Iatrogenesis – Sybil Exposed

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There is a body of psychiatrists who believe that DID is actually manufactured, whether intentionally or unintentionally, by the therapist. This phenomenon, known as iatrogenesis, sheds considerable doubt upon the existence of DID. It is speculated that some very famous cases of MPD/DID have been created by therapists. Debbie Nathan’s work, Sybil Exposed, explored the likelihood that Shirley Ardell Mason’s psychiatrist, Dr. Connie Wilbur, had induced false memories in Mason in order to create a best-selling “non-fiction” about multiple personality disorder, as it was then known.

Shirley Ardell Mason (Sybil)
Sally Fields made Mason (Sybil) a household name when she starred in the 1978 mini-series “Sybil.” Her portrayal of the many different alters that supposedly shared one body, as well as the supposedly non-fiction publication entitled “Sybil” became the “bible” for people who believed they suffered from MPD. Fields displayed a range of colorful characters including an infant, a child whose role was to accept physical and sexual abuse, a religious alter, an alter who replaced Sybil’s grandmother upon her death and numerous others. Patients who believed they possessed MPD diligently mimicked Fields and displayed extremely unique alters.

Dr Connie Wilbur, Mason’s psychiatrist has been accused of manufacturing not only Mason’s personas, but also her childhood trauma at her mother’s hands. Wilbur informed Mason she had no interest in treating Mason unless she possessed the disorder. Accordingly Mason informed the good doctor she did indeed possess several personalities, all of which were the result of childhood abuse.

Debbie Nathan, author of Sybil Exposed, strongly believes Wilbur and Mason invented the account, although their motives were very different: Sybil wished to retain Wilbur’s services and Wilbur was on a shirleyquest to become the first recognized American psychiatrist in psychiatric publications to treat a full-blown multiple. Wilbur encouraged her client to read about MPD. Moreover, Wilbur fed Mason with drugs that were prescribed for women during that era: tranquilizers for the sexually frustrated housewife. Dexenol, also known as speed, was another common prescribed medication.Wilbur used the drugs so Mason could “remember” her childhood trauma.

Flora Schreiber, the author of Sybil, had her own agenda. She was previously published with a number of non-fiction and fictions works but she hadn’t experienced financial success. Schreiber was in need of a literary breakthrough, one that would put her name on the map and earn her an income. It has been documented that Schreiber was unhappy about editing the book. She doubted Wilbur’s motives. At times Schreiber advised Wilbur that embellishing Mason’s childhood and changing stories wasn’t ethical. Wilbur’s response was that she would replace Shreiber if she refused to edit the account. Schreiber felt she had no choice but to acquiesce.

Wilbur went so far as to administer ECT, electro-convulsive therapy on Mason. Added to this, Wilbur gave Mason pentathol, an old drug from WWII that was used to help soldiers recover from shell-shock. At the time it was believed that pentathol was a type of truth serum that forced people to tell the truth but in reality the drug enables the user to experience fanasies.

Around this time Wilbur adopted the role of mother to Mason: she paid her rent, bought her clothes and made it clear she disliked Mattie Mason, Sybil’s maligned mother. Mason’s writings included a passage that stated: I idealize and idolize you. I believe whatever you say must be right. Wilbur and Mason decided to write a non-fiction book about Mason’s experiences. The author, Flora Schreiber suggested the book would be more interesting if the multitude of child alters Mason possessed were adults, so many child alters became adults in the book.

The Women’s Movement
In the 1970s, the women’s movement was at its peak. Many women wrote to Schreiber stating they had also experienced sexual and emotional abuse as children. Most women stated it was males in their histories, not a puzzling fact, considering the backlash against the predominantly patriarchal society. The diagnosis of MPD sky-rockted. women with eating disorders or anxiety disorders were now diagnosed as multiples. The ridiculous phenomenon of supposed Satanic cults abusing children became popular. In particular daycare centres became popular targets and innocent daycare workers spent time in jail for crimes they had never committed. This type of phenomenon is the result of what Nathan calls “junk science.”

Satanic Cults and Child Abuse
Finally too many women accused their elderly parents of Satanic abuse and the social tides began to turn away from the unlikely accusations. Along with the cynicism towards Satanic cults came a healthy skepticism toward the plethora of MPD diagnoses. The condition is still included in the DSM-5 but it is now listed as DID. The significant difference between the two is the belief that DID isn’t comprised of alters but rather the client is a victim of iatrogonesis who needs to be taught healthy ways to handle stress and trauma rather than relying upon the false belief that alters are needed to perform this function..The client isn’t a fake; rather is the result of unhealthy hypnosis. Quite like what happened to Shirley Ardell Mason.

