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This article was downloaded by: [Brown University Library] On: 29 October 2014, At: 20:00 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Journal of Trauma & Dissociation Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wjtd20 “So We Don't Exist?” Charles L. Proudfit PhD, LCSW Published online: 20 Oct 2008. To cite this article: Charles L. Proudfit PhD, LCSW (2002) “So We Don't Exist?”, Journal of Trauma & Dissociation, 3:2, 1-8, DOI: 10.1300/J229v03n02_01 To link to this article: http://dx.doi.org/10.1300/J229v03n02_01 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is

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Page 1: “So We Don't Exist?”

This article was downloaded by: [Brown University Library]On: 29 October 2014, At: 20:00Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH,UK

Journal of Trauma &DissociationPublication details, including instructions forauthors and subscription information:http://www.tandfonline.com/loi/wjtd20

“So We Don't Exist?”Charles L. Proudfit PhD, LCSWPublished online: 20 Oct 2008.

To cite this article: Charles L. Proudfit PhD, LCSW (2002) “So We Don't Exist?”,Journal of Trauma & Dissociation, 3:2, 1-8, DOI: 10.1300/J229v03n02_01

To link to this article: http://dx.doi.org/10.1300/J229v03n02_01

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all theinformation (the “Content”) contained in the publications on our platform.However, Taylor & Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness,or suitability for any purpose of the Content. Any opinions and viewsexpressed in this publication are the opinions and views of the authors, andare not the views of or endorsed by Taylor & Francis. The accuracy of theContent should not be relied upon and should be independently verified withprimary sources of information. Taylor and Francis shall not be liable for anylosses, actions, claims, proceedings, demands, costs, expenses, damages,and other liabilities whatsoever or howsoever caused arising directly orindirectly in connection with, in relation to or arising out of the use of theContent.

This article may be used for research, teaching, and private study purposes.Any substantial or systematic reproduction, redistribution, reselling, loan,sub-licensing, systematic supply, or distribution in any form to anyone is

Page 2: “So We Don't Exist?”

expressly forbidden. Terms & Conditions of access and use can be found athttp://www.tandfonline.com/page/terms-and-conditions

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EDITORIAL

“So We Don’t Exist?”:

Dissociative Identity Disorder

in the University Classroom

Editors’ Note: Academic papers–even clinical articles and case reports–sometimes fail to capture the experience of persons with dissociative dis-orders and those who live and work with them. This editorial reminds usthat scholarly debates are often very far removed from real life experi-ence. In the end, the validity of such debates rests not on which point ofview has been better argued, but which perspective best resonates withpersonal experience and personal reality.

–James A. Chu, MD and Elizabeth S. Bowman, MD

As a university professor of English, a non-clinical graduate of a psychoan-alytic institute, and a licensed clinical social worker, I have had the opportu-nity over the past twenty-three years to supplement my courses in literatureand psychoanalytic psychology with evolving psychoanalytic theories and in-creasing clinical experience. Often, however, the lectern becomes a chair inmy classroom, and I become the student and the student my teacher. Although

Journal of Trauma & Dissociation, Vol. 3(2) 2002 2002 by The Haworth Press, Inc. All rights reserved. 1

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on campus I am careful to be a university professor and not a therapist, stu-

dents do often share their emotional issues, and occasionally their psychiatric

diagnoses, with me. One diagnosis, dissociative identity disorder (formerly

personality disorder–MPD), elicits controversy in the classroom as well as in

the international mental health community. Among the more vocal skeptics of

DID are Hacking (1986), Aldridge-Morris (1989, 1993), Merskey (1992a,

1992b, 1992c, 1992d, 1994), Freeland, Manchandra, Chiu, Sharma, and Merskey

(1993), and Seltzer (1994). Most of these skeptics are British or Canadian aca-

demic psychiatrists. The majority of defenders of DID as a clinical entity are

from North America. Among them are Spiegel (1984), Bliss (1988), Putnam

(1989, 1992, 1997), Kluft (1985, 1990, 1991), Greaves (1993), Ross (1994),

Chu and Bowman (2000), Curtis (2000), Steinberg and Schnall (2000), Caldwell

(2001), and Silberg (2001).Melissa Caldwell (2001) believes that the main reason for the DID contro-

