Evidence of Dissociative Identity Disorder (formerly called Multiple Personality Disorder and hereafter referred to as multiple personality in deference to those who do not believe it is a disorder at all) is not a new development of the twentieth century. In fact, evidence of multiple personality is said to exist in the images of shamans changed into animal forms or embodying spirits in Paleolithic cave paintings(1). Throughout recorded history cases of demonic possession have been reported that many experts now believe are cases of multiple personality(2). Beginning in the eighteenth century, more detailed accounts in terms of multiple personality being a mental condition began appearing.

Although there are reports of an earlier account by Paracelsus who wrote of a woman who had amnesia about an alter personality who stole her money in 1646(4), Eberhardt Gmelin is usually credited as being the first to report a case of multiple personality(3). Whether it was the first report or not, Gmelin’s 1791 account of "exchanged personality" is the first known account of multiple personality written about in great detail(5).

The case Gmelin wrote about involved a 20-year-old woman living in Stuttgart who began to speak perfect French, behave like a French aristocrat and spoke German with a French accent. This took place the year the French Revolution began which is thought to be significant because during the uprising, many French aristocrats left France and fled to Stuttgart. When she was the "French Woman" she remembered everything she did but as the "German Woman" she denied any knowledge of the "French Woman". Gmelin claimed he could cause the personalities to switch from one to the other with a movement of his hand(6).

Around the same period of time, Dr. Benjamin Rush collected case histories of dissociation and multiple personality(7). Rush, chief surgeon of the Continental Army(8), is recognized as the "Father of American Psychiatry"(9). He wrote the first American text of psychiatry, "Medical Inquiries and Observations Upon Diseases of the Mind", published in 1812(10).  In his work with dissociation, he theorized that the cause for the doubling of consciousness related to a disconnection between the two hemispheres of the brain, the first of many speculations about this possibility(12).

It is the case of Mary Reynolds, first published in 1816 in "Medical Repository" by Dr. Samuel Latham Mitchell that was perhaps the most influential of these early cases(13). It also appears to be the first case to capture the attention of the public with accounts appearing in an article in "Harper’s New Monthly Magazine" in 1860 and an autobiography by Mary Reynolds herself(14). Ms. Reynolds was born in England in 1785 and moved with her family to Meadville Pennsylvania. The atmosphere she was raised in was described as strongly religious and, as a child, she seemed melancholy, shy and given to solitary religious devotions and meditations. She was considered to be normal until her late teens. At 19, she became blind and deaf for five or six weeks. Three months later she awoke after sleeping eighteen to twenty hours seeming not to know things she had learned. Within a few weeks, however, she became familiar with her surroundings and learned reading, calculating and writing although her penmanship was crude compared to what it had been previously. Her personality at this time was described as "buoyant, witty, fond of company and a lover of nature". After about five weeks, she slept again and awoke as her prior self with no memory of what had happened(15). This new state alternated with the original one at varying length for fifteen or sixteen years until her mid thirties when the alternations stopped and she remained in the second state until her death at 61 years of age. Mitchell confirmed the account about Mary Reynolds with her relatives, the Reverend Dr. John V. Reynolds and his brother William Reynolds(16).

Estelle’s case, described in a 1840 monograph by Despine, involved an 11-year-old Swiss girl who initially presented with paralysis and exquisite sensitivity to touch and later developed a second personality who could walk, play and could not tolerate her mother’s presence. Estelle exhibited marked differences in behavior, preferences and relationships between the two personality states. Despine reported being able to cure the child through treatment principles, some of which are recognized as valid today(17).

In the late 19th century, Eugene Azam, a professor of surgery interested in hypnotism, published a number of reports of Felida X, an extensively documented case of multiple personality he followed for over 35 years(18). Felida X was born in 1843, lost her father in infancy and had a difficult childhood. She exhibited three different personalities, each considering itself to be Felida’s normal state and the others to be abnormal. The second personality state first manifested when Felida was 13 years old and suffered none of the physical illnesses that the first personality suffered. Initially, switching was reported to happen almost every day after a pain in the temple and a profound sleep for two to three minutes but the frequency of switching decreased over time to the point that it would happen only every 25 to 30 days and last only a few hours at a time. The third personality, which appeared only on occasion, suffered from anxiety attacks and hallucinations. At one point, the first personality was pregnant without explanation and the second personality emerged and took responsibility for the pregnancy.

