The Murky History of Multiple Personality Disorder
The story of Sybil and how MPD became a cultural phenomena
The story I have for you today was born as a result of a serendipitous search on Google. I was looking up the cases of Borderline personality disorder and mistakenly typed in MPD instead of the correct acronym BPD. This mistake put forth in front of me an intriguing chart, similar to a mountain of the number of cases of Multiple Personality Disorder over decades in the US.
You will notice that in the period before the 1970s, MPD was rarely diagnosed. In fact, it was believed that there had only been 200 or so cases throughout human history before that point and yet the number of MPD diagnoses in the USA exploded into thousands within the next two decades before returning a mean in the present times.
Why was that?
What happened between the 70s and 90s that Multiple Personality Disorder became so common?
This question led me down a rabbit hole that, for a moment, had me wanting to disassociate (wink wink) with the field of psychology as a whole.
Meet Sybil
Sybil (1973) is a book written by the psychoanalyst Cornelia B. and journalist Flora Schreiber who shares the tale of one of her patients, “Sybil” (pseudo name), as she struggles with 16 different personalities within her, all demanding a different thing from the world around them.
The story goes from describing all sixteen of the personalities of Sybil to her ultimate triumph in integrating all these personalities into one with the help of her therapist, Cornelia. It mentions the abuse Sybil had undergone as a child at the hands of her mother and how she overcame all the odds and became a well-functioning adult. It is the story of struggle, helplessness and ultimate triumph. It has everything you could want from a book. It’s no surprise then that this book was one of the bestsellers of its decades and was adapted into multiple TV shows and a movie.
Suddenly, Multiple Personality Disorder was popular, both among the general public and psychotherapists.
Psychotherapists were fascinated by the success Caroline had received, both fame and money-wise and they wanted a share of the pie for themselves too. Patients, on the other hand, felt more and more connected to Sybil as the story got ever more popular.
The number of people living with MPD was very low in the US in the 1970s. This number was in the thousands in the 1980s and by the 1990s, there were 40,000 people diagnosed with MPD in the US itself.
All of this was because the story of Sybil had ‘liberated’ so many people and allowed them to seek the help they needed. People who had never known they were disassociating were now visiting therapists and being diagnosed with MPD. Sybil’s story became a cultural phenomenon. The idea of multiple people residing within the psyche of one person intrigued writers and led to a lot of fiction content on multiple personality disorder. Even today we see it being a popular trope in web series and OTT platforms. The Abhishek Bachhan starrer “Breathe: Into the Shadows” is a recent example from within India.
But there was just one small, minuscule problem.
The story of Sybil was largely fabricated.
An Inconvenient Relationship
The book had been a game-changer for the therapist and her patient. Their lives had changed quite a lot once the book was released but as time went on, suspicions grew as well.
In 2001, when everyone involved with the book had died, the therapist notes by Caroline were opened up which revealed a very disturbing relationship between the patient and the therapist.
Sybil, originally Shirley, was at one point struggling to pay for her therapy sessions. Caroline came up with a solution because she didn’t want to lose a patient she felt she had been making progress with. Caroline offered a book deal and the profits from it as back payment for the therapy sessions. The offer was simple. Let me heal you and write about you and the money I make from it can be used to pay for these sessions.
Shirley agreed.
The problem was that this made Shirley perform the role of a ‘good patient’ instead of actually sharing what she felt or thought. She didn’t want to disappoint her therapist who had been so kind to her and thus she made up personalities that she knew didn’t exist and allowed Caroline to help her with them.
During the sessions, Caroline would prescribe strong doses of barbiturates to Shirley in an attempt to “reveal” the memories that Shirley had repressed but the problem with this technique is that people say a lot of things when they are under the influence of opioids or barbiturates. People are susceptible to suggestions and if there is an authority figure constantly asking about the abuse you suffered, it is possible that you will start making things up.
The papers revealed in the last 20 years clearly point towards the case being a case of large scale fabrication. The majority of this work was done by Debbie Nathan, a journalist who exposed the malpractice that went on behind the book.
Abuse and Repressed Memories
At the time, MPD was believed to be caused due to childhood abuse from parents. Shirley, thus, was repeatedly told that she must be feeling the things she is because of some horrible childhood abuse. Slowly, Shirley started believing this and ‘generated’ memories that had been ‘repressed’ thus far. Memories of horrible abuse at the hand of her mother.
Abuse that never really happened.
Shirley was not alone in this. MPD was proliferating throughout the US at the time and there were a lot of people being told that their disorder was a result of childhood abuse. Even the DSM had included MPD as a legit diagnosis.
Trials were carried out.
People were jailed.
In a lot of cases, the abuse had never really happened. In such cases, therapists were then made to pay restitution costs for their misdiagnosis. (One of those went up to 2 million USD!!)
The Fallout
As these facts started trickling out, people naturally got suspicious of the diagnosis of MPD. The research into MPD revealed that disassociation was a lot more common than previously thought and MPD was turned into Disassociative Identity Disorder to make the diagnosis more in sync with the research.
Today, MPD or DID, as it is known today, is still considered a valid diagnosis for a disorder but the criteria for a diagnosis are more stringent. Disassociation is a real phenomenon that a lot of people experience. A lot of these experiences can be quite jarring for the people who have them to the point of being a disorder but it is not as common as the media would have you believe.
The number of cases of MPD/DID has again started declining in the last few decades. There are sociologists and psychologists who consider the disorder a fad (although I do not agree with them)
All of this happened because a patient wanted to please her therapist and a therapist did not know how to draw the boundaries between a professional and personal life.
You can read Debbie Nathan’s expose book on this link and the original work by Caroline on this link
And that is it for another week of Psychology with Arjun! Thank you so much for your support. This week has been quite bittersweet for me on the personal front but I hope the rest of the year will lean more towards the sweeter side.
Until next time,
Arjun Gupta
Thank you for this amazing read. I personally also thought that DID was not real in 12std and that childhood abuse cannot be a primary reason for DID. Your mention on feeling dissociation has intrigued me , would like if you could give more insight on it.