BBC HomeExplore the BBC
This page has been archived and is no longer updated. Find out more about page archiving.

24 September 2014
Science & Nature: TV & Radio Follow-upScience & Nature
Science & Nature: TV and Radio Follow-up

BBC Homepage

In TV & Radio
follow-up
:


Contact Us

You are here: BBC > Science & Nature > TV & Radio Follow-up > Horizon

Mistaken Identity
BBC2 9:30pm Thursday 11th November 1999

Sybil SALLY JESSY RAPHAEL: My four guests today have a total of 337 personalities. Hannah has 276, ranging in age from 1 year to 32. Duray says that she has 25 people living inside of her and by the way, some of them are male. Sheri is also Susan, Kimberly, Melissa, Teresa, Judy, Debbie, Tim and...

NARRATOR (ADEN GILLETT): In the 1980s Multiple Personality Disorder became the talk of the town. Tens of thousands of Americans were diagnosed with an illness that was previously almost unheard of. A trigger for this sudden epidemic was the release of a film Sybil. Telling the dramatic story of a woman diagnosed with Multiple Personality Disorder, the film was shown across America making Sybil a household name. But now Sybil's original diagnosis is being challenged. The psychiatric community is divided and people are asking whether MPD exists at all.

SUE KINER: We have 8-10 different personalities and the youngest being 6 and they range middle years, teen years, 20s, all the way up to my age which is 48 and they don't age. The names starting with the youngest is Sandi and then there's Rebecca, Lian, Trian, Nicole. Have to stop and think of 'em all.

NARRATOR: Sue Kiner lives alone and was diagnosed with MPD 6 years ago.

SUE KINER: I would go to bed at night and let's say it would be Monday and the next time that I would be conscious of the time it could be Friday. I know now that one of my other personalities were out and they were functioning during those times and when they are out I've no concept of time. When we get in to get into the car depending on which personality has driven since we don't always know the radio station'll be different, the seats and mirrors will have to be readjusted, always the volume on the radio needs to be changed 'cos it just kind of depends on which personality has been out and what they're doing, whether they've had the top down or had the top up.

NARRATOR: Sue first became aware of her alter personalities while in a therapy session with her psychiatrist.

PROF. DAVID SPIEGEL (Stanford University School of Medicine): As I worked with her a couple of things were clear. She was somewhat depressed and she was missing time and what she would tell me is she'd go home, fill the car with gas on the way home and in the morning half a tank of gas would be gone and there'd be another 100 miles on the odometer and she didn't know how she'd done it. What I look for are people who have these periods of amnesia where they'd be doing something in one identity or personality state that they're not aware of in another, so there start to be missing pieces, there are gaps in their life.

NARRATOR: Multiple Personality Disorder has been in the American psychiatric manual for decades, though until the 1970s hardly any psychiatrists claimed to have encountered the disorder. To be diagnosed with MPD a patient must have two or more distinct identities that regularly take control of their behaviour and their consciousness. One of Sue Kiner's most dominant alter-personalities is Susan.

SUE KINER: Susan's personality was out and I was gone. When I came back the car that I had was gone and this was in its place. I was confused 'cos sports cars are not what I enjoy. Susan had bought it and purchased it and had traded ours in. When I went to my job after I thought a 2 week vacation I found out that I had resigned and actually had started another job, but I had no idea where the other job was. I don't ever remember resigning. I had no idea what the job entailed so it was very frightening 'cos I had been at that job for 12 years and had seniority and stability and I liked my job, so it was very frightening to know that I was no longer employed there.

LINDA MASSEY: I never know what it's going to be like when I walk in the house. Another alter may have been out and they leave stuff around. I find stuff in the fridge all the time that I don't remember being there and I don't buy. Find stuff in the cupboard that I know I don't eat and I don't remember buying. All my plants are dead because nobody else waters them. I find clothing, unopened mail all over the place and I have this problem because I have Multiple Personality Disorder.

NARRATOR: Linda Massey is a psychology student. She also was not aware of having alter personalities until she started therapy.

LINDA MASSEY: I actually have two dozen to 30 personalities that I know of. They're very distinct. It's not like a facet of my personality. They actually believe they're different people and they're different ages and some are male and some are female.

NARRATOR: Once aware of their alters, MPD patients can then communicate directly with them. Each alter has its own life story.

