Adam Crabtree, Ph.D., is training therapist and lecturer atthe Centre rorTraining in Psychotherap}',TorOlllo, Ontario,Canada.

This articlc is adapted from a paper delivered at the FifthAnniversary Eastern Regional Conference on Abuse andMuhiple Personality: Training in Treatmclll,june 5, 1993.

For reprints write Adam Crabtree, Ph.D., Centre forTrainingin Psychotherapy. 316 Dupont Strect.Toronto, Ontario M5RIV9, Canada.

ABSTRACT

Tlte history oj the diagnosis and trealment oj mul/ij}lp personalityduring the 160-)'('ar j}eriod prrcedingThe Threc Faces of EveJafls into two periods: the Ifwg7letic Jleep jmiod and the dissocia­tion period. Using magnetic sl"/J techniques, early investigatorsUanwi to control switching and trust the palimt Jor guidance inthe treatment. IUcognition oj dissociation as a means of dealingwith traumatic matmal by forming muJtipk psychic centers ltd toall effective pSJchotherapyfor mlillip"personality disorder. The eti­ologiml role oj child aOwe wtU not acknowltd[!d unlil modmltimes. bul stalistiml roidl!tlft' ofsn:ual crimes against ckild,,'" inlatr "ineleenth-centuf)' Fra'lce rna)' j,rovide a fruitful area offutun'research. A smltin)' of histon·wl cases raises (jues/iorl.{ aoout thelmivoeafness of lhe concept of multi/}Ie persOlzalit),. It also reveall·data that have /lot yet been Jull)' acknowledgtd b)' modem dim··clallS.

INTRODUCTION

"The ps)'chiauic manifcstation called multiple personalityhas been extensh'ely discussed. So too havc the unicorn andthe centaur" (Thigpen & Cleckley. 1954, p.I). With thcsewords Doctors Thigpen and Cleckley opened the descrip­tion of their treatment ofa case of multiple personality thatwould soon becomc world famous. "Eve," whom we todayknow as Chris COStncr Sizemorc. was viewed by her thera·pists in 1952 as an example of a very rare condition. \¥henone examines lhe scientific sources cited by Thigpen andCleckley, it is clear that only one im'estigator really made animpression on them: ~'Iorton Prince, in his therap)' of "MissBeauchamp. ~ That they could have thought that treatmentof multiple personalit)' had by and large not gone beyondthe stage ofspeculation about unicorns and centaurs, sho\\'show out oftollch the psychiatric world ofthe 1950's was with

66

a rich therapeutic tradition.Although that deficiency has been somewhat correct­

ed today, with historical essays by Greaves (1980, 1993),Alvarado (I 989, 1991), Bowman (1990), Hacking (l991a,1991b, 1992), Fine (1988), Renn)' (1981,1986), Van derHan (1989), and myself (1985,1986,1992,1993), to mcn­tion some. an overall history of the treatment of multiplepersonality disorder before the modern era - before "Eve"- has yetta be written.

The case of "Eve" was a turning point in the modernhistory ofmultiple personality. Not that the ther-apl' carriedOUl.. by Thigpen and Qcckleywas innovati\'e-it was not. Thetrue importance ofthe case lies in the fact thatthc book andmovic, TIl' ThreeFoces ofEv(', kindled the imagination of thepublic and sparkcd curiosiry aOOm the nature of this mys­tcrious disorder. That was thc beginning of a renewal ofinterest that suddcnly burgeoned into full force in the latc1970s and early 1980s.

The case of "Eve-was the beginning of the modern eraof the stud}' of multiple personality disorder. In this articleI would like to sketch the histo!)' of treatment of multiplepersonalil}' disorder before "Eve.~ with the hope that it "illmake a contribution to a more complete histo!)' yet to bewritten. This is not meant to be a full account---or even alisting---of thc multil..llde ofcases that has occurrcd ovcr the160ycars before 1952. Instcad Iwould like to suggest a frame­work for understanding the cvolution ofour knowledge andtreauncnlof multiplc personalil}'over that period. and relatea few cases that illustrate aspects of that evolution. I wouldalso like to raise some questions that the sllId}' of this histo­ry provokes.

