Book Review Rewriting the Soul: Multiple Personality and the Sciences of Memory
Chapter 1
In 1972, multiple personality disorder (multiple personality) was a rare condition. Ten years later, in 1982, there were 6,000 people who had been diagnosed with multiple personality disorder, and it was considered an epidemic by clinicians who devoted clinics, wards, units, and entire hospitals to the treatment of multiple personality disorder. Multiple personality was considered an epidemic that surpassed belief, especially considering that it had been considered rare, ten years earlier. The notion has been made that the diagnosis was only made correctly in recent years. Early and repeated sexual abuse in childhood is elucidated by Ian Hacking as the principle cause of dissociated personalities. Multiple personality disorder’s validity has been contested by various sources, including the American Psychiatric Association in a 1988 debate regarding the veracity of claims that multiple personality disorder is a real illness.
This debate introduces the point of whether multiple personality disorder is a real entity and what that question effectively means and what it can be said to mean for the truth of whether multiple personality disorder is an illness that can be diagnosed and catalogued as an illness in a similar manner to other mental illnesses. An illness often confused with multiple personality disorder is schizophrenia, because schizophrenia’s root words mean “split brain.” Schizophrenia is distinct from multiple personality disorder in that it probably is caused by neurochemical stimuluses and has a different symptom picture than multiple personality disorder. Multiple personality disorder may contain short periods of schizophreniform behavior, but these episodes are not of a long duration. Multiple personality disorder is currently classified by the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM-III had criteria for diagnosis of multiple personality disorder Including “A. The existence within the individual of two or more distinct personalities, each of which is dominant at a particular time. B. The personality that is dominant at any particular time determines the individual’s behavior.” An addition to the DSM-III that was not included in the DSM-III-R was that “C. Each individual personality is complex and integrated with its own unique behavior pattern and social relationships.” Frank Putnam, A researcher at the National Institute of Mental Health, revised the then current criteria for diagnosis of multiple personality disorder. Among the revised criteria were that “The diagnosing clinician must: 1. Witness a switch between two alter personality states; 2. Must meet a given alter personality on at least 3 separate occasions… and 3. Must establish that the patient has amnesias, either by witnessing amnesic behavior or by the patient’s report.” However, the DSM is not a good basis for answering questions on the veracity of claims that multiple personality disorder is a real and not culturally contrived illness. However, multiple personality disorder’s relationship to the questions “Is multiple personality a real disorder as opposed to a kind of behavior worked up by doctor and patient?” and “Is multiple personality a real disorder as opposed to a product of social circumstances, a culturally permissible way to express distress or unhappiness?” is complicated at best, and the answer to these questions is more nuanced than a simple yes or no answer can convey. In fact, there does not necessarily need to be a conflict between a mental illness only appearing in certain historical or geographical contexts and the illness being real. Multiple personalities (multiples or alters) were also difficult to pigeonhole as being real, perhaps because of the fact that doctors were confounded by the spread of multiple personality disorder to different continents through missionaries and clinicians who established multiple personality disorder overseas. Multiples can also recover scenes of a terrible nature in their path to uncovering their trauma. Most of these scenes seem too terrible to be true and have led to the False Memory Syndrome Foundation being established in 1992 to defame irresponsible psychotherapy. Multiples are also prone to being hypnotized, which is perhaps a reason why multiple personality disorder has been correlated with dissociation and is classified as a dissociative disorder, but the evidence in favor of dissociation being associated with multiple personality disorder is not convincing to scientists who hold the opposite view that the correlation of multiple personality disorder and dissociation is by no means translatable into an idea of dissociation being related to multiple personality disorder.
The word “disorder” is important to note because it presents an image of pathology which is orderly and fits into neat boxes on the DSM. Alters are considered not whole personalities, but personality fragments, by some authorities on multiple personality. Certain clinicians, most notably Spiegel, a clinician who was chair of the dissociative disorders committee for the 1994 DSM-IV, wrote that it is of vital importance to emphasize the fact that there is a difficulty integrating disparate elements of memory, identity, and consciousness, and that the “proliferation of personalities” was less important to mention when describing the condition. This led to the name being changed to dissociative identity disorder.
The diagnostic criteria was also changed after the change in name, with it now being the following:
“A. The presence of two or more distinct identities or personalities or personality states…
B. At least two of these identities or personality states recurrently take control of the person’s behavior.
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological effects of a substance (e.g. blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (e.g. complex partial seizures)
Note: In children the symptoms are not attributable to imaginary playmates or other fantasy play”
The DSM definition of multiple personalities has also been changed to require the presence of multiple personalities rather than the existence of multiple personalities. This change is meant to parallel the wording used to describe the delusions of the various types of schizophrenia. This definition also shifts our attitude toward the experience of the patient and away from actual multiple personalities. Memories are seen to be essential to our understanding of multiple personalities, and memory is seen as being the key to the soul and development of multiple personalities.
