ANTHONY BROOKS, host:
This is TALK OF THE NATION. I'm Anthony Brooks in Washington. Neal Conan is away.
One January day in 1989, Chicago psychiatrist Richard Baer began treating a woman he calls Karen(ph). She was a depressed, suicidal, self-defeating, 20-something mother recovering from surgical pain. As her treatment developed, Karen revealed that she didn't remember intervals of time. She would find herself in strange places, unable to recall how she got there, why she was there, often surrounded by people she didn't recognize, sometimes in her own home. Karen's case took Dr. Baer to a place he'd never been.
As her treatment progressed, he received a letter from someone who identified herself as a 7-year-old girl named Claire(ph). She wrote, I live inside Karen. Over the years, Dr. Baer would meet other personalities - 17 in all. They were male, female, children, young adults, and each one revealed different pieces of Karen's frightening childhood, stories of horrific psychological and sexual abuse that included satanic rituals, torture and rape.
Richard Baer has chronicled Karen's case in a book called "Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities." And he joins us from member station WBEZ in Chicago. And welcome, Richard Baer, to TALK OF THE NATION.
Dr. RICHARD BAER (Author, "Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities"): Thank you very much, Anthony. I'm glad to be here.
BROOKS: It's good to have you. It's quite a book. Your patient, the woman who you call Karen Overhill(ph) in the book - not her real name - first came to you in 1989. Tell us what she was like then. What did she appear to be suffering from?
Dr. BAER: Well, her presentation was actually pretty simple. The way I had heard it from the very beginning, she had had a lung surgery and suffering -subsequent to a pneumonia that she'd had from a kind of botched cesarean section. Then, she'd had chronic pain since the surgery, and became depressed.
Well, when a person has chronic pain, depression is almost inevitable. So I thought it was a simple, secondary depression to chronic pain, and I was going to give her some antidepressants, a little bit of counseling and send her on her way.
Dr. BAER: At least, that's what I thought at the beginning.
BROOKS: But it got rapidly a lot more complicated. You began to hear clues that you might be dealing with someone with multiple personality. What were the clues? What did Karen tell you?
Dr. BAER: Well, after we had some starts and stops with treating her for the depression, and then I learned that the depression, and her being - her experience with her parents was one of a lot of turmoil and trouble, and she's being constantly demeaned by them, so I thought her depression could not be simply from the surgery.
Dr. BAER: And then, in addition, she started to tell me about episodes - this wasn't immediate, but she started to tell me about episodes where she would lose time…
Dr. BAER: …and have periods of time for which she couldn't account. And then, would show up places - she'd be driving the car, she'd be at a gas station, some place where she didn't know where she was, and there were very frightening to her. She didn't tell me these things right away because she thought she'd be labeled as crazy and I'd lock her up.
BROOKS: You know, Dr. Baer, I mean, you begin the book with an account from Karen of one of these episodes, and it's so frightening. She's literally waking up after surgery - I believe, after the cesarean section - she's in pain, she has no idea where she is, she has no idea about what has happened to her, she doesn't have any idea that she's married. It's harrowing, this description she offers.
Dr. BAER: Well, during the surgery, several parts came out, several of these alternate personalities came out to try and cope with the situation, but they all failed. And they sent out a part called Karen three, who actually hadn't been out for years. And so she came out and then that's who woke up after the surgery. She hadn't been out for a long time, she don't know where she was. But interestingly, she knew she shouldn't tell anybody.
Dr. BAER: In a part, she thought that - yes, she'd be labeled as crazy, but there was some sort of familiarity to the situation, and she knew she should just try to dissemble, get along and make the best of it. And I think on some level, you know, she had been out before in similar strange situations, and this wasn't really that unusual to her, except that it hadn't happened for years.
BROOKS: When you say she had been out, we're talking about the sort of emergence of these so-called alters, these personalities that - these various personalities that live inside of Karen. I want to go back a little bit. Four years into her therapy, you sort of have this first breakthrough. You received a letter from one of the so-called alters. This was Claire, 7 years old, she says. Tell us about Claire and what she wrote to you.
Dr. BAER: Well, Claire was a darling little girl and it was very interesting to see Karen sit in her chair. And when Claire would come out, she became kind of just in her subtle posture, small and girlish.
Dr. BAER: She would turn to the side, kind of curl up a little bit, and her voice would become a little sing-song, still her own voice and all. The changes were subtle - one personality to the next - but they were definitive. Oftentimes, when she switched from one to the next, I could tell who it was simply by their posture.
