humanist + humorist

I’m using the DW version of the original post as the masterpost, not gonna try to keep the WordPress mirror up-to-date. Off to add some new notes…

Related: an “oh, hey…” moment…

There’s a brief reference in Sybil Exposed to a diagnostic method that Sybil’s therapist reportedly used. As the author describes it:

After starting at the University of Kentucky in 1967/68, Dr. Connie Wilbur “showed residents how to test for [MPD]. She recommended that a patient be hypnotized, then encouraged to look into a mirror until someone different appeared. The patient was then asked if the person in the mirror had a name and an age. If the answer was yes, the diagnosis was multiple personality. Connie did not seem to realize what recent studies have shown: many people, even normal ones, will see different faces in a mirror within minutes of gazing.” (147-148)

(The book is from 2011, and apparently the paper that first named the “strange-face-in-the-mirror illusion” was from 2010. She meant really recent studies.)

It really sounds like both Jane Phillips and Christine Beauchamp could’ve been experiencing a version of this. They don’t describe a whole cinematic experience of seeing the figure in the mirror move and speak — they just describe looking at their face for a while, seeing it become someone else’s face, and connecting it to a separate presence. (Christine knew she was part of a system, so she was able to ID a specific headmate she already had some contact with. Jane was diagnosed years later, for other reasons, and only connected this in retrospect.)

So! Sybil’s doctor thinks that everyone who sees this illusion is multiple. And Sybil’s exposing author points out it’s an illusion everyone sees, inviting you to conclude that nobody is multiple.

But, look — compare this for a second to the mirror box illusion (video), the one used in mirror therapy for phantom limb pain. That works on everyone too! You can trick your brain into processing, say, “the mirror image of your right hand” as “actually your left hand” — and it still works whether or not you physically have a left hand.

Makes sense that everyone can optical-illusion their brain into processing “your face” as “somebody else’s face,” and it works whether you have other people in your head or not.

—

Finally, real quick, a Moon Knight thing:

From the strange-face article above: “The author, Italian psychologist Giovanni Caputo, describes his set up which seems to reliably trigger the illusion: you need a room lit only by a dim lamp (he suggests a 25W bulb) that is placed behind the sitter, while the participant stares into a large mirror placed about 40 cm in front.”

The first time Steven perceives Marc acting differently from him in a reflective surface, the shot looks like this:

Hmm. Hmmmm.

(A second later Steven turns on a better light, and the mysterious not-him motion disappears. For now.)

Finally finished reading this book! (Previously mentioned in the “talking to headmates in the mirror” post.)

I…can’t exactly recommend it?

I was really hoping to. As a detailed historical snapshot of “how the mental-health profession thought of dissociation in 1905”, it’s fascinating. I’m still not over the reveal of “one headmate claims they were plural as a toddler, and the doctor thinks that can’t be right, because that’s so implausibly young to start splitting.”

But as a record of the treatment of this particular patient — it’s really depressing. Gave me the same feeling I had reading The Third Person (Emma Grove’s 2022 graphic memoir, summary with content warnings on pluralstories), where you start out thinking “okay, this therapist doesn’t know what he’s dealing with and is clearly in over his head, but he seems thoughtful and open to learning, so maybe he’ll get better”…and by the end it’s just a constant escalation of “no, buddy, what are you doing, this is so obviously bad for your patient, oh noooo.”

Extra-frustrating because this book is written by the therapist, and…he notices! A few times he mentions having misgivings, or second-guessing whether he’s doing the right thing! And then he’ll talk himself right back into doing more of it.

There’s also a point where, in talking about teenage headmate Sally, he refers to “her true function — if she had one, which may be doubted” (405). My good sir, your own writing recounts multiple instances of Sally giving you key information that the other headmates were unaware of, and of her physically taking care of their body, including thwarting another headmate’s suicide attempt! You should be first in line to defend this girl as an essential protector, no matter how many obnoxious pranks or immature insults she pulls in between! Justice for Sally, dammit.

(Double-plus-frustrating because he’s the same doctor who treated the system in My Life As A Dissociated Personality, and it seemed like they had a really healthy, positive experience! Apparently that only happens if the patient’s therapeutic goals and attitudes line up with his own from the start. If not…disaster.)

—

I started writing this post back at the beginning of the book, because on the fourth page, the author just casually threw out the names of a half-dozen other previously-studied dissociative patients. More of them come up throughout the text, so I kept the draft open. Wanted to track down sources for as many as I could.

The bad news: if I had bet money on that plurality stat from the other day, it looks like I would’ve lost.

The good news: LB Lee came through with the citations, and between us I think we’ve nailed it down for real this time. Also, brought my list of relevant studies up to 5 — which is still tiny, but hey, still better than one.

