1. This presentation contains copyrighted material under the educational fair use exemption to the U.S. copyright law”  “This presentation contains copyrighted material under the educational fair use exemption to the U.S. copyright law”  Video 1  Thigpen & Cleckley (1954)  AICE Psych- Individual Differences

2. A Case of Multiple Personality Thigpen & Cleckley (1954) AICE Psych- Individual Differences 2015-2016

3. Background (Defining DID/MPD)  Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder [MPD])-  Involves two or more integrated personalities residing simultaneously within the same individual. Each personality has its own stable pattern of relating to and interpreting the world. These personalities seize control of the individual’s behavior on a repeated basis.  According to DSM-5- sudden, temporary alteration in the normally integrated functions of consciousness, identity, or motor behaviour

4. Background (characteristics of DID)  2+ personalities coexist within the same individual Each personality known as ‘alter’ Each has its own memories, behaviour patterns, social relationships, etc. One personality is dominant at one time  ‘Switching’- going from one alter to the other may be induced by a trigger cue, stress, or hypnosis  Original personality usually unaware others exist  Other personalities may have characteristics that the original lacks  Controversial diagnosis- exists?

5. Background (diagnosing/treating)  Diagnosing relied on patient’s subjective reporting- very skeptical to medical/psychiatric community  With tech today, we can use more objective measures to examine if ‘different’ personalities exist within one person http://www.youtube.com/watch?v=0aBPk46ZmV0 http://www.youtube.com/watch?v=zhM0xp5vXqY&list=PLd_BxLtdValVv- Boiuli3fqd4Sx_zZ9us http://www.youtube.com/watch?v=zhM0xp5vXqY&list=PLd_BxLtdValVv- Boiuli3fqd4Sx_zZ9us

6. Aim of the Study  Aim of the investigation: to document the psychotherapeutic treatment of a 25-year old woman that apparently had MPD  ‘Eve White’ (real name Christine Sizemore) had a history of severe headaches and blackouts & memory loss

7. Methodology & Procedure  Case & longitudinal study: 14 months  Primarily used interviews over 100 hours at irregular intervals heavily reliant on Eve’s self-reporting husband & family also interviewed  Hypnosis & observations used as well

8. Methodology & Procedure  Manners in which Eve’s ‘personalities’ were tested  Psychometric tests: Wechsler-Bellevue Intelligence Test (precursor to WAIS) Wechsler Memory Scale (WMS)  Projective tests: Rorschach & drawing human figures  Physiological test: EEG Analysis of handwriting from alters as well

9. ‘EW’- Eve White  T&C used the pseudonym Eve White for the patient (and what became the 1st personality)  At the 1 st interview, EW complained of severe headaches, blackouts, and memory loss Also discussed marital & personal problems Disclosed that she also had a 4 yr old daughter  T&C described her as a loving wife & mother who had a repressive personality and was conservative with a shy demeanor  T&C originally thought she may have been schizophrenic

10. (start of change)  During one interview, EW had no recollection of a documented recent trip that she went on…  T&C used hypnosis to help…  Several days after a visit to the therapists, a letter from Eve White appeared at T&C’s office.  The letter discussed her therapy and was written in her usual handwriting, but at the bottom of the page there was a paragraph that looked like a child had written it

12. (changing…)  On her next visit Eve White denied sending the letter, though she recalled having begun one, which she never finished and thought she had destroyed.  During the interview, she became distressed and asked “whether hearing voices in her head meant she was insane?” Several times she held her head as if she was in pain during the interview  “… her hands dropped. There was a quick restless smile, and in a bright voice that sparkled she said ‘Hi there, Doc…’” (p.137)

13. (ta-da! The change to ‘EB’)  When T&C realized something was different, they asked who she was, response was “Oh, I’m Eve Black”  Different to Eve White Referred to EW as “she” or “her” “Minute alterations in manner, gesture, expression... Could only be another woman”  The voice & language structure were also very different, and to T&C it, appeared to be an entirely different woman She “had a childish daredevil air, an erotically mischievous glance, a face marvelously free from the habitual signs of care, seriousness, and underlying distress”