THE ALTERNATE-CONSCIOUSNESS PARADIGM

The date of the first detailed report ora case of multi­ple personalil)' is 1791. An O\'enieworthe treatmcnt ofmul­tiple personality from 1791 to 1952 suggests that therc areI\mdistinct periods. The first lasted from 1791 to 1880. Outingthat time the only coherent theory of multiple personalitywas based on magnetic somnambulism or magnetic sleep.For thaI reason I will call it the magneticslup period. The sec­ond phase. from 1880 to 1952, began with a recognition ofdissociation and the fact that an individual rna}' be dividedinto any number of pS)'chic centers arising as the psycheattempts to deal with traumatic experiences. I will call thissecond period the dissociation period.

We have to go baek 1."\\'0 hundred ycars for the begin-

D1S-WCl\TItl\.\ol\1 \0 1.\Urd.I'lCJ1

ning of this slOry. In 1784 a discovery occurred that not onlymade it possible to recognize and treat multiple personali­ty. it may even have made it possible for multiple personal­ity to exist at all as a syndrome in our society (Crabtree 1985,1993). In the springof1784 the Marquisdc Pu),segur returnedhome to his CSLale ncar Soissons in France. He was freshfrom a series of healing seminars taught in Paris by FranzAnton Mesmer. a famous and conl.ro\'crsial Viennese physi­cian. Using too·tesmer's version of the la}'ing on aCthe handscalled "animal magnetism, M pu)'segur needed onlya few min­utes to cure the toothaches ofthe daughlcrofhis estate man­ager and the wife of his watchman.

Buo)'ed up by this success, he turned 10 a more diffi­cult task. One of his workers. Victor Race. was ill wim con­gestion of the lungs and fever. After moving his hands inthe prescribed mannero"erVictors body for a few minutes,Puysegurwillisurprised to find that the}'oungman fell peace­fully asleep. He soon discovered, howe\'er, that this was nota normal sleep.Victor had slipped illlo an unusual state ofconsciousness: he was awake while asleep,

While in this state Victor showed some peculiar quali­ties. He was extremely suggestible and his personalitychangedso that his usual rather slow ....iued ways were replacedby a remarkable brighUlcss and mcntal agilil)'. NOI only that,he seemed to be able to read Puysegur's thoughts and wasapparenllyable todiagnose his own illnessand those ofotherpeople. He could also predict the course of the disease andprescribe treatment. often with great success.

To top il off, Victor showed strange quirks ofmemor)'.When he came oul of this unusual state of consciousness,he retained absolutely no memory of whal had occurred.Yet when in the new Slate, he had complete knowledge ofboth his waking state and e"cry previous altered state,

Puysegurdecidcd to call this newlydisco\"ered state ~mag­

netic sleep~ (after kanimal magnelism~), He likened it tonaturally occurring sleepwalking or somnambulism, and soalso called it "magnetic somnambulism" (Puysegur 1784).

Magnelic sleep re"ealed a world of mental activity sep­arated from normal awareness. It pointed 10 a second oralternate consciousness that possesses distinct personal qual­ities and a sepamte memory chain, What Puysegur had dis­covered was that human beings are potentially divided andthat mental events can occur in which the nonnal consciousnesshas no parI. This state of dividcd consciousness became thebasis for all modcrn psychotherapies that accept the notionof unconscious mcntal activit)' (Crabtrec, 1993),

In fact, the discovery of magnetic slcep introduced awhole new paradigm for understanding the "";ay the humanpsyche .....orks. Before this time, ifan individual suffered froma mental disturbance 01' disorder. there were onl}' t.....oparadigmsavailable toexplain it. Either the person was innu­enced b}' some eXlernal entilY (as in possession or sorcery)or was suffering from some physical imbalance thai affect­ed the brain or nervous system, The explanation that posil­ed an external intruding cmit)' I c<"'\11 the intrusion paradigm.The approach that supposesan organiccause Jcall Lhe mgun·ic paradigm. With the discO\'ery of a second, alternate con­sciousness, a new explanation suddenly emerged: me dis-

CRABTREE

turbed person was being affected by mental processes out­side his or hcr conscious awareness. This is what I call thea/lmwIHonsciousllt$s paradigm. With this in mind it is easierto understand the (irst encounters with multiple personali­ty and the treatmelll approaches Ihat evolved.