Dr. BAER: It was always characteristic, they were always the same. So I would recognize Claire. And when Claire wrote that first letter to me, she was really reaching out. She didn't know exactly what to say - she asked me to help her tie her shoes. But she was reaching out because - she liked me, for one, because she had been watching me for a while, before she ventured out. And she had wanted a good, positive daddy figure, and she had hoped I would do that for her.
Dr. BAER: But I think in some way, she was also prompted by the others, but she was the one who took the first step. But it was really kind of a group effort, because there were a couple other parts that helped her. She didn't know how to address the envelop, she didn't put it in the mailbox, other parts helped her with those tasks.
BROOKS: You know, when the letter, I mean, there's so many interesting details about this story, the various alternate personalities that wrote letters to you. I mean, they write with different handwriting. I mean, they really are different people, aren't they? I mean, they write as though they are coming from different people.
Dr. BAER: Well, you know, are they different people or are they not?
Dr. BAER: They're really not. They're different sides of Karen that - the thing about multiple personality is, you know, if you look at any of us, we may act one way when we're dealing with out children, we may act another way when we're dealing with our significant other, we may act another way, yet, when we're being reprimanded by our boss. But we're aware of those different demeanors that we have.
Dr. BAER: With Karen, she had these different sides to herself as well, but she had an amnesia of one to the other. That's the real key to what makes a multiple personality person a multiple, is the amnesia from one side of themselves to another. So she had a little 7-year-old girl side of her that was kind of isolated and stuck in time, and she didn't know about her. So, she is amnesiac for that part of Karen.
BROOKS: Mm-hmm. Now, in the course of becoming acquainted with Karen's 17 personalities, you learned details of the brutal abuse that she suffered as a child. These are parts of the book I found extremely difficult to read, and it's actually hard to discuss - some of it in great detail here. But I think it's important part of her story. She was sexually abused by her grandfather, by her father. She was a victim of a kind of ritualistic sexual abuse by various groups of people to whom she was rented out by her father. And this went on for years. Have I got this about right? Is there more we need to say about the terrible, terrible trauma that she was subjected to?
Dr. BAER: No, she was, you know, victimized by her father and grandfather. The father was trying to please the grandfather, who enjoyed this kind of thing, and made the father all that much more encouraged to go ahead and think of all the various ways he could hurt Karen. And they were involved in some sort of loose group that had ceremonial characteristics to it. I think it was pretty loosely organized and isolated. I don't think it was any well-organized, extended activity.
But certainly, the kind of abuse Karen had was brutal, was sexual, and was extended. And I think it takes this kind of history to actually create such a multiple personality patient.
BROOKS: Could I get you to read a brief passage? This is on page 128. And what this is is it's your - one of your conversations with Claire. You've got Karen under hypnosis and this is how you reach Claire. It's the paragraph that begins, I realized she still thinks.
Dr. RICHARD BAER (Psychiatrist; Author, "Switching Time"): Yeah, I see it.
BROOKS: Good. And just go down to where you say goodbye to her.
Dr. BAER: Okay.
(Reading) I realized she still thinks the men from her past are still about to hurt her. Perhaps I can help with this. If I recall correctly, Claire is about 7 years old. She might be able to understand the passage of time.
What year is it, Claire? What year is it? Yes, can you tell you me? It's 1967. Is that the last time you were hurt, in 1967? Yes. Why? I'd like you to listen carefully to me, Claire. What I have to say may come as a surprise, but it may also help you. Okay. It's not 1967 anymore. It's 1994, the end of November.
Twenty-seven years have passed. The father who hurt you is dead, and all the other men have gone away. There's no one to hurt you anymore. I wait while it sinks in. I don't believe you. Ask Catherine and Holden what year it is - those are her other parts. Okay. Wait a minute. Claire is gone for a moment. Karen sits impassively, her face expressionless until Claire returns.
You're right. Her face lights up. You mean the father and the men won't hurt me anymore, ever? No, not ever. You don't need to hide in the closet if you don't want to. In fact, you could watch while some of the others are out if you like. I'll let you work that out. Thanks, Dr. Baer. You're welcome, Claire. I hope you can be happier now and not want to die. Perhaps you could step back and we'll see if someone would like to talk to me. Bye.
BROOKS: Mm-hmm. How did you reach these alters?
Dr. BAER: Well, it was a progression. First, Claire came out. Then, I got some communication - we did hypnosis first, and it didn't work out well the first time or two. We didn't really know how to go about it. The first time we did it, many of the personalities wanted to come out all at once and it was very chaotic, so it was a little traumatic for both of us. And I never wanted to suggest for her to have personalities, for any of them to come out, so I always let her run the show.
