Psychiatric Misadventures by Paul R. McHugh, M.D.

_PSYCHIATRY IS A RUDIMENTARY MEDICAL ART._ It lacks easy
access to proof of its proposals even as it deals with disorders
of the most complex features of human life--mind and behaviour.
Yet, probably because of the earlier examples of Freud and Jung,
a belief persists that psychiatrists are entitled to special
privileges-that they know the secret of human nature--and thus can
venture beyond their clinic-based competencies to instruct on
non-medical matters: interpreting literature, counselling the
electorate, prescribing for the millennium.
	At The Johns Hopkins University, my better days are spent
teaching psychiatry to residents and medical students. As I attempt
to make clear to them what psychiatrists actually do know and how
they know it, I am often aware that I am drawing them back from
trendy thought, redirecting them from Salvationist aspirations
toward the traditional concerns of psychiatry, which is about the
differentiation, understanding, and treatment of the mentally ill.
	Part of my justification for curbing my students' expansive
impulses is that they have enough to learn, and several things to
unlearn, about patients. Such sciences as epidemiology, genetics,
and neuropharmacology, which support and surround psychiatry today,
are bringing new power to our practice just as science did for
internal medicine and surgery earlier in this century. Only those
physicians with critical capacities--who see the conceptual
structure of this discipline and can distinguish valid from invalid
opinions--will be competent to make use of these new scientific
concepts and technologies in productive ways. I want my students
to number among those who will transform psychiatry in the future.
	But my other justification for corralling their enthusiasms
is the sense that the intermingling of psychiatry with contemporary
culture is excessive and injures both parties. During the thirty
years of my professional experience, I have witnessed the power of
cultural fashion to lead psychiatric thought and practice off in
false, eve disastrous, directions. I have become familiar with how
these fashions and their consequences caused psychiatry to lose its
moorings. Roughly every ten years, from the mid-1960s on,
psychiatric practice has condoned some bizarre misdirection,
proving how all too often the discipline has been the captive of
the culture.
	Each misdirection was the consequence of one of three common
medical mistakes--oversimplification, misplaced emphasis, or pure
invention. Psychiatry may be more vulnerable to such errors than
other clinical endeavours, given its lack of checks and
correctives, such as the autopsies and laboratory tests that
protect other medical specialties. But for each error, cultural
fashion provided the inclination and the impetus. When caught up
by the social suppositions of their time, psychiatrists can do much
harm.

II.

	The most conspicuous misdirection of psychiatric practice--
the precipitate dismissal of patients with severe, chronic mental
disorders such as schizophrenia from psychiatric hospitals--
certainly required a vastly oversimplified view of mental illness.
These actions were defended as efforts to bring "freedom" to these
people, sounding a typical 1960s theme, as though it were not their
illnesses but society that deprived them of freedom in the first
place.
	There were several collaborators in this sad enterprise--
prominent among them the state governments looking for release from
the traditional but heavy fiscal burden of housing the mentally
ill. Crucial to the process were the fashionable opinions of the
time about society's institutions and, specifically, the
oversimplified opinions about schizophrenia and other mental
illnesses generated by the so-called "anti-psychiatrists": Thomas
Szasz, R. D. Laing, Erving Goffman, Michael Foucault, and the rest.
These men provided an acid commentary on psychiatric thought and
practice, which in turn eroded confidence in the spirit of
psychiatric concern for the mentally ill that had previously
generated, and regularly regenerated, advocacy on the part of
mainstream psychiatry for their welfare. This traditional concern
had lasted for more than 120 years in America, or ever since the
1840s crusades led by Dorothea Dix to provide professional services
and humane conditions for the mentally ill.
	The "anti-psychiatry" school depicted mental institutions as
medically useless, self-serving institutions run for the
management, and quite unnecessary for patients. These commentators
scorned social attitudes about the mentally ill and the
contemporary psychiatric practice, but not one of them described
the impairments of mind in patients with schizophrenia,
manic-depressive illness, or with mental retardation or senility.
Data about these impairments were what Dix and an enlightened
public came to emphasize when founding psychiatrically supervised,
state-supported hospitals. These hospitals rescued the mentally ill
from destitution, jails, and the mean streets of cities.
	Description of the mental problems of psychiatric patients was
not the style of the popular 1960s commentators. They were more
interested in painting a picture of their own devising that would
provoke first suspicion and then disdain for contemporary
psychiatric practices and did so, not by producing new standards
or reforming specific practices, but by ridiculing and caricaturing
efforts of the institutions and people at hand just as fashion
directed. The power of their scorn was surprising and had amazing
results, leading many to believe that it was the institutions that
provoked the patients' illnesses rather than the illnesses that
called out for shelter and treatment.
	Here, from Szasz's book, Schizophrenia: The Sacred Symbol of
Psychiatry, is a typical comment:
	"The sense in which I mean that Psychiatry creates
schizophrenia is readily illustrated by the analogy between
institutional psychiatry and involuntary servitude. If there is no
slavery there can be no slaves.... Similarly if there is no
psychiatry there can be no schizophrenics. In other words, the
identity of an individual as a schizophrenic depends on the
existence of the social system of [institutional] psychiatry."
	The only reply to such commentary is to know the patients for
what they are-in schizophrenia, people disabled by delusions,
hallucinations, and disruptions of thinking capacities-and to
reject an approach that would trivialize their impairments and deny
them their frequent need for hospital care.
	On one occasion in the early 1970s, when I was working at
Cornell University Medical Center in New York, a friend and senior
member of the biochemistry faculty called me about a medical
student who was balking over a term paper because his career plan
was to become a champion of the "psychiatrically oppressed."
Biochemistry term papers seemed "irrelevant." Could I offer him a
project with psychiatric patients that might be developed into a
term paper satisfying the requirements of her department? "He's a
neat guy," she said, "but he is stubborn about this and full of
views about contemporary psychiatry." "Send him over," I said, but
I awaited his arrival with some apprehension. I needn't have feared
the encounter because, in contrast to many other students of those
times, he was not looking for a fight. "It's just that I know what
I want to do--understand the people who are isolated by the label
schizophrenia--and help them achieve what they want in life. I've
written enough irrelevant papers in my life," he said. He had
graduated summa cum laude from Princeton, with a concentration i
philosophy, so he certainly had placed a large number of words o
paper.
	"Have you ever seen anyone with schizophrenia?" I asked.
	"Not in the flesh," he said, "but I think I know what you do
with them."
	"Well," I replied, "I will be glad to have you see one, and
let you tell me how to appreciate his choice of an eccentric way
of life that he could be released to express it."
   I had plenty of patients under my care at the time and chose
one who was the same age as the student but who had a severe
disruption in his thought processes. Even to talk with him was a
distressing experience because few of his thoughts were connected,
and all of them were vaguely tied to delusional beliefs about the
world, his family, and our society. He wasn't aggressive or in any
way threatening. He was just bewilderingly incoherent. I left the
student with the patient, promising to return in half an hour to
learn what he thought.
	On my return, I found the student subdued. I started, in a
slightly teasing way, to ask where he suggested I might send the
patient to start his new life-but was quickly cut off by the
student who, finding his voice, said, "That was nothing like what
I expected and nothing like what I've read about. Obviously you
can't send this poor fellow out of the hospital. Please tell me how
you're treating him."
	With this evidence confirming my colleague's judgment of the
student's basic good nature in what, after all, had been a
heartfelt if inexperienced opinion, we went on to talk about the
impairments and disabilities of patients with serious mental
illnesses, their partial responses to combinations of medication
and psychological management, and, finally, to the meretricious
ideas about their treatment that had been promulgated by
contemporary fashion and the anti-psychiatry critics without making
an effort to examine patients.
	The student wrote his biochemistry paper on emerging concepts
of the neurochemistry of mental disorders. He buckled down in
medical school, and he came, after graduation, to join me as a
resident psychiatrist and eventually proved to be one of the best
doctors I ever taught. We had overcome something together--all out
of going to see a patient, recognizing his burdens, and avoiding
assumptions about what fashion said we should find.
	A saving grace for any medical theory or practice--the thing
that spares it perpetual thraldom to the gusty winds of fashion--
is the patients. They are real, they are around, and a knowledge
of their distressing symptoms guards against oversimplification.

III.

	The claim that schizophrenic patients are in any sense living
a alternative "life style" that our institutions were inhibiting
was of course fatuous. It is now obvious to every citizen of our
cities that these patients have impaired capacities to comprehend
the world and that they need protection and serious active
treatment. Without such help, they drift back to precisely the
place Dorothea Dix found them 150 years ago.
	From the faddish idea of institutions as essentially
oppressive emerged a nuance that became more dominant as the 1970s
progressed. This was that social custom was itself oppressive. In
fact, according to this view, all standards by which behaviours are
judged are simply matters of opinion--and emotional opinions at
that, likely to be enforced but never justified. In the 1970s, this
antinomian idea fuelled several psychiatric misdirections.
	A challenge to standards can affect at least the discourse in
a psychiatric clinic, if not the practice. These challenges are
expressed in such slogans as "Do your own thing," "Whose life is
it anyway?" "Be sure to get your own," or Joseph Campbell's "Follow
your bliss." All of these slogans are familiar to psychiatrists
trying to redirect confused, depressed, and often self-belittling
patients. Such is their pervasiveness in the culture that they may
even divert psychiatrists into misplaced emphases in their
understanding of patients.
	This interrelationship of cultural antinomianism and a
psychiatric misplaced emphasis is seen at its grimmest in the
practice known as sex-reassignment surgery. I happen to know about
this because Johns Hopkins was one of the places in the United
States where this practice was given its start. It was part of my
intention, when I arrived in Baltimore in 1975, to help end it.
	Not uncommonly, a person comes to the clinic and says
something like, "As long as I can remember, I've thought I was in
the wrong body. True, I've married and had a couple of kids, and
I've had a number of homosexual encounters, but always, in the back
and now more often in the front of my mind, there's this idea that
actually I'm more a woman than a man."
	When we ask what he has done about this, the man often says,
"I've tried dressing like a woman and feel quite comfortable. I've
eve made myself up and gone out in public. I can get away with it
because it's all so natural to me. I'm here because all this male
equipment is disgusting to me. I want medical help to change my
body: hormone treatments, silicone implants, surgical amputation
of my genitalia, and the construction of a vagina. Will you do it?"
The patient claims it is a torture for him to live as a man,
especially now that he has read in the newspapers about the
possibility of switching surgically to womanhood. Upon examination
it is not difficult to identify other mental and personality
difficulties in him, but he is primarily disquieted because of his
intrusive thoughts that his sex is not a settled issue in his life.
	Experts say that "gender identity," a sense of one's own
maleness or femaleness, is complicated. They believe that it will
emerge through the step-like features of most complex developmental
processes in which nature and nurture combine. They venture that,
although their research on those born with genital and hormonal
abnormalities may not apply to a person with normal bodily
structures, something must have gone wrong in this patient's early
and formative life to cause him to feel as he does. Why not help
him look more like what he says he feels? Our surgeons can do it.
What the hell!
	The skills of our plastic surgeons, particularly on the
genito-urinary system, are impressive. They were obtained, however,
not to treat the gender identity problem, but to repair congenital
defects, injuries, and the effects of destructive diseases such as
cancer in this region of the body.
	That you can get something done doesn't always mean that you
should do it. In sex reassignment cases, there are so many problems
right at the start. The patient's claim that this has been a
lifelong problem is seldom checked with others who have known him
since childhood. It seems so intrusive and untrusting to discuss
the problem with others, even though they might provide a better
gage of the seriousness of the problem, how it emerged, its
fluctuations of intensity over time, and its connection with other
experiences. When you discuss what the patient means by "feeling
like a woman," you often get a sex stereotype in return--something
that woman physicians note immediately is a male caricature of
women's attitudes and interests. One of our patients, for example,
said that, as a woman, he would be more "invested with being than
with doing."
	It is not obvious how this patient's feeling that he is a
woman trapped in a man's body differs from the feeling of a patient
with anorexia nervosa that she is obese despite her emaciated,
cachectic state. We don't do liposuction on anorexics. Why amputate
the genitals of these poor men? Surely, the fault is in the mind
not the member.
	Yet, if you justify augmenting breasts for women who feel
underendowed, why not do it and more for the man who wants to be
a woman? A plastic surgeon at Johns Hopkins provided the voice of
reality for me on this matter based on his practice and his natural
awe at the mystery of the body. One day while we were talking about
it, he said to me: "Imagine what it's like to get up at dawn and
think about spending the day slashing with a knife at perfectly
well-formed organs, because you psychiatrists do not understand
what is the problem here but hope surgery may do the poor wretch
some good."
	The zeal for this sex-change surgery--perhaps, with the
exception of frontal lobotomy, the most radical therapy ever
encouraged by twentieth century psychiatrists--did not derive from
critical reasoning or thoughtful assessments. These were so faulty
that no one holds them up anymore as standards for launching any
therapeutic exercise, let alone one so irretrievable as a
sex-change operation. The energy came from the fashions of the
seventies that invaded the clinic--if you can do it and he wants
it, why not do it? It was all tied up with the spirit of doing your
thing, following your bliss, an aesthetic that sees diversity as
everything and can accept any idea, including that of permanent sex
change, as interesting and that views resistance to such ideas as
uptight if not oppressive. Moral matters should have some salience
here. These include the waste of human resources; the confusions
imposed on society where these men/women insist on acceptance, even
in athletic competition, with women; the encouragement of the
"illusion of technique," which assumes that the body is like a suit
of clothes to be hemmed and stitched to style; and, finally, the
ghastliness of the mutilated anatomy.
	But lay these strong moral objections aside and consider only
that this surgical practice has distracted effort from genuine
investigations attempting to find out just what has gone wrong for
these people--what has, by their testimony, given them years of
torment and psychological distress and prompted them to accept
these grim and disfiguring surgical procedures.
	We need to know how to prevent such sadness, indeed horror.
We have to learn how to manage this condition as a mental disorder
when we fail to prevent it. If it depends on child rearing, then
let's hear about its inner dynamics so that parents can be taught
to guide their children properly. If it is an aspect of confusion
tied to homosexuality, we need to understand its nature and exactly
how to manage it as a manifestation of serious mental disorder
among homosexual individuals.  But instead of attempting to learn
enough to accomplish these worthy goals, psychiatrists collaborated
in a exercise of folly with distressed people during a time when
"do your own thing" had something akin to the force of a command.
As physicians, psychiatrists, when they give in to this, abandon
the role of protecting patients from their symptoms and become
little more than technicians working on behalf of a cultural force.

