Debbie Nathan’s Sybil Exposed: You Can’t Say a Case of Multiple Personality is Fake Unless You Know What the Real Thing Looks Like

For people who attack the validity of multiple personality, a favorite target is the bestseller Sybil by Flora Rheta Schreiber (Henry Regnery, 1973). They like to say that multiple personality was very rare before that book—and the movie based on it—and that it started a public fad and a psychiatric misadventure. Then Debbie Nathan published Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case (Free Press, 2011), which purported to prove that the case was a total fraud.

Note: Neither Debbie Nathan nor those psychiatrists who denounce multiple personality say that there has never been a valid case of multiple personality. No, they say that valid cases are very rare, but that they do exist. So the first question that arises about Sybil Exposed is whether its conclusions are supported by any psychiatrist who has actually diagnosed and treated some of those valid cases. After all, to know that something is a fake, you have to know what the real thing looks like.

Debbie Nathan did consult the late Dr. Herbert Spiegel, a psychiatrist who was a colleague of Sybil’s primary psychiatrist, Dr. Cornelia Wilbur. Indeed, Dr. Herbert Spiegel, who was an expert on hypnosis, actually saw Sybil and even used her as a subject for demonstrations of hypnosis. And what did he conclude? Dr. Herbert Spiegel concluded that Sybil did not have multiple personality. But had he, himself, ever seen any of those rare valid cases of multiple personality, so that he could compare and tell the difference? Sybil Exposed does not claim that he had ever seen any cases.

Debbie Nathan did not consult Dr. Herbert Spiegel’s son, Dr. David Spiegel. Why consult him? Dr. David Spiegel definitely has seen valid cases. In fact, he was the chief psychiatrist who wrote the sections on multiple personality in the American Psychiatric Association’s diagnostic manual, the DSM—in both DSM-4 (1994) and DSM-5 (2013). And besides his having a truly expert opinion about multiple personality, he probably knows whether his father was unbiased regarding multiple personality.

Another thing that undermines its own credibility is that Sybil Exposed describes the diagnosis as originating with the patient, and as having taken the psychiatrist by surprise: see pages 89-92. Page 92 even makes the point that Sybil could not have been faking multiple personality based on something that she had read, because she had child-aged alternate personalities, and any cases that she might have read about would have had only adult alternate personalities.

But what about certain subsequent occasions when Sybil told her psychiatrist, Dr. Wilbur, and also Dr. Herbert Spiegel, that she had made it all up? Here is where it pays to have had some actual experience with valid cases of multiple personality. Such patients (or at least their host personality) are notorious for denying their diagnosis even when it is blatant. For example, I recall one session in which a patient of mine switched into an alternate personality, who conversed with me at some length, and then switched back to her regular, host personality. The latter, who had no memory of what had just taken place, considered the idea that she had multiple personality to be far-fetched. (No hypnosis or drugs were used.)

Now, Sybil’s allegations that, as a child, she had been tortured by a psychotic mother, are another matter. Memories, especially implausible ones, need corroboration before they can be accepted as historical reality, as opposed to emotional reality or fantasy. But let me mention the statistics of child abuse to make a final point.

Debbie Nathan and other professional debunkers are very impressed by the statistics that before Sybil the diagnosis of multiple personality was rare, but after Sybil it was much more common. They conclude that Sybil provoked a fad, since how else can something that is true and valid suddenly go from rare cases to thousands of cases?

Well, the fact is that if you had looked up child abuse in a psychiatric textbook published in 1970, you would have read that child abuse happens to one out a million children: literally, only one out a million children. But since then, we have learned that child abuse happens to more than one out of every hundred children. Thus, suddenly, child abuse was said to be more than ten thousand times as common as we thought it was. Certainly, there have been some false cases, but would Debbie Nathan argue that the big jump in child abuse statistics was just a fad, and that it really happens to only one child out of a million? Of course not. So the argument that the jump in multiple personality cases could not have been real represents a misunderstanding of epidemiology and statistics.

In short, when someone claims to debunk assertions that someone has multiple personality, ask whether the debunker, or the authorities they quote, have had first-hand experience of the subject. Since they don’t deny that there are at least some valid cases, ask them if they have personal experience with the diagnosis and treatment of such valid cases. If not, then however expert they might be on other matters, they have undermined their own credibility with regard to multiple personality.

You can’t proclaim that a case of multiple personality is a fake unless you know what the real thing looks like, which most people—including most psychiatrists and most debunkers—don’t.