SUE KINER: There are some that get along very well with each other, they are some that tease back and forth like siblings. Then there's others who just downright don't like each other and do not get along at all. We'll sit down and we'll have like a conference or summit meeting and we negotiate time. If someone wants to go shopping and then someone else wants to go to the movies or someone wants to go visit one of their friends 'cos we all have different friends. I'm trying to teach some of the young ones to read and do other things, but they'd like to do what normal children like to do. One of 'em, Sandi, loves to cook so I'm teaching her how to cook which sometimes is more of a disaster because she makes messes and stuff and one of 'em wants to go for a drive up into the mountains. That's what she enjoys so the rest of us have to allow her to do that. It's hard to explain, but I can see all of 'em there and we sit and we talk and then we, we discuss and a lot of times we argue, unfortunately, until we can come to a compromise despite that... because there's only one body and we have to share it, so we have to come, make a lot of compromises with each other.

LINDA MASSEY: Sometimes I hear them in the background. It definitely feels like there's someone there. It's, it's kind of a weird feeling where you, it seems like you're sharing consciousness with someone else and that someone's very close. I'm kind of forced to think about having other personalities 'cos they're there in my head. I can't get away from that. It's like I walk around and you know there's this whole other world going on inside me that nobody knows about. I guess technically I'm not alone, but it's very easy to feel that way, even though they're there.

NARRATOR: No-one claims to know for sure what causes MPD, but specialists point to childhood trauma.

DAVID SPIEGEL: We believe that there is a connection between traumatic experience in childhood and these symptoms in adult life. It is the case that many people who are abused in childhood don't develop disorders and there are people with the disorders who weren't abused, but it is most common to have a story of abuse in childhood.

NARRATOR: The theory is that to cope with extreme distress a child's unconscious mind creates an alter personality with characteristics that can cope with the abuse and so this new imaginary personality shields the child from reality. As the abuse continues, more and more personalities may be created, each taking on a life of its own.

SUE KINER: I've always remembered my abuse and I've learned that it was a way of protecting myself as saying you can hurt this body but you cannot hurt me, so the part of me that couldn't deal with the trauma that was going on at that time was split and then a personality was created that could function and deal with that trauma that was going on at that time.

NARRATOR: Linda believes she was abused as a child though her memories of this are vague.

LINDA MASSEY: I know a little about where some of them came from, at what point in my life they were most active. They definitely seem to have a reason for being there. They seem like, even though they won't let me in on the details a lot of the time, they seem like they, they hold specific memories and specific feelings and specific experiences that were just not pleasant and maybe if I knew about them I'd have a hard time dealing with them. I have a hard time dealing with what I do know now.

NARRATOR: There's one case of Multiple Personality Disorder that is crucial to our understanding of the illness. This is the case of Sybil and it is also her story that lies at the heart of the current controversy. Sybil's real name was Shirley Mason. She grew up in the 1930s in a small mid-western town in Minnesota. Shirley Mason seems to have had a strange childhood, an impression sensed by those who remember her adolescence.

JOY ENGELSTAD (Teacher): One of the things I remember as a teacher was Shirley's mother taking her by the hand and bringing her, her from home to school and then being there to meet her at noon to come home for lunch and she was 13 years old, too old to be led around.

BETTY CHRISTENSON (Schoolfriend): Her mother was always in the background and when we'd go to the birthday party she would play the piano and, and sing and then laugh, just, well it was a harsh shrieking laugh. We often wondered why she did it.

PATRICIA ALCOTT (Cousin): I remember Shirley and her mother Mattie from my very early years because we did social things together. Shirley was very quiet, shy, demure. I got the feeling that Shirley would have never disobeyed.

NARRATOR: Whatever Shirley Mason's experiences as a child by the time she was a young adult she was showing signs of having psychological problems and sought help.

PATRICIA ALCOTT: There was a nurse on the staff at the college where she went to school who kind of took Shirley under her wing and said you really have some serious things wrong with you and I'll go with you to tell your parents and I don't know the outcome of that particular meeting, but I believe it was shortly after then that Shirley started seeing psychiatrists.