IV.

	Medical errors of oversimplification and misplaced emphasis
usually play themselves out for all to see. But the pure inventions
bring out a darker, hateful potential when psychiatric thought goes
awry. The invention of entities of mind and then their elaborate
description, usually fuelled by the energy from some social
attitude they amplify, is a recurring event in the history of
psychiatry.
	Most psychiatric histories choose to describe such invention
by detailing its most vivid example--witches. The experience in
Salem, Massachusetts, of three hundred years ago is prototypical.
Briefly, in 1692, several young women and girls who had for some
weeks been secretly listening to tales of spells, voodoo, and
illicit cultic practices from a Barbados slave suddenly displayed
a set of mystifying mental and behavioural changes. They developed
trance-like states, falling on the ground and flailing away, and
screaming at night and at prayer, seemingly in great distress and
in need of help. The local physician, who witnessed this, was as
bewildered as anyone else and eventually made a diagnosis of
"bewitchment." "The evil hand is on them," he said and turned them
over to the local officials for care.
	The clergy and magistrates, regarding the young people as
victims and pampering them by showing much attention to their
symptoms, assumed that local agents of Satan were at work and,
using as grounds the answers to leading questions, indicted several
citizens. The accepted proof of guilt was bizarre. The young women
spoke of visions of the accused, of sensing their presence at night
by pains and torments and of ghostly visitations to their homes,
all occurring while the accused were known to be elsewhere. The
victims even screeched out in court that they felt pinches and
pains provoked by the accused, even while they were sitting quietly
across the room. Judges believed this "spectral" evidence because
it conformed to contemporary thought about the capacities of
witches; they dismissed all denials of the accused and promptly
executed them.
	The whole exercise should have been discredited when, after
the executions, there was no change in the distraught behaviour of
the young women. Instead more and more citizens were indicted. A
prosecution depending on "spectral evidence" was at last seen as
capricious--as irrefutable as it was undemonstrable. The trials
ceased, and eventually several of the young women admitted that
their beliefs had been "delusions" and their accusations false.
	The modern diagnosis for these young women is, of course,
hysteria not bewitchment. Psychiatrists use the term hysteria to
identify behavioural displays in which physical or mental disorders
are imitated. The reasons for the behaviour vary with the person
displaying the disorder but are derived from that person's more or
less unconscious effort to appear more significant to others and
to be more entitled to their interest and support. The status of
the putatively bewitched in Salem of 1692 brought both attentive
concern and license to indict to young women previously scarcely
noticed by the community. The forms of hysterical behavior--whether
they be physical activities, such as falling and shaking, or mental
phenomena, such as pains, visions, or memories--are shaped by
unintended suggestions from others and sustained by the attention
of onlookers--especially such onlookers as doctors who are socially
empowered to assign, by affixing a diagnosis, the status of
"patient" to a person. Whenever these diagnosticians mistake
hysteria for what it is attempting to imitate-misidentifying it
either as a physical illness or inventing some psychological
explanation such as bewitchment--then the behavioural display will
continue, expand, and, in certain settings, spread to others. The
usual result is trouble for everyone.
	During the last seven or eight years, another example of
misidentified hysterical behaviour has surfaced and again has been
bolstered by an invented view of its cause that fits a cultural
fashion. This condition is "multiple personality disorder" (MPD,
as it has come to be abbreviated). The majority of the patients who
eventually receive this diagnosis come to therapists with standard
psychiatric complaints, such as depression or difficulty in
relationships. Some therapists see much more in these symptoms and
suggest to the patient and to others that they represent the subtle
actions of several alternative personalities, or "alters,"
co-existing in the patient's mental life. These suggestions
encourage many patients to see their problems in a fresh and, to
them, remarkably interesting way. Suddenly they are transformed
into odd people with repeated shifts of demeanour and deportment
that they display on command.
	Sexual politics in the 1980s and 1990s, particularly those
connected with sexual oppression and victimization, galvanizes
these inventions. Forgotten sexual mistreatment in childhood is
the most frequently proffered explanation of MPD. Just as an
epidemic of bewitchment served to prove the arrival of Satan in
Salem, so in our day an epidemic of MPD is used to confirm that a
vast number of adults were sexually abused by guardians during
their childhood. Now I don't for a moment deny that children are
sometimes victims of sexual abuse, or that a behavioural problem
originating from such abuse can be a hidden feature in any life.
Such realities are not at issue. What I am concerned with here is
what has been imagined from these realities and inventively applied
to others.
	Adults with MPD, so the theory goes, were assaulted as young
children by a trusted and beloved person--usually a father, but
grandfathers, uncles, brothers, or others, often abetted by women
in their power, are also possibilities. This sexual assault, the
theory holds, is blocked from memory (repressed and dissociated)
because it was so shocking. This dissociating blockade itself--
again according to the theory--destroys the integration of mind and
evokes multiple personalities as separate, disconnected,
sequestered, "alternative" collections of thought, memory, and
feeling. These resultant distinct "personalities" produce a variety
of what might seem standard psychiatric symptoms--depression,
weight problems, panic states, demoralization, and so forth--that
only careful review will reveal to be expressions of MPD that is
the outcome of sexual abuse.
	These patients have not come to treatment reporting a sexual
assault in childhood. Only after therapy has promoted MPD behaviour
is the possibility that they were sexually abused as children
suggested to them. From recollections of the mists of childhood,
a vague sense of vulnerability may slowly emerge, facilitated and
encouraged by the treating group. This sense of vulnerability is
thought a harbinger of clearer memories of victimization that,
although buried, have been active for decades producing the
different "personalities." The long supposedly forgotten abuse is
finally "remembered" after months of "uncovering" therapy, during
which long conversations by the therapist with "alter"
personalities take place. Any other actual proof of the assault is
thought unnecessary. Spectral evidence-developed through
suggestions and just as irrefutable as that at Salem-once again is
sanctioned.
	Like bewitchment from Satan's local agents, the idea of MPD
and its cause has caught on among large numbers of psychiatrists
and psychotherapists. Its partisans see the patients as victims,
cosset them in groups, encourage more expressions of "alters" (up
to as many as eighty or ninety), and are ferocious toward any
defenders of those they believe are perpetrators of the abuse. Just
as the divines of Massachusetts were convinced that they were
fighting Satan by recognizing bewitchment, so the contemporary
divines--these are therapists--are confident that they are fighting
perpetrators of a common expression of sexual oppression, child
abuse, by recognizing MPD.
	The incidence of MPD has of late indeed taken on epidemic
proportions, particularly in certain treatment centers. Whereas its
diagnosis was reported less than two hundred times from a variety
of supposed causes in the last century, it has been applied to more
than 20,000 people in the last decade and largely attributed to
sexual abuse.
	I have been involved in direct and indirect ways with five
such cases in the past year alone. In every one, the very same
story has been played out in a stereotyped script-like way. In each
a young woman with a rather straightforward set of psychiatric
symptoms--depression and demoralization--sought help and her case
was stretched into a diagnosis of MPD. Eventually, in each example,
an accusation of prior sexual abuse was levelled by her against her
father. The accusation developed after months of therapy, first as
vague feelings of a dream-like kind--childhood reminiscences of
danger and darkness eventually crystallizing, sometimes "in a
flash," into a recollection of father forcing sex upon the patient
as a child. No other evidence of these events was presented but the
memory, and plenty of refuting testimony, coming from former
nursemaids and the mother, was available but dismissed.
	On one occasion, the identity of the molester--forgotten for
years and now first vaguely and then more surely remembered under
the persuasive power of therapy--changed, but the change was as
telling about the nature of evidence as was the emergence of the
original charge. A woman called her mother to claim that she had
come to realize that when she was young she was severely and
repeatedly sexually molested by her uncle, the mother's brother.
The mother questioned the daughter carefully about the dates and
times of these incidents and then set about determining whether
they were in fact possible. She soon discovered that her brother
was on military service in Korea at the time of the alleged abuse.
With this information, the mother went to her daughter with the
hope of showing her that her therapist was misleading her in
destructive ways. When she heard this new information, the daughter
seemed momentarily taken aback, but then said, "I see, Mother. Yes.
Well, let me think. If your dates are right, I suppose it must have
been Dad." And with that, she began to claim that she had been a
victim of her father's abusive attentions, and nothing could
dissuade her.
	The accused men whom I studied, denying the charges and amazed
at their source, submitted to detailed reviews of their sexual
lives and polygraphic testing to try to prove their innocence and
thereby erase doubts about themselves. Professional requests by me
to the daughters' therapists for better evidence of the abuse were
dismissed as derived from the pleadings of the guilty and scorned
as beneath contempt, given that the diagnosis of MPD and the
testimony of the patients patently confirmed the assumptions.
	In Salem, the conviction depended on how judges thought
witches behaved. In our day, the conviction depends on how some
therapists think a child's memory of trauma works. In fact, severe
traumas are not blocked out by children but remembered all too
well. They are amplified in consciousness, remaining like grief to
be reborn and reemphasized on anniversaries and in settings that
can simulate the environments where they occurred. Good evidence
for this is found in the memories of children from concentration
camps. More recently, the children of Chowchilla, California, who
were kidnapped in their school bus and buried in sand for many
hours, remembered every detail of their traumatic experience and
needed psychiatric assistance, not to bring out forgotten material
that was repressed, but to help them move away from a constant
ruminative preoccupation with the experience .
	Many psychiatrists upon first hearing of these diagnostic
formulations (MPD being the result of repressed memories of sexual
abuse in childhood) have fallen back upon what they think is a
evenhanded way of approaching it. "The mind is very mysterious in
its ways," they say. "Anything is possible in a family." In fact,
this credulous stance toward evidence and the failure to consider
the alternative of hysterical behaviours and memories are what
continue to support this crude psychiatric analysis.
	The helpful clinical approach to the patient with putative
MPD, as with any instance of hysterical display, is to direct
attention away from the behaviour--one simply never talks to an
"alter." Within a few days of a consistent therapeutic emphasis
away from the MPD behaviour, it fades and generally useful
psychotherapy on the presenting true problems begins. Real sexual
traumas can be dealt with, if they are present, as can the
ambivalent and confused feelings that many adults have about their
parents.
	Similarly, the proper approach to end epidemics of MPD and the
assumptions of a vast prevalence of sexual abuse in ordinary
families is for psychiatrists to be aware of the potential,
whenever we are dealing with hysteria, to mistake it for something
else. When it is so mistaken, this can lead to monstrous concepts
defended by coincidence, the induction of memories, and a display
of "spectral" evidence--all to justify a belief that the community
is under siege. This belief, of course, is what releases the power
of the witches' court and the Lynch mob.
	As a corrective, psychiatrists need only review with a patient
how the MPD behaviour was diagnosed and how the putative memories
of sexual abuse were suggested. These practices will eventually be
discredited, and this epidemic will end in the same way that the
witch trials ended in Salem. But time is passing, many families are
being hurt, and confidence in the competence and impartiality of
psychiatry is eroding.

