End to a Twisted and False Episode in Psychiatry
Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case. By Debbie Nathan. Free Press, New York, 2011. ISBN: 978-1439168271. 320 pp. Hardcover, $26.
Horror stories can reveal and feed a society’s darkest fantasies. The Monk, the famous Gothic novel published by Matthew Lewis in 1796, is a striking example. With its portrait of lascivious monks and murderous nuns, The Monk reflected negative stereotypes about Catholics that were widespread in England during the late 1700s. It also helped to reinforce and perpetuate those prejudices for decades to come.
Sybil, published by Florence Rheta Schreiber in 1973, is another famously lurid book that both reflected and shaped the nightmares of its time. Gothically dark but with gleams of light, it recounted the supposedly true story of psychiatrist Cornelia Wilbur and one of her patients, a fragile young woman pseudonymously called Sybil to protect her identity. During eleven years of psychoanalysis Wilbur encountered sixteen of Sybil’s “alternate personalities,” which had supposedly developed during childhood in reaction to horrendous sexual and physical abuse by Sybil’s mother. The book recounted how Sybil dealt with these traumatic memories under Wilbur’s healing influence and gradually integrated her “alters” into a single stable personality.
A national best seller, Sybil was turned into an award-winning 1976 television miniseries with Sally Field as Sybil and Joanne Woodward as Wilbur. Soon afterward an epidemic of Multiple Personality Disorder (MPD), also known as Dissociative Identity Disorder (DID), swept across the United States, persisting through the 1980s and into the early 1990s. Only a handful of MPD/DID cases had previously been reported in the scientific literature. After Sybil, the number skyrocketed into the thousands.
The impact of Sybil was huge. For decades afterward its spellbinding narrative was accepted as factual. Schreiber declared in the book’s preface that it was a “true story,” and Wilbur herself vouched for its accuracy during television appearances and professional conferences. However, it is now clear that neither Sybil nor Wilbur should ever have been believed. In Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case, investigative journalist Debbie Nathan has revealed the true story of Sybil, whose real name was Shirley Mason.
Drawing from archives that only recently have been opened to the public, Nathan presents a description of Shirley/Sybil and Wilbur that is both compassionate and devastating. With a wealth of facts and extensive footnotes, Nathan demonstrates that Sybil, both the book and the miniseries, were packed with lies and distortions. Marketed to the public as nonfiction, Sybil instead should have been shelved next to The Monk among the Gothic horror novels and other dark fantasies.
Sybil Exposed presents overwhelming evidence that Shirley/Sybil never enacted multiple personalities until she met Wilbur. The young patient’s florid symptoms emerged and morphed over a period of years as she and Wilbur engaged in a complicated dance of mutually reinforced self-deception. According to her own admission, Shirley pretended to have alter personalities because she wanted Wilbur’s attention. The doctor quickly became fascinated by the personalities and began planning how she might attain professional fame and money by publishing about them. Wilbur then began using suggestive questions and barbiturate injections to extract ever more bizarre allegations of childhood abuse from her increasingly disoriented patient. Meanwhile she recruited Florence Schreiber to write a popularized book about the case.
Eventually Wilbur collaborated with Schreiber to create a narrative full of fabrications. For instance, according to the book, Shirley’s father once confessed to Wilbur that Shirley’s deceased mother had been diagnosed with schizophrenia. However, documented evidence clearly shows that this supposed confession never took place. Nor is there a shred of reliable evidence that Shirley’s mother had schizophrenia or any other psychotic disorder. Wilbur apparently allowed the phony confession to be inserted into Sybil to lend it more credibility.
Few topics in modern psychiatry arouse more controversy than MPD/DID. Many mental health professionals question whether the disorder even exists. According to these skeptics, MPD/DID is usually or always a socially created condition, fostered and reinforced in patients by suggestive therapists such as Wilbur. These skeptics contend that much of the supposed evidence for MPD/DID is based on shaky stories, weak methodology, and questionable data sources.
Sybil Exposed provides support for the skeptics; furthermore, the strange history of Wilbur and Sybil is by no means an isolated example. Like the House of Usher in Poe’s Gothic masterpiece, the edifice of MPD/DID stands on cracked foundations and has been shaken again and again by scandal and strange doings. For instance, a leading MPD/DID researcher, Bennett Braun of Rush-Presbyterian Hospital in Chicago, was sued by a string of patients in the mid-1990s after he diagnosed them with MPD/DID and convinced them that they were members of Satanic cults. The story of Braun and his bizarre approach to psychiatry was unforgettably depicted in The Search for Satan, a PBS Frontline documentary by award-winning director Ofra Bikel.
The sad and twisted events presented in Sybil Exposed and The Search for Satan illustrate why many mental health experts are skeptical regarding MPD/DID. This raises the point of whether this questionable disorder, repeatedly associated with fraud and charlatanry, should be listed in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, the so-called bible of psychiatry. The time has probably come to remove MPD/DID from the main part of the DSM and exile it to the special appendixes reserved for experimental, controversial, or culture-bound diagnostic categories.
When MPD/DID is relegated to psychiatry’s back pages, professionals fascinated with the disorder can still study and discuss it to their hearts’ content. Or perhaps it will eventually disappear into the twilight, to be remembered only as the specter of an embarrassing Gothic episode in the history of psychiatry.