During the late 19th century and early 20th century, Pierre Janet described a number of case of multiple personality including the cases of Leonie, Lucie, Rose, Marie and Marceline(19). Leonie appeared to have three or more personality states including a child alter named Nichette, a childhood name. In the case of Lucie, who also reportedly had three personality states, there was an alter personality named Adrienne who would seem to experience flashbacks of a traumatic childhood event. In the case of Rose, she would suffer from a variety of somnambulistic states. In some, she was paralyzed and in others she was able to walk.

Janet was also the author of  a famous book about dissociation. In 1906, Janet was invited to speak at Harvard Medical School where he spoke about the Felida X case, the most extensively documented case of multiple personality then known to French physicians and compared the case to the Mary Reynolds case. This 1906 meeting is believed to be the first transatlantic meeting on the subject of multiple personality.(20)

1906 is also that year that Mortin Prince published the account of the Christine Beauchamp case in "The Dissociation of a Personality"(20). Prince also founded the still-published Journal of Abnormal Psychology where he published other examples of multiple personality.

In the case of Miss Beauchamp, she was found to have additional personality states including one calling herself Sally who was childlike and differed significantly from Miss Beauchamp’s presenting personality, one that was very much like the presenting personality and one called the Idiot that was extremely regressed(21). Following is a passage of one of Prince’s descriptions of Miss Beauchamp from "The Dissociation of a Personality" as quoted in http://www.astraeasweb.net/plural/lizza.html "Why does the mental health industry regard people in multiple households as ‘not real?’" by John Lizza:

Miss Christine L. Beauchamp, the subject of this study, is a person in whom several personalities have become developed; that is to say, she may change her personality from time to time, often from hour to hour, and with each change her character becomes transformed and her memories altered. In addition to the real, original or normal self, the self that was born and which she was intended by nature to be, she may be any one of three different persons. I say three different, because, although making use of the same body, each, nevertheless, has a distinctly different character; a difference manifested by different trains of ought, by different views, beliefs, ideals and temperament, and by different acquisitions, tastes, habits, experiences and memories. Each varies in these respects from the other two, and from the original Miss Beauchamp. Two of these personalities have no knowledge of each other or of the third, expecting such information as may be obtained by inference or second hand, so that in the memory of each of these two there are blanks which correspond to the times when the others are in the flesh. Of a sudden one or the other wakes up to find herself, she knows not where and ignorant of what she has said or done a moment before. Only one of the three has knowledge of the lives of the others, and this one presents such a bizarre character, so far removed from the others in individuality that the transformation from one of the other personalities to herself is one of the most striking and dramatic features of the case. The personalities come and go in kaleidoscopic succession, many changes often being made in the course of twenty-four hours. And so it happens that Miss Beauchamp, if I may use the name to designate several distinct  people, at one moment says and does and plans and arranges something to which a short time before she most strongly objected, indulges tastes which a moment before would have abhorrent to her ideals, and undo or destroys what she had just laboriously planned and arranged.

As late as the 1960s and 1970s, the Beauchamp case was cited in textbooks at a typical example of multiple personality. It is believed that there are certain aspects of the Beauchamp case that are the roots of the interpretation that multiple personality is an iatrogenic phenomenon (meaning it is caused by therapists – usually through the use of hypnotism). It should be noted that experts today believe that multiple personality there is no evidence that multiple personality can be created iatrogenically other than on a transient basis(20) although even a cursory review of the literature will indicate there is no true consensus concerning the extent to which multiple personality may be created iatrogenically.

The published case literature on multiple personality during the 19th century and the early part of the 20th century would probably occupy several volumes(22) and yet the condition was declared "extinct" by E. Stengel in 1943(23). This has been explained by one writer as follows "French-speaking psychiatry dominated the English-speaking world during the 19th century; German-speaking psychiatry has dominated much of the 20th"(24).

In 1944, only a few months after the condition was declared extinct, a landmark paper was published by W. Taylor and M. Martin in  "The Journal of Abnormal Psychology." The paper surveyed all the cases known to its authors and "was the most quoted reference in the history of the illness" for the next 30 years.(25). Thereafter, there was a virtual blackout in the publication of accounts of multiple personality until the 1954 publication in Prince’s journal of the case of Chris Costner Sizemore.