MAGNETIC SLEEP PERIOD

It is intriguing that thc first detailed accoulll of multi­ple personality was publishedjust seven years after Puysegur'sdiscoveryofmagncticslcep.ln 1791 Eberhard Gme1in wroteabout a twent}'-one-}'ear-old Stuugart .....oman who suddenlyexhibited a personality that spoke perfect French and oth­eru'ise beha\'ed in the manner of a Frenchwoman of thetime. In that state she believed herself to be a native ofPariswho had emigrated to Stuttgart because of the FrenchRevolution. She ",,'auld periodically enter mese '"French ~

states and then return to her normal Gennan state, In herFrench state she spoke in elegant. idiomatic French, andwhen she attcmpted 10 speak German it was labored andhampered by a french accent. The two states had no directk.nowledge of each olher, but in her French stale she hadknowledge of all prf'\~ous French stales.

Gmdin immediatcl)'5.:'l.wa parallel between these alter­nating states and magnetic sleep. He trealed me woman·sFrench Slate as the coullIerpan ofmagnetic somnambulism,and her German state as the counterpart of the nonnal wak­ing state. Using magnetic procedures, he discovered thatwhen heemplo)'ed techniques for putting an individual intomagnetic sleep, he was able to bring foru'ard the Frenchstate. When she was in her French state and Gmelin appliedproceduresde\ised to bring someone outofmagneticsleep,the German state would comc foru'ard. In this way he wasable to control the switching,

Anotheraspect ofGmelin 's treatmentwassimilarly basedon experiences with magnetic sleep. J mentioned abo"e thatwhile magnetized, Puysegur's subject was apparently able todiagnose his own illness, predict the course of the disease,and prescribe remedies. Many magnetizers developed animplicit trust in these utterances and looked to the ill indi­vidual as the principle architect of the treatment. Gmelindid the same tbing. in that he asked thc Stuttgart womanhow these "attacks, ~ as he called them, of alternating per­sonality would proceed, She predictcd the onset and end­ing of each attack with accuracy and also predicted whenthe cure would take place, As it turned out, the alternationof personality ceased at lhe time she said it would (Gmelin1791), (Incidentally, the tendency ofmagnetizers to look tothe somnambulistic subject for guidance in treaunelll putsone in mind of the inner-self·helper phenomenon of mod­ern therapy,)

During the period between 1791 and 1880, many casesofdual personality may be found in me literature and prac­titioners ofanimal magnelism ,,'ere vcr)' imerested in Lhem.PU}'segu r himscl fspeculated about the relationship ber....·eenthe state ofartificial somnambulism (or magnetic sleep) andmental disorders in general. He successfully carried out aremarkabl)' sophisticated psychotherapy with a young boy

67DlS'illCl.\TIO\. \01. \1. \0.1. \1m 1911

MULTIPLE PERSONALITY BEFORE "EVE"

afflicted with memory problems and fiLS of rage, and cameto the conclusion that: ~the insane, maniacs, the frenzied.and mad people are simply...disordered somnambulists(Puysegur, 181$, pp. 39-40)." Similarly, in 1846 JohnEIliOlSOn of Universil)' College Hospital in London stated:~Mesmerismproduces no phenomenon that does not occurin nervous affections without mesmerisrn ....1t does produceall the most wonderful phenomena of all affcctions...ofthenervous system {Elliolson, 1846, p. 157)." Ofcourse, the nat­urally occurring disorder most easily related to magneticsleep was multiple personality disorder.

IlShould be nOled that while those steeped in the mag·netic tradition were busy drawing fruitful }><'\rallels betweenmagnetic sleep and multiple personality (e.g., Dewar (1823)and Mayo (1845), some who reported cases during this peri­od did not make the connection, but were content to ven­ture speculations about physiological causes, while altempt­ing little treatment (e.g.. Plumer (1860) andJackson (1869).

In 1842 the Manchester physician James Braid reject­ed certain phcnomena conncctcd with animal magnetismand renamed it "hypnotism." Fram 1860 on Braid's nomen­clature enjoyed wide acceptance in France, and when in 1876Eugene Azam wrate about his newly discovered case ofdualpersonality, he couched his explanation in terms of hyp­notic states. He observed "Felida X" for three decades anddescribed her ty,'oalternatingstates in many articles and twomajor works (Azam. 1887, 1893). Azam provided no treat­mentfor Fclida, but noted that over the years, her "secondarystate," which had memories ofboth slates, gradually gainedthe upper hand, so that the "primary' state~ showed itselfonly rarel}'. As the magnetizers before him, Azam dcscribedH:lida's t\Oo·o states as the counterparts of the waking slateand the state of artificial somnambulism. His work provid­ed respectability among conventional medical colleaguesfor born hypnotism and the study of multiple personalitydisorder.

