Exploring Multiple Personalities In 'Sybil Exposed' In a new book writer Debbie Nathan digs into archived material documenting the experiences of a patient known as "Sybil," who reportedly suffered from multiple personality disorder. Ira Flatow and guests discuss MPD, and its modern equivalent--dissociative identity disorder.

Exploring Multiple Personalities In 'Sybil Exposed'

Exploring Multiple Personalities In 'Sybil Exposed'

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In a new book writer Debbie Nathan digs into archived material documenting the experiences of a patient known as "Sybil," who reportedly suffered from multiple personality disorder. Ira Flatow and guests discuss MPD, and its modern equivalent—dissociative identity disorder.

Debbie Nathan, author: "Sybil Exposed: The Extraordinary Story Behind The Famous Multiple Personality Case" (Free Press, 2011), New York, N.Y.

Paul McHugh, University distinguished service professor of psychiatry, Johns Hopkins University, Baltimore, Md.

Bethany Brand, professor of psychology, Towson University, Towson, Md.

IRA FLATOW, host: Up next, a look back at a famous case of multiple personality disorder. In the 1970s, you might remember that sensational story of Sybil, captured the attention of millions of Americans. First it was a book and then a TV movie and then - remember that two-part miniseries, which was supposedly based on a true story? Sally Field played Sybil, a girl who suffered terrible abuse at the hands of her mother.

And to cope with the trauma, she developed multiple personalities - as many as 16. And after the book and the movie came out, the diagnosis of multiple personality disorder, well, you can guess it skyrocketed in the U.S, from less to 100 to thousands.

But was Sybil's story really true? A new book, "Sybil Exposed," suggests that Sybil, whose real name was Shirley, pretended - she pretended to have multiple personalities, in part to please her therapist. Joining me now to talk more about it is Debbie Nathan, the author of "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case." She joins us here in New York, at our studios. Welcome to SCIENCE FRIDAY.


FLATOW: This is an amazing story. Tell us first about the book and the movie "Sybil," for those youngins' out there who didn't see it.

NATHAN: Sybil was supposedly a young woman who as a small child, had been horribly, sadistically, violently sexually abused by her psychotic mother. And that mistreatment had caused her consciousness to split into many different personalities to hold the trauma, so that she wouldn't be aware of it.

She was unable to function, though, in a day-to-day way. She had all kinds of neurotic symptoms, and she went to a psychoanalyst, and the psychoanalyst was skillful enough to uncover the secret and spent many years thereafter trying to figure out what, exactly, had happened to her.

So the book is kind of a whodunit, you know, of trauma. And finally, the mother's abuse is uncovered as the personalities start to reveal. And the young woman reintegrates all the personalities and becomes a happy, functional person again. So it's a very heroic story.

FLATOW: Now your book, "Sybil Exposed," tells a whole different story about what happened.

NATHAN: It does, yes, because "Sybil" was marketed as nonfiction, which I think was about 99 percent of its appeal. It started a craze in this country, sold millions of copies within a few years, started that huge increase in cases that you mentioned. But I spent a long time in an archive in New York City that includes thousands of pages of Sybil's therapy records, and the records of the doctor and the journalist working on the book. And what I found was that the story is sort of a mishmash of fantasy, of lies, of confabulations, of confusion; certainly, should be called fiction rather than nonfiction; and that in fact, it was the - a very suggestible patient and a very demanding doctor who essentially, demanded the behavior from the patient.

FLATOW: Some people have called the story, after reading your book, a fraud. Would that be going too far to say that Sybil was a fraud?

NATHAN: No, I think a more helpful way to think about this is that Sybil herself surely was an extremely fantasy-prone child, very highly hypnotizable, went into trances probably spontaneously, very emotionally needy so that if she picked up on the idea that the psychiatrist wanted multiple personalities, I don't think she was always conscious at all of producing them. In fact, they produced a lot of pain and sickness in her. The psychiatrist, I don't think, was aware of how suggestible the patient was, and how bad the therapy was. The journalist had her own problems. She sometimes wanted to believe these enchanting stories, sometimes realized that they weren't true but couldn't go back because she was already halfway through the book. So a fraud? I don't - they didn't set out to perpetrate a fraud.