So, consider the previous mini-vent a trailer for this full-length dissection.

The big one, probably the actual Ground Zero source for the statistic, from 1991:

• Ross, C. A. (1991). Epidemiology of multiple personality disorder and dissociation. Psychiatric Clinics of North America, 14(3), 503–517. 10.1016/S0193-953X(18)30286-7

The abstract flat-out says “multiple personality disorder related to childhood abuse affects about 1 % of the adult population.”

(MPD was renamed to DID in the fourth edition of the DSM, released in 1994. This research straddles the year of the name change, so you’ll see both terms come up.)

I don’t have access to the full text, but Ross discusses the study in the second edition of his book, Dissociative identity disorder : diagnosis, clinical features, and treatment of multiple personality (1997). Sample was 502 people in Winnipeg, screened with the Dissociative Experiences Scale, then later re-evaluated with the Dissociative Disorders Interview Schedule.

From the book:

There are a number of serious methodological limitations to the DDIS portion of this study: No validating clinical interviews were conducted; the validity of the DDIS in nonclinical populations is unknown; the sample size is too small; the data come from only one city; and no other standardized interview was administered. Because of these limitations, the data from the study, shown in Table 5.2, must be regarded only as first approximations. The 1% prevalence of DID is a conservative interpretation of the data, because over 3% of respondents endorsed DSM-III-R criteria for multiple personality disorder. I excluded most of these people as false positives because they reported neither trauma histories nor the rest of the DDIS symptom profile for DID. It is clear that the DID cases detected in this study are far milder in symptom severity than clinically diagnosed cases, including their DES scores.

Several other interpretations of the data are possible. First, the prevalence of severe DID may be less than 0.2% because no such cases were detected in a sample of 502 respondents. Second, these data provide the strongest existing scientifically based (as opposed to ideologically based) argument in favor of the iatrogenic amplification of DID. If cases existing in the general population are mild, and those diagnosed clinically are severe, it is possible that symptom levels get amplified during recruitment into the mental health system in a substantial proportion of cases.

Much more research and more advanced methodology are required before any firm conclusion can be reached about the epidemiology of DID in the general population. (109)

So! Bunch of thoughts here:

• Wow, that’s a lot more softpedaling and caveats than he presents in the study itself, huh
• Spoiler alert, the next few studies have the same “methodological limitations”
• The way 2% of this group managed to “endorse DSM-III-R criteria” for MPD without having trauma histories or severe dissociation…this 2014 literature review pins it on the early criteria not involving amnesia at all, which was added in later versions of the DSM
• Again, the DDIS is a screening tool, it doesn’t give you a diagnosis (which Ross would know, since…he developed it)
• Which means, again, the 1% number appears to be “people whose DDIS results say DID is a possibility to look into,” not “people who definitely have DID”
• This number comes with even more caveats, but: “less than 0.2%” is a possible, preliminary estimate for the general-population rate of “people who have clinically-diagnosable DID”
• It’s unnerving to see a doctor present “people who seek mental-health treatment have worse symptoms than people who don’t” as an argument for treatment making the symptoms worse

A lot here depends on what exactly Ross means by “symptom severity.” Is he saying his DID patients have more disruptive/debilitating symptoms, while the study is flagging people who might be plural systems, but more healthy and well-adjusted about it?

Or does he just mean symptoms that are farther outside the norm — say, the study is flagging systems who only report 2 alters, while his patients all have at least 20? Or what?

(average system has 0 alters, Headmates Georg is an outlier and should not have been counted–)

Two more studies by Ross’s students, 1991 and 1994:

• Ross, C. A., Ryan, L„ Voigt, H., & Edie, L. (1991). High and low dissociators in a college student population. Dissociation, 4, 147-151.

Sample of 345 college students in Winnipeg, 8 of them (about 2.3%) came up as “people whose DDIS results say DID is a possibility to look into.”

• Murphy, P. E. (1994). Dissociative experiences and dissociative disorders in a non-clinical university group. Dissociation, 7, 28-34.

Sample of 415 students at the University of Idaho, 4 of them (about 1%) came up as “people whose DDIS results say DID is a possibility to look into.”

The study I found earlier, from 2007:

• Sar V, Akyuz G, Dogan O, 2007. Prevalence of dissociative disorders among women in the general population. Psychiatry Res. 149, 169–176. 10.1016/j.psychres.2006.01.005

Sample of 628 women in Sivas, Turkey, 7 of them (1.1%) came up as “people whose DDIS results say DID is a possibility to look into.” (I found another study from 2014 by the same people, but it appears to be a different evaluation of the same sample group.)