NARRATOR: Sybil ended up in New York. Feeling depressed and experiencing periods of amnesia she sought help from a new psychiatrist. She saw Dr. Cornelia Wilbur. Dr. Wilbur believed that the solution was to embark on a long exploration of Sybil's childhood. The doctor used hypnosis in many therapy sessions and then revealed to Sybil that something extraordinary had been happening. She claimed that during therapy an array of distinct and separate personalities had emerged from Sybil, each telling the doctor about some terrible experience of Sybil's early life, experiences that Sybil herself seemed to know nothing about. The experiences were of being sexually and physically abused by her mother. Cornelia Wilbur believed that Sybil had responded to the abuse by splitting into the different personalities that were coming out in the therapy sessions. Dr. Wilbur then gave Sybil the rare diagnosis of Multiple Personality Disorder. She wrote up the case in a best-selling book. This was turned into a film in 1976.

FILM EXTRACT:

SYBIL: I've got something to tell you. It's about Sybil. She puts guck all over her hair 'cos she has grey hair. I don't, I'm natural. You like the way I look? I have a real pretty face. See me in the mirror. A little nose and all my freckles and my bangs. I'm only 9. Do you believe me?

DR CORNELIA WILBUR: Yes I believe you.

SYBIL: My name's Peggy and you are Dr. Wilbur.

NARRATOR: Dr. Wilbur's account of Sybil's illness was not a medical textbook. It was a paperback written to capture as wide an audience as possible. However, within a short period of time it was being hailed as a crucial publication in psychology read by professionals and even distributed to American high school students.

DR PAUL McHUGH (Chief of Psychiatry, John's Hopkins Hospital, Baltimore): When the book first appeared it gathered a following. Dr. Wilbur was a charismatic person and many people were entranced by this idea about a condition that she was saying was being overlooked and was crucial..

DR LILLIAN GROSS (Psychiatrist): The early conferences were really amazing because everybody was electrified and full of energy and very excited about finding out about this diagnosis and everyone very hungry for methods of diagnosing and treating this illness. Dr. Wilbur felt that it was her job to be able to train other therapists. I remember going to several of the conferences where she was teaching and being very grateful for her experience in helping me deal with my patients.

NARRATOR: Dr. Wilbur described how she had met and talked with Sybil's alter personalities in her New York office. She claimed that each time Sybil's mother abused her Sybil had retreated behind one of these other personalities. The timing of the connection between childhood trauma and MPD was crucial. It coincided with a new and increasing awareness of child sexual abuse in 1970s America.

PAUL McHUGH: With Sybil the idea that multiple personalities were out there that we were, we were overlooking many of them and that they represented sexual trauma that was, that was the, the take-off point.

NARRATOR: The goal of therapy, according to Dr. Wilbur, was to integrate all the alters into one personality. To achieve this the therapist had to get to know the role each alter was playing in the person's life. Dr. Wilbur taught that this meant having conversations with these alters, however many there were.

LILLIAN GROSS: The patients who came to see me had variable numbers of alters. Some only had 2 or 3 and others had many thousands and the reason for the number of alters my patients had depended on several factors. First of all, how severe the abuse was and secondly, what their internal system was. Some patients would produce new alter every time they were traumatised and other patients would let the same alter come out for the same kind of trauma. I think knowing about Sybil gave psychiatrists idea of what to look for because if you don't look for something you cannot find it.

NARRATOR: by the end of the 1980s tens of thousands of people were being treated for MPD. Dr. Wilbur's message to therapists was to look out for alter personalities in their patients. After all, even Sybil had not known about her other personalities until Dr. Wilbur introduced them to her in therapy.

FILM EXTRACT:

SYBIL: Oh Dr. Wilbur, it's getting worse. This is getting a lot worse. I feel, do you know those things. I don't tell you them and who does those drawings?

DR. WILBUR: You do. Oh but you do them as other people. Do you understand? You do them as other parts of yourself...

SYBIL: No I don't.

DR. WILBUR: ...they were still children.

SYBIL: No I don't.

DR. WILBUR: It's true.

SYBIL: No it's not.

DR. WILBUR: You've got to understand it is true.

SYBIL: This is not possible.

DR. WILBUR: It's possible.

SYBIL: It ain't.

DR. WILBUR: In fact most of the analysis I've been talking to you through them. They all have names and they come here and they protect you, they keep your appointments and they're the ones who pour out this information...

SYBIL: Oh no.

DR. WILBUR: ...that you're afraid to face. You've got to understand...

SYBIL: No it's not true.

DR. WILBUR: It's true.

SYBIL: It's not true.

NARRATOR: 20 years on, both Cornelia Wilbur and Sybil have died, but the standard treatment for MPD is still therapy. When Sue Kiner has a period of amnesia Dr. David Spiegel uses hypnosis to access each of her alters.