V.

	Major psychiatric misdirections often share this intimidating
mixture of a medical mistake lashed to a trendy idea. Any challenge
to such a misdirection must confront simultaneously the
professional authority of the proponents and the political power
of fashionable convictions. Such challenges are not for the
fainthearted or inexperienced. They seldom quickly succeed because
they are often misrepresented as ignorant or, in the cant word of
our day, uncaring. Each of the three misdirections I have dealt
with in this essay ran for a full decade, despite vigorous
criticism. Eventually the mischief became obvious to nearly
everyone and fashion moved on to attach itself to something else.
	In ten years much damage can be done and much effort over a
longer period of time is required to repair it. Thus with the
mentally-ill homeless, only a new crusade and social commitment
will bring them adequate help again. Age accentuates the sad
caricature of the sexual reassigned and saps their bravado. Some,
pathetically, ask about re-reassignment. Groups of parents falsely
accused of sexual mistreatment by their grown children are
gathering together to fight back in ways that will produce dramatic
but distressing spectacles. How good it would have been if in the
first place all these misguided programs had been avoided or at
least their spa abbreviated.
	Psychiatry, it needs always to be remembered, is a medical
discipline--capable of glorious medical triumphs and hideous
medical mistakes. We psychiatrists don't know the secret of human
nature. We cannot build a New Jerusalem. But we can teach the
lessons of our past. We can describe how our explanations for
mental disorders are devised and develop--where they are strong and
where they are vulnerable to misuse. We can clarify the
presumptions about what we know and how we know it. We can strive
within the traditional responsibilities of our profession to build
a sound relationship with people who consult us--placing them on
more equal terms with us and encouraging them to approach us as
they would any other medical specialists, by asking questions and
expecting answers, based on science, about our assumptions,
practices, and plans. With effort and good sense, we can construct
a clinical discipline that, while delivering less to fashion, will
bring more to patients and their families.

------------------------------------------------------------

PAUL R. McHUGH is Henry Phipps Professor and Director of the
Department of Psychiatry and Behavioural Sciences at the Johns
Hopkins University School of Medicine. He is the author (with
Phillip R. Slavney) of _The Perspectives of Psychiatry and
Psychiatric Polarities._ This article is from The _American
Scholar,_ Autumn 1992.

Dr. McHugh holds the copyright to this article. Reprint with permission.
.

The Most Dangerous Idea in Mental Health by Ed Cara

USA, Pacific Standard: The Science of Society. November 3, 2014.

Ed Cara Mr. Cara lives in New York City. He writes about the intersection of science and social justice at his blog, Grumbles and Rumbles.

Excerpts:

“The belief that hidden memories can be “recovered” in therapy should have been exorcised years ago, when a rash of false memories dominated the airwaves, tore families apart, and put people on the stand for crimes they didn’t commit. But the mental health establishment does not always learn from its mistakes—and families are still paying the price.

Nearly four years ago, Tom and his ex-wife sent their daughter to an eating-disorder clinic called the Castlewood Treatment Center, outside St. Louis. In her five months there, Anna grew to believe she had recovered memories of a deeply abusive childhood that she had previously banished from her conscious mind.”

Full article retrieved 11-18-14.

I am adding Mr. Cara’s article to my growing list of historical developments of the false memory syndrome craze, repressed memory theories, multiple personality, dissociative identity disorder and others. Society can no longer ignore the fact that some of these treatments began way back in the 1905, and earlier, but they still thrive today – one hundred years later.

The ever growing list of family tragedies stemming from some types of psychotherapies based on pseudoscience that may treat medical disorders with personal beliefs and politics, rather than science, will no longer be ignored on this blog.

The organizations listed below, to my knowledge, have not taken major steps to insist on science-based treatment for people seeking mental health care. These goofy-therapy debacles that were largely ignored by the United States organizations, like the American Psychiatric Association, the American Psychological Association, the American Medical Association and most recently the US backed National Association of Social Workers – who recently offered continuing education credits for attendees of a recent conference on multiple personalities, disguised in my opinion, as a trauma and dissociation conference held in Seattle, Washington, USA, must be include for an accurate history.

 

 

Dr. Phil Exposes the Flaws & Fallacies of Repressed Memories

Thank you, Dr. Phil for your show:

Sex Abuse and Murder:

A Daughter’s Repressed Memories or Lies?