\Vhile treatment by magnetic sleep did enjoy some suc­cess during this first period (witness the treatment of theyoung "Estellc" by Dr. Charles Antoine Despine (1838; alsoFine, 1988), a fully satisfactory treatment approach was notyet in place. Part of the problem was an imperfection in thetheory. While the concept ofan alternate consciousness thatcould be reached in magnetic slecp was a crucial step for­ward. it was lacking in two ways. First. although it \'ery nice-­Iy explained dual personality, it could not easily account formulJiph personalities. Second, it did not specify a precipi­tating cause of the disorder.

DISSOCIATION PERJOD

This brings us to the second great period in the treat­ment of multiple personality disorder before "Eve": the dis­sociation period. This period is characterized by two insights.The first is an awareness ofdissociation and the fact that thepsyche is capable of partitioning offsegments ofexperience.The second is the discovery that dissociation often occursin response to trauma. and that in the process any numberof psychic centers may be formed. These insights provided

68

the basis for understanding how it is possible to have mull;_ph personalities and for pinpointing what causes the for­mation of the personalities.

Although it was PierreJanet who, in thc 1880's, devel­oped the notion of dissociation as a mature psrchologicalconcept, a....'arenessofdissociative phenomena preceded himby manydccadcs. The concept ofalienated parts oftlle psy­che ""'as alluded to by several magnetizers. August ROllllier(1817) and Friedrich Fischer (1859) noted in somc som­nambulists a dissociated voice phenomenon that they iden­tified as an external projection ofa part ofthc psyche. Friedrichvon Strombeck's somnambulist 'Julie" hallucinated a help­ful, advising figure whom she came to recognize as an exter­nalized part of herself (Strombeck. 1814). Then there wasthe bizarre case reported byWilliamJames (1889) ofa womanwhose right arm became completely split off from her ordi­nary consciousness and functioned as a kindly guardian tothe rest ofthe body. These and many other cases hinted thatparts of the psyche could be separated offand experiencedas alien to the normal self.

Thcn in the early 1880s me treatment ofa case ofmalemultiple pcrsonality was published that opcncd new vistas.Louis Vivc was twenty-two years old when he came undertreatment by Drs. Bourru and Bural, professors at the med­ical school of Rochefort, France. Louis exhibited six distinctpersonalities, each with its own set of muscle contractionsand anesthesias, and each with its individual group ofmem­ories. Each personalitywas tied to a particular period ofLouis'slife and held memories only for that period. except for onepersonalitywhose memories overlapped with fOUfofthe oth­ers. Pcrsonality I wasvlolent and unruly. Personalities 2 and3 were quiet and well educatcd. Personality 4 was shy, child­like in speech, and had the skill of a tailor but little educa­tion. Pcrsonality 5 was obedicnt, boyish and well cducated.Personality 6 was the best balanced of them all, with a decentcharacter, moderate education, good physical strength, anda memory for nearly all the events of Louis's life.

Bourru and Burat, who described their treatmcnt in alandmark book called Variations de fa personnalite (1888), usedhypnotic regression to return Louis to the various periodsof his past. In this way they were able to tie specific person­alities tospedfic memories. Then they could control switch­ing of personalities by inducing the memories of the dif­ferent time periods. They considered this discO\'Cry to be ofgreat importance, because it allo",,'ed retrieval and restora­tion of the blocked memories that caused the formation ofeach personality.

Bourru and Burat called Louis Vivc's states "variationsof personality," seeing them as successive trance--Iike states.Their view was influenced by the great theornt of hypno­tism, Hippolyte Bernheim, who noted that hypnotic stateswere merely special manifestations ofaltered states that peo­ple go into all the time. In a framework that makes one thinkofmodern ideas about state dependent memory. BernheimS<'lid that these various states become tied to memories ofthe specific events that occurred in those states. Bourru andBurot viewed Louis VivC's personalities as successive hyp­noid states of one individual. successive variations of one

Dl\~OClmO\.\01 \1 \0.1. \Iri 1991

:. CRABTREE;L-4•.