SUE KINER: I have two days missing in the last couple of days that I'm going to see Dr. Spiegel for so that he can help me to find out what happened in those 2 days with the personality that was out.

DR. DAVID SPIEGEL: Now you've had episodes where you've lost track of time. Is that right? It happened.

SUE KINER: Yes.

DAVID: Uh-huh. What was the last thing you remembered before...

SUE: The last thing I remember was lying down.

DAVID: OK and the next thing you remember.

SUE: Is being on the street at night walking.

DAVID: And that's not typical for you?

SUE: No, it's not typical.

DAVID: You don't go walking at night. (No) OK. Well would it be alright if we used the hypnosis to try and sort of fill in the blanks?

SUE: Sure, that'll be fine.

DAVID: Now this is when, this is just the other night.

SUE: Yes it was, was a Tuesday night.

DAVID: Tuesday night, OK. Alright, so let's go into the state of hypnosis again. (OK) So I'm going to do one thing. Look up 2, slowly close your eyes and take a deep breath, 3, breath out, eyes relaxed, body float, one hand or the other. Float up in the air, that's good. And now let's use this state of self-hypnosis that you've learnt to control to get access to what was happening last Tuesday night after you laid down in bed. Can you describe what's happening.

SUE : Everybody fighting with everyone.

DAVID: Is this Sandi? (Uh-huh) Hi Sandi.

SUE: Hi Dr. Spiegel.

DAVID: Everybody was fighting. What was going on?

SUE: They were arguing with each other.

DAVID: What did you do?

SUE: I took Kelly and I took my pill on my neck and I was going to go away. I was going down to see Richard and stay with them.

DAVID: I see, uh-huh, so you just took off and were walking.

SUE: Yeah, they didn't want me no more so I was going to leave.

DAVID: Uh-huh, that made you feel pretty bad. How old are you Sandi?

SUE: I'm 6.

DAVID: You're 6. (Uh-huh) I see, uh-huh and how do you get along with these other parts of yourself?

SUE: They tell me not Sue, but the others not too well. They say I'm a pain.

DAVID: Yeah, what, what makes them say you're a pain?

SUE: 'Cos I make messes and they don't like to play with me.

DAVID: What sort of messes do you make?

SUE: Only when we cook. (Oh yeah) Just sometimes we get flour on the ceiling but not, not our fault.

DAVID: You get flour on the ceiling.

SUE: All kind of mixture go too high.

DAVID: I see. What, what is it you like to make?

SUE: I like to make bread and pies. they're fun.

DAVID: That's good. OK, good. Now let's come out of the formal state of hypnosis. Counting backwards from 3 to 1, on 3 get ready, 2 with your eyelids closed, roll up your eyes, wide open. Now do you remember what we just discussed...

SUE: Yes I do.

DAVID: ...what Sandi said as well. (Yes) So this was one of those situations where you're...

SUE: Right, well Sandi didn't tell me that somebody had come up and spoken to her. That's what frightened her. I didn't know that. I knew she was upset about something that had happened but I didn't know the whole gist of it until I heard her tell you.

DAVID SPIEGEL: The mystery to her initially is what's going on because different parts of her have different parts of the experience so they don't have that continuity of history so what I was trying to do was help her reconstruct what happened and resolve some of this inner conflict about distress that led up to it.

NARRATOR: Linda's alter personalities come out in therapy sessions too. In fact in her experience it's the alters that go to therapy not her at all.

LINDA MASSEY: I go into therapy now once a week. When I wasn't in school I was going twice a week. I'm generally not the one present at my therapy sessions. Usually it's Leah, occasionally it's someone else and I'm not quite sure what they talk about.

INTERVIEWER: How much of the session do you tend to remember?

LINDA: If I remember anything at all it's just bits and pieces of the session. Mostly I remember, if I remember anything, it's the drive there and the drive back, maybe walking into the little lobby. A lot of times I remember what the inside of the office looks like, but not much else. Right now, as far as I know, Leah has talked to the therapist, Alex has talked to her, Jeannie talked to her once. When we first started working she asked us to write about the different alters and we also made an organisational chart of all the alters, how the system is organised. She knows of a lot of the alters, but she hasn't actually met them.

INTERVIEWER: What's the purpose of the therapy sessions?

LINDA: I'm actually not really sure myself.