Air Date  February 17, 2014
Summary:
Tracy says that about three years ago, disturbing memories from her childhood began to surface about sex abuse and murder — involving her mother, Donna, and now-deceased father, Alan. Tracy claims that she and her sister, Kelly, were molested by their father and grandfather, and alleges that Donna killed Kelly’s best friend and buried the girl in their backyard. Donna and Kelly vehemently deny the claims, calling Tracy “delusional.” Emotions run high when Tracy faces her family on Dr. Phil’s stage, including Donna, whom she hasn’t seen or spoken to in more than a year. Is Tracy remembering actual events, or are these fictionalized memories? Plus, don’t miss part two tomorrow, when Donna agrees to take a polygraph test to clear her name. Will Tracy get the answers she’s looking for? This program contains strong sexual content. Viewer discretion advised.
~~~~~~~~
The argument regarding the truth of repressed memories boils down to one question:
Are decade old memories, newly discovered, accurate?

I do not think that repressed memories are lies because a lie is a deliberate attempt to deceive. Repressed memories that erupt decades after an event cannot be 100% accurate as the science of human memory repeatedly shows, and proves in a laboratory, that memories in general are a confabulated rendition of truth, falsehood, and fill-in-the blanks.

I was once caught in a web of repressed memories much like that displayed by the guest on the Dr. Phil show. And like her, my memories grew during therapy and were reinforced by those around me. My decade old memories morphed into a story that, when investigated, were found to be utter nonsense.

I am grateful that the Dr. Phil show educated the public about the controversy that continues to swirl around the veracity of repressed memories. When science and investigations are employed, we have a chance of getting to the truth of these memories. When people are being accused of heinous crimes that never occurred, we have a responsibility to seek the truth and scant memories of events that may or may not have occurred decades earlier are simply not reliable.

The family who told their horror story regarding accusations of murder and sexual assault based on the repressed memories of a family member now have a chance to recover and heal from the toxic psychotherapy that tore at their souls. Science prevails in this case and I wonder how many other families could benefit from evidence rather than dubious memories of wrong doing.

It’s time to pressure the American Psychiatric Association and the American Psychological Association, the two most influential organizations responsible for overseeing mental health care practitioners in the United States, to hold their members accountable for their actions.

When patient’s welfare is sacrificed for theories and beliefs held by the therapist – it’s simply a crime against humanity.

The Warping of the American Women’s Movement

The credibility of the “survivor movement” reached a higher level in the late 1980s when victims of  sexual abuse perceived that American culture had changed significantly in their favor. Women rejoiced believing they were finally able to speak of their silent sexual abuses and that society was ready to listen and take action. Some voices were heard publicly -  others privately.

Women, including me, had marched for equality and the right to be heard in the hot, summer streets of Washington D.C.. We carried banners and colorful flags and sang our songs for years – years that stretched into decades, but our time had come.

By the early 1990s, the survivor movement warped into the “victims” movement. It wasn’t a calculated change, but one that occurred when the psychology industry grasped onto the struggles of women who were sexually abused. Born from the marriage between vulnerable women and psychotherapy was repressed memory therapy. A new technique believed to help women recall buried memories of sexual abuse. The victim movement warped yet again when some women remembered satanic ritual abuse and other atrocities that included human sacrifices and violent torture.

Over the next decade, while women flooded therapist’s offices remembering all sorts of abuses, the large survivor movement took yet another turn that was not apparent until years later. After years of repressed memory therapy, an increasing number of women realized that the psychology industry took advantage of them when they were vulnerable and in need of medical care. In a variety of ways, many of came to understand that they had not been sexually abused, but had been led to believe so by overzealous therapists who refused to hear their protestations.

What happened to those of us swept into the psychotherapy machine? We were silenced. Women, silenced again. The women’s movement had been fractured by a tenacious psychotherapy beast unwilling, and by then, unable to back down and confess its wrongdoing. But this time the silencing was done by other women.

It was a difficult time for me because I as an activist, I fought in the streets of Washington with thousands of other women and now my voice was silenced. No one wanted to hear that I was coerced into believing I had been sexually abused when I had not been because it was feared that women who had been abused would once again be silenced and disregarded.

I don’t know if Americans understand the power, might, and influence of the psychology industry. The beast keeps many women in its claws by supporting and encouraging the “victim” mentality. This group of women will not relinquish their position in society as abuse survivors who demand understanding and support by the rest of us. By the increasing number of Internet blogs and groups alone, it is clear that some women will never be healed no matter how much therapy is received or to what depth therapists encourage them to fall.

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On Bullshit Psychology

 I enjoy reading essays penned by people who tell is like they see it. Well done article IMHO. JB

“I was going to write this post on ” pop psychology ” but decided that moniker just doesn’t cut it, and the scope is too limited and easy.  What we are referring to when we say “pop psychology” is 99% bullshit.  Not too hard to see that, if you read 50 of those books and your life still sucks .  But for that matter, what passes for “evidence-based” psychology is still probably at least 60% bullshit.  I’m going to go beyond bashing the obvious targets that lard up our bookshelves, the self-help books and so forth.  I want to target much of what clinical psychology that the public encounters eagerly defines itself as.  It’s not “popular” necessarily, but it is awfully self-important and mostly wrong and potentially damaging to the public.  Actually, So let’s call it what it is: Bullshit psychology.

The main premise of bullshit psychology is that there is something wrong with you, and you need psychology to fix what’s wrong with you.  This is the first premise of bullshit.  I want to highlight this premise because all else in bullshit psychology rests on it.  You are broken, we will fix you.  We, the experts, will provide you the information to fix yourself.  Bullshit.”

 

 

About Dr. Rinewine

Retrieved 08-12-14, Full Article: Portlandmindful.com

Are Primary Causes of MPD Psychotherapists? by Scott Mendelson, M.D.

Dr. Mendelson examines the explosion of multiple personalities in the United States between 1980 to 1986 which can be viewed as a culture-bound syndrome – one most closely associated with the United States rather than a world wide mental illness seen in many other countries.
Scott Mendelson, M.D.

Scott Mendelson, M.D.

Posted: January 31, 2011 04:55 PM

“Multiple Personality Disorder (MPD), or, as it is referred to in most recent version of the manual DSM-IV, Dissociative Identity Disorder, is a genuine psychiatric disorder. However, the numbers of cases of MPD are far higher in North America than in any other part of the world. Many suspect that this surplus of MPD cases is the product of American culture and over-indulgent psychiatrists and psychotherapists.”

In a 2004 review for the Canadian Journal of Psychiatry, the American psychiatrist, Dr. August Piper, remarked that more MPD cases were discussed in the medical literature in the five years after inclusion in the DSM-III than in the preceding two centuries. Between 1980 and 1986, more than 6000 patients in the United States were diagnosed with the disorder. Champions of the disorder, such as psychiatrist Colin A. Ross, began to claim that MPD was rampant…”

Most psychiatrists believe that the diagnosis of MPD has gotten entirely out of hand, and it isn’t merely due to the unexpectedly large number of patients being diagnosed with the illness. … Personalities began to propagate like locusts. … Yet, reports of patients with hundreds of separate alter personalities became routine. For example, Dr. Richard P. Kluft, a psychiatrist specializing in the treatment of MPD at the University of Pennsylvania, reported in a 1988 paper that one of his patients had over 4000 “alters”.

Others suffer delusions and thought disorders bizarre enough to warrant diagnoses of schizophrenia rather than MPD. Still, the question remains as to what degree leading questions and indulgences of vivid imaginations have prompted the alternate “personalities” to come into being.”

“The sufferers of Multiple Personalities also appear to feed off each other’s imaginations. Websites and Internet discussion groups for “multiples” abound, and sufferers take pride in how many alter personalities populate their minds. Pseudoscientific jargon flows freely in sites aiming to provide a technical basis for the illness and snare “multiples” for cutting edge psychotherapy. … This is pure baloney.”

Full Article: Huffington Post Retrieved 4/2/11.

Multiple Personality Disorder and other culture bound psychiatric conditions are discussed in Dr. Mendelson’s new book, “The Great Singapore Penis Panic and the Future of American Mass Hysteria“.

Psychiatric Nonsense at Noon: “FMSwordF”

My, my, my, I have a rather humorous comment to report on today. If only the commenter, Christopher, read the article below and was outraged that a mental health facility was accumulating medical malpractice suits instead of coining stupid acronyms and failing at insulting me, perhaps a dialogue would have started. Instead, I am dealing rather humorously with Christopher’s lack of education and moral fortitude.

Christopher commented to my post entitled: Treatment Facility, Mercy Ministries: Harm Continues to Women Patients? The post was to update readers that there is a 4th medical malpractice suit filed against this organization and those who run it. But I digress.

Christopher came to this blog intending to be obnoxious and condescending to me, but instead only managed to tickle my funny bone. Christopher didn’t mean to be humorous, but heck, when something’s funny, I’m gonna laugh – and share.

Uneducated and vindictive commenters like Christopher seem like disgruntled pseudo-survivors who are more interested in attacking me instead of the issues I report on. Choosing to demean me (which never works) rather than discussing what is going on at Mercy Ministries 4th medical malpractice suit is pathetic and glaringly shows that pseudo-survivors are not interested in safe and effective mental health care.

Back to Christopher. Trying  to coin a new phrase instead of working to make mental-health care safe and affordable – while simultaneously thinking my heart will break at personal insults, is deplorable. But heck, you have to give ‘em “The Psychiatric Nonsense at Noon Brown-Banana Award” for trying. Christopher’s new phrase is: FMSwordF.  Mean anything to you? Of course not. I, on the other hand, am an accomplished fencer with real swords resting here and there around the house, so what I saw was the word “sword” smack dag in the middle of FMSwordF.  Nah, I told myself, this isn’t a cute fencing term so I read on.

Christopher came here intending to trash the False Memory Syndrome Foundation (FMSF), but didn’t want to write out the full acronym of the organization because s/he claims there is no such “thing” as false memory syndrome. OK, fine with me if Christopher wants to make a point (I’d be careful though because there are real swords about 6 feet from where I’m sitting and they have real points) but I digress. FMS is a well established term meaning “false memory syndrome” used to describe remembering an event that, in reality, never occurred. It’s been used for decades. Most people familiar with the term FMS know it is not a syndrome per se but that didn’t prevent Christopher from trying one more time – to make a lame point.

Well, well, well. What did Christopher accomplish with the FMSwordF mumbo-jumbo-nonsense besides winning a blog post dedicated to the absurdity they spouted?

The post, see below, is about the harm sustained by patients at this particular facility. Hey Christopher, what do you think about Mercy Ministries?

Article here

Comment below:

Christopher’s comment: Submitted on 2014/11/10 at 12:03 PM

“It is evident that your inability to harmonize and process your own past experiences is what drives this very bizarre conspiracy theory-driven vendetta against those with Dissociative Identity Disorder. Your personal experience is not a valid foundation on which to launch projections onto the different and individual experiences of others. Perhaps you ought find a more productive pasttime [sic]than passing your days seeking to unearth further means of discrediting and undermining a group of people you are openly and admittedly not a part of.

I will also point out that the vast majority of your “supporters” are emotionally-lax women who openly profess issues with their purportedly dissociative mother; hardly an objective point of reference. Best of luck sorting yourself out.”

“`

p.s. Christopher, dear, what is “emotionaly-lax women”? Harmonize and process? Does that have something to do with digesting my brown bag lunch? What is “purportedly dissociative mother”. What does offering me “luck sorting yourself out” mean? I have supporters? Wow, thanks for the kudos!

You can count on me Always being here to report on mental health practices that harm, or have the potential to harm, patients and their families. Just one of those irritating facts of life

If you want to know who the blogger is behind the hilarious “FMswordF Brown Bag Brown Banana Award , good luck. I was banned from a comment immediately. So, dear public, if you have a cause to take up, surely this one led by a nameless person telling you nothing about it, toss your money out the window – where I can catch it on the way down.

Cheers!

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British False Memory Society

British False Memory Society

About

“False memory is the phenomenon in which a person is convinced a memory is true when it is not. It was first postulated and diagnosed more than 100 years ago. More recently, clinical evidence suggests it is more widespread than had previously been appreciated.”

In particular, it is creating severe problems in the field of alleged sexual abuse. Naturally, the Society acknowledges and abhors the fact that there are many genuine cases of child abuse that may require the application of the criminal law. However, what is happening is that a number of people, usually during psychotherapy or counselling, are recovering ‘memories’ of having been sexually abused in childhood, even though those accused – usually, but not always, their parents – deny such abuse and there is no corroborating evidence.” …

In 1992, after an article in the American press drew a huge response, a group of accused parents in America attended a meeting with professionals from the University of Pennsylvania and Johns Hopkins University and the False Memory Syndrome Foundation (FMSF) was formed. The appointment of a scientific advisory board led to a critical scrutiny of the social movement in which these therapeutic theories and practices were emerging. The rationale being offered by the therapists and their designated forms of treatment began to be challenged.

In Britain, the turning point was 1990 when the British edition of The Courage to Heal appeared and, following the American experience, a belief arose that ‘repressed memories‘ of sexual abuse were commonplace. After the first FMSF conference in Philadelphia in the spring of 1993, accused parents who attended from the UK met and formed an organisation which was to become the British False Memory Society.”

The British False Memory Society offers a newsletter and many links.

British False Memory Society

Treatment Facility, Castlewood: Harm Continues to Women Patients?

update: 11-17-14. My error, this is about Castlewood, not Mercy Ministries. My apologies and thanks to a reader who brought this to my attention.
update: 11-09-14. A fourth medical malpractice suit has been filed against Castlewood.
Lincoln, California, USA
According to the Lincoln News Messenger, Mercy Ministries, an international nonprofit organization that claims to help “females with life-threatening situations” namely anorexia nervosa a life-threatening eating disorder, has reopened its doors to patients.
Mercy Ministries, formerly of Australia, paid $120,000 for misrepresenting itself to women clients yet was permitted to open facilities in the United States after closing it’s treatment facility in Australia. Currently, it has treatment facilities in Lincoln, California; Monroe, Louisiana; Nashville, Tennessee.; St. Louis, Missouri, Canada, New Zealand and the United Kingdom.

Although some of Mercy Ministries former patients claim the Lord showed them healing, there is a growing number of families telling horror stories of treatment using out-dated and debunked repressed-memory-therapy (RMT) which gained popularity in the 1980s. RMT treatment focuses on remembering alleged childhood sexual abuse that has shown to produce tainted, if not purely made-up, recall fraught with inaccuracies.

Mercy Ministries is repeating a period of psycho-social history and pop psychology in the United States that humiliated the entire profession and left it on its knees. Yet learning from their mistakes did not happen because fathers are once again being accused of sexually abusing their daughters only after their adult-children were influenced at various Mercy Ministries treatment centers to remember. Memories of horrific sexual are meant to heal their serious medical condition.

The Lincoln News Messenger claims that “Someone with an eating disorder might die without the appropriate medical treatment.” Furthermore it’s editor, Carol Feineman, says that while the United States Joint Commission on Health Care Accreditation JCHCA, acknowledges Mercy Ministries, it did not accredit them as a provider of mental health services. The JCHCA oversees hospitals within the United States and it is a serious infraction for Mercy Ministries to operate without their accreditation – not that they are not permitted to do so, but full-disclosure needs to occur with all and any clients that come to them for treatment.

Evidence is growing and indicating that Mercy Ministries may be treating women with debilitating eating disorders without proper authority, supervision, or medical and psychological health-care providers.
A Bible-based counseling and treatment center, Mercy Ministries is permitted under United States, Canadian, New Zealand, and United Kingdom law to open it’s doors to ill women who may or may not know it is not a proper medical facility. Is God’s love and guidance enough to help women overcome anorexia in lieu of medical treatment? Patients deserve and warrant proper nutritional, therapeutic or medical oversight of their medical and psychological conditions. Otherwise, they may just as well go to church and save themselves the money.
What do we does a society concerned with proper mental-health care going to do? How about sending this article to your friends and family? Tweeting, talking, and educating others about how to obtain proper medical care is a good start.
To read more mercyministries.org

Therapeutic Hazards of Treating Child Alters as Real Children in Dissociative Identity Disorder by Shusta-Hochberg, S.R.

Shusta-Hochberg’s article below supports the existence of child personalities  – and supports dissociative identity disorder, yet she does not think that exploring child alters is a productive method of treating patients.

~~~~~~~~~~

Therapeutic Hazards of Treating Child Alters as Real Children in Dissociative Identity Disorder
Shielagh R. Shusta-Hochberg, PhD

ABSTRACT. “Dissociative identity disorder (DID), with its typical etiology of extreme, repetitive childhood trauma, usually includes manifestations of childlike ego-states, among others. For many patients, these
ego-states, originating with the initial traumatic insults to the psyche in childhood, have been called forth again and again as new situations evoke the earlier trauma. When clinicians, family and friends react to
them with warmth, nurturing, and empathy, this may exacerbate the illusion that such ego-states are indeed actual children. This can result in a patient becoming increasingly resistant to working through the issues and experiences by which these ego-states have become fixed, with the risk of therapy reaching an impasse. Attitudes, interventions, and approaches to move past such impasses are addressed.”

Shielagh R. Shusta-Hochberg is a clinical psychologist in private practice in New York City, NY.

This paper was originally presented as “Fixed Illusions: Treating the Reification of Child Alters in Dissociative Identity Disorder,” at the 18th Annual Conference of the International Society for the Study of Dissociation, November 2002, Baltimore, MD. Journal of Trauma & Dissociation, Vol. 5(1) 2004.

Retrieved 3/30/11. Available as a PDF.

ABSTRACT. “Dissociative identity disorder (DID), with its typical etiology of extreme, repetitive childhood trauma, usually includes manifestations of childlike ego-states, among others. For many patients, these
ego-states, originating with the initial traumatic insults to the psyche in childhood, have been called forth again and again as new situations evoke the earlier trauma. When clinicians, family and friends react to
them with warmth, nurturing, and empathy, this may exacerbate the illusion that such ego-states are indeed actual children. This can result in a patient becoming increasingly resistant to working through the issues and experiences by which these ego-states have become fixed, with the risk of therapy reaching an impasse. Attitudes, interventions, and approaches to move past such impasses are addressed.”

Shielagh R. Shusta-Hochberg is a clinical psychologist in private practice in New York City, NY.

This paper was originally presented as “Fixed Illusions: Treating the Reification of Child Alters in Dissociative Identity Disorder,” at the 18th Annual Conference of the International Society for the Study of Dissociation, November 2002, Baltimore, MD. Journal of Trauma & Dissociation, Vol. 5(1) 2004.

Retrieved 3/30/11. Available as a PDF.

Emerging Science Shows Evidence that Post Traumatic Stress Disorder (PTSD) is also a Learning Disorder

Dissociative Identity Disorder (DID), initially called Multiple Personality Disorder (MPD), has little credible science showing the disorder actually exists beyond individuals (and their therapists) believing in it.

People who allege they suffer from multiple personalities, or alter selves, use scant neuroimaging studies to prove the psychiatric condition is real. They claim different personalities can be seen in the brain when the suffer changes to different personality states. Studies debunking that conclusion show that intentionally changing ones thoughts can also change brain images are ignored in favor of the multiple personality model.

Although neuroimaging tests repeatedly debunk the Dissociative Identity Disorder model, the DID community is not swayed to question results of studies supporting it. It’s unfortunate when therapists and their clients ignore scientific evidence in favor of belief systems – but they have a right to toss out science if they so choose.

The study below shows new evidence that Post Traumatic Stress Disorder (PTSD) is both an anxiety disorder and a learning disorder.

I offer this study because professionals diagnosing Dissociative Identity Disorder use trauma as evidence that an abusive past likely occurred whether or not the trauma is actually known to the sufferer or believed to be buried deep in the psyche and, therefore, unknown.

Post Traumatic Stress Disorder is often used attached to the DID diagnosis. If indeed, patients are incapacitated not only with anxiety from childhood sexual trauma but also a learning disability, how does that knowledge impact theories of multiple personalities and Dissociative Identity Disorder?

Dissociative Identity Disorder hinges in part on the belief that severe impairment in adulthood is linked to a physically and/or mentally abusive childhood. Will emerging research indicating that learning disabilities also occur in patients suffering from PTSD add to the disability seen in DID patients? I contend it will.

If science indicates Post Traumatic Stress Disorder sufferers are also learning disabled, the psychiatric disability net that snares individuals into the multiple personality diagnosis widens and will rein in more unsuspecting patients.