FLATOW: It's just a perfect storm of all those situations...

NATHAN: That's exactly right.

FLATOW: ...coming together. We're talking with Debbie Nathan, author of "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case." Our number, 1-800-989-8255 if you'd like to talk about "Sybil," or you'd like to talk about multiple personality disorders.

You can also tweet us @scifri, @-S-C-I-F-R-I. You can go to our website at sciencefriday.com and join the discussion there. We're going to take a short break. When we come back, we'll talk more with Debbie Nathan, author of "Sybil Exposed"; take your calls and your tweets. Stay with us. We'll be right back after this break.


FLATOW: I'm Ira Flatow. This is SCIENCE FRIDAY from NPR.


FLATOW: This is SCIENCE FRIDAY. I'm Ira Flatow. We're talking with Debbie Nathan, author of "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case." Our number, 1-800-989-8255. Debbie, let's talk a little bit about the doctor involved here, Connie Wilbur.

NATHAN: Connie, before she was a psychiatrist, was a chemist, and she came from a family of inventors. When she became a psychiatrist in the '30s and the '40s, she was very into - extreme sort of physical interventions. She got involved early on in chemical shock, electroshock of mentally ill people, procedures that were later shown to be very unscientific.

She did some of the first lobotomies, and she also began injecting people that she called hysterics with intravenous barbiturates, to try to get them to talk about things they couldn't talk about. She did not understand when she did this that these kinds of drugs can make people fantasize like crazy.

She also discovered a very early interest in multiple personality disorder. She became interested it in the '30s and the '40s, when very few psychiatrists were interested anymore.

FLATOW: Didn't Sybil come to her and say to her - according to your book - I'm making all of this up?

NATHAN: She came to her after she'd been in therapy for the second time for about three years. She'd been getting sicker and sicker. She was addicted to some of the drugs that she was being given, and she wasn't getting any better. She seemed to be getting worse.

So she did write a very long letter and bring it to the psychiatrist - to Dr. Wilbur - saying: I made this up. I don't have multiple personalities. My mother never abused me. I want to really do real therapy. Please help me. Let's really start talking about the truth.

FLATOW: And what happened after that?

NATHAN: And the doctor used the rationale - which was so common at the time - the psychoanalytic word: resistance. She said, you just don't want to go further and deeper into the therapy. You're resisting your real problems. And the message was: Get with the program, or I'm not going to treat you anymore.

And Sybil, or Shirley, was extremely dependent upon Dr. Wilbur by then and really couldn't give her up, and so she re-recanted.

FLATOW: And what about the writer who wrote the book? Was she in on - at this time, and knew about the holes in the theory?

NATHAN: Well, she got involved with the writing in the mid-'60s, and her mistake was that she spent about five years writing before she started fact-checking. When she started fact-checking - for example, going to the town where Shirley was from, finding the recantation letters - she was very upset. She couldn't find any evidence of abusive activity by the mom in the town.

So - but, you know, that was five years after she started working on the book, and she had a contract by then, and she had an advance by then. It was almost like trying to - she couldn't turn the Titanic around.

FLATOW: Yeah, I understand. Our number, 1-800-989-8255; talking with Debbie Nathan, author of "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case." She's right here with us in New York. And Sybil's story made multiple personality disorder a household name. Did it also change the way therapists treat patients?

The disease now goes by another name: dissociative identity disorder, DID. But some mental health-care professionals argue it's time to do away with the idea of multiple personalities. Joining me now to talk more about it are Paul McHugh, he is University Distinguished Service Professor of Psychiatry at Johns Hopkins in Baltimore; he joins us from WYPR in Baltimore. Welcome to SCIENCE FRIDAY.