NARRATOR: It's the very process of therapy for MPD that has recently been seen in an entirely new light. In treating Sybil 30 years ago Dr. Wilbur claimed she had uncovered alter personalities that she had talked to and examined. However, one of the original psychiatrists who met Sybil has recently made a claim that challenges Dr Wilbur's entire theory and practise.

DR HERBERT SPIEGEL (Columbia University, New York): I did not meet Sybil until she came to New York. Dr. Wilbur phoned me and said that she had to go out of town and, because Sybil was at times suicidal, she asked me if I would serve as a surrogate therapist to supervise her during Wilbur's absence and I was glad to do that. One day I was talking to Sybil about an event in her life and she asked me if I wanted her to be Helen to talk about it and I said not necessarily, why do you ask, and she said well when I talk about this with Dr. Wilbur she wants me to be Helen and I said to her well if you feel you must feel you must be Helen by all means go ahead, but it's not necessary and then she seemed a little surprised and said well if it isn't necessary I'd just as soon not and I said OK, that's fine with me, so in that sense she was able to talk about it as an event in her life as Sybil. That's when I got on to the idea that she was being cued by Dr. Wilbur to live certain experiences in her life as she was recalling 'em as if she were somebody else. When Sybil was with me she did not experience alters. It was a kind of a game that she accepted in working with Wilbur, but we joked about it when we worked together.

NARRATOR: Dr. Herbert Spiegel's doubts about the case of Sybil are shared by other psychiatrists.

PAUL McHUGH: Sybil herself is obviously a troubled individual. Vulnerable too, emotional distress and eager to find some help for it. She's very willing as any patient is willing to listen to what the doctor says, and this doctor and she developed this process of trying to create an answer. Sybil is looking for an answer and Dr Wilbur is ready to try to offer one.

NARRATOR: Herbert Spiegel was concerned that suggestible patients were being unduly influenced in therapy. He tried to voice his doubts at the time during a medical conference, but he was ignored and by the 1980s the numbers of those diagnosed with MPD rose so rapidly that specialist clinics were opened.

HERBERT SPIEGEL: Once the Sybil story took off it stirred the interests of a, of a number of therapists to establish training institutes where they attracted therapists to come along to learn how to "diagnose" translated meaning how to train people to become multiples. They called them hospitals, but I would refer to them as training institutes for multiple personality. They not only trained the therapists for doing it, but they trained the patients at the same time how to comply or how to develop an alliance with the therapist to bring about this phenomenon. In essence it took on a cult-like quality.

PAUL McHUGH: Therapists who have previously never made a claim to of having seen such a patient now were saying that they were seeing hundreds of them and in fact that there should be separate units to take care of them. The important thing to know about these patients is that they are not frauds or cheats or, or are trying to entertain you. They are very troubled people with all kinds of different troubles. They come to those doctors like Dr. Cornelia Wilbur who have strong opinions about what can exist and then impose that on a suggestible patient and the rest is history.

HERBERT SPIEGEL: The danger of taking alters seriously and increasing them is to add to the confusion and the anxiety and even the depression that the person has. I see nothing therapeutic about that at all.

NARRATOR: This is by no means everyone's interpretation. While Herbert Spiegel believes psychiatrists should not engage with the alters in therapy as this only reinforces them, other psychiatrists still believe it is essential that you do. Indeed a key proponent of this approach is Herbert Spiegel's son.

DAVID SPIEGEL: Would it be alright if we talked with Susan now?

SUE KINER: Certainly.

DAVID: Thank you.

SUE: I was wondering when you were going to get on to me.

DAVID: You were huh. Were you feeling left out?

SUE: Just a little.

DAVID: Just a little, OK. Well what do you have to contribute to this discussion?

SUE: Well if it wasn't for me Sue would never have survived.

DAVID: How do you mean?

SUE: Sue's very weak and if it wasn't for us she would have never changed jobs, she would have been stuck or laid off. She hasn't been taking chances, she plays things too safe.

DAVID: And you tend to be tougher and more assertive than she is.

SUE: I don't let people walk on me.

DAVID: Uh-huh, OK, thanks very much. I'd like to talk to Sue again if I could.

SUE: Sure.

DAVID: Thank you.

SUE: Yes doctor.

DAVID: Hi Sue. Were you listening to this discussion? What do you make of it?

SUE: It's the same things Susan's been saying all along.