versy lies in “the central paradox of dissociative identity disorder: . . . DID is

both real and not real at the same time. It is true that DID is not literally real and

that people have only one personality. On the other hand, and equally true,

DID is very real for the people who suffer from it” (p. 4). Those of us who treat

people with dissociative identity disorder operate with this paradoxical under-

standing; those, like Merskey, who have never knowingly seen a case, and

deny the validity of the diagnosis, sidestep this paradox, and focus only their

attention on only on the literal question. My encounter several years ago with a

student diagnosed with DID offers, I believe, a unique report on when the sec-

ond half of the paradox confronts the first.In her early thirties, married and without children, N. had returned to col-

lege after several years working in Washington, DC to complete her under-

graduate degree in psychology. Following my presentation of DID which

included references to my own clinical experience and several excerpts from

the movie Sybil, she came to my office and said: “You know what you are talk-

ing about.” I asked her to explain. “Last year in therapy I realized that I was

multiple,” she said, “and your clinical description is right on. And, by the way,

do you know that the son of the actress who played Sybil is in our class?” “How

did you know?” I exclaimed. (The son is blue-eyed whereas Sally Fields is

not.) “Oh, he has her face: it’s round, and he has her eyes.” Unbeknownst to N.,

Field’s son had come into my office, told me who he was, asking me not to

share that information with the class, and said: “You know, my mother feels

that her portrayal of Sybil is her best effort as an actress, so far.” On second

thought, I wasn’t surprised that N. had made this identification. Children dis-

sociate for very good reasons, chief among them child abuse: they must learn

to read faces. I thought of the poet Robert Browning’s (1970) painter-monk,

Fra Lippo Lippi’s observation:

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But, mind you, when a boy starves in the streets

Eight years together, as my fortune was,

Watching folk’s faces to know who will fling

The bit of half-stripped grape-bunch he desires,

And who will curse or kick him for his pains, . . .

Why, soul and sense of him grow sharp alike,

He learns the look of things, . . .

[1855]

One day after class N. told me that she was very worried about taking themidterm examination the following week because of her absences. I checkedmy seating chart and told her that two missed classes over an eight-week pe-riod was certainly nothing to worry about. “But I’m not always here when I’mhere, ” she said. I quickly realized my error, and asked who was? “Oh, usuallyS., she writes my papers [I learned later than S. was N.’s internal self helper],and then W. finds parts of the course really interesting.” I then said what Iwould have said to a dissociative client (in an attempt to break down amnesicbarriers and foster closer cooperation with the other alters): “Why don’t thethree of you come to the exam and share your disparate information?” Appar-ently this is what occurred, because N. wrote the best exam in a class of 35juniors and seniors.

On another occasion, I asked my students to write a response to a selectedreserve reading. N. asked for some suggestions, and together we reviewed thereading list. When we got to the “M’s,” I laughed and said: “You ought to readthis paper by a Canadian psychiatrist, Harold Merskey (1992). He doesn’t be-lieve that MPD is a valid diagnosis. I’ve attached several pro and con letters tothe editor that followed the publication of Merskey’s paper. I’d be interested inyour response.” N. accepted my suggestion with alacrity. She handed in her(their) response the following week, and has given me permission to share it inthe hope that it might help convince skeptics and offer support to those whosuffer from DID:

The Manufacture of Personalities (Merskey, 1992a) Response

We really had fun reading Merskey’s view on the manufacture of

multiple personalities. He went to all this trouble to dig up Janet’s and

Prince’s research from the nineteenth and twentieth centuries yet never

bothered to talk to any current MPD sufferer to learn about their path to

an eventual diagnosis. It seems absurd to make posthumous speculations

when bright, articulate, and very alive subjects are available for inter-

viewing. We’re really glad he’s not our therapist!