personality. . .Pierre Janet went a StCP beyond. Workmg with hyster­

ics he developed the COllCept ofMdissocialion,.. dcmonstrdlingthat some individuals can form several psychic centers, eachofwhich carries its own pcrsonallraitsand mayiniliatc actionsGanet 1887). Janet called these dissociated centers M per_sonaJities" and considered them not merely successive vari­ations of the personality. as posited by Bourru and Burot,but psychic centers that coexist, each thinking and reactingsimultaneously ....ith the others. Janet's work concenrratedon hysterics, where the personalities coexist and operate onsubconscious levels, only occasionally taking o\'er from thenormal consciousness in hypnosis or automatic writing. Hediscovered that the subconscious personalities of the hys­teric were constructed in response to traumatic events thatfonned subconscious fixed ideas that became the seeds ofthe new personalities. As it turned out, Janet's S)'Stem wasequally effective for underslanding and treating multiplepersonalitydisorder,in which the various personalities spon­taneously emerge LO illleract with the world.

With Janet's work. the potentials of the alternate-con­sciousness paradigm .....ere fully revealed. His ahernatc-con­sciousness psychotherapy served as the basis for the efIec­th'e diagnosis and treatment of a variety of pS)'chologicaldisorders. From here on the dissociation/trauma model ofpsychotherapy is established and begins toshowup in descrip­tions of cases of multiple personalily.

Let me add in passing that the momelllum orthe alter­nate-consciousness paradigm, having provided an effectiveframework for explai ning functional mental disorders in gen­eral and dissociative disorders in particular, lost ground withthe rise ofpsychoanalysis. Valuable insights inlO dissociationand therapeutic integration were acknowledged by Breuerbut for the most part ignored by Freud. For that reason, inlhe early decades psychoanalysIS were not very interested inor adeptat treating mult..iple personalitydisorder, a fact poinl­ed out both by contemporaries (e.g. Hart 1926) and recentwriters (e.g., Bliss 1986). I have taken up lhis issue at morelength elsewhere (Crabtree, 1986, in press).

TREATMENT

Returning now to treatment of multiple personality, astudy of cases reported in the dissociation period revealsthat, as in the magnetic sleep period, some cases were mere­lyobselVed, with noattempt to provide treatment-forexam­pIe FelidaX and Molly Fancher the "Brooklyn Enigma~ (Dailey,1894). Ho.....ever, many did aHempt pS)·chol.herap)'. It is notpossible to do justice to these interesting cases. It will haveto suffice to mention two: the "Miss Beauchamp" case ofMorton Prince and the "Doris Fischer" case of WalterFranklin Prince.

Morton Prince, founding editor of the Journal ojAbnormal Psychology, through his own .....ork and articles pub­lished in hisjoumal, con tributed greatl)' to our understandingof the nature ofdissociation. His "Miss Beauchamp" case ofmultiple personality was first mentioned in the Proc«dingsoJtheSocietyJor Psychical &search in 1901 and then published

in book form in 1905 as The Dissociation oja Personality. "MissBeauchamp~ (real name Clara Norton Fowler) had threeprincipal personalities. There was BI, called the "saint,"whowas meek, religious, and dependent. Then there was BIY.called the "woman~and the "realist, ~ who was strong, quickto anger, and self relialll. The third personality was "Sail)',"mischievous, breezy, and irresponsible. Sally \\Ias alwa)'Scoconscious with the other personalities and, according toPrince, ....'aS made up offragments repressed from the mainconsciousness dllringchildhood. Prince considered Sally tobe a subconscious personalit)'present from infancy who onlytook executive charge of the lxxly much later in life. BI, thesaint, wasformed 10 ~save" her mother from illnessand unhap­piness. BIY embodied personal qualities that were unac­ceptable to 81 and emerged for the first time in the courseof therapy.

Prince's treatment plan "'as simple: get 81 and BIY tomerge, and then force Sally back into the subconscious whereshe belonged. Thiswould result in the ~real"MissBeauchampand a completely unified life. By his own standards Prince....'aSsuccessful in his treatment and, writing more than [wen­ty years latcr, claimed that the result was pemlanent andthat Miss Beauchamp, like the princess in the fairy tale, "'as

married and ~lived happilyel'erafterward" (~1. Prince, 1929,p.208).

Waller Franklin Prince (no relation to Morton Prince)published a summaryaccoun[ofhis therapywith Doris Fischert.....elve years afler Monon Prince's case study, and he pub­lished it in Morton Prince'sjournal (W. F. Prince, 1917).This article was preceded by a mammoth thirteen-hundredpage treatise on Doris and her treatment (Prince & Hyslop1915) and followed b)' another one thousand pages of psy­chical cxperimenlSdone in connection with her case (H)'slop,1917; W. F. Prince, 1923). This makes Doris Fischer b)' farthe most massively documented multiple personality to date.

