let
him/her know that they will do all they can to keep him/her safe in
the future. But, if the parents are the perpetrators, or if the
parents deny the child's report that someone is abusing the child,
then the child must make what sense s/he can of such events, and s/he
may dissociate or develop psychosis as a result.

In a recent course I attended, which was specifically on MPD,
professor Dee Spring (Ph.D. granted by Fielding Institute) said that
it is not yet known what causes some persons to develop dissociative
disorders and others to not do so. There may be genetic components
similar to those which may account for variations in concordance rates
in schizophrenia. Dissociation is established by age 8, Dr. Spring
said, and persons who develop MPD are persons who are already easily
hypnotizable. Those who do not "learn" to dissociate have to develop
other means of coping with severe trauma. I am inclined to believe
that those whose lives are too traumatic to bear either die, as in the
celebrated case of 3-year-old Eli Creekmore who died in Washington
State several years ago as a result of child abuse, or they develop
psychoses.

MPD is not craziness. It is a logical and sane response to living in a
crazy situation. It keeps the child victim alive by compartmentalizing
and locking away memories which are too traumatic to incorporate into
the person's accessible consciousness.

So the multiplicity is a survival mechanism. It is a very functional
way to survive a hellish life. BUT--it is not functional in adulthood.
In fact, it is a pretty complicated way to live. So recovery is
desirable and it is accomplished by therapy which recovers the
memories, helps the person feel the feelings (because the child victim
dissociates so that s/he DOESN'T FEEL, physically or emotionally, what
is being done to him/her) and grieve the losses. Eventually the
various alters begin to share consciousness and then integrate into
one whole and well-rounded personality. Persons who have MP tend to
not want to integrate, or at least the alters don't want to integrate,
until they realize that none of the aspects of the personalities will
"die" or be lost.

MPD is occasionally used as a claim for defense in legal cases.
Usually these cases involve potential for the death penalty and the
defendents are highly motivated to try ANYTHING to avoid capital
punishment. The Kevin Bianchi case is the most famous of these in the
US, and to this date it has not been established that Kevin Bianchi
did or did not have MP.

It would take a very fine actor to provide a consistent factitious
presentation of MPD. It would take a LOT of energy and concentration
to fake it well.

Most of the Big Names in MPD study agree that persons who commit
crimes while an alter is in executive control are still responsible
for their actions. It is not as though demons have possessed these
persons' bodies! Also, I believe that persons who commit crimes while
under the influence of alcohol and/or drugs are similarly responsible
for what they have done.

At the same time, I believe that adjudication for such crimes ought to
be different than crimes committed when stone cold sober and there is
no mitigating internal activity. For example, a sociopath who goes on
a shooting spree ought not to be sent to therapy instead of prison,
because research has shown that persons with Antisocial Personality
Disorder don't recover. But, for persons who offend while intoxicated,
if they are remanded to treatment, they can become clean and sober and
prevent future altercations. And persons who have MPD can be treated,
albeit longterm, and regain full functioning and appropriate impulse
control. And even though treatment is lengthy, it is still far less
costly to society than life imprisonment. Furthermore, these persons
tend to be extremely creative and intelligent and they can make fine
contributions to our society.

The case of Billy Milligan, made famous in the book,
_The_Minds_of_Billy_Milligan_ by Daniel Keyes (New York: Bantam Press
1981), is an interesting case in point. Billy didn't claim he had MPD
--it was "discovered" by his lawyer who realized that something
unusual was happening in him. Billy was treated by the late Dr. David
Caul, with good results--until the State decided to lock him up in a
psych ward and keep him on Thorazine. The tranquillizers made him
decompensate. He was not dangerous to those in the hospital, but other
patients and staff were jealous about his receiving a great deal of
attention.

There is a lot more I could say about the subject. I invite questions
and/or comments. Please, no flames. Thanks.

-MaryAnne
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