In 1957, the Sizemore story was popularized by Corbett Thigpen and Hervey Cleckley in The Three Faces of Eve. The story was adapted for film with Joanne Woodward playing the title role for which she won the Best Actress Oscar and which experts have hailed as "so clinically accurate, so typical of explicit cases of MPD, that the effect is chilling."(26)  Chris Costner Sizemore has also written two autobiographical accounts: I’m Eve and Mind of My Own : The Women Who Was Known As ‘Eve’ Tells the Story of Her Triumph over Multiple Personality Disorder. In addition, Chris Costner Sizemore recently appeared on ABC’s Primetime Live (March 4, 2020) in an interview with Diane Sawyer who also interviewed Ms. Sizemore’s son who spoke about life with a multiple. At the time of the 1957 account by Mr. Thigpen and Mr. Cleckley, it was believed that the condition was extraordinarily rare.

The re-emergence of multiple personality begins with the publication by H. Ellenberger’s extensively researched The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry which devoted attention to dissociation and multiple personality(27). Throughout the 1970s, a number of clinicians worked toward defining and establishing the legitimacy of the condition. Margareta Bowers along with six other contributors published "Therapy of Multiple Personality" in 1971. "Therapy of Multiple Personality" has been called "brilliant" and outlines rules for treating multiple personalities which are still used today(28). Cornelia Wilbur, M.D. (who treated Sybil) and others at the Department of Psychiatry at the University of Kentucky published a series of case reports and papers during the 1970s(29). The efforts of pioneers such as Ralph B. Allison, Dr. Wilbur, and David Caul, M.D. led to the availability of workshops on multiple personality thereby increasing the number of clinicians able to diagnose and treat the condition(30) leading to greater numbers of clinicians studying and treating the condition.

However, it is the case of Sybil Isabel Dorsett which is considered "the most important clinical case of multiple personality in the twentieth century"(31). It is certainly one of the most famous after the 1973 publication of the book Sybil by Flora Rheta Schreiber. The book was a best seller and led to a television movie by the same name starring Sally Field and Joanne Woodward. Cornelia Wilbur describes her discovery of Sybil’s multiple personalities:

One day, when she was talking to me about something that should have made her angry, she jumped off the couch, went over and stuck her fist through one of the window panes in my office. I jumped out of my chair, ran over, grabbed her wrist and said "Let me see if you cut yourself." She ducked down and hunched her shoulders, peered up at me and said, "Let me go." I said, "No, I want to see your hand, and if you cut yourself." She looked at me and said, "Am I more important than the window?" I said, "Certainly. A handyman can fix the window, but if you are cut, it would take a doctor to sew you up." She had not cut herself, but she was not talking like her typical self. She looked younger and frightened, so I asked her a spontaneous question, "Who are you?" She said, "I am Peggy." I thought immediate that this must be a dual personality, but I said nothing to the patient about this.

The next time this patient was due in the office, I opened the door, and here was a young woman in high heels, hair piled on top of her head, very elegan looking, who looked at me and said, "I am sorry, Sybil was ill today, so I came — I am Vicky." I said "Come in," and during this hour "Vicky" apprised me of the fact that, yes there is "Peggy" and herself and "others" as well as Sybil, but I should not tell Sybil this because it would upset her. So here I was with a Multiple Personality, never having diagnosed one before, never having treated one, and not really knowing what to do. I was, as usual, very excited about this new kind of case.(32)

Dr. Wilbur continued working with Sybil and wrote papers on dissociation and hysteria and multiple personality but she could not get her papers published.(33). Over sixteen years of work with Sybil, Dr. Wilbur learned that Sybil was the victim of horrific abuse inflicted on her by her psychotic mother. Her father failed to protect her from it. As a result, she developed alter personalities which embodied feelings and emotions the ‘real’ Sybil could not cope with. The waking Sybil was deprived of all these emotions, and was therefore a rather drab figure. She was unaware of her other personas; while they were in ‘control’ of the body, Sybil suffered blackouts and did not remember the episodes. Cornelia Wilbur helped Sybil integrate the personalities. Denied the ability to publish about her work in professional journals of the time, Dr. Wilbur invited Schreiber to write the popularized account of Sybil’s case(33).