Dr. PAUL MCHUGH: Good afternoon.

FLATOW: Good afternoon. Bethany Brand is a professor of psychology at Towson University. She joins us from WTMD in Towson. Thank you for being with us today.

Dr. BETHANY BRAND: Thank you, Ira, I'm pleased to be here.

FLATOW: Dr. Brand, you treat patients with dissociative identity disorder. What do you think of this, that the case of Sybil was something perhaps more fraudulent than we were led to believe?

BRAND: I actually do treatment and research on dissociative disorders. What I think about it is that case studies such as "Sybil" are really interesting to read. They grab the public's attention. But neither this book nor the original book have any bearing whatsoever on science.

They're media portrayals. No single person's story, even if it's accurately portrayed in a popular press book, generalizes to a whole group of patients. So even if Sybil was a factitional case or a malinger case or something in between, whether it was genuine DID or not, it doesn't tell us about all the - whole group of patients who have dissociative disorders, nor does it actually inform us at all about what is being done in treatment today.

We would never see, for example, the kind of dual relationship that seems to have occurred between Dr. Wilbur and Sybil - or, you know, that was her book name. And being in that kind of dual relationship - where they had a personal relationship, and they were out, you know, making a movie and a book together - that alters the course of treatment.

So her outcome does not at all generalize to the outcomes that can be obtained and empirically, that we show are obtainable if somebody has a well-trained therapist using currently empirically supported treatments that follow the standard of care that have been established by experts on a consensus model.

FLATOW: Dr. McHugh, do you believe, do you think that Sybil actually had this dissociative identity disorder?

MCHUGH: No, I don't believe she had identity disorder, multiple personality or anything. I think she did have an intensely suggestible personality, and she was in a situation where she was open to the suggestions - looking, as she was, for help for the conditions that she suffered from.

And the imposition of this idea upon her was a kind of method that she could have to keep the attention of the doctors and the others around her, and see her as a victim.

FLATOW: Would you have challenged her on this if she were your patient?

MCHUGH: Not only would I have challenged her, but I would've - like a coherent therapist and doctor would today in the evaluation process - done what Ms. Schreiber did, go and use - find out whether these claims of hers, that her mother abused her, were in fact correct.

I mean, the real problem with cases of this sort - most of the cases with DID, for that matter - is that they're meaningfully sensible, but they aren't causally sensible. No one bothers to look and find out whether this abuse that is claimed to be behind this manifestation is correct.

FLATOW: So Dr. Brand, you would disagree with this?

BRAND: Yes, I would. There's a great deal of research now that shows that DID is strongly correlated with early, chronic history of trauma. So for example, in a study of death-row inmates - none of whom were aware they had DID, none of whom were trying to use it to get out of the legal ramifications of their actions - the authors, after scrupulous investigation into their backgrounds, found evidence, like Department of Protective Service evidence and school records, that documented in 17 out of 20 cases that in fact, they'd had horrible exposure to very severe trauma.

FLATOW: So you would - how would you treat a patient like Sybil if she showed up in your office?

BRAND: Well, first I would start with a very thorough assessment, using the current standardized measures that we have available to us that assess for the range of dissociative disorders but the whole range of other psychological disorders, too. I would need to know what I'm working with, and I'd be very careful and make my decisions slowly, based on data about what she has.

And furthermore, with therapists who are well-trained in dissociative disorders, we do keep an eye open for suggestibility. But that research, too, is not anywhere near as strong as what the other two people in the interview are suggesting.

It shows - for example, there's eight studies that have a total of 11 samples. In the three clinical samples that have looked at the correlation between dissociation and suggestibility, all three clinical samples found non-significant correlations. So it's just not as strong as what people think. That's a myth that's not backed up by science.

FLATOW: Dr. McHugh?

MCHUGH: I think that's rather shabby science. The whole point about this craze that crested in the 1990s and was really, a total misdirection of psychotherapy and of psychiatry, was refuted by all kinds of evidence dominated by claims of science behind it and ultimately, collapsed as a misdirection of conception.