Chapter 2
Doctor’s expectations shape the multiple personalities that were brought to them, and people who are classified as being a certain way develop in that way and also develop in their own ways, making a feedback loop that causes descriptions and classifications to be constantly changing.
Doctors are moving away from diagnosis as a definition or set of necessary and sufficient terms and towards a way of defining multiple personalities involving a set of words applying to a set of people, in this case, people with multiple personalities. The idea of a prototype is also important in psychiatry. In psychiatry, the prototype refers to a patient that is the best example of an illness. The Casebook, the companion to the DSM, illustrates many such best examples. An example of an important criterion of someone with multiples is the existence of lost time in the memory of the person. Mood swings and hallucinations between sleeping and being awake may also be present in these patients. Alters cannot be distinguished until they come out individually. Instead, alternate personalities mesh together under the behavior of whoever is in control of executive function. Multiples have also been featured on talk shows such as The Oprah Winfrey Show and The Geraldo Rivera Show. Multiples are important and ordinary Americans who are lost in the public sphere but are importantly mentioned in talk shows such as these two. People afflicted with this disorder deserve our empathy and respect, not our scrutiny and disbelief. There is also controversy as to whether the multiple movement is in any way similar to the gay movement in that the homosexual movement grew to become independent of society’s medical restraints, and being homosexual is no longer classified as a disease. The multiple personality movement can be seen by people as a way of life but may or may not reach a level where it can exist independently of the medical community.
Chapter 3
Ralph Allison, a man who created his own model of multiple personality says that people with multiple personality disorder are not in touch with their inner selves. Ralph Allison believed in getting in touch with one’s inner self to obtain mental and spiritual health.
The leaders of the multiple personality movement were hosting workshops by 1979 at the American Psychiatric Association’s Annual Meetings. They then proceeded to make elaborate preparations for the Diagnostic and Statistical Manual’s 3rd edition, which stated that there were three characteristics, which I have mentioned before, that add together to become diagnostic criteria for the third DSM’s diagnosis of multiple personality disorder.
A later split occurred between the ideas of two groups of the multiple personality movement into one camp that consists of highly qualified clinicians and another camp that consists of a grassroots alliance of patients and therapists who welcome multiples. The appearance of the False Memory Foundation might be enough to heal the split between the two camps because they both can revel in the fact that memory is key to fully understanding this disorder.
Chapter 4
The concept of cruelty to children emerged in the Victorian era and did not span the same scope as the newer term “child abuse” spans. The term “child abuse” (versus cruelty to children) effectively medicalizes family violence and its causes as an object of scientific study. This medicalization can be known about and empirically reduced to types. The term of “child abuse” has not always existed; and the concept of child abuse also has not always existed, however, sexual, physical, and emotional, violence against children has always existed.
Deontology also plays a role in cracking down on child abuse because the deontologist point of view is that child abuse is an absolute evil and the consequences are less important for determining whether or not the evil is a true evil. Consequentialism has no role to play in deciding whether child abuse is moral or not. Regardless of the consequences, child abuse is and always will be immoral. The assumption that child abuse has profound effects on the developing child and the adult they will later become is an assumption that is important to understand when looking at the development and etiology of multiple personality, and to some extent, when looking at the soul itself.
Chapter 5
Some clinicians assert that the patient with multiple personalities’ victim status may dredge up further problems in painting the patient as a helpless, perpetual victim of the abuse experienced as a child. As the majority of multiples are women, and many of these women’s multiples are of a different and queerer sexuality than their “host,” these alters reveal social undertones in American society, undertones which are indicative of how masculinity and femininity play out in society, says Margo Rivera, in a feminist analysis of multiple personality and the etiology of the female multiple.
Chapter 6
Childhood abuse, especially sexual abuse, is considered one of the principal etiological causes of Multiple Personality. multiple personality. In fact, childhood sexual abuse makes upconstitutes part of the “best case”,” or prototype, of multiple personality. The theory of child abuse and levels of dissociation causing multiple personality is just one of many theories used to describe the etiology of mental illness. This theory is simply one of many theories that can be used to reveal the secrets of memory and the role that memory plays in multiple personalities.
Chapter 7Interestingly, Alfred Binet, one of the founders of intelligence testing, was fascinated with multiple personality at the beginning of his career. A crucial component of intelligence testing when Binet was formulating it was that intelligence testing results have to agree with common knowledge about who is intelligent or unintelligent. Tests agreeing with the standard body of knowledge as to what constitutes, in this case, a person of high intelligence, is a feature of Binet’s paradigm of intelligence testing. This is relevant to multiple personality disorder because multiple personality has also historically been studied through questionnaires similar to those used for intelligence testing. An example of one such questionnaire is the Dissociative Experiences Scale, introduced by Putnam and Bernstein. These researchers developed a scale that is flawed because it includes questions that give neurotypical people non-zero scores. The fact that it contains questions relating to normal phenomena gives normal people non-zero scores and also invalidates the test as a measure of whether normal people experience some type of dissociation or not.
