Unraveling The Secret Of "Alters"

(CBS)  Multiple personalities are at the heart of a number of books, movies and TV shows, and they're at the heart of a contentious debate … and our Cover Story reported by Tracy Smith:

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You could call it the role - or roles - of a lifetime. In the TV show "United States of Tara," Toni Collette plays just one woman who has multiple personalities.

They all come from the mind of Diablo Cody, the Oscar-winning writer of the hit film "Juno." She created the series for the cable network Showtime.

"We've met Buck, who is this very, sort of, aggressive male personality that she has," Cody said. "We've met 'T,' who's a very, kind of, sexualized teenage personality; and Alice, who's the ultimate homemaker."

"Have viewers recognized themselves in Tara, said, 'Maybe I have this disorder'? Have you gotten that reaction?" asked Smith.

"Yeah, it surprises me," Cody said. "People actually have said that."

And though Tara doesn't exist in real life, many therapists say her illness sure does.

"Tara is extremely real," said Dr. Richard Kluft, "but extremely unrealistic. What I mean to say is, everything that Tara demonstrates is real. I've seen it, many, many times over. What is unrealistic is that you see so much of it so … it's much more …"

Smith: "It's concentrated?"

"Precisely."

Dr. Kluft is a psychiatrist who teaches at Temple University Medical School in Philadelphia and consults on "Tara."

Today, doctors prefer the less flashy name "dissociative identity disorder" (DID) to "multiple personality disorder" (MPD). They are the same.

How many personalities are typical in an MPD case?

(CBS)

"In an MPD case in the United States these days, about 16 for women and about eight for men," said Dr. Kluft (left).

He says most people with this disorder develop multiple personalities - or "alters" - as a way to cope with trauma or abuse:

"Whatever allows you to say, 'This did not happen to me. This is not going to happen to me again. I'm someone else.'"

And, believe it or not, according to Kluft, multiple personalities often go unnoticed.

"So do you think that there are, what, thousands of people walking around out there with MPD who don't even know it?" Smith asked.

"Oh, easily," Dr. Kluft said.

"Tens of thousands?"

"Easily."

"Hundreds of thousands?"

"Easily."

"Millions?"

"We might be at that level," said Dr. Kluft.

But there is a whole school of therapists that say the number is not in the millions, but zero … that not even a single case of multiple personalities is real … the whole concept not Sigmund Freud but junk science.

"I believe all MPD cases are artificial productions provoked by the attention doctors and others give them - all of them, said. Dr. Paul McHugh, a professor and former head of psychiatry at Johns Hopkins Medical School in Baltimore.

"People are persuaded that they have multiple personalities embedded within them," he told Smith, "and are encouraged to bring them out in the process of trying to get treatment for depression or anxiety or things of that sort."

(CBS)

It all began, says Dr. McHugh, not with shrinks but celluloid: First, the film "The Three Faces of Eve" in 1957, then in 1976 with the TV movie "Sybil" (left, with Sally Field).

Before "Sybil" there were fewer than 200 reported cases in the world. Not long afterwards, there were 8,000 in the United States alone.

"It's a story generated by 'Sybil' and generated by the people who followed on after it," said Dr. McHugh. "Multiple personality and trauma are two separate things. And these people have put them together as though they do match. But they only match in story form. We are in Oz here."

If MPD is make-believe, you wouldn't expect to find it in a manual - the DSM-IV, the Bible of mental health professionals - used to diagnose mental disorders.

Symptoms include "The presence of two or more distinct identities or personality states … at least two of these "recurrently take control" of the person's behavior," plus an "inability to recall important personal information."

The DSM authors claim that as many as one percent of Americans have the disorder.

(CBS)

But even that doesn't sway detractors like Dr. Paul McHugh (left).

"So, the DSM doesn't validate that a disease is actually out there?" Smith asked.

"Absolutely no," Dr. McHugh said. "All it says is, this is what several people say exists, and this is what it looks like to them."

And how does it look to Hershel Walker? Smith asked him, "How many personalities did you think you have? Gimme a number. Dozens?"

"Oh, yeah. I've had dozens."

MPD is no fantasy to this former football player, a Heisman Trophy winner, arguably one of the greatest running backs of all time. Herschel Walker, the University of Georgia All-American, recently revealed that he's been diagnosed with multiple personalities.

Walker, now a successful businessman, says he developed the disorder when he was a kid.

"I had a stuttering problem, I have a speech problem. I couldn't put a sentence together," Walker said.

"And the kids teased you?"

"Teasin' me all the time."

"Do you think that abuse was severe enough that you turned [to] multiple personalities?" Smith asked.

"It was severe, yeah."

He describes his alters in an autobiography, "Breaking Free: My Life With Dissociative Identity Disorder" (Simon & Schuster). They don't have names, just titles, like the General - who tried to keep his alters in line - and the Warrior, a competitive personality who was uncontrollable … the one who made him play Russian Roulette.

"And I remember pullin' a gun and spinning the cylinders, my puttin' it to my head and pullin' [the trigger]."

