Cultic Studies Journal, Vol. 13, No. 1, 1996, page 46
With one exception, the cases cited by Ellenberger (1970) resembled those of Prince. In the
late 1930s and early 1940s, Milton Erickson reported two cases with beneficent alters whose
help and strengths he engaged to aid in the patient‟s recovery (Richeport, 1994). In none of
these cases was there any implication that the development of multiple personality disorder
routinely involved incestuous child abuse, nor did anyone find the extremely hostile self-
mutilating, suicidal, and downright nasty alters of today‟s dissociative identity disorder
patients.
The milder version of MPD was still seen as recently as the 1950s. The Three Faces of Eve
(Thigpen &Cleckley, 1957) portrayed a patient whose disorder was traceable to her
parents‟ well-meaning demand that she kiss her dead grandmother goodbye, hardly a case
of incestuous abuse. Similarly, Eve‟s alter, Eve Black, was flamboyant and sexually
provocative, but overall was no more evil than Miss Beauchamp‟s alter, Sally. It was not
until Sybil (Schrieber, 1973), the story of Cornelia Wilbur‟s patient, was published that we
began to see the multilayered, numerous alters that are common today. For the first time
we also had a media-disseminated view of MPD that included a truly dangerous and
destructive alter whose “birth” was occasioned by incestuous and sadistic anal and vaginal
rape. Unfortunately, since the book‟s publication and the subsequent television
presentation, Sybil seems to have become the prototype for MPD (Ganaway, 1995).
At present, multiple personality disorder is a severe and malignant syndrome. Orne and
Bates (1992) note that since Bliss (1984) reported that 21% of MPD patients had self-
mutilating alters, the proportion of such patients has been increasing. Coons, Bowman, and
Milstein re-ported a 34% rate in 1988, while Coons and Milstein (1990) reported that 48%
of the patients in their sample had self-mutilating alters. It has also become increasingly
rare to find patients with just two or three personalities. More than 10 alters has become
modal, and more than 100 have been discovered in several patients.
The changing and malleable nature of this disorder suggests that we are seeing underlying
pathology expressed in a manner shaped by the expectations and demand characteristics of
the clinical setting. The geographic distribution of this disorder, which is observed largely
among North American women, also suggests that this latest form of possession (Spanos,
Burgess, &Burgess, 1994) is not inherent in the patient, but is shaped by cultural
expectations and the availability of a role model. Finally, the infrequency of childhood cases
of MPD (Kluft, 1984b) suggests that the disorder is an adult expression of psychopathology,
not a defense employed by overwhelmed children.
Multiple personality disorder has been conceptualized as a lesion in memory (Orne &Bates,
1992 Orne &Dinges, 1989). Patients cannot or will not remember and “own” ego-dystonic
behavior. They suggest appropriate therapy involves gentle exploration in order to allow
patients to accept and control behavior and impulses that otherwise might be dissociated.
McHugh (1993, 1995) proposes a more dismissive approach in which manifestations of
dissociative behavior are simply ignored and thus extinguished. Both approaches assume a
major feature of appropriate therapy is the therapist‟s assignment of and patient‟s
acceptance of responsibility for all their feelings, thoughts, and behaviors.
Orne and Bauer-Manley (1991) suggest that the normal self is a complex mixture of
information, impulses, and feelings, and that the unidimensional alters of multiple
personality disorder reflect the concept of a unitary self, not the reality of a multifaceted
one. In another similar view, Ganaway (1995) sees multiple personality disorder as an
expression of underlying dissociative pathology that is iatrogenically shaped into its
malignant form by well-meaning therapists. Like Orne and Bates (1992), Ganaway sees the
shaping as a product of therapist expectancy and demand. Spanos et al. (1994) take a
similar position, seeing multiple personality as one of a series of role enactments, such as
being possessed or remembering an abduction by space aliens, in response to the

Cultic Studies Journal, Vol. 13, No. 1, 1996, page 47
availability of the social role and an environment that provides acceptance for such
behavior. Similarly, Sarbin (1995) sees multiple personality as role enactment involving
believed-in imaginings and self-deception.
It is difficult to conceptualize MPD without accepting the common elements of the positions
noted above. Certainly, standard models of autobiographical memory are entirely
inconsistent with more simplistic models of MPD that involve a series of traumatized selves
and quickly alternating fugues. As noted above, true psychogenic amnesia remains a rare
condition lengthy fugue states are still rarer. In MPD, we supposedly have quickly
alternating fugue states that come and go on request, as well as a variety of different
psychogenic amnesias, such that A knows what B knows but not what C knows, while D is
unknown to A, B, and C, but knows all about them. It is as if we were being told of people
who routinely run 3-minute miles and jump 15 vertical feet. The human organism is not
built that way. Consider the mutable nature of the disorder, its geographic distribution, the
difficulty of finding the syndrome among children, and the way it contradicts our
understanding of memory. In light of these factors, the belief that MPD symptoms are
purely the product of defensive dissociative states, rather than a social role legitimized by
the media and therapists, seems naïve.
Another factor should be considered. Most MPD patients also satisfy the diagnostic criteria
for borderline personality disorder. Although it is clear that some multiples are not
borderlines, estimates of comorbidity have ranged from over 60% (Horevitz &Braun, 1984)
to over 90% (Putnam, 1989). Clinically, patients with borderline personality disorder may
be expected to enthusiastically embrace any role that is sufficiently melodramatic and
provides enough attention and activity for them to avoid feeling the chronic emptiness
endemic to the condition.5
Narrative Truth, Historical Truth, and Therapeutic Hypnosis
We have focused on the hidden presentation of ICA (Gelinas, 1983) because it
demonstrates the dangers present when therapeutic hypnosis is considered a source of
veridical information (and because it was Ms. Borawick‟s claim). Information obtained in
psychotherapy is often true in a symbolic sense, not a literal one. The person who is age
regressed to his or her 4-year-old birthday party may vividly reexperience a conversation
with Aunt Jane. The conversation may have occurred at another birthday party, with
another relative, or not at all. In psychotherapy, it does not matter. The content and nature
of the interaction are the critical factors because they may provide insight into how the
patient thinks and feels. However, they do not tell us what happened historically or legally
on the patient‟s fourth birthday.7
In recent years, scholars of psychotherapy have increasingly described historical
reconstruction during psychotherapy in terms of the creation of a fictive narrative (Spence,
1982, 1994). This view gave rise to hermeneutic interpretation of autobiographical
information obtained in psychotherapy. The narrative is treated as you would treat a literary
text in which you wish to discover meaning (cf. Woolfolk, Sass, &Messer, 1988). The notion
that any procedure used in psychotherapy will routinely elicit reliable history is contradicted
by the work of both early pioneers and modern investigators. Adding hypnosis to
psychotherapy inevitably has the same effects that occur when hypnosis is used to influence
memory retrieval in any other context. Hypnosis increases productivity, certainty, and
believability without a corresponding increment in historically correct information.
There are rare instances in which hypnosis may stimulate the return of historically accurate
memory that has been blocked for emotional reasons (cf. Raginsky, 1969). Given what we
know about memory for stressful events, true psychogenic amnesia can be expected to be
very rare. In more than 20 years of practice and research, the first author has encountered
one case that seems to involve true psychogenic amnesia. In more than 30 years of practice