Reading Room

The People Inside

by Edward Dolnick

page 2

George is the tough guy.
Sandi is the terrified four-year-old.
Joanne is the outgoing adolescent.
Elizabeth knows them all.
Julia - who is all of them - knows none.

The condition is still far from the medical mainstream. Part of the problem is that it is too glitzy for its own good, too easy to write off as more suited to Hollywood and Geraldo Rivera than to serious clinicians and scientists: In a single human being, we are told, there might be both female and male personalities, right-handers and left-handers, personalities allergic to chocolate and others unaffected by it.

Just as the symptoms strain credulity, the cause, too, is almost beyond imagining. Nearly always, people who develop multiple personalities were subjected to horrifying abuse as children. Therapists recount one case after another of children tortured - for years - by parents, or siblings, or cults. The abuse is typically far worse than "ordinary" child abuse: These children were cut or burned or raped, repeatedly, and had no place they could see refuge.

Almost every therapist who has diagnosed a multiple personality was blinded at first by skepticism of ignorance. Robert Benjamin, a Philadelphia psychiatrist, recalls a woman he'd been treating ten months for depression. "Every now and again, she'd have slashed wrists. I'd ask how that happened, and she'd say, 'I don't know.'

"'What do you mean, you don't know?'
"'Well,' she'd say, 'I don't know. I certainly wouldn't do something like that. I'm a proper schoolteacher. And by the way, I find these strange clothes in my closet, outfits I wouldn't be cought dead in, and there are cigarette ashes in my car.'
"'What's so strange about that?'
"'I don't smoke,' she'd say, 'I'm on the Pennsylvania Turnpike halfway to Pittsburgh, and I don't know what I'm doing here.'

And then a couple of weeks later," Benjamin goes on, "a young woman walked into my office who looked like my patient, except she was dressed like a streetwalker, with a cigarette hanging out of her mouth. I knew my patient didn't smoke, and then I had my brilliant diagnostic moment. She looked at me and said, 'Well, dummy, have you figured out what's going on yet?"

He was so slow to catch on, Benjamin says, because he'd had drummed into him the old medical saying, "If you hear hoofbeats, think horses, not zebras. "But, precisely because the disorder is exotic, the diagnosis remains controversial. Even the harshest critics concede that some people have multiple personalities, but they insist that bedazzled therapists incorrectly slap the label on every confused patient who comes through the door.

Before 1980, when the condition made it into the psychiatrists' handbook, the total number of cases ever reported was about 200: the number of current cases in North America is about 6,000, according to one expert. Does that support the fad theory? Or does it reflect a new awareness that a real disorder was long overlooked, that sometimes what sounds like a horse really is a zebra?

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