Some digging turned up one more, from 2006:

• Johnson JG, Cohen P, Kasen S, Brook JS. Dissociative disorders among adults in the community, impaired functioning, and axis I and II comorbidity. J Psychiatr Res. (2006) 40:131–40. 10.1016/j.jpsychires.2005.03.003

Sample of 658 people in New York State. This is the only one that didn’t use the DDIS; apparently it used a bespoke combination of items from the DES and the Structured Clinical Interview for DSM-IV Dissociative Disorders. 1.5% came up as “people whose results on this custom setup say DID is a possibility to look into.”

I found that cited in Dissociative identity disorder: An empirical overview, a 2014 literature review. It was the only mention of a specific “trying to measure the rate in the general population” study that hadn’t already been scrounged up by either me or LB.

Looking at “related research” for any of these brings up a lot of studies about dissociative disorders overall, or dissociation in general as a symptom. So it’s possible some of those tried to get rates of DID along the way (and if it was since 2014, that one group of reviewers wouldn’t have found it). But I didn’t go paging through them to check.

That makes 5 studies, done in 3 countries, across 2 continents, being fairly consistent about “at least 1% of the general population has serious-enough dissociative symptoms to rate follow-up evaluation for DID.”

Obviously we should have more research. And I don’t know if this number would bear out under more studies. But you know, I wouldn’t be surprised or skeptical if it did? In my personal, non-medical, non-expert opinion, this sounds credible! The vibes check out.

And it’s still not the same as saying “1% of the general population has for-sure diagnosable DID.” There are, to date, zero (0) studies where the data support that.

(Sidenote: none of these studies have even looked for “people who have the experience of being plural, whether or not they qualify for a DID diagnosis.” So the prevalence of that could, conceivably, be higher. Based on vibes alone, I suspect it’s not a lot higher.)

A section I have to put in here somewhere:

Colin Ross is a Problem Guy.

That doesn’t mean he’s wrong 100% of the time — some patients have reported amazing and helpful therapeutic experiences with him. And of course, some critics want to discredit anyone who acknowledges DID at all. (Along with, you know, anything that involves confronting the long-term effects of serious child abuse.)

But other critics, including patients, accuse Ross of committing serious medical abuse. In a broad and depressingly-plausible range of ways — including plenty of things that would’ve been abusive from any doctor, with any patient, unrelated to whether they should have gotten an MPD/DID diagnosis or not.

This harrowing interview with an ex-patient, who ended up suing him for malpractice, starts with “he diagnosed me with MPD after 15 minutes of conversation” and vaults all the way to “he convinced me I had been abducted by aliens and gave birth to a half-alien baby.” It’s not good!

So maybe it’s not surprising that this particular guy massaged his “1% of the population” statistic until it said the more-dramatic thing he wanted it to say.

We know he did not invent DID, previously MPD, previously [doctor’s multi-paragraph explanation of how their patient has this strange dissociation-based experience of being more than one person in the same body]. Other medical professionals were already documenting that 40+ years before Ross was born.

But he did develop the DDIS! Which is used in 4 of these 5 studies! It’s widely used in good faith by doctors who I hope are mostly not-terrible, it does well when tested on patients with already-diagnosed dissociative disorders, and I haven’t seen any studies (or callout posts) that discredit it…but I wouldn’t blame anyone for worrying, just from the Colin Ross of it all.

And even if the DDIS is rock-solid, and hugely useful for the thing it was actually designed to do (help rule in/out possible diagnoses for a person who came in actively seeking mental-health support)…nobody has done a study big enough to say “of the 1% of average people this interview flags for DID follow-up, how many of those get the diagnosis when you do the follow-up?”

(Since it rules out 99% of people, if you want to end up with a sample of at least 100, you need to start by running the interview on a group of at least 10,000.)

The DID rate could turn out very close to 1% of the general population. It could also be 0.01%. We just don’t know.

So that’s the deal. If you’re reading this and you know of any relevant studies I missed (or if new ones have come out since I posted), drop a comment, I’ll add it to the list.

And if any DID Youtubers come across this post and want to use the history/research as a jumping-off point for a video…go for it. The platform could really use somebody to bring it up there.

I didn’t come across this book in any kind of DID-related context — it was a conversation about trans issues, this author reportedly identifies as transgender and transracial — but reading the title/summary of White Girl Within, I thought “huh, this sounds kinda plural.”

And then I got the ebook from the library, and spent the whole thing like the interviewer in this one meme, except I’m thinking “Sir are you aware you are a system?”

The whole memoir is an extended dialogue between two people sharing a body, they address each other as “you” and refer to themselves collectively as “we”, and yet somehow it never comes up? They try all these different lenses and frameworks to understand their situation — the trans experience, the history of American race relations, analogies to a whole library of plays and TV shows — but they never mention DID, even to say “we looked into this and decided it doesn’t fit us”??