14. Video As you are watching, RECORD: -Symptoms of DID that you are observing https://www.youtube.com/watch?v=BZ 3fl18XQ0A

15.  Actual T&C video snippet http://www.youtube.com/watch?v=BZ3fl18XQ0A  Short clip of changes http://www.youtube.com/watch?v=A6AQAnd6YqY  Full movie http://www.moviesub.net/watch/the-three-faces-of-eve- 1957/812.html

16. (during therapy- EB impacted EW’s life)  After EB appeared, T&C had a new interest in the patient  At first, EB had to be ‘called out’ through hypnosis later T&C could have her appear just by asking to talk to her  EB could appear anytime during EW’s everyday life  Some things that were revealed during the 14 months of therapy: EB was around independently since childhood EW was unaware of EB, but EB was very aware of EW EW was ‘in abeyance’ when EB was ‘out’ EB could follow the thoughts/actions of EW EB denied having Bonnie and being married

17. (during therapy- EB impacted EW’s life)  When EB was in control, she often got EW into trouble Such as EB partying and letting EW have the hangovers  EB was more prone to lying made it difficult for T&C to get “true” info & thus skeptical at times she admitted that she at times imitated EW’s manners/behaviours around family members and immediate family (husband & child)  EB at times hurt EW’s marriage and family ordering expensive dresses, going to night clubs, flirting w/others confessed to hurting the daughter & letting EW take the blame

18. (Results of testing)  As the therapy continued with EW and EB, T&C wanted to conduct more tests on Eve for a ‘scientific basis’  T&C utilized independent experts to administer the tests on both EW & EB PersonalityPsychometricProjectiveBehaviour Eve WhiteIQ 110 Memory far above IQ Poor recall of digits Repression, anxiety – least Healthy Reserved, rigid, responsible Eve BlackIQ 104 Memory similar to IQ Poor recall of digits Regression, hysterical – but most healthy Irresponsible, pleasure- seeking

19. (more revelations during interviews)  A distant relative claims the patient had been previously married/living with someone… Both EW and EB denied this EB eventually admitted it– says there was “some sort of ceremony” though no legal paperwork anywhere  Basically, this was a long period of EB being out and being able to control Eve  EB “had no desire for sexual relations but often enjoyed frustrating her husband by denying herself to him.” As a result, he was often abusive of her but let EW take the wrath- EW had no such memories EB claimed that she removed these memories

20. (things get better… than worse)  After about 8 months of progress… EW had decreased headaches/blackouts EW heard less imaginary voices EW was maintaining a job and gaining financial security with the hopes of fixing her marriage & seeing her daughter again EB was coming out less & caused less havoc

21. (going down the slippery slope…)  Almost out of nowhere, headaches started to return EW’s roommates found her passed out twice from blackouts EB claimed she was not the cause of the headaches and that she too was experiencing blackouts T&C told EB that they considered institutionalizing Eve and that this would limit her nonsense as a result  T&C thought that they could eliminate these problems by trying to fuse EW & EB together They thought that Eve ‘fractured’ in childhood Wanted to discuss that time, but caused stress for Eve During one session, EW recalled a painful experience and went motionless in the chair…

22. (third time’s the charm…)  (p.144) Eve asked “who are you?”  T&C said it was apparent that this was not EW or EB- it was another alter- Jane T&C said that Jane seemed to be more adjusted, mature, and responsible than EB, and more interesting & confident than EW Jane was aware of both EW & EB Jane only came out through EW  T&C thought that Jane could ‘take over’ and help Eve live a normal life

23. (Testing results between EW, EB, & Jane)  EEG test results (administered by professionals) EW & Jane- 11 cycles/second (normal) EB- 12.5 cycles/second  Handwriting analysis: 3 different, distinct styles  Jane soon took over many of EW’s tasks at home and work and showed compassion to EW’s daughter  T&C concluded that if Jane could take possession of the personalities, she would regain full health and have a happy life