Attaching learning disabilities to the Dissociative Identity Disorder diagnosis will enable clinicians to bill insurance companies for compensation using PTSD. I suspect that few clinicians report DID as the primary diagnostic disorder on insurance claim forms – instead, PTSD, anxiety, depression, Bipolar DisorderBorderline Personality Disorder and other psychiatric categories are used because insurance companies are not allowing multiple personalities or DID to be compensated as they did in the 1980s before the disorder was debunked and shown to have caused grave harm to some patients.

I suspect the diagnosis of Learning Disorders via PTSD will increase in the near future as therapists attach it to Dissociative Disorders to gain credibility and monetary compensation for services rendered.

Regions of the brain affected by PTSD and stress.

Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Individuals with posttraumatic stress disorder show a selective deficit in generalization of associative learning.

Levy-Gigi, Einat; Kéri, Szabolcs; Myers, Catherine E.; Lencovsky, Zvi; Sharvit-Benbaji, Hadas; Orr, Scott P.; Gilbertson, Mark W.; Servatius, Richard J.; Tsao, Jack W.; Gluck, Mark A.
Neuropsychology, Vol 26(6), Nov 2012, 758-767. doi: 10.1037/a0029361

Abstract

Objective: Drawing on two different populations, Israeli police and Hungarian civilians, the present study assessed the ability of individuals with posttraumatic stress disorder (PTSD) to generalize previous learning to novel situations.

Past neuroimaging studies have demonstrated diminished medial temporal lobe (MTL) activation and/or reduced hippocampal volume in individuals with PTSD. Our earlier computational models of cortico-hippocampal function and subsequent experimental tests of these models in MTL-impaired clinical populations argue that even mild hippocampal dysfunction may result in subtle impairments in generalization.

Therefore, we predicted that individuals with PTSD would show impaired generalization. Method: We compared the performance of five groups from two countries, including 19 Israeli police with PTSD and 22 trauma-exposed police without PTSD, and 22 Hungarian civilians with PTSD, 25 trauma-exposed civilians without PTSD, and 25 individuals without PTSD unexposed to the same trauma. Participants were tested on a two-phase learning paradigm, the Acquired Equivalence Task, which measures the ability to generalize past learning to novel situations.

Results: We found that both PTSD and non-PTSD participants were capable of learning the initial stimulus-outcome associations, F(4, 108) = 1.79, p = .14. However, as predicted, only individuals with PTSD showed a selective deficit in generalization of this learning to novel situations (F(4, 108) = 8.35, p < .001, Partial η2 = 0.26). Conclusions: Individuals with PTSD show a selective impairment in generalization of past learning similar to other clinical populations with MTL/hippocampal dysfunction.

This is consistent with an emerging view of PTSD as being not only an anxiety disorder but also a learning disorder.

~~~~~~~~~~~~~~~~~~~

Chris Costner Sizemore: AKA The Three Faces of Eve (1927- )

Update 01-11-14. To date, I know of one high profile case of multiple personalities or Dissociative Identity Disorder that did not claim childhood sexual abuse as it antecedent or cause. That case is reported by Hershel Walker, former American football icon, who claims his multiple personalities were caused by childhood bullying.

If there are people out there who claim to have developed multiple personalities by causes other than childhood child abuse, I’d be interested to hear from you.

~~~~~~~~~~~~~~~~~~~~~~~~

Christine (Chris) Costner Sizemore

born 1927 -

Most Noted for:

Diagnosed in the 1950s, she is considered by some to be the first documented case of multiple personality disorder in the 20th century. Chris Sizemore is known by the pseudonym, Eve.

Sizemore had eight psychiatrists during her lengthily treatment that spanned over two decades. Corbett Thigpen and colleague, Hervey Cleckley, M.D., published a book that was a historical case study based on her life titled: “The Three Faces of Eve” which gained best-seller status as did the movie by the same title.

During the later part of her illness and recovery from multiple personality disorder, Chris Sizemore was treated for four years by Dr. Tony Tsitos in Virginia.

Early childhood traumas:

Chris Sizemore, in a YouTube documentary “Hard Talk,” a BBC Interview, said that at the age of two, she experienced three consecutive traumas.

  1. her mother cut her arm badly
  2. she saw a drowned man being recovered from a ditch, heard the word “death,” and began to believe that anyone who was sick or hurt was “dying.”
  3. she witnessed a man cut in half at a lumber yard.

Chris Sizemore repeatedly states that it was with the help of her psychiatrists, devoted family, and her belief in God that saw her through her illness and led to her recovery.

Publications:

1958.  The Final Face of Eve

1977. I’m Eve

1989. A Mind of My Own

Sources:

Georgia Encyclopedia

Sizemore, Chris Costner, 1989. A Mind of My Own.

Wikipedia: “Chris Costner Sizemore”

YouTube: “Multiple Personality Disorder on Hard Talk BBC Interviews – Chris Costner Sizemore, Part I”rumiscience”  watch?v=CTvr2fDBjmg Retrieved 3/14/11.

Debunking Byington: Book Review of Twenty-Two Faces – a Story of Multiple Personalities

This is an ongoing book review. As time allows, I will add to the text.

You are welcome to make comments on this publication. I ask is that you be respectful to the author and others who voice opinions.

Thank you in advance for your patience in reviewing this highly controversial book and for following guidelines set forth. This book includes acts of murder, rape, and other felonies that is why I ask that comments address the writing – not people making comments.

I decided to write what will be an exhaustive analysis and critique of 22 Faces because of the positive impact it is having on patients diagnosed with Dissociative Identity Disorder, commonly known as multiple personalities and because of arguments and opinions against the contents of this book found on the Amazon book review section and the forum of the Dr. Phil Show.

In my opinion, there is a resurgence of the discovery of multiple personalities among American women and the subsequent psychiatric diagnosis of Dissociative Identity Disorder (DID), therefore, it is extremely important to comb through this book to illustrate the inconsistencies in the narrative and the implausibility of the events the author declares occurred.

Supporting women abused as children is what society should do …. supporting a work of fiction touted as nonfiction is an act society needs to scrutinize particularly when crimes and childhood malfeasance are alleged.

This book is self-published and, therefore, was probably not scrutinized by a legal department with the vigor a conventional-publishing house would conduct prior to publication, therefore, statements made by the author require the reader to research whether or not the text is accurate.

Sexual abuse is horrid and dealing with the aftermath is difficult. Acts of ritual abuse undoubtedly occur. Satanists exist as a religion but I do not believe Byington’s depiction of this group are accurate.

Caveat: I am a former believer in multiple personalities and Dissociative Identity Disorder. I was entrenched in this lifestyle and psychotherapy for over 6 years and I have an excellent grasp of the inner workings of the events portrayed and alleged in this book.

Here we go…

~~~~~~~~~~

Judy Byington (Mrs.Weindorf) describes Twenty-Two Faces as a biography of Jenny Hill although the author also states that Jenny wrote the book. First question: is this an autobiography or a biography?

Byington states that Jenny Hill endured childhood sexual abuse, ritual abuse, satanic ritual abuse, kidnapping, parental abuse & neglect, sibling abuse, domestic abuse, Nazi mind control, divine intervention by God, psychiatric hospitalization, multiple personalities, and Dissociative Identity Disorder, to name a few. This book was published by Tate Publishing (May 15, 2012).

The author, Judy Byington, appeared on the Dr. Phil show on January 11, 2013 as did Jenny Hill and her son, Robert. (Note: Robert stated that Byington did not depict his family history accurately)

Retrieved 01-23-13.

~~~~~~~~~~~~~

 1. About the Author from her media kit @ www.22faces.com

Twenty Two Faces, A Division of Trauma Research Center, Inc.

Trauma Research Center CEO is Judy Byington, MSW, LCSW, retired. Author, Twenty-Two Faces,  and panel members are Linda Quinton-Burr, Ph.d, J.D. ; Susan Peterson, L.P.C. Therapist, Neurofeedback Specialist and Practitioner and Sharon Reese, mother to five children and 49 alter personalities and Author, Healing Broken Wings.

There is no such designation as LCSW – Licensed Clinical Social Worker, retired. One is either licensed or not licensed. One does not “retire” from this profession and retain a license to practice. The designation of “retired” is meaningless, misleading, and a professional designation created by the author.

2. Let’s look at the endorsement from the back cover:

Robert Kroon (1924 – June 24, 2007). According to Wikipedia (01-23-13) Kroon… “was a prominent Dutch journalist who reported on conflicts and other stories as a foreign correspondent from Africa, Asia and Europe for nearly 60 years.” http://en.wikipedia.org/wiki/Robert_Kroon

.Although Mr. Kroon died four (4) years before the publication of this work, the author secured an endorsement from him.

This blogger finds it highly unlikely that a journalist of Kroon’s stature would endorse a book without reading the final draft and highly unlikely to do so after death.