BROOKS: Mm-hmm. Dr. Baer, we're going to just take a very brief break, so hold that thought and stand by. We're talking about the story of a woman with multiple personality disorder, commonly known as dissociative identity disorder.
And if you have question for Dr. Richard Baer about the disorder or about Karen's story, our number here in Washington is 800-989-8255, that's 800-989-TALK. Our e-mail address is firstname.lastname@example.org. We're going to take a short break.
I'm Anthony Brooks. It's TALK OF THE NATION from NPR News.
(Soundbite of music)
BROOKS: Right now, we're talking to Dr. Richard Baer. He's the author of "Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities. To learn more about what his patient - he calls her Karen - was like when she first started seeing Dr. Baer, go to our Web site at npr.org/talk.
And if you have questions for Dr. Baer about dissociative identity disorder, commonly known as multiple personality disorder, or any questions about Karen's story, our number here in Washington is 800-989-8255. That's 800-989-TALK.
And Dr. Baer, I want to ask you, you know, as these alters began to emerge and you began talking to them, was there a point, maybe early on, when you were skeptical? I mean, could you believe what was happening?
Dr. BAER: Well, it happened gradually. And again, this is over the course of some years. And, you know, when I first heard about the episodes of losing time, that tells me she's having dissociative episodes. Now, what kind, I didn't know. And they became - they were revealed slowly, you know, and then they became the main symptom that she was talking about and causing her distress, although she seemed to be in no particular danger about them.
Dr. BAER: And then, she told me that she would hear voices at night. This was something she was really afraid to reveal because she thought this meant that she had schizophrenia or something. But actually, it was a conference of the different alternate personalities, talking among themselves, and they would update her at the end of the day. This was actually kind of a creative thing that Holden, the older male personality, created.
BROOKS: Mm-hmm. Richard, let's take a…
Dr. BAER: But…
BROOKS: I'm sorry. Just hold that thought. I want to take a call because we have a lot of callers standing by who want to get in on this conversation.
Dr. BAER: Sure.
BROOKS: Let's go to Robert(ph) who's calling from San Antonio, Texas. Hi, Robert, You're on the air.
ROBERT (Caller): Hi. Thanks for taking my call.
ROBERT: I have a question for Dr. Baer. I have been married for 17 years and my wife was diagnosed and studied extensively at one of the universities here in Texas for MPD. And…
BROOKS: MPD is multiple personality disorder, for those who don't know.
ROBERT: Correct. Yes, sir.
ROBERT: And the biggest question I had was, even today, in today's society, the skepticism and the doubtfulness in the medical field is still so rampant that it is hard to find good, qualified help.
My wife has been through a dozen therapists, a dozen psychiatrists. Luckily, we were able to find one of each about seven years ago that has really, really done a good job in treating her, and her life have been more stable. But we still - when we go to the ER or to another physician to learn fir physical ailments, and they start questioning the different medication that she's on. And, of course, we're reluctant to discuss why she's on those medications because when you mentioned dissociative disorder or multiple personality disorder, you're looked at, basically, like you're crazy or, yeah, okay, sure.
BROOKS: Okay, Robert, let's put the question to Dr. Baer. Advice for Robert, Dr. Baer?
Dr. BAER: Well, this is a difficult issue of - several issues. One, is it real? Does the medical profession regard it as real? Part of the problem is even though there are some, you know, highly publicized cases, almost nobody sees one, because real ones are rare. It's not that they don't exist, but they're unusual. And I think there's been enough sense it was a fad in the mid '80s and early '90s, where there are a lot of created diagnoses of multiple personality disorder. People are skeptical.
It's - I mean, certainly not in your wife's case, but it's much sexier to be a multiple personality disorder than just be, you know, really annoying and screwed up. So, it's - there's a secondary gain for both therapist and patient to adopt that, so people are skeptical, I think.
And the other problem is finding good care. It's that who's got a lot of experience in this?
Dr. BAER: There are only a few people who have written on it and are - people that are referred to widely by other physicians to treat the disorder. So, finding qualified person is difficult.
But in my case, what I found was that if you're just a good therapist and follow the rules of good psychotherapy - and that's, for me, would be a psychodynamic, psychoanalytically oriented psychotherapy - it works out fine. You don't have to do anything special for multiple personality disorder in the therapy regard. You just have to be a good therapist.
BROOKS: Hmm. Well, thanks for the call.
Robert Baer, I want to get some more callers in, but I also want you to just continue to tell the story about Karen. The challenge becomes, for you, you have to - you make contact with these 17 alters - and the challenge becomes how to integrate them, how to get them to disappear and essentially become one person. How do you do that?