The case of Sybil is significant in several respects. Sybil’s psychiatrist, Cornelia Wilbur, went to great lengths to validate the accounts of abuse including interviews with Sybil’s parents, a visit with Sybil to her childhood home, and speaking with Sybil’s doctor and reviewing his records(35). The case firmly linked multiple personality disorder with child abuse(36). The graphic treatment of the amnesia, fugue episodes and conflicts among alters in Schreiber’s book "served as a template against with other patients could be compared and understood(37). Dr. Wilbur’s therapy which included hypnosis and other therapeutic interventions and produced a successful resolution "served as an example for many multiples and their therapists"(38).
 
Work by the pioneers in the field of multiple personality culminated in the publication of the DSM-III by the American Psychiatric Association in 1980. The DSM-III created a separate category for the dissociative disorders and set forth the criteria for a diagnosis of Multiple Personality Disorder(39) giving legitimacy to the condition. 1994 was another landmark year in the field of multiple personality study with the publication of the Diagnostic and Statistical Manual of Mental Disorders : DSM-IV. This was the year that the condition got its current name: Dissociative Identity Disorder (DID). Also during this year, The International Society for the Study of Dissociation published "Guidelines for Treating Dissociative Identity Disorder In Adults" (which was updated in 1997).  The past 18 years have seen a a virtual explosion in the publication of journals, books, biographical accounts about the subject including:

• E. L. Bliss’ study of fourteen patients, P. M. Coons systematic treatment of making a diagnosis, G. B. Greaves "classic" review article, B. G. Braun’s treatment recommendations, and S. S. Marmer(40) psychoanalytic study published in 1980;
• Daniel Keyes’ The Minds of Billy Milligan published in 1981 (which documents the story of a man who raped a number of women on and around the Ohio State University campus  and who was found not guilty by reason of insanity due to Multiple Personality Disorder);
• special issues in four journals and Multiple Personality, Theory, Diagnosis, and Treatment : A Case Study by R. Douglas Smith published in 1984;
• Diagnosis and Treatment of Multiple Personality Disorder by Frank W. Putnam of the National Institutes of Mental Health and Multiple Personality Disorder: Diagnosis, Clinical Features, and Treatment by Colin A. Ross, a noted clinician and researcher and founder of The Colin A. Ross Institute published in 1989;
• United We Stand: A Book for People with Multiple Personalities by Eliana Gil, Ph.D. published in 1990;
• Multiple Personality Disorder from the Inside Out edited by Barry M. Cohen, Esther Giller and Lynn W. published in 1991;
• The Family Inside : Working With the Multiple by Doris Bryant, Judy Kessler and Lynda Shirar, Living With Your Selves : A Survival Manual for People With Multiple Personalities by Sandra J. Hocking, and The Flock: The Autobiography of a Multiple Personality by Joan Frances Casey with Lynn Wilson published in 1992;
• Clinical Perspectives on Multiple Personality Disorder edited by Richard P. Kluft, M.D. and Catherine G. Fine, Ph.D. (dedicated to the memory of Cornelia B. Wilbur, M.D. who died April 10, 2020), People in Pieces : Multiple Personality in Milder Forms & Greater Numbers by Alan, Ph.D. Marshall and Multiple Personalities, Multiple Disorders : Psychiatric Classification and Media Influence (Oxford Monographs on Psychiatry, No 1) by Carol S., M.D. North, Jo-Ellyn M., M.D. Ryall, Daniel A., C.m Ricci, and Carol S. North published in 1993;
• The Osiris Complex : Case-Studies in Multiple Personality Disorder by Dr. Ross, Someone I Know Has Multiple Personalities : A Book for Significant Others– Friends, Family, and Caring Professionals by Sandra J. Hocking, and My Mom Is Different by Deborah Sessions published in 1994;
• Beyond Integration : One Multiple’s Journey by Doris Bryant and Judy Kessler, Internal Family Systems Therapy by Richard C. Schwartz, and Dissociative Identity Disorder : Theoretical and Treatment Controversies edited by Lewis M. Cohen published in 1995;
• Dissociative Identity Disorder : Diagnosis, Clinical Features, and Treatment of Multiple Personality by Dr. Ross published in 1996;
• Dissociation in Children and Adolescents : A Developmental Approach by Frank W. Putnam, More Alike Than Different : Treating Severely Dissociative Trauma Survivors by Margo Rivera, and Jekyll on Trial : Multiple Personality Disorder and Criminal Law by Elyn R. Saks and Stephen H. Behnke published in 1997.

