David Baxter PhD
Late Founder
Canadian doctor's scathing report on multiple-personality disorder says it should never have been included in DSM-V
National Post
December 10, 2012
With the latest edition of psychiatry's diagnostic bible devoting a whole section to what used to be called multiple-personality disorder, a leading Canadian specialist has written off the controversial condition as an unscientific "fad" that should be abandoned entirely, sparking an angry retort from another expert.
In his scathing new critique, psychiatrist Dr. Joel Paris of McGill University argues the affliction now called dissociative identity disorder (DID) gained popularity among some psychiatrists in the 1980s and 1990s largely because of popular books and movies, the most famous of which ? Sybil ? he said has been exposed as a fraud.
Linked to repressed memories of childhood sexual abuse and even of satanic ritual, the disorder is given little credence by the specialty today, Dr. Paris wrote. DID should never have been included in the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), concludes his journal paper.
?Although DID provided a dramatic narrative, it was quite unscientific in theory and practice,? said the article in the Journal of Nervous and Mental Disease. ?It was only when patients who had been harmed by the methods used to treat it started going to court that its days were numbered.?
The American professor who oversaw multiple-personality?s write-up in the diagnostic manual reacted angrily to Dr. Paris?s article, saying it unfairly disparages a field that enjoys mainstream acceptance.
?He is both wrong and he is intellectually extremely sloppy,? said Dr. David Spiegel of California?s Stanford University. ?It?s just nonsense, and I frankly think it does not represent psychiatry well, Canadian psychiatry well.?
It gets more personal. In his critique, Dr. Paris cites Dr. Spiegel?s late father Herbert, a prominent psychiatrist himself, to back up his contention that the patient known as Sybil did not have a host of different personalities. David Spiegel says his father was misrepresented about his encounter with the woman, and had in fact said Sybil suffered from a condition related to DID, though she did not have multiple personalities.
The DSM-V summary of the disorder drafted by Dr. Spiegel and several colleagues describes a disruption of identity featuring two or more distinct personalities ? or an ?experience of possession? ? inability to recall important traumatic or other events, and significant distress in the patients? lives. The Stanford psychiatrist said as many as one in 100 people may suffer from DID ? making it as common as schizophrenia.
There seems to be little debate about the basic concept of ?dissociation,? a separation of parts of the personality, such as the feeling of unreality that people sometimes experience after a car accident, Dr. Paris said.
Multiple personality was first described in a single American case in the early 1900s, he said, followed by a similar patient report in the 1950s, later turned into the book and Hollywood movie The Three Faces of Eve.
There was not much fallout, Dr. Paris contends, until publication in 1973 of Sybil, about a patient who claimed to have 16 different personalities, and described a history of bizarre abuse by her parents. The book sold six million copies, a resulting TV movie drew a huge audience and the epidemic was afoot, he said.
Doctors began diagnosing thousands of multiple-personality cases, and the number of journal papers soared from 39 in the 1970s to almost 400 in the 1990s, said the article. Psychiatrists theorized that the splintered personalities were caused by childhood abuse, memories of which could be recovered through counselling.
Many of the patients related tales of satanic cults whose practitioners molested and murdered babies, prompting investigations by police even in Canada. Little hard evidence turned up, though, and even then the ?vast majority? of psychiatrists failed to see any multiple-personality cases, said Dr. Paris in an interview.
The explosion of cases began ebbing by the end of the 1990s, after a series of U.S. lawsuits by patients who claimed that therapists had implanted memories.
Dr. Spiegel, however, said there is plenty of evidence to validate the ideas behind DID, including an epidemiological study of 16,000 trauma victims, and brain-imaging scans of dissociative patients.
The fact the condition is listed in both the DSM and the World Health Organization?s international classification of diseases shows it is well accepted by psychiatry, he said. Dismissing it as a fad will only discourage fragile patients already reluctant to open up, said Dr. Spiegel.
However, in Canada at least, DID is generally not paid much heed by specialists, said Dr. Donald Addington, chair of the Canadian Psychiatric Association.