Statistics requires researchers to have a random sample of people to test the hypothesis that there is a smooth gradient of quantity of dissociative experiences from normal people to multiples. A random sample was not chosen for testing the Dissociative Experiences Scale, with the sample being chosen from limited groups such as college students and subgroups of people who had the same type of mental health diagnosis. Therefore, Putnam and Bernstein did not test that whether or not there must be a smooth flow of gradation in dissociation levels from normal to multiple personality. The authors of the study also incorrectly interpreted data that was stated to not normally distributed. They wrongly interpreted the data because they did not choose a sample group randomly, as is the procedure for data collection in order to determine if the distribution is normal or not.
Unfortunately for our understanding of dissociation and related disorders, no one has looked into the veracity of claims that the curve, or “hill” of dissociative experiences is Gaussian and, when a random population sample is used, the curve is seen to be smooth and hill-like, but no further inquiries were made as to whether the curve is Gaussian or not. In fact, the authors of the study said that it did appear similar to the curves for hypnotizability, although those curves are skewed and the curve generated by random sampling is smooth and like a camel’s hump. Unfortunately, the idea that dissociation exists on a spectrum was already imbedded in the ideas of the psychologists studying multiple personality.
To find the best way of determining whether or not a person is ill, when they really are ill, is important because it can help us screen the people who seem to be ill and see if they actually are ill. This conclusion can be calculated by using the base rate, or rate of occurrence in the population. Researchers Carlson et al. seem to have failed because they take the base rate to be five percent and do not say from where this data comes. These researchers also seem to take the survey as a fact, and they do not question the validity of the test as a way of distinguishing who is ill from who is not; in fact, apart from attempting to calibrate the test using a base rate, they do not engage in proper science. They also attempt to discriminate between high scores and low scores on the test, with the cutoff score for multiple personality or a dissociative disorder being thirty. The question is open as to what dissociation is, then, if as mentioned before, certain leaders in the field of multiple personality would like to make it into a scientific term, dependent on the construct of a dissociation continuum, where normal people dissociate a little and multiples dissociate more.
Chapter 10
Locke believed that there are two concepts of identity: One for a forensic concept and one for a bodily continuity based concept (p 146). The forensic person has a role in the divine plan, same body in hereafter… but rewards or punishments are prepared for the same person. Another concept similar to Locke’s was the concept of there being one soul per body which was said by the Thomists. Anti-Thomists said there could be more than one soul in a body.
Chapter 12
Bourru and Burot said that there was a connection between personality and memory. After Bourru and Burot said this, Mabille and Ramadier, scientists who studied Louis Vivet thought there was a correlation between certain physical and nervous states and the psychological personality states. Bourru and Burot also expanded upon the theory postulated by Mabile and Ramadier by postulating that they could locate a normal state using the body parts associated with the normal state of mind. Bourru and Burot believed that using magnets and metals could wake the patient up into a normal state.
Chapter 14
We should not study a unitary moi, according to Ribot, a disciple of British associationist psychology who was trained in philosophy, not a neurologist or pathologist as others were at the time. In multiples, there was not a single self, or soul, thus challenging the existing non-scientific philosophical and religious monopoly on the soul and providing a frontier on which a scientific examination of the soul could begin.
Chapter 17
Mary Reynolds switched by her vivacious alter becoming principal in her personality (237). Effectively, as the multiple personality movement changes and people begin to move towards a dissociative identity disorder model, the intentionality of the change between alters is replaced by an involuntary “switching” concept that proposes that it is not an intentional decision on the part of a developed personality fragment that decides to come out. It is in fact an involuntary switching that occurs with alters.
Interestingly, categorizing certain relatively less severe abusive actions as child abuse may open the window to worse forms of child abuse in people who are predisposed to abuse. After things are put under the same name, child abuse, it is easier to believe that there is less separating the abuser from grosser forms of abuse entirely. The movement towards progressively worse child abuse is something that may be causing increasing rates of child abuse. Not just because there are more actions considered abusive or because more people are being discovered to have committed child abuse, but also because of the semantic contagion of actions under the heading of child abuse (238).
Feedback effects cause people to rebel against authorities who tell them that they are a certain kind of person or the science that makes them seem to be a certain kind of person. THe process of being viewed to be a certain kind of person or of being viewed to be someone who commits certain acts, may also affect the person involved in a similar form. The manner in which things affect people who are subjected to certain definitions of who they are and the standards that uphold these definitions is called the feedback effect (239).
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