DAVID SPIEGEL: I believe her. I've known her for many years. I have seen her react to stress with this kind of fragmentation, this, the pattern of personality states has been quite consistent, so yes, I believe her. There are people that recommend just ignore it or tell it to go away and I'd say they've run across plenty of people who do that and if it worked you wouldn't be seeing them. My experience as a psychiatrist over many years has been that people do better when you allow them to express what they're experience is and help them restructure it.

PAUL McHUGH: In psychotherapy we are trying to find an explanation that will fit the patient's troubles. It's perfectly true that we don't necessarily find the exact truth when we're working in psychotherapy with a patient, but look, it is not helpful to the patient to produce very implausible ideas and use them as the vehicles to try to bring psychotherapy along. Multiple personality, the idea that they've split up into 5, 50, 500 personalities is so implausible that it only opens the doors to more and more outrageous ideas rather than more and more plausible ways of seeing yourself as a person in a life trying to do your best within it.

LINDA MASSEY: I had heard of Sybil. I knew there was a movie. I saw some snippets of the movie in one of my psychology classes. Sometimes I think well I had to have made this up, this can't possibly be real. It seems so fantastic, it seems like it's just really something strange out there, that I always come back to well there probably is such a thing as MPD and it seems to fit what I am going through. The rabbits have always been there and there are times where I think if it wasn't for the rabbits that I might have taken my own life and then I think what's going to happen to these rabbits, I can't desert the rabbits.

NARRATOR: For patients like Linda, the experience of having alters feels entirely real, whatever caused them to be created. They are so vivid to her that she knows exactly what many of them look like.

LINDA MASSEY: I have a visual sense of some of them. Some of them I can picture right in my head, some of them have actually pointed out to me in my photo albums who they are. This is Lexie. Lexie is 5. She comes out, she likes to play, she likes ice cream and cake and then this is Alex. He is 17 and the picture's probably taken we're about 19. He's male and he's very sensitive about that. And then I don't know who these are of, I don't recognise them as me. These are pictures of Leah and she's very distinguishable 'cos her hair sticks up and she's usually smiling and goofing off. Typical teenager.

INTERVIEWER: But you don't recognise them as you?

LINDA: No. I recognise the physical features, but I, I just don't recognise them at the same time. I just have nothing to connect those pictures within it feels, I just get this, this strange confused sort of feeling when I look at them.

HERBERT SPIEGEL: I have not seen an authentic multiple personality personally, but I have seen many, many potential multiple personalities which I could have contributed to developing had I chosen to. It's a behaviour game that's going on and since a therapist is calling the shots the therapist has the ability to call an end to it.

NARRATOR: There is now a new generation of therapists who specialise in MPD. They do not accept that the therapy can create the disorder and believe it is actually under-diagnosed. Sarah Francis is one such therapist. The theory of treatment remains the same: acknowledging and talking to the alters.

SARAH FRANCIS (Therapist): Most of my clients actually come because I'm well-known for working with it. Clients' alters will probably include ones who are very angry and who will move in to protect the system if the children are starting to talk about the things that happened, other angrier and probably older alters will start to interfere with that. As trust develops between the client and the therapist other identities inside who are watching may start to feel like this is somebody that I can trust, this is somebody that maybe I can risk talking to. You will also as a therapist be tested because they need to know that you're a safe person. If I realise that there is somebody else out I usually start by saying hi.

NARRATOR: In fact MPD has recently faced another challenge to its credibility. In the last 10 years hundreds of patients who remembered childhood abuse while in therapy now believe these memories are false and claim they came about through suggestions made to them during therapy. They have what has come to be known as False Memory Syndrome. This has come to cast doubt on the case of Sybil herself and on the supposed connection between child abuse and MPD.

PAUL McHUGH: One of the problems with Sybil is the claim that the whole problem rests upon a series of sexual abuses that occurred in her childhood. With Sybil, as in many other cases, we can never confirm that these things did happen and no attention is given to the possibility that these ideas, memories confabulated in the process of the therapy with the patient.

NARRATOR: This is contested. Those who treat MPD say they are aware that memories may be unreliable in vulnerable people and this has been noted in the official diagnostic manual. They have also changed the name Multiple Personality Disorder to Dissociative Identity Disorder and the therapists continue diagnosing. Indeed, if their patients express doubts about their diagnosis some therapists may see this as evidence that their patients have the disorder.