"What do you think would've happened to you if you didn't get therapy?" Smith asked.

"Oh, I could have ended up in jail, dead, could have hurt someone and stuff."

"You know, there's a lot of debate about this. There are respected therapists out there who say - "

"Why, why are they respected?" Walker said.

"By their peers," Smith said. "There are people who say -"

"That's what I'm saying, these are doctors. But I'm the one that have been through it. They're very good at sayin' that. But I'm here to, just to say, you know, they didn't have to go through it."

But there are scores of patients who did go through it … treatment, that is … who say their lives were ruined by therapists who convinced them they had a disorder that didn't exist.

Mike Wallace of 60 Minutes spoke to one of them in 1997, Nadean Cool:

Wallace: "126 different personalities. What does that mean, Nadean?"

Nadean Cool: "It means that I have a 126 different people."

Wallace: "In you."

Cool: "Inside me."

Wallace: "And you believed in multiple personality disorder?"

Cool: "He taught me to believe it."

Wallace: "So you believed."

She sued her psychiatrist, who settled the case for 2 point three million dollars. Dr. Kluft closely watched that case and others where doctors paid big money:

"Settling is not an admission of guilt," he said. "Settling is a way of ending a process in a way that's agreeable to the various parties."

"In point of fact, we know that people who go through trauma do not develop multiple personalities," said Dr. McHugh, "or that's what we know when we follow people after they've had traumas. The important thing to know is the trauma does not produce multiple personality."

But Hollywood is of one mind about MPD - spellbound. After all, "Tara"'s creators are not doctors but dramatists … the series not science, but show biz.

"Are you adding to the discussion about whether this is a real disorder?" Smith asked.

"I think so, for better or for worse," said Cody. "But to generate discussion at all, I see that as a positive thing."

Renewed for another season, "Tara" will continue to raise questions about mental illness … multiple questions.


For more info:

"Coming Apart: Trauma and the Fragmentation of the Self" by David Spiegel, Cerebrum, January/February 2009 (The Dana Foundation)

"Breaking Free; My Life With Dissociative Identity Disorder" by Herschel Walker (Simon & Schuster)

"Clinical Perspectives on Multiple Personality Disorder" by Richard P. Kluft and Catherine G. Fine (Editors) (American Psychiatric Press)

"Hoax and Reality: The Bizarre World of Multiple Personality Disorder " by August Piper (Amazon)

"The Stranger In The Mirror" by Marlene Steinberg and Maxine Schnall (Harper Collins)

"Try to Remember" by Paul R. McHugh (Dana Press)

American Psychiatric Association

False Memory Syndrome Foundation

International Society for the Study of Trauma and Dissociation (ISSTD)

Dissociative Identity Disorder (Psychnet-uk.com)

[dreshany]

My question to all those who dispute the validity of Dissociative Identity Disorder is:
How do you then explain the vast amount of evidence in regards to "fugue" states, "switching" etc of multiples as children, growing up, in early adult life and before therapy?
I am a multiple with various alters. I have only seen one therapist in my life, AFTER, I was diagnosed with DID. I was first diagnosed with DID during my first hospitalization for suicidal ideation and self injury. I had never even thought about multiple personalities before this, but it made a lot of sense.
Going back over my past are countless episodes of switching and appearance of alters. I grew up labeling my mother as a liar because I was always being accused of things "I" didn't do.
In school, I was unable to hold my focus in class and was always being reprimanded for "blanking out" "day dreaming" or "staring out the window." Report cards from grades 1-8 repeatedly stated the same thing. Very sweet, bright girl, if only she would pay attention in class.
There are times I remember acting out but feeling like I was not in control of myself.
If all DID is iatrogenic, who brainwashed me?

[acptulsa]

But my friend is NOT well, Patphil. And neither are her children. What good is the psychiatric profession if they don't believe what is, and instead rely on "the popular diagnosis of the hour" (which in her case was bipolar disorder and landed her on psychotropic drugs that did more harm than good)?

[sybilsfriend]

There is a wonderfull website about Shirley Mason/aka Sybil
it is
www. sybilsfriend.com

[eyebeat]

"But there is a whole school of therapists that say the number is not in the millions, but zero ? that not even a single case of multiple personalities is real ? the whole concept not Sigmund Freud but junk science."

It's well understood now, that Sigmund Freud was Junk Science.

[Gangleri58]

As someone who has DID I find the comments here very interesting. There is so much emotion and drama wrapped up in whether or not one "believes" in this disorder and I understand where those feelings are coming from. But isn't it curious that it is so difficult to have a sane, civil discussion of it?

I have had all sorts of experiences with the psychiatric and medical community around being diagnosed with DID. The majority of my life I pretty much suffered in silence. DID maybe portrayed as over-the-top behavior as seen on Tara, but in a lot of cases the person is not trying to attract attention. If anything they are trying to be invisible and not attract attention.