update: 03-29-13. There will be no further review of Judy Byington’s book. There is little credible evidence that any of the event occurred. I, and many others, critiqued this Amazon book reviews and asked the author specific questions – each and every time, the author did not address the questions, rather she attacked the questioner.

~~~~~~~~~~ Will not be back later. ~~~~~~~~~~

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Is Change in Handwriting Evidence of Multiple Personalities & Dissociative Identity Disorder?

English: Cournut_handwriting_and_signature_25_...

Image via Wikipedia

I updated this article because Dr. Yank, whose research was sited, stated that I misunderstood her research study from 1991.

I am grateful that she came here and gave me this opportunity.

Dr. Yank submitted the following (an excerpt):

I happened to stumble upon this website and noticed a comment about my research. The research was rigorously performed and evaluated, but it seems that the blogger may not have understood the intent of the study.

I am a handwriting researcher. My goal in this study was to determine whether individuals could write different styles so consistently over time that it would make it difficult to ascertain authorship on documents. This question is relevant in the case of questioned signatures and writings (wills, forgeries, written statements, and others). That goal was clearly stated in the article.

I do not have an opinion on whether or not DID exists. My research showed that in some rare cases, alleged alters wrote in unique and consistent patterns over the time that samples were gathered (several months). These situations were very rare and were verified by people who knew the writers (I did not).

Original article:

Is a change in handwriting proof that an individual possesses multiple personalities or has dissociative identity disorder as many expert believe?

Different and/or changing handwriting styles has been used as evidence of the existence of multiple personalities for decades. It is argued that an individual, either believing in or having a diagnosis of MPD/DID, can have alter personalities who write and express themselves differently on paper. It is furthermore argued that each personality can be identified by their handwriting.

I won’t argue the point that any given alter personality can be identified by their handwriting as Jane Redfield Yank, M.S.S.W. did in “Handwriting Variation in Individuals with Multiple Personality Disorder, 1991. It’s easy enough to create a character with all types of personality traits that can be reenacted and recreated over time. It occurs in films, theater, novels, and television every day. It would be interesting, however, to have a handwriting expert analyze writing samples of someone who believes they have multiple personalities. I know of no such study, but my guess is that there would be consistent inconsistency through all personalities.

I was researching the life and work of  Dr. Wallace Nutting, a minister who was also a photographer and interested in preserving antiquities. Nutting (1861-1941) became interested in photography after ill health forced him to retire from ministry. His photographs were sometimes hand-colored and often signed by the colorist, rather than Nutting himself. As a result, there are many authorized signatures on file at the Wallace Nutting Library.

Here are quotes from the Library website that address the multiple personality/handwriting theory:

“Wallace Nuttings career spanned several decades so it would reasonably be expected that his signature style would change to some degree.” Of course, my handwriting is not the same as it was when in high school is yours?

“During the several decades that the Nutting Studio was in operation, several head colorist were authorized to sign Nutting’s name to his work. For this reason the signature style will vary depending on when and in what studio the picture was made.”

Wallace Nutting Library Authorized Signatures

The library shows illustrations of Nutting’s signatures over the decades of his life. They are most interesting as they changed considerably as the culture changed, his health failed, time constraints on his art grew, colorists entered his work, and daily life moved on.

While I was in treatment, and diagnosed with multiple personalities, my former doctor used my handwriting changes as evidence that I had alters inside me that wanted to have a voice. I was initially shocked. His observations and analysis were enlightening because they quelled my doubts, and his observations were terribly frightening – leaving me with increased feelings of unreality, disconnectedness, and loss of control. Upon further thought, however, I found the statement odd for several reasons.

First, I was a prolific journalist in the early 1980s before I met him and wrote for many hours daily  – easily filling a blank book in a few weeks with tiny letters and tight use of space. When I told the doctor, he chose to ignore me.

I also knew that at times I got tired and my hand hurt – so of course my handwriting changed. When I told the doctor, he chose to ignore me.

When I was mad, or in a hurry, my letters were larger, as were the loops. The script in general was more intense, bold, and forceful. When I told the doctor, he chose to ignore me.

I savored the joy of the physical act of writing, the texture and smell of different types of paper, the feel of fountain pens or plastic ones off an assembly line, and enjoyed watching how the ink flowed as I wrote. I liked the colors, the feel of a pen in my hand and how the right combination of pen and paper could keep me writing for hours. And how the wrong texture of paper and pen could keep my journal entries short. I wrote at my desk, on my lap, while on a bus, and any other place whether or not I was stationary – so of course my handwriting changed. When I told the doctor, he chose to ignore me.

I gave up trying to tell him how writers love the instruments of their craft and that there was an another explanation to the changes in my handwriting. I let the matter go and choose to ignore him – sometimes.

Back to Wallace Nutting. His plethora of signatures could easily have been used as evidence of severe childhood sexual abuse and, therefore, he could have been diagnosed with multiple personalities had he survived and lived in America during the explosion of the MPD diagnosis in the 1980s and 1990s.

I know some will say Nutting was an undiagnosed multiple. I can’t change that. Those who put weight on changing handwriting using it as proof or evidence that multiple personalities and dissociative identity disorder exist might take a moment and factor into the equation that different handwriting exists just because we are human and change all the time.

Yank, J.R. Dissociation_Vol._4_No._1_p._002-012_Handwriting_variations_in_individuals_with_MPD

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Satanic Ritual Abuse Calendar of Events for Dissociative Identity Disorder Patients

Spoiler Alert! The information below is ridiculous and has no business in a psychotherapy room where women are allegedly being treated for multiple personalities.

During my treatment to recall childhood sexual abuse that eventually proved to have never happened, I was coerced into believing I was raised in a satanic cult. My former doctor gave me a satanic calendar similar to the one below but it was more detailed and had many more events scheduled throughout the year. This one lists dates of interest by month and day and states the reason for the celebration or “fear” inducing events that are meant to occur.

This is not only questionable information, but a psychiatrist has no business giving this to a vulnerable patient – or any patient for that matter, IMO.

After receiving a satanic calendar, I became more frantic – especially before the dates listed. The document was the doctor’s way of proving that satanic ritual abuse (SRA) is real and that he would protect me from the evil villains – which by the way, never surfaced. Nonetheless, he admitted me to the hospital and kept me sequestered until the holiday passed.

~ From the 1st National Con­fer­ence on Cult & Rit­ual Abuse Boston, MA, June 1991 ~

Date Cel­e­bra­tion Usage Age
Jan 7 St. Winebald Ani­mal or human (dismemberment) 15–33
M if human
Jan 17 *Satanic Revel Oral, anal, vagi­nal activity 7–17 F
Feb 2 *Satanic Revel Oral, anal, vagi­nal activity 7–17 F
Feb 25 St. Walpur­gis Day Com­mu­nion w/animal blood & dismemberment Ani­mal
Mar 1 St. Enoch Drink­ing of blood for strength & bondage to demons Any age
Mar 20 **Feast Day
(Spring Equinox)
Oral, anal, vaginal Any age M or F
April 21–26 Prepa­ra­tion for sacrifice
Apr 26 –May 1 *Grand Cli­max Cor­pus de Baahl Ages 1–25 F
June 1 **Feast Day
(Sum­mer Soltice)
Oral, anal, vaginal Any age M or F
July 1 Demon Rev­els Druids sex­ual asso­ci­a­tion w/demons Any age F
Aug 1 *Satanic Rev­els Oral, anal, vaginal 7–17 F
Sept 7 Mar­riage to Beast Satan Sac­ri­fices, Dismemberment Infant-21 F
Sept 20 Mid­night Host Dis­mem­ber­ment bonds placed Infant-21 F
Sept 22 **Feast Day
(Fall Equinox)
Oral, anal, vaginal Any age, M or F, Ani­mal or Human
Oct 29 –Nov 1 *All Hal­lows Eve
(Halloween)
Sex­ual cli­max, asso­ci­a­tion w/demons Any age M or F
Nov 4 Satanic Rev­els Oral, anal, vaginal 7–17 F
Dec 22 **Feast Day
(Win­ter Solstice)
Oral, anal, vaginal Any age, M or F, Ani­mal or Human
Dec 24 Demon Revel High Grand Climax Any age M or F

*Sig­ni­fies most impor­tant hol­i­days
**Sig­ni­fies hol­i­days of lesser sig­nif­i­cance
Rit­u­als may take place the evenings before the hol­i­day
Birth­days cho­sen as date to begin indoc­tri­na­tion into the cult

Open letter to Dr. Phil: “a public mental health menace” (process.org)

updated 10-22-14

The Illusive Satanists: What Many in the Multiple Personality Community Believe about Satanic Ritual Abuse

Mr. Satan Head

Mr. Satan Head (Photo credit: Scott Beale)

Last year, at Halloween, I designed a costume and attended Kate’s annual
party. She decorated her property, starting at the curb, with blinking orange
lights, cob webs, and hidden boxes that made unpredictable sounds when I
walked by. The house was dark with intrigue. I wondered what scary characters
awaited my arrival.

After dark, her neighborhood was full of adults and children in costume. We
pretended to be witches or walking trees or scarecrows. We gave ourselves
permission to create, fantasize, and play. For one night, we became someone,
or something, other than ourselves. Mystery and intrigue are what make Kate’s
Halloween parties enticing.

Oddly, treatment for Multiple Personality Disorder (MPD), now known as Dissociative
Identity Disorder (DID), has similar enticing qualities. For example, once
labeled a “multiple,” I was often viewed as exotic and mysterious. My thought
patterns and subsequent behaviors were intriguing and bewildering to therapists.
Treatment twisted my thinking. I became a devoted student of repressed memory
therapy
, believing I was raised in a Satanic cult. Therapy helped me “remember”
cult meetings with gory smoldering cauldrons of blood, dismembered animals,
the screech of tormented women, and the foul smell of burning flesh. The
Halloween season, once a time of fun and theatrics, became an annual nightmare
referred to as “The Satanic High Holidays.” Therapy transformed the play of yesteryear into terror.
The Halloween season became life-threatening. My doctor instructed me to
beware of encoded messages sent by Satanists, either by mail or by telephone,
programming me to suicide. He said I needed protection from them because I was
exposing their cult secrets. I agreed to be hospitalized, drugged and
quarantined.

My doctor’s thinking was not logical. In fact, it was pure nonsense. The
tricks, illusions, and deceits of treatment lured me in.

What made it impossible to distinguish fact from fancy? Prior to therapy, I
knew nothing about Satanism. While hospitalized, however, I was inundated with
information about Satanic cults from my doctor, therapists, nurses, other
patients, self- proclaimed “professionals” who survived Satanic abuse, and books.
Initially, I was a willing participant in the exchange of information. Later,
I was a captive audience and my caretakers’ professional opinions quickly
flipped my belief system upside-down.

I often proclaimed that my uncovered “memories” were fabrications, but I was
ignored. New “memories” weren’t as real as those I’d never forgotten; they
were dream-like and fuzzy. The idolatrous manner in which I related to my
doctor blinded me to the truth regarding my history. I was tricked into
believing there was Satanic abuse when, in fact, there wasn’t.

The illusive Satanists never surfaced at Halloween. Just the same, my feelings
of terror were real. Therapy created panic, insomnia, anorexia, abuse of
prescription drugs, gastrointestinal distress and fatigue. My behavior was
irrational. I hid under the bed, shrouded myself in blankets, and hugged
Leroy, my teddy bear.

Unknowingly, I was caught in the web of my doctor’s delusions. Halloween is
payday for some therapists and hospitals because clients are often in a
heightened emotional state. The fabricated Halloween horrors create chaos;
they breed confusion and anxiety. Clients seek comfort and often require extra
with therapists while needing more prescription drugs,additional phone contact,                                               and even hospitalization.

I challenge therapists who treat clients for Satanic abuse to follow their own treatment regime this year. By mid-October, check into a hospital, stay behind locked doors, speak to no one, ingest mass quantities of narcotics, and starve yourselves — then stay awake while watching horror movies night and day.

Since leaving treatment I learned the illusive Satanists, created in therapy, don’t exist. Halloween has returned to what it’s always been — a day of fun, fantasy, and theater. I’m looking forward to Kate’s party.

~~~~~~~~~~

Originally published in the False Memory Syndrome Foundation Newsletter,
October, 1999

Apologies for the formatting. The original article does not translate well.

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1904: Multiple Personality & Human Individuality, by Sidis & Goodhart

Multiple Personality:

An Experimental Investigation Into the Nature of Human Individuality

ISBN: 978-1-59147-626-9   Publication Date: 1904
APA Print-on-Demand books are currently unavailable for purchase. We apologize for the inconvenience.

This book looks at multiple personality through the lens of individuality. Each part deals with a specific aspect of multiple personality: personality, double personality, and finally, consciousness and multiple personality. The work of Parts I and III covers a period of eight years. Out of the material accumulated by Dr. Sidis and his collaborators, some experiments and observations of functional psychopathic cases have been utilized in the last part of this volume. The authors note that the case of double personality described in Part II is of great interest and is specially recommended to the reader’s attention. This case was investigated in the Pathological Institute of the New York State Hospitals.

Here is a link to the table of contents http://www.sidis.net/mpcontents.htm

Boris Sidis

Boris Sidis (Photo credit: Wikipedia)

~~~~~

Excerpt from wikipedia

Boris Sidis, Ph.D., M.D. October 12, 1867 – October 24, 1923) was a Ukrainian psychologist, physician, psychiatrist, and philosopher of education. Sidis founded the New York State Psychopathic Institute and the Journal of Abnormal Psychology. Boris Sidis eventually opposed mainstream psychology and Sigmund Freud, and thereby died ostracized.

From Google Books:

S. P. GOODHART, PH.B., M.D. Assistant Professor of Neurology, Columbia University Neurologist to the Montefiore Hospital NEW YORK CITY, USA

~~~~~~

I am finding old, old articles that refer to multiple personalities as “functional psychosis”. Unfortunately, this book is out of print and no longer a print-on-demand. Maybe one of you will get lucky and find it. JB

Updated: 09-15-14.

Helen: Woman with 7 Personalities, Part 2 (YouTube)

Running Time: 15:01

This video includes interviews with:

Dr. Larry Culliford, psychiatrist, Royal College of Psychiatrists

Dr. Joan Coleman, psychiatrist who works with ritually & satanically abused people.

Overview:

  • Helen and her friend visit a former teacher
  • It is reveled that Helen is a recovering alcoholic
  • Overt eye blinking to indicate personality change & display of child personalities and baby talk
  • Reveled that Helen cannot hold a job, is living in a counseling flat (public housing) and survives on benefits
  • Shows piles of pills & bottles of medicines that Helen consumes including: sleeping pills, anti-psychotics, antidepressants, central nervous system depressant – Valium, and many over the counter products to quell the side-effects of these pharmaceutical drugs
  • Minute 5:20 Helen states she overdosed on pills over 100 times

Her friend continues the quest to find out what is causing Helen so much pain.

  • Minute 9:20 Helen claims she was “severely abused as a child”
  •           10: 39 Dr. Larry Culliford interview

The quest to find who is responsible for Helen’s condition

  • Minute 13:30 ritual and satanic ritual abuse introduced
  •             13:51 Dr. Joan Coleman interview

Retrieved  10/07/11. YouTube: Woman with 7 personalities Part 2

Inpatient Suicide

by the Law Offices of Skip Simpson

The loss of a loved one is devastating

An inpatient suicide is a shock to friends and family. You may have spent time choosing the right facility. You may have placed your loved one into a psychiatric or rehabilitation center, believing he or she would receive increased attention from healthcare providers. Unfortunately, when healthcare providers fail meet the standard of care, or to follow procedures or lack adequate training, inpatient suicides can occur. A suicide might occur because a staff member failed to conduct a regular check of the patient’s well-being. It is not the standard of care to put a suicidal patient on an every 15 minute observation level.

It is estimated 1,500 patients die each year by suicide in our hospitals and many thousands more make non-fatal attempts. Among other factors, investigations have shown these injuries and deaths can be attributed to inadequate staff training in a) how to detect, assess, and communicate suicide risk, and b) how to properly monitor known at-risk patients in the emergency room or hospital.

Dangerous hospital practices persist

Even when clinicians know patients are at elevated risk for suicidal behaviors, antiquated, untested, and dangerous hospital practices persist; e.g., the so-called every 15 minute monitoring level – a routine “intervention” that allows patients 14 minutes and 59 seconds to kill themselves using obvious anchor points, ligatures and sharp instruments.

There is no standard of care that allows healthcare professionals to needlessly endanger patients known to be at risk for suicidal behaviors. Published studies point to improved practice models, use of environmental safety and procedural checklists, and evidence-based training in how to detect, assess, monitor and manage suicidal patients – training that is now accessible, available, affordable, and which establishes the standard of care.

When a patient is at increased risk for suicidal behavior

Suicidality is the most common reason for inpatient psychiatric hospitalization. When a patient is admitted to the hospital because of thoughts of suicide, the clinician and hospital is on notice that the patient is at an increased risk for suicidal behavior. When hospital staff members are aware of a patient’s suicidal tendencies, the hospital assumes the duty to take reasonable steps to prevent the patient from inflicting harm.

Filing a claim can be difficult following a traumatic event. At the Law Offices of Skip Simpson, we provide compassionate representation for family members who have lost loved ones. You and your family have placed a large amount of trust in the medical professionals, from doctors to orderlies. They have a duty to provide their patients with correct diagnoses and to take appropriate action based on the symptoms.

How an inpatient suicide can happen

An inpatient suicide usually occurs in a psychiatric hospital, but can occur in a general hospital. They may have been placed at the facility involuntarily (a court has made a determination that they’re imminently suicidal). They may have checked in to a facility voluntarily.

An inpatient suicide may occur under any of the following circumstances:

  • Inadequate suicide assessment
  • Improper suicide watch or negligent suicide watch
  • An unsafe environment of care
  • Failure to remove environmental dangers
  • Inadequate policies and procedures regarding dangerous contraband
  • Failure to remove shoe laces or belt from patient

In handling an inpatient suicide case, we typically investigate hospital records and patient charts. Our investigation consists of interviews with witnesses and reviews of logs.

Contact our law firm

For a free and confidential consultation, contact a compassionate attorney who cares about people and demands justice. Contact the Law Offices of Skip Simpson. See what we can do for you. Call 214-618-8222 or reach a personal injury lawyer by completing our online contact form.

Retrieved 06/21/12. Reprint by permission.

45 Years of Psychotherapy Fails to Heal Psychiatrist with Multiple Personalities

Treatment for  multiple personalities is known to be long and arduous but I doubt few, if any, psychotherapists disclose the probable cost and duration of the treatment they sell. It is common for patients to be in treatment for decades and sometimes a lifetime.

Dissociative Identity Disorder, the formal diagnosis for those deemed to have multiple personalities, is a disorder that finds the patient’s personal life crumbling whereby making it difficult to take care of daily activities, jobs, and children.

How this psychiatrist managed to treat others while having such a debilitating condition himself makes me skeptical. Does this doctor really have typical symptoms of multiple personalities?  Did he offer psychotherapy that is up to the standard of care of other psychiatrists?

 

Meet Dr Jekyll

29 August, 2014 Amanda Davey

Published by: 6 Minutes of interesting stuff for doctors today

A South Australian psychiatrist practised for decades while suffering from dissociative identity disorder (DID), according to a case report in Australian Psychiatry (see link below).
The recently retired Dr S* underwent over 45 years of psychotherapy for the disorder and continues to see a private psychiatrist weekly.

Dr S says he regularly treated DID patients in his private practice while dealing with his own psychiatric illness.

 

Full story here

Related links:

Journal of Australian Psychiatry

 

 

 

 

 

Full Story here

On the incidence of multiple personality disorder: A brief communication (by the early therapists for “Eve”) 1984

According to two of the psychiatrists who treated Chris Sizemore (The Three Faces of Eve), they found only one (1) case that fit the diagnosis of multiple personality disorder until this article was published in 1984.

Given this analysis of the medical literature it seems there was a huge explosion of misdiagnosed patients after 1984. Why is this information tucked in old medical journals? Because it would not serve the needs and wishes of some contemporary theorists and psychotherapists – and patients who desperately want to fit into what they perceive as a romantic and highly- intellectualized diagnostic category.

Chris Sizemore was an interesting clinical case study for her first two psychiatrists, Corbett H. Thigpen & Hervey M. Cleckley, but mundane in comparison to the multiple personalities displayed by Shirley Mason AKA Sybil, years later.

Sizemore, the earlier face of multiple personalities, claimed that successive tragedies she merely witnessed as a three-year-old caused her personality fragmentation. She did not claim to have been sexually abused during childhood.

Why then, do nearly 99% of people diagnosed with multiple personalities or dissociative identity disorder claim to have survived childhood sexual abuse? Where are the people like Chris Sizemore who have multiple personalities due to other reasons? Are other non-sexually abused cases of multiple personalities going unreported other that Hershel Walker, famed football player? Perhaps they simply vanished or didn’t exist in the first place.

If we look at Shirley Mason and the character of “Sybil” that grew from her therapist, Cornelia Wilbur’s, imagination and clinical observations, Chris Sizemore’s life played out in The Three Faces of Eve pales in comparison. In comparing these two cases, it must be remembered that both women behind the flamboyant theatrical characters had other therapists who treated them. Withholding this information to the pubic only serves to perpetuate the mystery and entertainment value behind these iconic folk legends. If it was widely known that these women had other doctors on their treatment teams who disagreed with the multiple personality diagnosis, and stated so, would it have made as much money at the box office? Note too, that the therapists of Chris Sizemore banked the money, not Chris.

Read the summary of the article below written by Chris Sizemore/Eve’s first two therapists who were responsible for the diagnosis of multiple personality disorder. And let’s not forget that it was they who led their patient to Hollywood and reaped the financial rewards – not their patient. Read their own words, not mine or anyone else’s. Find out for yourself and reach your own conclusions.

In hindsight, this is a profound warning to the psychiatry industry who chose to ignore warnings of impending disaster to their profession as the diagnosis of multiple personalities and Dissociative Identity Disorder (DID) proliferated and continues to do so.