SARAH FRANCIS: It's very common for people to say I've just been making all this up, this isn't really happening, I made a mistake, that's it, I'm not multiple. I may simply remind the person that that's such a common part of MPD to have a tremendous amount of denial that it can actually be used as an indicator as having it. They resist, they have a great deal of difficulty with being able to know and to be able to hold on to that knowing that that's really what's going on.

NARRATOR: Sarah Francis, however, has a distinctly personal perspective on the disorder.

SARAH FRANCIS: If, if I'm going to work, Sarah, as a therapist, I might wear something like this: long skirt. If Jimmy comes out and, and we're wearing a dress he's very unhappy, very unhappy. Kelly might wear a little mini-skirt, little short tops.

NARRATOR: Sarah Francis has herself been diagnosed with MPD.

SARAH FRANCIS: I mean I've been actually walking out the door and, and, and it won't, and I can't. Somebody will come out and come back and change. I sometimes have a pile of clothes on the bed because somebody's just, no way I can't stay in that and everything comes off and something else gets put on and that can happen. On bad days I can do that 10 times before I leave the house. My experience being a therapist and multiple it has not been a problem in my system. It's, it's very clear and it's very sure who is the therapist and that never waivers. There's a group of about 10 alters. I had been in and out of therapy for a long time. As alters started to come out I became immediately aware of what was going on. I knew enough about the diagnosis to recognise it. One of the ways that the alters manifest themselves in a very real way is through their writing. I have a book full of journals and this is just a few examples. You can see that the, the handwriting changes quite a lot. It's written, you know, and I had no recollection of putting it there. My handwriting has always changed a great deal for as long as I can remember. I didn't know why until I got the diagnosis.

NARRATOR: The world of Multiple Personality Disorder is a world where patient and therapist can be one and the same, where critics believe that the major symptom of the illness is created through its treatment. The doctors who believe it is real continue to trust in their treatment. As in the days of Cornelia Wilbur therapists who believe their patients have multiple personalities aim to merge them into one. They still call it integration.

DAVID SPIEGEL: The goal is integration, is to have them see these different aspects of themselves as just that, aspects of themselves rather than actually different personalities or identities and in therapy you try to improve communication, you try to enhance the patient's ability to control access to these different parts of themselves. We access these different alters not to perpetuate them, but to help patients integrate them.

NARRATOR: However, the very idea of integration, the cure, seems to be resisted by the patients. Once alter personalities have become identified the patients get used to them. They seem to need them and fear losing them.

SARAH FRANCIS: If I was going to just try to be just me, just Sarah, and ignore all the other alters I would be ignoring much of, of who I am, so to, or who we are. Without Sarah Anne there wouldn't be any spontaneity, there wouldn't be the fun, the light-heartiness. Different alters hold different aspects of who we are as a whole and so I would be very two-dimensional.

SUE KINER: To us integration is a form of death because I will no longer exist either as I am today. I don't know what kind of a person I will be. I mean will I be who I am now, or will I be more like a personality that I don't like, because in our mind we see ourselves as different people, even though we know we're sharing the body and we're actually part of one whole, but it's, it's easier to function thinking that you're separate.

LINDA MASSEY: We're personally now at the point where even thinking of doing any kind of integration. I know a lot of my alters are just so opposed to it because they feel so individual, they feel that they're individual people and that they were never part of a whole, that they can't become part of a whole and that if they do that if they integrate somehow that means they're dead.

NARRATOR: It took 11 years before Dr. Wilbur claimed she had integrated Sybil. Doctor and patient stayed in close contact, with Sybil nursing the doctor for the last 5 years of her life. These days the number of people diagnosed with MPD is falling, although new diagnoses are still being made and the controversy continues.

PAUL McHUGH: I occasionally get sent patients who other people have diagnosed as Multiple Personality. A variety of them may show their different so-called alters, but my treatment is to turn attention away from those aspects. I see the multiple personality behaviour as a distraction both to the patient and to everybody else at getting to the heart of the psychological problem that the patient really has. It's a dead-end.

LINDA MASSEY: I thought I was like a single one person, there was no-one else in my head and then I realised that's not true.

INTERVIEWER: Who do you feel you are, do you know who you are?

LINDA: I thought I did and then I get diagnosed and that all changed. I think most of the time I don't know who I am and my whole self concept was turned on end when I got diagnosed. I'm still trying to figure out who I am and who these people are.