24. (one is the loneliest number that you’ll ever do?)  T&C asked themselves “would any physician order euthanasia…?” Basically, was it right to ‘rid’ Eve of EW and EB in lieu of Jane?  After EW saved a little boy in a street, Jane wrote letters saying that she did not want EW to go yet as she wanted to know more about her  And that’s it… no Hollywood ending… alters were not merged at the time

25. This presentation contains copyrighted material under the educational fair use exemption to the U.S. copyright law”  “This presentation contains copyrighted material under the educational fair use exemption to the U.S. copyright law”  Video 3  Thigpen & Cleckley (1954)  AICE Psych- Individual Differences

26. 5 problems  Killing one/more of the personalities - who should decide this?  Making a film for profit - who benefits & what about patient confidentiality?  During the treatment Eve White got worse  ‘Who’ gives informed consent for the treatment procedures?

27. Discussion  T&C noted that they may have been “hoodwinked by a thorough actress” but stated it was unlikely given the longitudinal study  T&C noted that they may have let their relationship with Eve sway their outlook They did not specifically diagnose Eve with MPD They pointed out that though the 3 alters appeared to be distinct & separate, the objective tests were not that impressive  Suggested future MPD research

28. (Postscript- do not talk about on test!)  After several months of therapy after Jane appeared, EW was able to recall a traumatic event at age 6, her aunt forced her to kiss her dead grandmother  During this time, Eve already married a new guy and another alter, Evelyn, appeared Evelyn had all the memories of the other 3 and acted much more mature than the others  The movie, The Three Faces of Eve, came out in 1957  It was revealed that T&C were writing a book on Eve  Also revealed that Thigpen filmed portions of their interviews that were available for public use

29. (Postscript- do not talk about on test!)  In 1975, Chris Sizemore revealed that she was Eve Said she had other alters before and after therapy (22 total) At least 9 before EB  Said she developed these alters as young as 2 years old after instances of seeing a man drown, a man cut in three by a saw, and her mom badly cut  In 1977, she released I’m Eve that differs from T&C’s account with an earlier childhood, more alters, and longer time frame.  In 1991, says she was adjusted & living fine  http://news.bbc.co.uk/2/hi/programmes/hardtalk/7961351.stm http://news.bbc.co.uk/2/hi/programmes/hardtalk/7961351.stm

30. Strengths of the Study  Detailed interviews (taped, written, video) with Eve and relatives  Produced thick, rich qualitative data most likely difficult to fake over the 14 months  Separate objective tests were utilized (EEG)  Somewhat of a strength in the subjective tests The attitude tests were later independently analyzed and noted 3 distinct personalities (15 years later, the secret video of the interviews were also analyzed and showed 3 different patterns of micro- strabismus [(eye axis & movement])

31. Weaknesses of the Study  Relationship between T&C and Eve (interested in the case when EB appeared and noted her attractiveness) Were they tricked? Did they overlook something? Did they interpret some things wrong?  The projective tests were subjective  Cannot pinpoint MPD as personality is not stable across time  Cannot generalize case study  Data was based on primarily self-reports

32. Ethical Issues (general)  Deception- only if Eve was lying  Harm- most likely not, but possible mental trauma through therapy and memories?  Consent- given for therapy/interviews, but not for videotaping  RTW- Eve could have left at any time  Patient Confidentiality during the study, it was confidential revealed herself to public 20 years later

33. Ethical Issues & Ecological Validity  Case predated guidelines for research with human participants  Was Eve treated as more of a subject rather than a patient? Did T&C just use her to make a name for themselves?  Was it right to possibly ‘kill off’ alters?  T&C noted that they did not have enough experience or background in treating such a patient yet they continued without seeking outside help or referring her  Videotape/publishing without her consent  Gender/culture bias?