Now certainly, if you go to death rows - inmates and find that they had abuse in their childhood, it's hardly a surprise. That they have DID, though, is in my opinion, the kinds of things that get imposed upon them by therapists that are interested in finding that enterprise.

The Sybil issue, really, generated all this interest in multiple personality and DID. It was a central case and Cornelia Wilbur, for a long time, was celebrated amongst the people interested in this conception of trauma. And only, really, with the work of people like Robert Reiber and others, and now wonderfully depicted here by Debbie Nathan, have we seen that this was a case that was factitious in its beginnings, and destructive in its force today.

We see lots of patients at Johns Hopkins who claim to have DID, and we discover that behind their problems are not only therapists that make the suggestion that this is a viable thing and call upon science, but that they've been turned into invalids, sick people, because the real problems of their lives, the kind of problems that got these people on death row that Dr. Brand is talking about, have other natures to them and need those natures directly treated.

FLATOW: One-800-989-8255. Talking about Sybil - the case of Sybil and - based on "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case," written by Debbie Nathan. Debbie, whatever - what was the fate of Sybil and her doctor?

NATHAN: She - Sybil had a job - when she finally finished therapy and got away from the doctor, which didn't happen 'til the late '60s, she got a nice job as an art teacher at a small college in the Midwest. But as soon as the book came out - within months - she'd been recognized by people in her hometown, and by her colleagues in the art education world. And the book was so nonfactual that she had to flee. She literally left her teaching job almost overnight; abandoned her house; moved to Lexington, Kentucky, where Dr. Wilbur was living and teaching; and was - and lived in her shadow without a job.

Really, for the rest of their lives, they were together. Dr. Wilbur died earlier. But Shirley never had an independent life after "Sybil" came out. And the movie portrayed her as being free and professional and teaching. It wasn't true. It was a lie.

FLATOW: One-800-989-8255. Let's go to Patrick in New York. Hi. Welcome to SCIENCE FRIDAY.

Dr. PATRICK SURACI: Oh, hi, Ira. This is Dr. Suraci, and I'd like to commend you. You did have the right idea of how this develops. It develops from a fragmenting of the person's identity and personality - not as Ms. Nathan said, a fragmenting of consciousness. It is a fragmenting of identity, and that's why it's called dissociative identity disorder. And let's pick up what Ms. Nathan just said about the end of Shirley's life. She didn't know Shirley. I knew Shirley. I knew Flora Schreiber, the writer. I knew Dr. Wilbur, the psychiatrist.

What happened after the cure, after the end of the first book and the end of the movie, Shirley did live in Lexington, Kentucky, and she painted. She was a prolific artist. Her company was called Mason Incorporated; her name was Shirley Mason. And I have 30 paintings of her book - of her - that she did after her cure, in my book. And her cousin Naomi Rhode(ph), in Phoenix, Arizona, has hundreds of paintings.

And we have a record of all the galleries around the country that have Shirley's paintings. She led a full life. She went to the theater. We have a psychiatrist who lived in Louisville, Kentucky, Dr. Leah Dickstein, who knew both of them. She went to the theater with them. She went out with them. They were good friends with Roddy McDowall, the actor. This is not true, what Ms. Nathan says, because she never knew Shirley.


SURACI: She doesn't know what happened after the first book.

FLATOW: OK. Let me just remind everybody that I'm Ira Flatow, and this is SCIENCE FRIDAY from NPR.

BRAND: Ira, could I address the allegation that treatment makes people worse - because there's science behind that, too.

NATHAN: Well, I wonder if I could answer the call.

FLATOW: Let - yeah - let Debbie answer the caller.

NATHAN: Dr. Suraci met Sybil, or Shirley, long after the treatment ended, long after the book came out. He refused to talk to me, actually, and told people not to talk to me while I was researching my book. He looked at very limited portions of the archive, which I researched, in fact was not even aware that there are documents in the archive regarding him. I don't think that the knowledge that he has of Shirley, or any of the other people that he's talking about, are relevant to these issues.