Doris had live pcrsonalities in all. The first was RealDoris, tile "primal}' personality~ who had disappeared for)'ears at a time bccause of traumatic shocks. Real Doris wasamiable and self-reliant. The second was Sick Doris, a per­sonalitywithout afTcct or initiative. The third personalitywasMargaret, a lively, mischievous sprite, somewhat reminiscentof Morton Princc's Sall),. Like Sally, Margaret was cocon­scious with the other personalities. The fourth, Sleeping RealDoris, was actuall)' a som nambulistic personalitywhoappearedonly when Doris was asleep. The most puzzling personalitywas called Sleeping Margaret. She was not. in fact, Margaretasleep, but a pcrsonalitywhose function was to protect Dorisagainst harm and aid Prince in the conduct of his therapy(in the tradition ofthe inner healerof magnetic practitionersand the inner-self-helper of modem times). Interestingly,Sleeping Margaret also claimed to be a spirit and not a partof Doris (Prince & Hyslop, 1915, p. 14).

Doris had been encouraged in her ability to dissociateby her mother who loved to play what she called the "sup-­posing"game "ith herdaughter. The hours theyspent togeth­er in shared fantasy, creating imagined adventures, height­ened what seemed to be an unusual ability to dissociate.

The relationship between multiple personality disor-

69DI';.'iOCl\TIO\,' Ii. \1. \0 1. \t.riIl~

~IULTIPLE PERSO!\'ALITY BEFORE "EVE"

derand childhood trauma isset outquilccJcarly in thee-ourseof Doris's treatment. Doris's father was a selfish and \iolentman who had a severe problem with alcohol. The first for­malion ofan aher look place as a result of "iolcnce thaI heperpetrated Oil the threc-year-old Doris. His violence wasextremeandcolilinllcd until Doriswas (wenty-two. Theques­lion of possible sexual abuse by the father cannot be con­firmed or disconfirmed from the information given. Dorisdid, howel-'cr, have a powerful aversion to being touched byanyone, even her belm'cd mother.

Walter Fmnklin Prince's approach to treatment was rem­iniscent of thaI of Morton Prince, with a few original twistsof his own. Doris actually lived with Prince and his wife formost aCthe duration of the treallnent, and Prince was ableLa make use of the unique therapeutic opponunities thatarose. It became clear early on that hypnotism was COll­

traindicated because of the perturbation it caused and, as itturned out, it was not necessary. Prince was able to usc RealDoris's periods ofsleep to implant suggestions to quiet herfears and induce helpful dreams. \Vith the cooperation ofSleepingMargaret, Prince took measures that weakened SickDoris and Margaret, while strengthening Real Doris. As SickDoris and Margaret faded, they also regressed in age andlost more and more of their memories, which were trans­ferred to Real Doris. As treatmem progressed, SleepingMargaret began to say that she ....'as not needed as much anymore and began to be absent for periods, apparently spend­ing more and more time on ~thcother side ~ (the spirit world),where she claimed to be from. Finally, Real Doris attainedcontinual consciousness, and the other personalities passedfrom sight, except for Sleeping ~·targaret,who would occa­sionally put in an appearance fora few minutes in thee\'eningpan of sleep.

SEXUAL ABUSE

Before closing this rapid sketch of the treatment ofmultiple personality before Eve. I would like to refer to acase that more directly raises the issue of sexual abuse. In1926 the American psychologist Henry Herbert Goddardpublished a description oftreatment carriedout with a BemiceR., whom he diagnosed as having multiple personality(Goddard, 1926). Goddard's plan "'as 10 use hypnotism 1.0

try to fuse her two principal personalities. His approach wasto put her in the trance in OIlC personality and awaken herin the other. In the process Goddard also did a great dealof abreactive work with traumatic memories. Among themwere Bcmice's dear and persistent recollections of incestwith her father. Goddard treated those memories as hallu­cinations, giving as his reason the fact that the incestuousacts purportedly happencd al age fourteen but had not beenmentioned until she was nineteen and a half. This indicatesthat Goddard was nOI really\'o'ell acquainted wiUlthe nalUreofdissociation, and thai he wassluck within widely held con­tcmporary notions of hysterical sexual hallucination.