Dr. BAER: Well, I've done a lot of reading about it. And interestingly, there's tons and tons of literature about multiple personality, and almost nothing about how to reintegrate them.
Dr. BAER: It's all about how to manage them, how they look, their symptoms. So, I didn't really have a good recipe.
What we started doing was letting different alters share time with one another, and hopefully that you would dilute the barriers between them as they shared time. And that began to happen, but it cost her a lot of distress. And then amazingly, Holden, the oldest male personality, wrote me a memo - these were very cute. There even is - he was left-handed, so his handwriting was a little shaky because everybody else - and Karen was right-handed. But he wrote me this memo, which gave me a recipe of how to do the integrations.
And this is something that's actually been written about sparsely. I mean, I couldn't do - I've never saw a paper where someone laid out, as a recipe, what to do. But he gave me a procedure. And it was done under hypnosis where one personality after another, one at a time, because each one was a pretty traumatic episode for Karen.
I was integrated into her under hypnosis, and then subsequently in the weeks and months afterwards, the barriers between those personalities were broken down, and the memories that they contained flooded into Karen, including all of their physical characteristics. After some of the reintegrations, she couldn't walk very well because she was trying to integrate the way one personality walk with the way she walk.
BROOKS: Here's my question about why that helped Karen, because - and just correct me if I'm wrong, but sort of my rudimentary understanding of what happened to her is she's traumatized at a very young age, the memories are so painful that she compartmentalizes them with all of these different alters. So my question is if they all become integrated, doesn't Karen become - have to face all of these dreadful memories that could overwhelm her? I mean, how does this cure her, I guess, is my question.
Dr. BAER: So the question is why integrate?
Dr. BAER: Being a multiple personality is really inconvenient. You go through the day - she would go to the grocery store and come back with 17 boxes of Cocoa Puffs that one of the children had put in the cart, and she only remembers getting in the car going shopping and coming home and starting to unload groceries. And then she looks in the bags and has no idea what she has bought because she didn't buy things. Several of the alters came out at the grocery store and bought things. Then she'd have to go back and return the Cocoa Puffs. So it's difficult.
It's necessary to have that system if you're trying to escape a terrible abuse when physically you cannot escape. So, it's a very useful coping mechanism in childhood - really inconvenient in adulthood.
Dr. BAER: You can't go to college because you can't consistently study and take tests, because there may be test-taking time and somebody else comes out who doesn't go to college.
BROOKS: Yeah. Right.
Dr. BAER: So…
BROOKS: Well, let's take a couple more calls. Let's go to Justin who's calling from Seattle. Hi, Justin. You're on the air.
JUSTIN (Caller): Hi. My name is Justin. Thank you for taking my call. I turned on the radio and I heard this and I nearly drove off the freeway. It struck me like a stone here. My ex-wife had been diagnosed with DID, and then subsequently has disappeared. Getting someone to believe me about this - so I have experienced, I think, 20 to 21 different personalities with this. And it's interesting how the different personalities will interacts with each other here. I have since lost my marriage. I've lost my children. And having anyone believe me with this has been extremely difficult when, let's say, you're dealing with a 7-year-old? Yeah, right.
BROOKS: But Justin, was she diagnosed by a medical professional as having multiple…
JUSTIN: A doctor of neuropsychology. Yes.
BROOKS: Oh, well. Dr. Baer, again, another call about sort of skepticism out there in the world about this disorder. Any advice for Justin?
Dr. BAER: Well, that's an amazing story. And a couple of things come to mind: one is the idea of 17 personalities, 21 personalities - there's no magic number. They just create the number that they need to cope with the various circumstances they have. You can have 21 smaller, 17 larger, but you do need a variety of them because there are lots of different tasks that need to be done.
When you say that she took off, I think I've seen, perhaps three multiple personalities in all of my practice. One of them I saw one time, and she was brought into me by the Oak Lawn police who found her on 95th Street, and she flagged them down. She said she didn't know where she was. It turned out, she was a housewife from Cincinnati who found herself in Oak Lawn on 95th Street. And a couple of policemen and - locally knew I was a psychiatrist and they brought her up to me.
And so, I talked with her for a while - and does it happen once or twice before but never so far from home? And I told her that she had a dissociative episode and that, you know, she needed to go back and find some care for this. And she had money in her purse and, you know, she found her transportation and off she went. She may have been a multiple personality - I don't know, but there is an episode. And I recalled it because I wondered if something similar to that happened to your wife?
BROOKS: Mm-hmm. Well, Justin's no longer with us. But Justin, thank you for the call.