FLATOW: All right. Let me just remind everybody again, I'm Ira Flatow, and this is SCIENCE FRIDAY from NPR. And Dr. Suraci, I'll give you one chance to answer.

SURACI: Her page 99 in her book - that Dr. Wilbur crawled into bed with Shirley to give her electric shock treatment. And I went back and read where she cited she got this information - from box number 38 in Flora Schreiber's archives - and there is only one reference to electric shock that Shirley makes, when she says this was one of the treatments she had, along with sodium pentothal. There's absolutely no statement that ever says that Dr. Wilbur crawled into bed to give her the electric shock, which is outrageous and defaming against Dr. Wilbur.

FLATOW: Debbie Nathan?

NATHAN: There is no box 38, and Dr. Suraci needs to really go back and...

SURACI: She - quoted it, in your book.

NATHAN: ...carefully look at the new documents.

SURACI: It's in the back. Look at the notes of page 99.

NATHAN: It's...

SURACI: ...you quoted - I'll read it right here to you.

NATHAN: It's box 37, Dr. Suraci.

SURACI: Chapter eight, number 38, Flora Schreiber's box 37, files - I'm sorry. You're right. It was Flora Schreiber's box 37. It was your note number 38. You said files 108 (unintelligible)...


SURACI: ...(unintelligible) 124.

FLATOW: OK. Dr. Suraci...

SURACI: I looked at it (unintelligible)...

FLATOW: I'm going to have to let you go here.

SURACI: ...(unintelligible) verify that with a special collections librarian at John Jay College of Criminal Justice.

FLATOW: All right.


FLATOW: 1-800-989-8255. Dr. Brand, did you want to jump in there? You said you wanted to say something.

BRAND: I would love to. So let's go beyond one sensationalistic story, and go back to science. The field, at this point, has developed consensus-based treatment models of best practices, including evidence-supported treatment strategies for dissociative disorders. So a group of us a couple of years ago did a meta-analysis, which combines treatment studies across different teams, across countries, samples. And what we found is, across eight different studies, that there were significant improvements in almost all domains looked at.

And most of these were what researchers called large effects. Then, most recently, a group of us - have done the largest study to date on treatment outcome, using 280 patients with dissociative identity disorder, or a related disorder called DDNOS, in patients from 19 countries. We had both their - the patients and their therapists complete measures prospectively over time, over the course of 30 months of treatment. And once again, we found that in every - this is a little bit advanced, in every continuous measure we looked at - that means the most rigorous measures we used - every single one was statistically significant in terms of improvement.

There was improvements in occupational and social functioning, increasing socializing. We just do not see this kind of decline when we look at large studies. Now that, of course, doesn't mean that individuals don't sometimes decline, but that can happen for any disorder.

FLATOW: All right. We have to take a break. We'll come back and talk more about the story, "Sybil," with Debbie Nathan, Paul McHugh, Bethany Brand. Our number, 1-800-989-8255. Stay with us. We'll be right back.


FLATOW: This is SCIENCE FRIDAY. I'm Ira Flatow. We're talking this hour about multiple personality disorder - or dissociative identity disorder, as it's now called, with my guests, Debbie Nathan, author of "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case"; Paul McHugh, University Distinguished Service Professor of Psychiatry at Johns Hopkins in Baltimore; Bethany Brand, professor of psychology at Towson University. Our number, 1-800-989-8255. Debbie, you said you wanted to react to what you've been listening to the last few minutes.

NATHAN: Yes. Professor Brand's description of the studies about the effect of therapy, I mean, certainly, everyone knows that when people come in with problems, psychological problems, no matter how they're diagnosed, if they're treated, they tend to get better regardless of what was wrong in the first place. So I don't think that any of those studies are particularly significant regarding the validity of DID.