(It was published in 2023, they’re active on social media, but it would be weird to ask them directly, right??)

(I wrote up an entry about it for pluralstories, if you want more of a summary + content warnings. Diagnosis notwithstanding, their experience is so clearly in the Plural-Ish Ballpark.)

—

This only briefly comes up in the book, but Ronnie and WG believe Rachel Dolezal is a Legitimate Transracial Person. And there’s a Netflix documentary about her, which in turn has a brief appearance by Ronnie. So I ended up watching that next.

Some backstory, which goes by pretty quickly in the doc, but which I didn’t osmose at all when she was actually in the news: Rachel was abused by her white bio-parents for as long as she could remember, her white brother was the golden child who supposedly deserved everything she didn’t, and she also had four black adopted siblings who didn’t have such a hot time either.

She was conditioned, in traumatic ways, from the day she was born, to bond and identify with her black relatives. While being profoundly unsupported by her white relatives. There’s a moment where an interviewer asks something like, if she would “go back” to being white, and she says — I went back and looked it up, it’s at the very end — “I’m never going to be that [young] white girl in Montana again…I’m not going to subject myself to the punishment of my parents all over again.”

(Ronnie’s headmate, drawing a similar connection about his abusive childhood, though she seems a lot more self-aware about it: “Would your dad have beat a young girl? Would he have beaten a young White girl?”)

I don’t know if “transracial” is the right word for what all that did to Rachel’s brain. I’m definitely not here to say she should be running a chapter of the NAACP about it.

And she’s not doing herself any favors to give a bunch of interviews saying “gosh, anyone could do this, no reason why not, race is just a social construct anyway!”

But, oof, it doesn’t seem weird to think that changed something deep and foundational in her psyche, something she can’t just shake off.

—

Ending this post with something a little nicer! And a lot older.

“My life as a dissociated personality” (digitized on the Internet Archive) is a 1909 therapy memoir about exactly what it sounds like. (Didn’t see it on pluralstories at a quick glance, but LB, I’m sure I got this link from y’all.)

Thinking back on their experience after some fusion, they recall “A” and “B” having different outlooks, tastes, reading preferences, socialization habits. We get excerpts from the journals where they got around amnesia barriers by writing to each other! Fascinating how recognizable it is — including the use of terms like “dissociated personality” and “co-conscious”, in what sure looks like the same way they’re still used today.

At first, the preface from their therapist describes the “A complex” and “B complex”, but the prose quickly switches to calling these “personalities.” Later, they try to reconstruct a personal timeline, and decide that a “B complex” existed in some form since a traumatic incident at a young age, but only “flowered” into the full “B personality” some 20 years later, triggered by the sudden fatal illness of their husband.

It’s short, less than 50 pages if you don’t count the endpaper/title page/etc, and has a really clear, easy-to-understand writing style. Would recommend. (Especially to whip out the next time you hear someone claim DID was made up by Sibyl/Tumblr/TikTok.)

ETA: Went and gave that a pluralstories writeup too!

Youtube has started reccing me channels of “plural systems making educational content based on their own experiences,” so I’ve been watching the backlogs of a bunch of those recently.

It’s…complicated?

…to finish this off on a nice note, I ended up on this 2002 archive.org capture of a page that’s no longer live, and there’s a collection of jokes at the end.

This sketch was fun enough that I wanted to copy and save it on a more-searchable, less-dead site. I didn’t write it, the source doesn’t say who did write it, I just like it.

(CW for the characters mentioning suicide.)

I know, I know, at first I said this would be two parts. Please fill in your own “there’s never just two” jokes here.

Previously, on Part One of the Beaubier System Primer: an overview of Aurora and/or Jeanne-Marie’s appearances and development in the first Alpha Flight team book. At 130 issues, even with the system getting written out for a hefty chunk of the middle, there was a lot of good material!

…And then the book got canceled, and it’s been a real mixed bag ever since.

Aurora, often along with her brother Northstar, gets a ton of “looking cool in the background of a fight scene” kinds of cameos. Hard to argue, because the twins do look cool! But frustrating when you’re digging through a bunch of one-off appearances looking for characterization details, and it’s another “I flipped through 27 pages for nothing but one cool-looking panel” issue.

So, full disclosure: in the Marvel wiki’s list of Aurora/Jeanne-Marie issues, I skipped a fair number of “they’re in the character list, but don’t rate a mention in the summary” cameos. If this overview ends up skipping something good, feel free to rec it to me in the comments!

With that, let’s dive into the Beaubier system content from 1997 through 2011: