MESSENGERS OF THE GODS
It's like a bad horror film. For those who suffer from multiple personality disorder (MPD), it is as if their bodies and minds have been invaded as they shift from one distinct ego state to another. Each alter personality previously waiting in the wings assumes the forward position on stage, while the original personality recedes. Following this strange, hypnotic phenomenon known as switching, the new self may display flamboyant body language, clothing, and hairstyle and a drastically modified voice, vocabulary, and handwriting. Even the memories are changed.
In "Mind Menagerie" (this month's book excerpt, on page 74) you'll read about the bizarre lives of M. M. George, an MPD patient. But M, M. George may not be that unusual, and MPD may not be the rare disorder it was once thought to be. In fact, cases of multiple personality are burgeoning. "There's a galaxy of them out there," says Eugene Bliss, of the University of Utah School of Medicine. Chicago psychiatrist Bennett Braun estimates that some 5,000 cases may now be on record. Is this an epidemic, or are our methods of diagnosis improving?
Certainly there has been an information explosion in the field. Several professional journals have recently devoted entire issues to MPD, and a new organization, the International Society for the Study of Multiple Personality, held its second national meeting in Chicago this past October. This upsurge in interest provokes bottom-line questions: Who is the self in the driver's seat? Do "normal" people, sensing their internal parts or subpersonalities in conflict, have a less noticeable version of MPD? And what can this incomparable disorder teach us about the mind/brain/body relationship?
Multiple personalities break all the rules. A unified sense of self with a singular personal history is shattered, replaced by a teeming multitude of idiosyncratic selves with varying degrees of autonomy. According to recent reports, the number of alternates ranges from 8 to 13. but in one woman as many as 180 have been observed. Similarly, a singular pattern of physiological response is violated. Brain-wave patterns, handedness, allergies, and pain thresholds vary as multiples change gears.
Brendan O'Regan, vice president for research at the Institute for Noetic Sciences, which funds conferences on MPD, believes multiples provide fertile ground for inquiry into the nature of the self. "The whole issue of mind/body plasticity." says O'Regan, "seems about to undergo a major reformulation if what we learn from multiples is developed in clinical and research terms.(1) Psychotherapist Armand DiMele, of New York City, who has treated several cases, concurs: "Suddenly, multiples are here in numbers, like messengers of the gods who can skip us eons ahead in our scientific understanding of brain and body."
Once thought to be an unusual form of schizophrenia, MPD is a discrete, treatable disturbance. Although most multiples are still misdiagnosed or not diagnosed until adulthood, early identification might help prevent more severe disorders. Nearly all multiples were abused children -- beaten, cut, burned, or sexually abused by a parent. In a typical case, the first "splitting defense" occurs before age five, during an incident of extreme abuse. Eventually the person creates additional selves, resulting in an internal division of labor to handle unwanted tasks. MPD may run in families. Philadelphia psychiatrist Richard Kluft once saw three generations of multiples in treatment. This tendency may be caused by a chain of abuse, or it may reflect an inherited capacity to dissociate easily.
Before treatment, multiples are typically unaware of their many personalities. Amnesia between ego states serves to protect the original self, but it also causes grief and frustration. "Everybody hates you and thinks you're a liar," one female multiple said. After becoming aware of the other selves, the dominant personality can exert influence over the others, even calling on them for assistance. A personality who is tired or tipsy, for example, can relinquish control to one who is alert and sober. A female graduate student writes of just such parallel processing; "When I am writing a paper on dichotic hearing, one of the others is composing the proposal for the master's thesis. Someone else has prepared dinner..."
Some multiples also appear to heal more quickly than other people do. Symptoms appear and disappear rapidly, and even third degree burns improve more quickly than normal. "There is an intriguing trail of clues," O'Regan says, "suggesting that certain kinds of dissociative states similar to MPD facilitate extraordinary healing. Perhaps it will be possible to characterize the healing states that multiples use and train them in others."
Multiple personalities are more than just bizarre case histories. They offer interesting possibilities for enriching scientific knowledge. Their gifts represent proof of the human nervous system's capacity for instantaneous reorganization. Each person is a living lab, a testing ground of human ability -- CONNIE ZWEIG
BY JUDITH HOOPER AND DICK TERESI
In January 1984 we wrote a short article in Continuum [an OMNI column] about multiple personality disorder (MPD), the bizarre psychiatric syndrome known in the vernacular as "split personality." You may know it as The Three Faces of Eve syndrome, after the 1957 best seller. Several weeks after the article appeared, we received a well-written and thoughtful letter from "M. M, George." a self-described "multiple." We wrote back, eventually establishing contact with Marion, the thirty-five-year-old Massachusetts woman behind the pseudonym (M. M. George is an amalgam of her three major personalities: Mary, Monica, and George). Marion is not her real name, either; proper names and certain personal details in this article have been changed to protect her identity. But her life as a multiple, as verified by her psychiatrist, is painfully real.
I am thirty-five years old, and I have been multiple for thirty-two years, because I was three when it started. I was molested a lot by my stepfather, and when I was six I was raped. My core personality went out at age six, and my host personality, Mary, took over. Only one person in my family knows. That's the case with most multiple personalities. You just don't see it if you're not looking for it. My first husband, poor dear, never knew what hit him. See, part of my personality went to sleep for a year and woke up married to Eddie -- that's my ex-husband -- and I could not tolerate him. Monica was the one who married him. What happened was that Mary's fiance had drowned, and when he drowned she konked out for a year. When she woke up married to Eddie she couldn't stand him. She also resented being thrown into this situation because she didn't know she was a multiple at the time. She didn't know that Monica existed.
Like most multiples, Marion has been through more trials than Job, including misdiagnosis as a schizophrenic, commitment to a Bedlamesque state mental hospital, repeated suicide attempts, inappropriate drug treatment, even a would-be exorcism. Until recently multiple personality disorder was usually dismissed as a rare and rococo psychiatric hoax. If a many-faced Eve appeared on the couch, mainstream psychiatry labeled her (for most multiples are female) a schizophrenic, a manic-depressive, or a clever, manipulative fake. The general public frequently confuses multiple personality with schizophrenia, a far more common and debilitating disorder characterized by wildly disorganized thought and a loss of contact with the environment.
Psychiatrist Frank Putnam discovered his first multiple languishing in a ward for depressives at the National Institute of Mental Health (NIMH) -- glum, suicidal, unresponsive to treatment. "She had been presented at grand rounds as a classic example of various neurological diseases -- brain tumor, epilepsy, you name it," he tells us. "In my therapy group she went through a series of startling changes that she did not acknowledge. Usually she was withdrawn, hostile, and quiet, and then she'd shift and become witty, laughing and making puns."
That was 1979, and over the next few years Putnam went on to study some 150 "Eves," rigorously analyzing their brains as well as their psyches. "When I got into multiple personality disorder, I got so involved in it I essentially gave up everything else," he says. He and his co-workers at the NIMH and St. Elizabeth's Hospital, in Washington can now report that the alternate selves inside a multiple are more real and more autonomous than anyone suspected.
Putnam, working with NIMH colleague Monte Buchbaum, began his studies by analyzing the brain waves of ten multiples. He exposed each personality to flashes of light and then, using electrodes attached to the scalp, measured the brain's electrical response, called an evoked potential."In each multiple we studied at least three different personalities that were capable of cooperating -- usually, the core personality, a child personality, and an obsessive-compulsive personality," Putnam explains. 'And we tested each personality at least five times. For controls we used normal actors, who merely imagined being different people." His results elevated split personality from late-late-show melodrama to hard neuroscience. The actors' brain-wave, or electroencephalogram (EEG), patterns didn't change much from one feigned personality to another. But the Sybils, Joes, Harriets, and Marys inhabiting each multiple patient looked like different people, neuroelectrically speaking. MPD -- which California psychiatrist Ralph Allison likens to a cancer of the personality, because selves multiply like malignant cells -- proved to have a basis in biology.
Putnam probed further. With NIMH's Daniel Weinberger he did cerebral blood-flow studies (in which inhaled radioactive xenon is used to illuminate active brain regions) and reported "striking differences" between different personalities. Since it's common to find both left-handed and right-handed characters inside a multiple, Putnam did a series of physiological tests and found corresponding shifts in hemispheric dominance.
"We now know of a thousand cases," says Putnam. "So while it's a rare disorder, it may not be as rare as we thought." Eighty-five percent of the victims are women.
"But," says Putnam, "I suspect that there are many unrecognized male multiples in the criminal justice system because they usually have one personality that's violent." In 1978 William Milligan, of Columbus, Ohio, became the first person in the United States acquitted of a major crime (four counts of rape) by reason of multiple identity. His ten personalities included an intellectual named Arthur who spoke in a clipped, British manner; several child personalities; two lesbians; "Ragen," a feisty male with a Slavic accent who threatened to fire his lawyers; and an escape artist named Tommy, who once slithered out of a straitjacket in ten seconds flat. Though each personality knew the difference between right and wrong, all of them together did not compose a whole person, according to the psychiatrists who testified at the trial -- ergo Milligan could not be held responsible for his crimes.
Many multiples, however, shuffle through their pack of selves inconspicuously, working as corporate lawyers, secretaries, PTA presidents, or dentists -- incognito even to themselves. The first hint may be odd gaps in the temporal stream, disquieting memory lapses, perhaps the Twilight Zone experience of waking up in a strange motel room with a perfect stranger (if not married to one).
One day in 1979 I woke up -- or rather, Mary woke up -- in a motel room with somebody Monica was involved with. I called my psychiatrist at four a.m. and said, "All right, what's going on here?" He said, "Okay, it's time we talked."
Lurking somewhere behind all the personae is the original, the core personality, which may take years to unearth, In the meantime the "host," the facade that the patient uses to simulate unity, presides like a long-term guest host on the Johnny Carson show. Usually, no one perceives the change. Typically, some of the personalities are more charismatic, more flamboyant, than the rather drab original. But despite their myriad identities, most multiples are not psychotic, according to Putnam, and may function quite well, often delegating different tasks to each of the personalities.
Mary was a marvelous artist, a good writer, a moderate singer. Monica was the real singer in the bunch; she had a beautiful voice. In my high-school chorus I was listed in three different categories -- second soprano, which was Mary; alto, which was Monica; and George was first tenor. It didn't happen very often, but whenever my singing teacher needed an extra voice he'd put me in wherever, because I had a three-octave range. Mostly I was in the alto range, which was Monica's range. . . . I don't consider myself as good now. My husband thinks I have a chance to be as good as Monica was if I just practice.
Therapists who treat multiples often find themselves in dialogue with different voices -- some male, some female, some childlike -- eerie as the alien voices emanating from a medium at a seance. In 1983 neurologist Christie Ludlow, of the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS), tested this phenomenon by making high-tech "voiceprints" of some of Putnam's patients. Using a computerized technique called spectral analysis, which essentially sorts out the different frequencies composing a single sound, Ludlow confirmed that the subvoices were indeed distinct.
One multiple has three menstrual periods every month, one for each of her identities. Others require different prescription glasses for their alter egos. A multiple can harbor one identity that knows how to drive and another that doesn't: one that speaks a foreign language fluently and another with a tin ear. Chicago psychiatrist Bennett Braun studied a man who was allergic to citrus drinks in all personalities but one. Putnam has met multiples who are actually married to two different people. "I wouldn't be surprised," he adds, "if a certain percentage of people who lead double lives -- spies, double agents, bigamists -- are actually multiples. Some mediums and victims of 'demonic possession' probably are, too." The repertoire of a multiple includes dramatic shifts in facial expression, accent, vocabulary, body language, clothing and hairstyles, handwriting, phobias, and -- above all -- memories.
For twenty-eight years of my life i was amnesic. When I was younger I didn't notice it; I just thought everyone had these moments. Later, as things got more traumatic, there was more and more time I would miss. I just thought I was crazy.
With a battery of sophisticated tests, Putnam and NIMH psychologist Herbert Weingartner determined that multiples' memory circuits are well compartmentalized. Personality X may remember nothing that happens to Y while Z is consistently aware of Y but not of X, and so on. Braun believes that MPD may be an extreme case of state-dependent learning: information encoded during a given psycho-physiological state is best retrieved in the same state. (In other words, if you misplaced your wallet while drunk, a couple of pina coladas may be the best route to finding it.)
What causes a personality to split in the first place? The clear and chilling answer is child abuse: 85 to 90 percent of MPD patients were beaten, cut, burned, half drowned in bathtubs, locked in closets, hung out of windows, and/or sexually assaulted as children (generally before the age of ten), and their early histories are sagas of criticism, betrayal, abandonment, and inconsistency. "It is a coping mechanism," says Putnam. "The child compartmentalizes his or her pain so as not to have to deal with it all the time. A form of self-hypnosis is probably involved. The child goes into trances, and that trance-state consciousness grows more and more autonomous and differentiated."
When I was six, the Topper series was on TV. and I was madly in love with George Kirby -- the ghost who always helped to get Topper either into or out of trouble -- who mostly helped him against the bad guys. I used to think, 'Gee, I wish I had a George who could protect me against my stepfather.' And then the night I was raped, bingo, there was George. He pulled me away from my stepfather. Then Mary was born a few instants after. She was like the temporary host of the body. I never actually knew her because I went to sleep, and when I woke up, Mary had taken over.
Unfortunately, it isn't very easy to put Humpty-Dumpty together again. MPD is not cured in a day. "I don't believe there are any medications that work," says Putnam. Integration, as the healing process is called, can take years. Therapy takes the form of an intrapsychic encounter group in which the various buried identities are coaxed into the open, sometimes through hypnosis. "The first step in treatment," Putnam explains, "is to get the personalities to meet one another."
As for Marion, six different personalities took their turns upon the stage of her life for 30 years. Despite her potpourri of nicknames (three of her personality monikers appear under her picture in the high-school yearbook), her three-part harmony in the chorus, her often bizarre behavior, her own family didn't notice her psychic multiplicity. Like many multiples, she was (and is) intelligent and talented, an accomplished singer, artist, and writer. But depressions, mental breakdowns, suicide attempts, and confusion inevitably aborted all her career plans.
Not until 1979. after her sobering morning after in the motel room with "Monica's" date, did she learn she was a multiple personality. With a therapist, she began the slow, painful process of reconnecting her scattered selves, establishing lines of communication between them. Mary, the acting "host," learned of George and Monica; Monica began to leave notes for Mary ("Oh, by the way I made an appointment for you. . ."); the personalities heard one another's voices and traded memories. On Halloween, 1982, integration occurred, and all her "personal spirits" coalesced into a whole person. With her husband, a self-taught, amateur therapist (who "fell in love with all of us" and married them/her in 1982) acting as hypnotist and guide, the real Marion returned after her long, Rip van Winkle-like sleep. She now assists with the reintegration of other multiples and is working toward a career as a therapist for abused children, This is her story:
There were six personalities in all, Mary, Monica, George, Daphne, Ginny, and me. There was also a fractional personality, Nancy, but she never really developed into anything. She was a reaction to a car accident, and then she was integrated, so we don't really count her.
A few months after this conversation, we got another letter from Marion, which read, in part: "To be perfectly honest, I have resplit, but we don't think it is a serious situation. There were stressful circumstances involved with the possibility of seeing my stepfather again. That on top of an overloaded work schedule and doing volunteer work, too ... I just blew a fuse. We feel (my doctor and I) that as soon as I can calm down, put my stepfather out of my mind, and rest from the overload, I should be able to reintegrate George and the new young personality named Anna (aged fifteen). They seldom come out, and when they do, it startles my husband. After all, I had been integrated for sixteen months. But I think I can reintegrate soon. . . . It's time that people understood that this illness is a reality, not just a figment of someone's imagination."
Given the often astonishing gifts of their satellite personae -- like the ability to converse in fluent Russian or to perform Houdini-like escape feats -- multiple personalities make a strange showcase for the untapped potentials inside every brain. Multiple personalities are not freaks; they are like you and me -- only more so. Or so some psychiatrists maintain. As Marion wrote us in one letter, "I am all in favor of educating the public and letting them know that we multiples are really ordinary people with a bit of an odd illness, but we live and survive. That's what it's all about, a unique and wonderful defense mechanism that not everyone can have."
But maybe everyone does have this mechanism.. Maybe you, too, harbor closet selves in various degrees of evolution: an intellectual, a Don Juan, a bon vivant, an ascetic, a hero, a melancholiac, a housewife, a revolutionary, a hysteric, a lonely child, a Machiavellian power broker, an artist. Perhaps mental unity is a matter of repressing the alternate selves struggling to be born. And consider the dream self, your nocturnal alter ego: Is that you? What about your pack of previous selves, from four-year-old, bedwetting Stevie to teenage Steve with the ducktail haircut? "You" disappear in anesthesia, deep sleep, coma, and certain twilight states. Where's the self?
So far no electroencephalogram, no positron emission tomography scan has pinpointed the neuron, or network of neurons, that encodes the "I." Obviously, the self is a global property of the brain -- if, that is, it is "in" our gray matter at all. Even in this age of neurotechnological miracles, selfhood remains a deep mystery.
MULTIPLE PERSONALITY TWINS
During admission to New York City's Odyssey House drug facility, a twenty-eight-year-old identical twin confessed to Dr. Ariene Levine that she had six personalities "living in her body." According to psychiatrist Levine and Dr, Robert S. Mayer, "What was shocking was that the second twin had six distinct personalities that were twins of the sisters' personalities."
Drs. Levine and Mayer speculate that this first known case of multiple-personality syndrome in identical twins was triggered in the younger twin by the trauma of an incestuous relationship with the father, begun at age two and a half. The second twin,. also sexually abused, learned from her sister to become a multiple personality "in order to fully relate to her."
Accordingly, the twins created a man-hating personality who acknowledged the affair with the father. At age nine or ten each twin formed tougher, "mistress" personalities. The twins grew up attractive, and it was the mistresses who were inspired to handle the employment question by becoming first a topless twins act and finally a pair of professional dominatrices.
Neither twin knew about the father's sexual abuse of the other. The mirror personalities seemed designed not just to distance the vulnerable self from the truth but also to shelter the other twin. In a bizarre twist the father denied sexually abusing his daughters and was discovered to be a multiple personality as well. Mayer and Levine report: "The father always abused and used them separately: He appeared to be keeping two mistresses who did not know about each other, namely his daughters."
Under therapy conducted by Levine and Mayer, one twin fused her personalities, while the other returned to drugs and multiplicity. Dr. Mayer reports, however, that after two years on a destructive life path this twin is back in a drug-treatment program. -- Tracy Cochran