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We’ll briefly discuss why we don’t believe that hypnotic suggestion,medical induction, social facilitation, or iatrogenesis contribute to theemergence of MPD. Basically MPD is too damn miserable, all-consum-ing, disconcerting, and terrifying to merely adopt because we readSybil!! With the possible exception for the need of an insanity defense,nobody in their “right mind” would choose an MPD diagnosis. Not onlyis the disorder shrouded in mystery and misconceptions, the DSM-III-Rdiagnosis 300.14 is akin to having an AIDS diagnosis: judgments flour-ish, opportunities cease to exist, you are thought of as a freak, and yourbasic humanity is denied. “Researchers” like Merskey perpetuate themyths about MPD and inhibit appropriate treatment.

We have to share our own path to an MPD diagnosis. After 15 years ofsevere drug abuse, some of us fell into a deep depression. The availabil-ity of the drugs and their effectiveness were declining and all sorts ofbizarre behaviors began to emerge. One minute “she” would be contem-plating swallowing the hundreds of anti-depressants, anti-psychotics,and tranquilizers the psychiatrist (jerk!) had given us and within twominutes “she” would be wanting to go shopping for a dress to wear to hercompany’s Christmas party. “She’d” bounce out the door and get on thesubway, only to have a panic attack and end up at some Metro stop shehad no recollection of. We’d look at the Metro map yet have absolutelyno idea where we were in reference to anything and would just ride thetrains until something seemed familiar.

People always thought they knew me and I had a pat answer. “Oh, Ijust have the world’s most familiar face!” We had clothes in our closetwe could never remember buying, we always thought our watches andclocks were broken. My partner would complain about mood swings,and we just couldn’t remember things we supposedly had done. We re-ally though we were out of our mind. Of course we were given Lithiumand Tegretol to manage our rapid-cycling bipolar illness, benzodiazepinesto help with the anxiety, sleeping pills to aid our insomnia, anti-depres-sants to counteract the severe depression, and so on and on.

We presented our story of horrible abuse (as much as some could re-member) yet the shrink never got it. We ended up hospitalized twice inpa-tient and once outpatient with chemical dependency and PTSD diagnoses,yet no matter how hard we “worked our program,” restructured ourthoughts and behaviors, set up good boundaries, journaled our feelings,and spoke out truths, we still lost time, experienced feelings of unreality,couldn’t remember doing things, and still felt suicidal most of the time.Hopeless was our overwhelming feeling. We were so motivated andthings were really getting worse. We could no longer stop the internal di-alogues, and we had chronic headaches and pelvic main. We were losing

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weight and all the while performing well at our job and acting as if thingswere great. How exhausting!

Anyway, after four years and tens of thousands of dollars of therapy,we happened upon a woman who understood. We’d work on bringing upmemories and apparently when the memory was discussed, a differentvoice would talk about what happened. When another event was re-called, yet another voice (persona) would emerge. This went on withoutmy knowing it for quite some time but I did notice I was feeling better.There wasn’t so much internal warring. I could remember if I’d eatenlunch that day, and I felt trusting towards someone for the second time inmy entire life. Finally, with great reluctance, I admitted to my therapistthat I thought I had MPD and her response was, “Oh, honey, I know andit’s really okay.” So contrary to Merskey’s contention, my splitting wasn’tprecipitated by my therapist’s suggestion or by hypnosis, or by my read-ing accounts of MPD. We evolved to save ourselves. Now that we thinkabout it, Cornelia Wilbur is right. If you’ve been practicing for years andhaven’t diagnoses a case of MPD, perhaps your skills aren’t up to par.Are you listening, H. Merskey?

N.’s articulate rebuttal of Merskey’s academic attack on the validity of DIDas a diagnosis is the second half of the paradox: the “very real” experience ex-pressed by a client–not a clinician or researcher. She is committed to her sideof the paradox as Merskey is to his.