Goddard was not the first to allude to sexual abuse inthe treatment of multiple personality disorder (e.g., Dewar,1823). Ne\'ertheless. uleconnection between childhood ~x-

ual abuse and multiple personality was not dead}' made untilthe modern era. Even so, certain preliminary speculationsmay be offered regarding the role ofchildhood sexual abusein thc formation of multiple personality disorder in earlytimes. For that Ict us return to the era of PierrcJanet.

II is impossible to know at this distance in time howmany of the cases of hysteria trealed by Janet or what por­tion of the hundrcdsofCharcot's hysterics at theSalpetrierehospital were in faci multiples. In reading the case lilcra­tureone suspects that MPD was fairly common in this patientpopulation. But, for lack of informalion ill the case materi­al. if there issomeslrong relationship bet.....een l\'IJ>Dandsex­ual abuse, corroborating evidence will have to be obtainedfrom another quarter.

That evidencc may in fact be amilable. The data 10

which I refcl' arc contemporary statistics about individualscharged with sexual crimes against children. Onicial statis­tics of the government of France show that between 1860and 1890 there were 22.000 sexual crimes committed againstchildren less than thirteen rears old-this through a peri­od when thc population of France \'o'as around 37,000,000(Thoinot. 1911; see also Tal'dieu, 1878). Il seems to me thatwhen one considers lhat Ulesc statistics rcfer toactual crimesbrought to trial at a time when there was little legal sensi­tivity to children, one can cxtrapolate a very high incidenceof childhood sexual abuse.

Could the apparently high incidence ofchildhood sex­ual abuse in France account for the large numbers of hys­lerics a\'ailable for study and obscn'ation during tllis peri­od? And could this also indicate a high incidence of l\IPD?These questions await a much more thorough study. Sucha snldy might compare French statistics to those ofEngland,where the incidence of hysleria in the same period seemsmuch lower (as indicated, for example, by F.W.H. Myers'scomment dil'ected to Janet (Myers. 1903) that in Englandhe could find no h)'sterics to study and so had to concen­trate on dissociativc phenomena produced by normal indi·viduals in automatic writing).

QU£STIONS ARISING

If one looks closely al accounts of multiple personali­ty over the pasl twO centuries. certain questions come tomind. They call be summed up under one heading: is mul­tiple personalily a univocal concept?

In 1899 Theodore Hyslop wrote an article on ~double

consciousnesswin which he distinguishedscven types: I) casesoccurring in early life and preceded by night terrors, som­nambulism, or both; 2) cases in which the abnonnal state ispreceded by profound sleep. and in which the normal stateis only again reached afler prolonged sleep; 3) cases result·ing from accident injury or disease: 4) epileptiform cases;5) insane cases; 6) hysterical anaesthetic cases: 7) casesim'olv­ing P?ssession. Hyslop's calegorization seems to me to con­form very well to the data, and I would like to usc it as aframework for discussion.

Types 1 and 6 combined seem to very \\'ell cover casesthai are now considered to be typical of multiple personal-

70

itvdisorder. Type 2 is represented by the fumousMary Reynoldsc.'t.se (Mitchilt 1816. Plulller 1860). Here the lirst onset waspreceded bya severe convulsion and a long period ofuncon­sciousness; later shifts between the two states occurred afterlong periods of sleep from which she could not be awak­ened. T}'pe 3 is exemplified b}' the case of I-Ianna describedbr Boris Sidis (1905). In this instance lhc ahcration beganwith a blow on the head and led to a secondary personalitythat was ~dcpri"cd of mosl of his leamed knowledge" andhad to be reeducated in perception, speaking, eating. andsocial interaction. After a while the secondary personality.....asablc to function competently.The two pcrsonalilieswercevelltually merged. Other c~s of lIlis type were describedb, McConnack (1883). Daile}' (1894), and Gilbert (1902).A Type" case is described by Trowbridge (1891). The caseof SOrgei (Feuerbach, 1846) illusl1.ues Type 5. The "DorisFLSCher~ case is an cxamplc ofTrpe 7.

H)'Slop's distinction of types is based on !.he presem­iug symptoms. Evcn though the literature docs not containenough infonnation to reach reliable conclusionsabout caus­es. a careful reading of the old cases of types 1-6 makes itdifficult to beliC\'e that we are dealing"'':ith a singlesyndrome.