But, you know, speaking of getting better, I was at a conference of the organization that you're active in, the International Society for the Study of Trauma and Dissociation. And I know that you gave a talk about a patient that you had treated for 14 years. And I believe you're still treating her, which seems like an unbelievably long time to be treating anybody and certainly, raises some of the same questions that were raised in Sybil's lifelong, almost, treatment.

MCHUGH: Yes. And I'd like to say the same thing. The - or in another way. All these reports of so-called successful treatment to DID are always being done by believers in DID, and they never have the same patients or sample of those patients being treating by other therapists who have other ideas about the nature of the problem. And so they're talking to each other about these matters. And ultimately, yes, I think patients get better from all kinds of kindly related therapists, but not from the ideas that are being generated and which have been pretty well discredited in coherent psychiatry today.

FLATOW: Dr. Brand?

BRAND: Due to my ethical obligations, I can't reveal anything about a particular patient, but what I will say is that I don't publish about them. But I will say that I've also seen patients who've made significant progress. If I don't see patients making progress in treatment with me, we address that. We talk about it. We see if there's something we need to alter in their treatment. If we can't make it better in our work together, I refer them to somebody else. And I have, occasionally, had patients where I felt that they were too wed to their diagnosis.

And I talk to - eventually, gradually, over time, if they didn't put in more effort into improving, then I terminate a treatment with them. I wanted to throw out there - I know there are patients out there who are listening and who are sufferers, and clinicians who are wanting to get more training in how to treat dissociative disorders. So I did want to just refer back to what Ms. Nathanson was talking - Ms. Nathan was referring to. It's the International Society for the Study of Trauma and Dissociation.

Their website - I think Ira has gotten on the website there at NPR. There are a number of frequently asked questions. There are free, downloadable treatment guidelines for adults, as well as for children and adolescents. It's a great source for training for clinicians.

MCHUGH: Let me speak...

FLATOW: It's on our website at sciencefriday.com if you want to ...

MCHUGH: You can look there, but you should look at the history of this and the founders of this organization, and the kinds of troubles that they've had when their cases were brought up before courts where they had mistreated and people like Miss - Dr. Brand and other people who are now discredited. This is an organization that is really, no longer properly thought of as a coherent scientific organization, but one that is promoting an ideology.

BRAND: Well, a while ago, Dr. McHugh had said that the dissociation was kind of collapsing in on itself. I wanted to address that because DID, and a number of other dissociative disorders, continue to be recognized in the Diagnostic and Statistical Manual, which means that it has passed peer review at multiple levels. In the last year, (unintelligible) task force, there were skeptics about DID who were included in that task force, and the science was overwhelming enough that the top level of reviewers kept the dissociative disorders in, including DID. Furthermore, if you now go...

MCHUGH: Well, let me...

BRAND: If you go to an academic search engine...

MCHUGH: Let me say, there's about - let me...

BRAND: ...called site - let me finish, please.

FLATOW: Dr. McHugh, let her finish.


BRAND: If you put in the search engine - in psych info - dissociation, you come up with 16,000-plus hits. At this point, the most used self-report measure of dissociation - that is, the dissociative experience scale - has been used in over 3,000 studies. There are epidemiology studies from around the world, from three countries. They're finding consistent results across research groups using different methodologies, different measures. It's not collapsing in on itself.

In fact, in the upcoming version of the DSM that's currently being worked out, it appears the word dissociation will be showing up in post-traumatic stress disorder as well. The dissociative disorders will remain in. And there is a great deal of other researchers who've not previously been looking at dissociation, who are now adding measures of dissociation because it looks like, from preliminary research presented as recently as at the American Psychological Association Conference in August, that even amongst normal treatment for just regular PTSD, that if you look at the patients with high levels of dissociation, they have altered treatment outcome. So we need to be assessing, in all of our trauma samples, for levels of dissociation and then treating accordingly.