When I was originally diagnosed I read everything I could get my hands on to try to understand what was happening to me and at that time all the books (Sybil, When Rabbit Howls, etc.) made the diagnosis sound like a condemnation to the seventh ring of hell. If you were DID you could expect to commit suicide, end up in jail or spend your days talking to the wallpaper in a mental hospital, maybe all three. The possibility of any kind of normal, productive life was denied you. If that is not enough to make you consider self medicating I don't know what would.

Over the years I worked with a variety of mental health professionals, some really good and some really bad. It wasn't until I started advocating for myself and taking responsibility for where I wanted my life to go that I found people to help me who were a good fit for me.

The book that made that even possible for me was The Stranger In The Mirror. It was the very first book on DID that offered any kind of hope that it was possible to get to the other side and lead, dare I say, a productive, happy life. I consider myself lucky to have gotten a chance to work with Dr Marlene Steinberg. Her techniques are 180 degrees away from "brainwashing" and continually put the locus of control firmly back into my hands while showing me all the options available to me.

In closing, I guess I would say to all of the people out there who are trying to deal with DID don't settle for treatment that is not working for you, but also realize you have a lot more control over the outcome than you may think. Advocate for yourself and those close to you
and don't assume that because someone is a mental health professional they have all the answers. There are good and bad people in all professions, even medicine.

[helstopbrainwashing]

For those individuals convinced MPD/DID exists fine For those on the fence and have doubt look into the credentials of these therapist, psychiatrists,,psychologists a family member might be seeing. don't be naive and to trusting

[Patphil]

Comments like the one by actpulsa are what we need to avoid when attempting intelligent discussion regarding the horrendous abuse history for this disorder. To say such things as "faking voluntarily" and "appealing to a hypochondriac" seems to show who really has his head in his rump. If there was any science fiction going on, it was the abusive and humiliating treatment that women like myself were subjected to under doctors like Kluft. I thank God that doctors like McHugh and Piper helped put a stop to it by closing down the MPD units so that I could get my life back. Actpulsa, I'm glad you know someone with MPD, and I'm glad that she's well. But try to intelligently follow these comments if you can - we are discussing the horrific treatment and abuse, disguised as "therapy," that many women, like myself, suffered, women who iinnocently sought therapy for things like problems at home/anxiety/depression. It happened to me - and NOT TO YOU. Unfortunately, I suffered in one of these places - and - Actpulsa, you did not - and so you are clueless as to what went on. So please don't make snide comments - it only adds to the abuse and shows such ignorance. If you believe MPD exists, that's your right, as is the right of others who believe it may not exist. The point - and I will try to make this clear one more time - is that no one, no doctor has the right to traumatize, abuse, drug, frighten, and bully a patient into believing she has a disorder THAT SHE DOES NOT REALLY HAVE.

[helstopbrainwashing]

PSYCHIATRIC MALPRACTICE CLAIM AGAINST RICHARD KLUFT, M.D. Marietti
v. Kluft, Dissociative Disorders Program and Institute of
Pennsylvania Hospital, Ct. of Common Pleas, Phila. Co., Pennsylvania,
No. 9509-02260.[16] A psychiatric malpractice suit against Richard
Kluft, M.D. and the Institute of Pennsylvania Hospital was settled
after two days of trial testimony. The amount of the settlement is
confidential. The suit, brought by one of Richard Kluft's former
patients, alleged that Kluft used suggestive and coercive techniques
which caused Marietti to falsely believe that she was the victim of
childhood sexual abuse by her father. Plaintiffs also allege that the
Institute of Pennsylvania Hospital where Marietti was hospitalized
failed to establish procedures to insure that patients were cared for
in a skilled, competent fashion and to insure proper supervision.

[acptulsa]

Paul McHugh has his head in his rump.

I know a woman with MPD. Let's call her Star. She was raised on an Indian reservation and abused within an inch of her life practically from birth. She doesn't advertise her condition. She covers it up. Under the circumstances, she covers it up magnificently and brilliantly. But then, consider the amount of circuitry one must have upstairs to even have two personalities (in my opinion, a far more realistic number than eight plus--what would be the point of so many?). She is simply a brilliant woman.

So, some patients fake it voluntarily because what could be more appealing to a hypochondriac, and others are bullied into faking it. So, that makes it nonexistent? There's a huge hole in your failed attempt at logic, McHugh. I don't know what science-fiction writer you think had enough imagination to dream up the scenario in the first place, but I do know what I have seen with my own eyes.

Psychiatry seems like such a good idea in theory. Yet in practice, it would appear the human mind is too much for us. Otherwise, we could concentrate on helping people rather than using the mentally ill as political footballs within the psychiatric community...

Pity only psychiatrists, and not psychologists, are required to take the Hippocratic Oath. Pity more psychiatrists aren't adult enough to follow it even when their feelings get in the way. The woman I know can't get help, McHugh, at least not from your 'professional' community. And you share the burden of blame...

[gold_standard]

Keep in mind that all service industries make money by serving more customers. The more demand you can generate, the more money you make. Service providers may sincerely believe in their service, but that does not mean that the need for service is not fabricated.

This can be the case for mental health care or lawn care. Everyone needs more help when their is money to be made.