The History of Multiple Personality Disorder

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MPD has been diagnosed very early in history. Some professionals believe that it was first “described” in the images of “shamans changed into animal forms” on cave walls during the Paleolithic Era. Throughout recorded history cases of demonic possession have been reported that many experts now believe are cases of of multiple personality. At that time, people interpreted these odd behaviours as best as they were able for such a primitive era.

Eberhardt Gmelin
Millenia later, in the 1800s, American psychiatrists began diagnosing what appeared to be cases of multiplicity. Eberhardt Gmelin’s 1791 account of “exchanged personality” is erroneously credited as being the first documented case of multiple personality.

Paracelsus 1646
However, in 1646, Paracelsus wrote of a woman who had “amnesia about an alternate personality who stole her money.” The case involved a 20-year-old woman living in Stuttgart who began speaking perfect bifurFrench and speaking German with a French accent. Tellingly, this case took place the year the French Revolution began. During this time many French aristocrats left France and fled to Stuttgart for safety. When she was the “French Woman” she remembered everything she did while she was the “German Woman”, but while she was the “German Woman” she denied knowing anything of the “French Woman“. Gmelin could cause the personalities to switch with a movement of his hand. That sounds like therapist manipulation to me, and this is the grey area surrounding DID.

Benjamin Rush
Benjamin Rush, the “Father of American Psychiatry“, and chief surgeon of the Continental Army wrote the first text “Medical Inquiries and Observations Upon Diseases of the Mind.”  Rush included the concept of MPD and theorized the doubling of consciousness related to a disconnection between the two hemispheres of the brain.

The Strange Case of Mary Reynolds
Dr. Samuel Latham Mitchel
 in 1860, publiMary-Reynoldsshed an account entitled “The Strange Case of Mary Reynolds” in “Harper’s New Monthly Magazine“. Reynolds was born in England in 1785 and moved to Pennsylvania. The Reynolds household was strongly religious. During her childhood Reynolds was very melancholy and spent significant time in religious devotions. At 19, she became blind and deaf for six weeks, in what might have been a form of somatic disorder. Three months later she suddenly forgot things she had learned. Eventually she learned how to read and write although her penmanship was crude. Mitchel described new nature her as “buoyant, witty, fond of company and a lover of nature”. After five weeks, she suddenly returned to her prior self. The alter egos switched between each other for sixteen years Reynold reached her mid thirties, when she remained in her “buoyant, witty” ego until she died at 61.

Estelle 1840
Estelle was an 11-year-old Swiss girl in 1840 who seemed to have paralysis and was extremely sensitive brain-0to touch. It was believed that she developed a second personality who could walk and play. Tellingly, this alter could not tolerate her mother’s presence.  Her paralysis and sensitivity was probably a form of somatoform disorder and was embodied in an alter. It was quite probable that the mother was her abuser and the sensitivity to touch was a result of painful abuse from her parent. The child was supposedly cured the through various treatment methods, some of which are currently utilized in the psychiatric community.

Eugene Azam 1843
In the late 19th century, Eugene Azam, a surgeon and hypnotist, published reports of Felida X, an alleged case of multiple personality. Born in 1843, Felida X’s father died in her infancy. Felida X experienced a difficult childhood, meaning she was very abused. She exhibited three different personalities, The second personality manifested when Felida was 13 years old. Switching happened every day after a strong pain in the temple and a solid sleep for three minutes. The switching happened every 25 to 30 days and lasted a few hours. The third personality exhibited anxiety attacks and hallucinations. Eventually the first personality became pregnant and the second personality took responsibility for it.

Pierre Janet early 20th century
In the late19th century and early 20th century, Pierre Janet described the five cases of Leonie, Lucie, Rose, Marie and Marceline. Leonie had three or more personality states including a child named Nichette. Lucie, had three personality states with an alter named Adrienne who experienced flashbacks of a traumatic childhood event. Rose suffered from somnambulistic states. Sometimes she was paralyzed and sometimes she could walk. Often these symptoms are clustered under somatoform disorder, making this DID diagnosis a case of co-morbidity.