MCHUGH: It's always hard to get a word in edgewise with these dissociative enthusiasts. This is scientism, pure and simple. And someday, maybe SCIENCE FRIDAY ought to talk about DSM and what, really, it represents as a classificatory system, and the problems that have been generated by it. But look, the issue of dissociative identity disorder and multiple personality disorderswas shamed a long time ago in the courts of this country, where people who claimed to be scientists, and claimed to be psychiatrists and psychologists, were shown to have abused their trust with patients in all kinds of ways. And huge sums of money were awarded to them in malpractice claims.

This is, fundamentally, a dead end in psychiatry. And it started off, in a disturbing way, by the Sybil case and the celebration by the dissociative groups of Cornelia Wilbur.

BRAND: The same could be said for how we, at one point in our field, viewed schizophrenia and the causes that schizophrenogenic mothers, cold, distant mothers, causes schizophrenia. But research and science has changed our opinion and treatments.

MCHUGH: You're welcome to belong to that group, too.


BRAND: No. I listen to the science, and I follow the science, Dr. McHugh.


FLATOW: One-800-989-8255 is our number. Meredith in Chicago. Hi, Meredith.

MEREDITH: Hi, Ira. Nice to talk with you.

FLATOW: Thank you.

MEREDITH: I am a member of the ISSTD, and I've been a trauma therapist for quite a few years. I still do many, many trainings, though, because it is a very complicated disorder and requires a lot of peer and colleague review on these sorts of things. But I would like to say that it sounds - I mean, very much so sounds now that there's a sense, maybe, from Miss Nathan's book and also from the psychiatrist from John Hopkins, that DID does not exist whatsoever. And that is fairly insulting to many of us who work very, very diligently in training and education and working with these clients, who we clearly see have very many different parts and problems. So I thank Dr. Brand for your explanation of everything. And I'll take my comment off the air. Thank you.

FLATOW: Thank you. So there is - it'd be safe to say this is a giant - a very controversial issue in...

MCHUGH: There's a controversy only in the sense that - these kinds of statements about people saying it doesn't exist. We say it does exist, but exists as an artifact and an artifact being generated and supported by these enthusiasts in the same way Sybil existed as an artifactual product of Cornelia Wilbur.


BRAND: I have some more science about that, Ira. Could I share a study about that?

FLATOW: Sure. Go ahead.

BRAND: A study that was the award winner for the best publication last year in the Journal of Trauma and Dissociation. A group of researchers went to China, where dissociative disorders are not in their equivalent of a diagnostic manual. So there have been no cultural influences there - not from therapists, not from the media. And they used these systematic ways of assessing dissociation - they've been translated, of course, the different measures and interviews. And they've found, in fact, that dissociative disorders existed there. So it can't possibly be just suggestibility, or just these socio-cultural influences, that are causing dissociation. In fact, they found histories of trauma that were consistent with the diagnoses of dissociative disorders.

FLATOW: Let me end - we have a very - few seconds ago, where I began. Let me ask Debbie Nathan. What is the takeaway message of your book?

NATHAN: The takeaway message, I think, is that not just for this particular issue in science but for a lot of other ones, and certainly other diagnoses - depression, DID, and any number of diagnoses - what we really need to do is be very cautious when claims are made, especially when they're new and when they're very dramatic. And we need to look at the limitations of the culture that's creating the claims. We need to look, for example, what are the politics of the pharmaceutical industry that might be pushing some of this stuff? What are the politics of gender relations that might be pushing an entrancement with a certain diagnosis? We have to realize that scientists are just as much subject to the prejudices and limitations of the culture as everybody, and be very cautious and skeptical.

FLATOW: I want to thank you all for taking time to be with us today. Debbie Nathan, author of "Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case." Paul McHugh, Distinguished Service Professor of Psychiatry at Johns Hopkins in Baltimore. Bethany Brand, professor of psychology at Towson University. Thanks again for taking time to be with us today.

NATHAN: Thank you, Ira.

BRAND: Thank you.

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