Photo credit unknown. If you are the owner, please contact me.

~~~~~~~~~~

International Journal of Clinical and Experimental Hypnosis

Volume 32, Issue 2, 1984

On the incidence of multiple personality disorder: A brief communication

Corbett H. Thigpen & Hervey M. Cleckley
pages 63-66

Available online: 31 Jan 2008

Abstract

Abstraet: Since reporting a case of multiple personality (Eve) over 25 years ago, we have seen many patients who were thought by others or themselves to have the disorder, but we have found only 1 case that fit the diagnosis. The other cases manifested either pseudo- or quasidissociative symptoms related to dissatisfaction with self-identity or hysterical acting out for secondary gain. One particular form of secondary gain, namely, avoiding responsibility for certain actions, was evident in a recent legal case where the person was diagnosed as having the disorder and successfully pled not guilty by reason of insanity. We urge that a diagnosis of multiple personality not be used in such a manner and recommend that therapists consider the hysterical basis of the symptoms, as well as the adaptive dynamics of personality before diagnosing someone as having the disorder. (type face by blogger) If such factors are considered, the incidence of the disorder will be found to be far less than the “epidemic” recently claimed.

Retrieved 7/24/11.

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Dr. Bob Newhart: How to extinguish multiple personalities

This is as simplistic as it gets.

YouTube

Inadvertent hypnosis during interrogation … by Richard Ofshe

Inadvertent hypnosis during interrogation: False confession due to dissociative state: Mis-identified multiple personality and the satanic cult hypothesis.

Ofshe, Richard J.
International Journal of Clinical and Experimental Hypnosis, Vol 40(3), Jul 1992, 125-156. doi: 10.1080/00207149208409653

Abstract

Presents the case of a 43-yr-old man who, after induction of a dissociative state followed by suggestion during interrogation, developed pseudomemories of raping his daughters and of participation in a baby-murdering Satanic cult.

The pseudomemories coupled with influence from authority figures convinced him of his guilt for 6 mo. During this time, S, the witnesses, and all the evidence in the case were studied. No evidence supported an inference of guilt, and substantial evidence supported the conclusion that no crime had been committed.

An experiment demonstrated S’s extreme suggestibility. It was concluded that the cult did not exist and S’s confessions were coerced internalized false confessions. During the investigation, 2 psychologists diagnosed S as suffering from a dissociative disorder similar to multiple personality. Both psychologists were predisposed to find the involvement of satanic cult activity.

Related links:

Defending The Innocent: Interrogation and False Confession  http://www.nacdl.org/Champion.aspx?id=1089

Wikipedia http://en.wikipedia.org/wiki/Richard_Ofshe

Mark Schwartz, accused of malpractice, removed from Castlewood clinic staff

I have been informed that The Examiner.com who published the article below received complaints about someone the author, Mr. Mesner, named in the article below. While the complaints are without merit and Mr. Mesner followed journalistic integrity, I have redacted the name of the person and the organization cited.

If you are outraged by the actions of The Examiner pulling Mr. Mesner’s article, contact David Horan @ dhoran@examiner.com

What continues to occur from people who do not like opinions expressed on this blog and others, is that bogus complaints are levied against us threatening legal action if we do not comply with their demand to take their name(s) off our blogs.

When people write articles and form organizations they do not have a right to threaten legal action when cited properly – yet that is what happened to Mr. Mesner and me.  Authors of blogs, websites, and publications are considered “public figures” and have no right to file complaints when journalists cite their work and quote their words properly – which Mr. Mesner and I do.

There is, of course, no copyright or other infringement nonetheless these complaints pour in. I have to admit the action works and they get what they want even though people like me and Mr. Mesner publish with journalistic integrity and abide by journalist ethics.

It’s You, readers, who suffer. Journalists cannot offer you complete information and you should be outraged.

These actions are pure highjacking of freedom of information. The individual Mr. Mesner named in the article below filed a bogus lawsuit against Mr. Mesner and choose not to show in court. The point only seems to have been to silence Mr. Mesner and cause him financial harm.

Although under duress I redact the article below, I choose to take the easy route even though it impinges on my freedom of speech and your freedom of information. I am working on many projects bigger and more important and tangling with people who file bogus complaints and who encourage silencing of information must take a back-seat so I can keep focused on my work.

Below is the article published by The Examiner.com with the name of said person and the organization they operate – redacted. This action is done under duress until such time as those making bogus complaints and filing bogus lawsuits can be stopped from doing so and held accountable for their deplorable behavior.

Seems those supporting the existence of multiple personalities and Dissociative Identity Disorder hate the truth and do not want the public to know what happens behind closed doors.

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Guest re-blog     By:

May 25, 2013    www.Examiner.com

The bizarre nature of the lawsuits created a minor, short-lived sensation among the national press at the times of their filings. The first, dated November 21, 2011 — Lisa Nasseff vs. Castlewood Treatment Center, LLC. — alleged to gross malpractice suffered while undergoing “treatment” at the St. Louis eating disorders clinic. To quote directly from the suit:

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“defendant carelessly and negligently hypnotized plaintiff at a time when she was under the influence of various psychotropic medications and said hypnotic treatment directly caused or contributed to cause the creation, reinforcement, or increase in plaintiff’s mind, of false memories including the following:

a) Plaintiff suffered physical and sexual abuse;
b) Plaintiff suffered multiple rapes;
c) Plaintiff suffered satanic ritual abuse;
d) Plaintiff was caused to believe she was a member of a satanic cult and that she was involved in or perpetrated various criminal and horrific acts of abuse;
e) Plaintiff was caused to believe that she had multiple personalities at one time totaling twenty separate personalities.”

By November 09, 2012, four total lawsuits had been filed, all of a similar nature, all of which are still yet to go to trial. The allegations claim that among the false memories cultivated under the influence of Castlewood’s systematic narcosis “therapy” are disturbed, traumatizing delusions of ritual murder. No doubt, such “memories”, even when recognized as delusions, must exact a severe emotional toll, nor could the intentional cultivation of such delusions be considered anything but malpractice.

(The four lawsuits represent only some patients who now recognize their “memories” of abuse as false. Numerous families — some having started an online support network under the name of Castlewood Victims Unite — claim that they may have forever lost their daughters to false memories of Ritual Abuse that have caused them to withdraw from contact, and reason, entirely.)

But how could such delusions be cultivated in the course of treatment for eating disorders, and for what purpose? According to the allegations, it seems, the theory at Castlewood is (or was) that eating disorders signify outer manifestations of inner repressed traumas of abuse.

“Repressed”, of course, is to say that the patient does not consciously remember the traumatic event(s). Treatments based on these assumptions always seem to rely on bringing these presumed traumas out into conscious scrutiny. This, we are told, is the only way to neutralize them… the only way to end the outer symptoms these hidden traumas are believed to cause.

Is it credible to think that the co-founders of Castlewood, Mark Schwartz and his wife Lori Galperin — both internationally recognized experts in eating disorders, and both implicated in the suits — could have been reckless enough to lead vulnerable and medicated patients to cultivate absurd delusions of satanic cult abuse, or is something else going on?

In fact, wherever the idea of “repressed memories” and multiple personalities rears its ugly, debunked head, unhinged “memories” of imagined abuse are never far behind. Throughout the 80s and 90s, internationally recognized experts in trauma and dissociation (such as Richard Kluft and Colin Ross) promoted a deranged conspiracy theory of satanic cult abuse based upon accounts that had been “recovered” by their clients. Multiple investigations debunked the narrative of these accounts entirely, and it became quite clear what was really going on: an irresponsible and unscientific therapeutic practice was being employed to encourage vulnerable mental health consumers to confabulate memories of abuse — and then, in many cases, further encouraged them to insistently believe them. These confabulations, not-so-remarkably, had an enormously high probability of validating the therapist’s assumptions, regardless of how improbable those assumptions may have been.

In parallel to the satanic ritual abuse scare (now known to sociologists as the “Satanic Panic”) the exact same theories of memory retrieval brought us the mythology of alien abduction. Believing they had developed a check-list of probable symptoms of extraterrestrial contact that had subsequently been concealed from memory, “abductologists” used the same techniques employed by multiple personality specialists to draw forth elaborate narratives involving interplanetary visitors.

Interestingly, some professionals of abductology have found, in their probing explorations of their clients’ concealed “memories”, that the extraterrestrials are here to help us — they occasionally intervene in our affairs, but only on our behalf, and with unconditional benevolence and love. This contrasts heavily with narratives revealing a nefarious plot of oddly anal-centric human vivisection and exploitation. Why the discrepancy? I have personally sought out and interviewed a number of the top names in alien abduction research with this very question. In every instance, the answer has been the same: the other guys are doing the therapy wrong. They are interpreting “screen memories” improperly, or they are interpreting fear of the unknown as malice on the part of the extraterrestrials. Both sides assert that if only the other was to “dig deeper”, they would find the truth.

Incidentally, I attended a lecture, just last month, given by one Richard Schwartz, former member of Castlewood’s clinical staff, and creator of a therapy model, used at the Castlewood treatment center, called Internal Family Systems (IFS). IFS asserts that we all have multiple personalities, called “parts”, and by understanding and reconciling these parts, we may find inner peace. Some parts are destructive (suicidal, self-undermining, irrational, etc.) and it is the therapist’s job to find those parts and understand what distresses them individually.

During a Question & Answer segment of Dr. Schwartz’s presentation, I raised my hand:

Q: I worry about the distinction between getting people to recognize naturally occurring “parts” and being blamed [as a therapist] for causing people to contextualize themselves into parts to the point where you’re blamed for [creating] destructive parts. And I know there’s an eating disorders clinic that was using IFS and has lawsuits against it now. I was wondering if they could have done things differently [in their utilization of IFS therapy], or if that’s just a professional hazard?

Dick Schwartz: You know… that one’s a tough one, because what I’ve done — early in my career what I’ve done… The lawsuit’s around false memories — that whole movement’s come back some. Early in my career I had a client who went through all these cult memories. You know, I was really into it. Did some investigating, checked things out. And then, one session, we found a part that was generating all this to keep my interest because I had seen (some interest in her[?]) I’m very, very careful to never lead people toward any kind of… never presume what’s going to come out as they do their own witnessing. Even in ways — when something scary comes out — something like that — [I] say, well, we can’t really know whether this is true or not, but it is what the part needs to show so we’re going to go with it for now and later you can evaluate it, whether it’s true or not. So, it’s not just IFS, but any therapy that goes deep with people will come upon that phenomenon… and not everybody is careful in… those… realms…

Just as with alien abduction, one can always “dig deeper” in the context of IFS so as to re-narrate the entire tale. How do licensed professionals fall for this rubbish? The lecture I attended was delivered to a full-house of professional, credulous rubes in the mental health profession.

In 2009 I attended a “Ritual Abuse/Mind-Control conference” held annually in Connecticut by an organization known as XXXXXX. The conference is organized by a licensed Mental Health professional, XXXXXX, from XXXXXXXXX. A vendor booth at the conference was selling electromagnetic-beam blocking hats, and one of the speakers casually lectured us about mind-control and “demonic harmonics”, which “involves using musical tones and quantum physics to open up portals into the spiritual realms.” XXXXXX claims to have recovered memories that XXXXXX was a brainwashed assassin for the satanic cult conspiracy within the Illuminati-controlled CIA. Theories of repressed trauma are used to support the notion that if this type of lunacy can be “recalled”, so too must it all be true. (I wrote a report about this conference which XXXXXX has subsequently been attempting to litigate against on grounds of “defamation”, though, interestingly, none of the factual claims in the report are contested in the suit at all.)

The International Society for the Study of Trauma and Dissociation (ISSTD) hosts professional conferences where the debunked diagnosis of Multiple Personality Disorder (MPD) (now referred to in the American Psychiatric Association’s [APA] Diagnostic & Statistical Manual [DSM] as Dissociative Identity Disorder) is discussed and elaborated upon. Their last conference found a regular speaker from the annual xxxxx conferences co-delivering a lecture on “Ritual Abuse”, a slightly euphemistic term for the conspiracy theory of satanic cult abuse.

The task force chair of the 4th edition of the DSM, Dr. Allen Frances, has recently admitted to the Wall Street Journal that MPD/DID is “complete bunk”, yet the diagnosis remains in the current 5th edition, rolled-out only last week, of the revised DSM. This refusal to acknowledge the harmful realities regarding some of their imaginary disorders surely played a role in the National Institute of Mental Health’s (NIMH) decision, announced early this month, to abandon the DSM altogether, along with a statement recognizing that “patients with mental disorders deserve better.”

Indeed they do. The APA must bear responsibility for enabling the quackery endorsed by the ISSTD, who must bear some responsibility for lending any credibility to the delusional assertions of XXXXXX

…And Richard Schwartz’s IFS must bear some responsibility for the allegations against Castlewood… and Castlewood must bear responsibility for Mark Schwartz and Lori Galperin.

New evidence suggests that Castlewood is trying to distance themselves from that responsibility as much as possible. Both Mark Schwartz and Lori Galperin were recently removed entirely from the Castlewood staff shortly after depositions were taken regarding the malpractice suits. Whether they were allowed to abruptly resign, or were outright fired is unclear at this time.

If the accusations against Schwartz and his wife prove true, let us hope they never practice again… But let us also understand, the problem is far bigger than the both of them, and it is a long way from being resolved.

More on Castlewood, by journalist Ed Cara, can be read here: http://www.dysgenics.com/author/ed/

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Related topics

  • Castlewood Victims Unite (Facebook)
  • Dissociative Identity Disorder
  • eating disorder treatment
  • false memory
  • repression
  • repressed memories
  • parts therapy
  • IFS
  • Internal Family Systems
  • memory recall
  • false accusations of sexual abuse
  • Multiple Personality Disorder
  • multiple personalities
  • Diagnostic & Statistical Manual of Mental Disorders
  • DSM-5
  • International Society for the Study of Trauma & Dissociation (ISST-D)
  • False Memory Syndrome Action Network (Facebook)

Halloween, Big Business for Therapists Treating Dissociative Identity Disorder & Ritual Abuse

October 31st, Halloween. A time to cash in on patient angst is Big Business for psychotherapists, drug companies and hospitals as I will explain in this post. What you will read below is not my academic conclusions or my distorted and naive understanding of what occurs for patients who believe they have multiple personalities due to being ritually tortured as a child. Instead, you will read about what I experienced while a patient. My psychiatrist convinced me that I was ritually abused as a child. In short, I’ve been there – done that. This is what I and other patients I knew experienced during the Halloween holidays – every year.

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The Guibourg Mass by Henry de Malvost, in the ...

The Guibourg Mass by Henry de Malvost, in the book Le Satanisme et la Magie by Jules Bois, Paris, 1903. (Photo credit: Wikipedia)

Psychotherapists treating women for multiple personalities after diagnosing them with Dissociative Identity Disorder is shameful because their patients routinely regress into a heap of emotions and new memories of child abuse that may also include ritual abuse and on the far extreme, satanic ritual abuse. Therapists entrenched in this psychological treatment usually do not find it their responsibility to question their patient’s memories or to assist their patients in verifying their recall no matter how outrageous and implausible the alleged ritual abuse remembered may be.

Instead, these particular therapists support and encourage more and more memories of ritualized child abuse that may include satanic worship and torture. What occurs in the lives of these patients, usually exhausted and worn down from years of therapy sessions, is intense fear and hyperviligence. Due to constant reinforcement for alleged ritual abuse during psychotherapy and in Internet chat forms, they constantly look over their shoulder believing their alleged persecutors are coming for them. These women are convinced their abusers are planning to abduct them and/or cause them to return to the ritual cult to continue the torture by sending a pre-determined message to commit suicide via an encoded telephone message, for example, because they dared to tell secrets held by the cult they remember being forced to participate in as children.

Most of these ritual and satanic memories of torture, murder, rape, and consuming human body parts are bogus but again, therapists do not care, find it necessary, or their responsibility to find the truth behind these absurd memories born during psychological treatment or other influential sources like self-help books and Internet forums full of like-minded individuals. I am not naive enough to think that ritualized abuse does not happen but take a look at how these particular memories and then look at the content. What you will likely find is that memories were born in therapy or in an environment that encourages and supports widespread ritualized torture of children are more than absurd.

No need to take my word for it. Do a simple Google search using terms like:

  • dissociative identity disorder blogs or websites
  • multiple personality disorder blogs or websites
  • childhood ritual abuse memories
  • therapists who treat satanic ritual abuse

Or, if you would like more information check yahoo groups. There, you will find hundreds of groups who pander to these types of memories and alleged ritualized and satanic behaviors.

Halloween is big, big business for psychotherapists who treat patients in an environment that supports and encourages digging for memories of satanic and other ritualized childhood abuse that, upon close examination, are often implausible and too outrageous to have actually occurred.

Does the implausible nature of patient recall deter these therapists from continuing to encourage these questionable and outrageous memories? No. It’s big business, job security, and a hefty paycheck usually cut from an insurance company unaware of what is actually occurring behind the closed doors of therapy largely because these therapists use other diagnostic categories to bill insurance reimbursement such as Borderline Personality Disorder, Post Traumatic Stress Disorder, anxiety disorders, and eating disorders among others. Insurance companies are unlikely to reimburse treatment for satanic ritual abuse if a therapist was honest about what they are treating behind closed doors. Is fudging medical records for reimbursement illegal? You bet. Fraudulent data supplied to insurance companies for a paycheck illegal? You bet. Does that deter therapists from doing it? No.

The Halloween season is believed to be the most dangerous time of year for patients allegedly ritually abused as children because it is inherently chock full of celebrations – again it’s a huge payday for therapists. Patients being treated for ritual and/or satanic abuse are in a heightened state of anxiety that is often so crippling they are unable to function on a day to day basis. When these patients are parents, their children are impacted as they too experience a parent in a state of unrest, chaos, and unrelenting fear. Watching a parent disintegrate must be terrifying for a child.

So, what actually occurs in the lives of the psychotherapist? Overtime. Overtime. Overtime. Booking double sessions and/or additional weekly or daily sessions to support their patients through the terrifying Halloween season become the norm and are planned for year after year after year.

What actually occurs for Big Pharma? Sales. Sales. Sales. As the anxiety levels and suicidal thinking and/or attempts begin to unfold, more psychiatric drugs are prescribed. Anxiety meds, sleeping meds, antipsychotic meds – anything that will quell the fear and anxiety of those believing they will be abducted and returned to a cult to be sacrificed or otherwise tortured. Anyone under these conditions would cry out for help to get through a day while awaiting the inevitable October 31st — Halloween.

What actually occurs for Hospitals and psychiatric units? They fill up with patients believing one or more of their alter personalities have been ritually tortured as a child and are terrified their alleged abductors are after them. Hospitals and therapist offices are safe havens. Hospital beds fill up as do emergency rooms ill equipped to understand or cope with this type of patient.

Halloween. Autumn. Big business for psychotherapists.

Creative Commons License
Halloween, Big Business for Therapists Treating Dissociative Identity Disorder & Ritual Abuse by Jeanette Bartha is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.mentalhealthmatters2.wordpress.com.
Permissions beyond the scope of this license may be available at www.mentalhealthmatters2.wordpress.com.

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