Mortin Prince 1906
Mortin Prince published the Christine Beauchamp case in “The Dissociation of a Personality“. Beauchamp allegedly had three personality states including one calling herself Sally who was childlike. 3facesofeveSally differed greatly from an alter called a very regressed alter called Idiot. Eventually MPD was declared “extinct” by E. Stengel in 1943. Months later Prince released a landmark paper of “The Journal of Abnormal Psychology” which “was the most quoted reference in the history of the illness“. After this documentation however no mentioned was made of MPD in the journal until Prince’s published famous account of Christine Costner Sizemore. In 1957 the case was made into a film starring Joanne Woodward playing the title role in The Three Faces of Eve. It was presented as extremely rare and bizarre although since then psychiatric communities who accept the DID diagnosis state it is not as rare as once thought.

Dr. Cornelia Wilbur 1978
Most people are familiar with the famous case of “Sybil an alias for Shirley Ardell Mason, a woman Wilbur claimed possessed 16 personalities as a result of a traumatic and highly abusive childhood.Mason’s story Sybilfirst arrived as a best-selling book that was” ghost-written” by author Flora Shcreiber who told the story in the third person(s). It sold in the millions. Not long after the book’s release, Hollywood actress Sally Fields starred in the movie Sybil, along with Joanne Woodward as her psychiatrist.

The text has come under fire in recent years, significantly weakening the argument for MPD/DID. An author named Debbie Natham, released “Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case,” an account that disputes much of the information. She claims that Wilbur was a fraud and intentionally invented several of Mason’s so-called personalities using the hypnotic drug sodium pentothal. Wilbur’s method was to suggest abusive trauma to Mason, who agreed with Wilbur’s account. Medical records do not support Sally_Field_1971Wilbur’s claims about Mason’s physical and sexual abuse at her mother’s hands. Mason herself once asked a different psychiatrist who temporarily treated while Wilbur was away, which alter he would like her to portray, stating the name of an alter Wilbur especially preferred. Mason also admitted that if she didn’t agree she had multiplicity Wilbur wouldn’t treat her. Wilbur herself admitted that if she didn’t use the term multiple personality disorder in the account, her publisher would not publish the text.

H. Ellenberger published a paper entitled “The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry” that focused on multiple-personalities-paulo-zerbatomultiple personality disorder. Throughout the 1970s, a number of clinicians worked toward defining and establishing the legitimacy of the condition. Margareta Bowers along with six other contributors published “Therapy of Multiple Personality” in 1971. “Therapy of Multiple Personality” outlines rules for treating multiple personalities. Several psychiatrists in the 1970s and 1980s have written notable accounts of case studies and treatment methodology.

Cecil Adams 2003  The Straight Dope
Adams writes for an online publications called The Straight Dope, a site that is self-described as “fighting ignorance since 1973.” Adams answered a writer about the phenomenon of multiple personality disorder. In his view, the disorder resulted from nothing more than media influences, misguided clinical practices and mass hysteriaAdams emphasized that the disorder was manufactured  “under the influence of hypnosis and other techniques,” whereby patients were coaxed into “uncovering bloodcurdling stories of child abuse” or satanic cults. The whole satanic cult-thing has never appealed to me as especially legitimate. If so many of these abusive cults exist why aren’t more people being charged, arrested and thrown in prison for their abuse of children and youth?

The disagreement over the definition of personality also complicates the diagnosis of DID. Supposedly in DID is open-uri20120817-11927-1fr97jaalters are independent of one another, but this is difficult to prove. Speech and behavior can be faked. In support of DID brain-wave patterns may vary although some doctors insist this is not due to a genuine personality switch.  In a study of DID, patients and their alters, different sets of words. When different personality states were asked whether a word was recognized, if it supposedly belonged to a different alter, patients hesitated. The implication was —I’m not supposed to know this. Were those alters truly independent? Obviously not.

My personal feeling is that it may be possible for a single ego not to form due to repetitive, extreme trauma but this is extremely rare. I believe the many currently diagnosed cases are false. DID is just one of those “disorders” that is nigh impossible to prove. It appears to be extremely difficult for therapists to produce legitimate, longitudinal studies about DID, unlike almost all other disorders and illnesses listed in the DSM-5. I doubt that any current clinicians go so far as to use sodium pentothal with their patients but I do believe there is room for error and the use of false memory syndrome. I don’t believe most patients or clinicians do this on purpose. Very few people gain “fame and fortune from this disorder anymore, ergo the extrinsic rewards are nil. There may be intrinsic rewards for the patient but none thus far have been documented. Unlike Wilbur’s deliberate, false account of Mason, I believe it is misguided belief in an interesting, unique phenomenon.