 
During the past decade, screening instruments, structured diagnostic instrument, and a specialized mental status examination have been developed(42). Given the increasing availability of information to the general public and clinicians, the development of screening and diagnostic instruments, and the intensity of debate surrounding issues related to multiple personalities, it seems likely that the future will bring continued discussion, publication and debate about the condition and, with that, growth in our understanding of the condition and our ability to treat it. Yet even today there are still professionals in the mental health fields who continue to believe that Dissociative Identity Disorder is not a legitimate psychiatric diagnosis(43).

1. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: Guilford, p. 27

2. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: Guilford, p. 27; Greaves, G.(1993) "A History of Multiple Personality Disorder" in Clinical Perspectives on Multiple Personality Disorder, Kluft, R. and Fine, C., editors. Washington, D.C.: American Psychiatric Press, Inc., p. 356; Phillips, M. and Fredericks, C. (1995). Healing the Divided Self. New York: W.W. Norton & Company. p. 1; and Golub, D. (1995). "Cultural Variations in Multiple Personality Disorder" in Dissociative Identity Disorder, Cohen, L., Berzoff, J., and Elin, M., editors. New Jersey: Jason Aronson, Inc.

3. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 355 and "Child Abuse And Multiple Personality Disorder" by Philip M. Coons, M.D. at Anonymous Sexual Abuse Recovery (Canada) (http://www.worldchat.com/public/asarc/library/mpd1.html)

4. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

5. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 356

6. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 355 and Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

7. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

8. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

9. "History – Dr. Benjamin Rush"
(http://www.pahosp.com/timeline/tline7.html) and "Some Famous Unitarian Universalists" (http://www.cyberstreet.com/uu/famuu.htm)

10. "History – Dr. Benjamin Rush" (http://www.pahosp.com/timeline/tline7.html)

11. omitted

12. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

13. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

14. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 357 and Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

15. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 356-7

16. Merskey, H. (1995). "The Manufacture of Personalities: The Production of Multiple Personality Disorder" in Dissociative Identity Disorder, Cohen, L., Berzoff, J. and Elin, M., editors. New Jersey: Jason Aronson, Inc., p. 10

17. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 28

18. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 29 and Merskey, H. (1995). "The Manufacture of Personalities: The Production of Multiple Personality Disorder," p. 12

19. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 29 and Merskey, H. (1995). "The Manufacture of Personalities: The Production of Multiple Personality Disorder," p. 12

20. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 358-359

21. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 30

22. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 357

23. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 361 and Kluft, R. (1995) "Current Controversies Surrounding Dissociative Identity Disorder" in Dissociative Identity Disorder, Cohen, L., Berzoff, J. and Elin, M., editors. New Jersey: Jason Aronson, Inc., p. 351

24. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 357

25. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 361

26. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 362

27. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 35

28. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 363

29. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 35

30. Kluft, R. (1995) "Current Controversies Surrounding Dissociative Identity Disorder,"  p. 353

31. Greaves, G.(1993) "A History of Multiple Personality Disorder", p.364

32. Wilbur, C. with Torem, M. "A Memorial for Cornelia B. Wilbur, M.D., in Her Own Words: Excerpts From Interviews and an Autobiographical Reflections" in Clinical Perspectives on Multiple Personality Disorder, Kluft, R. and Fine, C., editors, p. xxviii

33. Wilbur, C. with Torem, M. "A Memorial for Cornelia B. Wilbur, M.D., in Her Own Words: Excerpts From Interviews and an Autobiographical Reflections," p. xxix

34. omitted

35. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 364

36. Gold J. (1993). "Cornelia B. Wilbur, M.D.: An Appreciation" in Clinical Perspectives on Multiple Personality Disorder, Kluft, R. and Fine, C., editors (1993). Washington, D.C.: American Psychiatric Press, Inc., p. 4

37. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 35

38. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 35

39. Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder, p. 34

40. Kluft, R. (1995) "Current Controversies Surrounding Dissociative Identity Disorder", p. 353

41. Greaves, G.(1993) "A History of Multiple Personality Disorder", p. 367

42. Kluft, R. (1995) "Current Controversies Surrounding Dissociative Identity Disorder", p. 354

43. Merskey, H. (1995). "The Manufacture of Personalities: The Production of Multiple Personality Disorder" and Wilbur, C. with Torem, M. "A Memorial for Cornelia B. Wilbur, M.D., in Her Own Words: Excerpts From Interviews and an Autobiographical Reflections," p. xxx

 

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