Let's go to Bill(ph) who's calling from Oklahoma. Hi, Bill. You're on the air.
BILL (Caller): How are you doing, sir?
BROOKS: Very well.
BILL: I've got a background with mental health and one of things that I encountered in my background was I worked with about four separate cases like the ones that you're describing. And in your time, did you ever have it affiliated with a bubble? A lot of my patients described a bubble that they would go in and out of and they could go into this bubble to be with the other personalities and then one would be pulled out at that time. Did you ever hear of it being referred to as a bubble?
BROOKS: Great question, Bill. Because - Dr. Baer didn't - wasn't there a safe room in Karen's consciousness where these people lived?
Dr. BAER: Well there - her internal mind was divided up into rooms as in a house. There was a conference room, where in the evening, any part that wanted to participate could share thoughts and feelings with other parts. There was a safe room, where Karen went to - and when we put her under hypnosis, and different parts could come in to that safe room - you know, this was all visualized by Karen - and talk with us, if they wanted to talk with me. That was the mechanism we used under hypnosis to get a different part to come out and speak with me is we would have them do that procedure and it kept it all well under control.
Now, most of parts - some of the parts had knowledge of others. A couple of the parts had knowledge of many. Most of the parts weren't really aware of the others. And since the amnesia between parts is the whole purpose for developing multiple personality, so you can separate off areas of experience, so not every has to experience it, is the purpose of it. I'm not quite - Karen never talked about a bubble so I'm not quite sure what the purpose of that is.
Dr. BAER: It sounds a little bit like her experience, Karen's experience, of when she would switch from one personality to the next. She wouldn't go into a bubble, but she would have a kind of fainting experience where she would disappear and come back. I'm not sure if that's what you're referring to.
BROOKS: Thanks for the call, Bill.
We're talking to Dr. Richard Baer, he's author of "Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities."
You're listening to TALK OF THE NATION from NPR News.
Let's go to Beth(ph) who's calling from Kansas City. Hi, Beth.
BETH (Caller): Hello. I have a question about how she's doing now. Does she have problems with self-esteem and with issues about, perhaps, shame or guilt or things that are holding her back since she's been reintegrated?
BROOKS: Mm-hmm. Good question, Beth. I wanted to ask you that. How is Karen doing now, Dr. Baer?
Dr. BAER: It sounds like Beth knows her. Karen, since she was fully reintegrated in April of 1998, has never disassociated again. So, in that regard, she's been well. But even at that time, she was still married to an abusive husband. She wasn't working full time, and so there were lots of issues to get her to cope with over the next 10 years of treatment that hadn't been magically cured once she was no longer multiple personality.
So issues of self-esteem, issues of self-worth and particularly issues of shame over what had happened to her, you know, she felt that people would look at her and somehow magically know, those were all - we worked on those a long time. She's much better. She's working full-time, her children are doing well and she's much happier.
BROOKS: Mm-hmm. So she's taken - so she's separated from her husband and she's actually living with her children and able to care for them and hold down.
Dr. BAER: Right. She got divorced several years ago, actually.
BROOKS: Mm-hmm. Now, she cooperated with you in writing this book, why was it so important to her to have his book written?
Dr. BAER: Well, she was invaluable in making the book accurate, she would fact check everything I wrote because she has an amazing memory. And of course, all these stories and all the memories are hers, so she's finally the ultimate authority on them. And so that was very helpful. But in her experience as a child - even though she was very good at covering up the abuse, which she felt she had to do - there were a few people she told and she received no help. So, she had hoped that by having this book written, it would heighten the awareness of people to what can happen to little girls and happens to little girls all the time, especially when there's no one protecting them.
BROOKS: Mm-hmm. Dr. Baer, you spent 18 years treating Karen, and you write about this. Tell us what kind of toll this took on your own life.
Dr. BAER: Well, that's hard to explain. It took a lot of time, more time than with anyone else, obviously. It's not the 18-year time because there are a lot of therapist who patients that last a long time, but - and it was only the sessions, but it was usually two or three extended phone calls a week during most of that time. And, you know, as people ask me, how did you do it or why did you do it, at some point, I just kind of took ownership for Karen. It's like having a special-needs child. And yes, they require more than other children. But if they're your children, you'll do it. So…
BROOKS: Well, Dr. Baer I want - it's an extraordinary story and I want to thank you for coming in today to talk about it.
Dr. BAER: Thank you.
BROOKS: That's Dr. Richard Baer, he's author of "Switching Time: A Doctor's Harrowing Story of Treating a Woman with 17 Personalities." You can read an excerpt from the book at npr.org/talk.
And Dr. Baer, thank you again.
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