As her professor, of course, it was important for me to remember that N.was a bright, verbal student in my course who would graduate the followingspring as well as a young woman who had an inner dissociative life compli-cated by bipolar disorder and histories of child abuse and chemical depend-ency. She taught me how to respond to a student with DID in an academicsetting as opposed to the consulting room. She also shared with me how some-one like herself feels when her inner reality is denied by a skeptic likeMersekey. Gerard Manley Hopkins (1970), a nineteenth century poet-priestwho suffered from severe depression, offers, an eloquent poetic description ofthe reality in which N. and other sufferers of severe emotional disorder oftenfind themselves:

O the mind, mind has mountains; cliffs of fallFrightful, sheer, no-man-fathomed. Hold them cheapMay who ne’re hung there.

[1885]

Although the controversy over DID continues, and has entered the courtsystem (Frankel, 200l; Scheflin & Brown, 1999; Williams, 2000) encouraged

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by the False Memory Syndrome Foundation (Hamilton & Ondovik, 1993),

and has been taken up by the media (Hunter, 1998), perhaps saner voices will

prevail (Caldwell, 2001; Chu & Bowman, 2000; Dell, 1988, 2000; Putnam,

1989, 1992, 1997; Steinberg & Schnall, 2000). If the answers we get depend

on the questions we ask, then perhaps viewing DID as a paradox, as Caldwell

suggests, will enable both critic and supporters of DID to move beyond accu-

sations and defensiveness. Our focus needs to be on the treatment of those who

suffer from this special form of childhood post-traumatic stress disorder

(Kluft, 1985; Spiegel, 1984), not arguing for or against a DSM-IV (or V) diag-

nosis. “MPD,” as N. asserts, “is too damn miserable, all-consuming, discon-

certing, and terrifying to merely adopt because we read Sybil!!” Ought we not

listen and empathize and learn with our dissociative clients, realizing that the

person across from us is a single personality with a psyche divided against it-

self, rather than waste time in futile arguments?Charles L. Proudfit, PhD, LCSW

Charles L. Proudfit, PhD, LCSW525 Northstar CourtBoulder, CO 80304

E-mail: [email protected]

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Adridge-Morris, R. (1993). Correspondence. British Journal of Psychiatry, 162, 569-570.Barton, C. (1994). Backstage in psychiatry: The multiple personality controversy. Dis-

sociation, 7 (3), 167-172.Barton, C. (1994a). More from backstage: A rejoinder to Merskey. Dissociation, 7 (3),

176-177.Bliss, E.L. (1988). Commentary: Professional skepticism about multiple personality.

Journal of Nervous and Mental Disease, 176, 533-534.Browning, R. (1970). Fra Lippo Lippi. In A.M. Eastman (ed.), The Norton anthology

of poetry (pp. 762-769). New York: W. W. Norton & Co.Caldwell, M. (2001). Diagnosis and treatment of factitious and iatrogenic disorders.

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Freeland, A., Manchandra, R., Chiu, S., Sharma, V., & Merskey, H. (1993). Four cases

of supposed multiple personality disorder: Evidence of unjustified diagnosis. Cana-

dian Journal of Psychiatry, 39, 243-244.Greaves, G.B. (1993). A history of multiple personality disorder. In R.P. Kluft & C.G.

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American Psychiatric Press annual review of psychiatry, 10, 161-188. Washington,

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personality disorder. British Journal of Psychiatry, 160, 327-340.Merskey, H. (1992b). Correspondence. British Journal of Psychiatry, 161, 269-270.Merskey, H. (1992c). Correspondence. British Journal of Psychiatry, 161, 418-420.Merskey, H. (1994). The artifactual nature of multiple personality disorder: Comments

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den epedemic of our time. New York: Harper Collins.Williams, M. H. (2000). Victimized by ‘victims’: A taxonomy of antecedents of false

complaints against psychotherapists. Professional Psychology: Research and Prac-tice, 31 (1), 75-81.

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