National Post
December 10, 2012
With the latest edition of psychiatry's diagnostic bible devoting a whole section to what used to be called multiple-personality disorder, a leading Canadian specialist has written off the controversial condition as an unscientific "fad" that should be abandoned entirely, sparking an angry retort from another expert.
In his scathing new critique, psychiatrist Dr. Joel Paris of McGill University argues the affliction now called dissociative identity disorder (DID) gained popularity among some psychiatrists in the 1980s and 1990s largely because of popular books and movies, the most famous of which ? Sybil ? he said has been exposed as a fraud.
Linked to repressed memories of childhood sexual abuse and even of satanic ritual, the disorder is given little credence by the specialty today, Dr. Paris wrote. DID should never have been included in the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), concludes his journal paper.
?Although DID provided a dramatic narrative, it was quite unscientific in theory and practice,? said the article in the Journal of Nervous and Mental Disease. ?It was only when patients who had been harmed by the methods used to treat it started going to court that its days were numbered.?
The American professor who oversaw multiple-personality?s write-up in the diagnostic manual reacted angrily to Dr. Paris?s article, saying it unfairly disparages a field that enjoys mainstream acceptance.
?He is both wrong and he is intellectually extremely sloppy,? said Dr. David Spiegel of California?s Stanford University. ?It?s just nonsense, and I frankly think it does not represent psychiatry well, Canadian psychiatry well.?
It gets more personal. In his critique, Dr. Paris cites Dr. Spiegel?s late father Herbert, a prominent psychiatrist himself, to back up his contention that the patient known as Sybil did not have a host of different personalities. David Spiegel says his father was misrepresented about his encounter with the woman, and had in fact said Sybil suffered from a condition related to DID, though she did not have multiple personalities.
The DSM-V summary of the disorder drafted by Dr. Spiegel and several colleagues describes a disruption of identity featuring two or more distinct personalities ? or an ?experience of possession? ? inability to recall important traumatic or other events, and significant distress in the patients? lives. The Stanford psychiatrist said as many as one in 100 people may suffer from DID ? making it as common as schizophrenia.
There seems to be little debate about the basic concept of ?dissociation,? a separation of parts of the personality, such as the feeling of unreality that people sometimes experience after a car accident, Dr. Paris said.
Multiple personality was first described in a single American case in the early 1900s, he said, followed by a similar patient report in the 1950s, later turned into the book and Hollywood movie The Three Faces of Eve.
There was not much fallout, Dr. Paris contends, until publication in 1973 of Sybil, about a patient who claimed to have 16 different personalities, and described a history of bizarre abuse by her parents. The book sold six million copies, a resulting TV movie drew a huge audience and the epidemic was afoot, he said.
Doctors began diagnosing thousands of multiple-personality cases, and the number of journal papers soared from 39 in the 1970s to almost 400 in the 1990s, said the article. Psychiatrists theorized that the splintered personalities were caused by childhood abuse, memories of which could be recovered through counselling.
Many of the patients related tales of satanic cults whose practitioners molested and murdered babies, prompting investigations by police even in Canada. Little hard evidence turned up, though, and even then the ?vast majority? of psychiatrists failed to see any multiple-personality cases, said Dr. Paris in an interview.
The explosion of cases began ebbing by the end of the 1990s, after a series of U.S. lawsuits by patients who claimed that therapists had implanted memories.
Dr. Spiegel, however, said there is plenty of evidence to validate the ideas behind DID, including an epidemiological study of 16,000 trauma victims, and brain-imaging scans of dissociative patients.
The fact the condition is listed in both the DSM and the World Health Organization?s international classification of diseases shows it is well accepted by psychiatry, he said. Dismissing it as a fad will only discourage fragile patients already reluctant to open up, said Dr. Spiegel.
However, in Canada at least, DID is generally not paid much heed by specialists, said Dr. Donald Addington, chair of the Canadian Psychiatric Association.