Type 7 cases create further puzzlement. For purposesof this discussion I would like to expand this categol1' to

include cases involving ostensible past-I ife personalities. Andat this point we rCturn to our point ofdepanure-to ~Eve."

In her recent book, A Mind of M)' Own (1989), ChrisSizemore relates thc story of her final healing from mulli­pie personality disorder under the guidance of Dr. TonyTsitos. Since the integration of her twenty-four personali­ties, she haswriucn two books (Sizemore. 1977, 1989), il1\'es­tigated the role ofart in the healing process. promoted thecause of therapy by speaking on behalfof the Mental HealthAssociation, and been Ihc recipient ofa number ofawards.In A Mind afM)' Own she makes thissl.<trtlingstatemcm: "Despiteauthorities' claims LO the cOlllrary, my former alters werenot fragmenLS of my bil'lh personality. They were entities,whole in their own rights. who coexisled with my birth per­sonalitybcfore Iwas born. Theywere not me, but lheyremainintrinsically relaled to whal il means to be me (p. 21 I)."'A/hat are these entities? Past-life personalities.

Chris Sizemore is not unique among multiples inreponing that they experience some of their alters as past­life personalities. A number of therapists have informed meof this phenomenon in their patients. When these data arecombined with reported instances of ostensible possessionin connection with multiple personality disorder (seeCrabtree, 1992), we are confronted with a great man)' Type7 cases. This information seems to require more attentionthan it has so far received in clinical literature.

Howoften have thascofuswho read the old cases wishedthat the authors had asked more, gone deeper. given lIsgreaterdetail. On the one hand, it simply did not occur to manyinvestigators to probe into areas that we now consider impor­tant. On the other, some exercised a reOexh'e censorship.so that information presented by the patient was deliber­ately omitted on !.he basis of the author's prejudgmenL Anexample ofthis is Goddard whose patient consistentlyspokeof incest with her father. He did nOt even mention that fuct

CRABTREE

in his bookabollt the case (Goddard, 1927).and heacknowl­edged it in a dismissive way in his technical paper (Goddard,1926). It is important that we do not repeat the mistakes ofpast researchers by omitting to mention material broughtforwa.rd b}' patients because .....c prejudge iLSsignificance.Todaythis is perhaps most likely to occur in regard to Type 7 phe­nomena.

ChrisSizcmore remarks (personal communication. 1993)that there has been no response from clinicians nor re\ie\\"­ers to her Sl...'ltement that she experienced her personalitiesas past-life personalities. That is. to sa)' the least, surprising.Whether one believes in lhe reality of past-life personalitiesor not, her report must be ....·orthy of some kind ofacknowl­edgement. Wh)' ""ould her description be ignored?

In 1991 Colin Ross drew our attention to a phe­nomenon he caIled the ~culturaldissociation barrier," erect­ed b)' a societ)'or culture to keep unacceptable ~part selves~

from access by the ~execulh'eself. ~ Ross identifies three dis­S(>ciated part selves in our culture at large: 1. the receiv­er/ transmitter for eXlrasensoryand paranormal experiences,2. programs responsible for running the physical body. and3. the deep intuitive consciousness. Type 7 ffiultiplicit)'expe­riences clearly fall under dissociatcd part self I. I believe thatclinicians working ....'ith multiple personality disordcr haveto make a special effort to refrain from the cultural dissoci­ation that is going on all around them. That effort iJl\'olvesacknowledging reported experiences that are not broadlyaccepted by our society.

CONCLUSION

TreatmelH of multiple personality disorder before"E\'e" took place in the COI1teXI of a remarkably sophisticat­ed psychothcrapclIlic tradition arising from the aItcrnate­consciousness paradigm. Far from pursuing lhe psycholog­ical equivalents of unicorns and cenl.<1.urs, as Thigpen andCleckley thought, lhcrapisLSofthat I50-year period laid solidgroundwork for the rcnewed and deepened knowledge ofmultiple personality that we enjoy today.

Allhough modern clinical practice tends to view mul­tiple personality disorder as a single syndrome. a study ofthe history of the past two hundred years and a scrutiny ofthe data of the consulting room today raises questions aboutthat perception. Those questions may be disconcerting forclinicians, since lhcy thrcaten lO introduce further compli­cations intoan alrcadycomplcx situation. Nevertheless, treat­ment of multiple personality will profit from an)' investiga­tion that truly rcspects the data. •

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