Myth of the Cultural Construction of Multiple Personality: The truth is that “Sybil” (1973) was propaganda against multiple personality, and was ignored by most American psychiatrists.

Critics of multiple personality often cite the case of “Sybil”—search “Sybil Exposed” in this blog—as the prime example of how a popular book and movie (about a case of multiple personality) was responsible for a large increase in diagnosed cases.

But Sybil portrayed multiple personality as extremely rare. Otherwise, what would have been the big deal?

The other reason that Sybil was actually propaganda against multiple personality is that most real patients are frightened by books and movies like that.

When people who don’t know they have multiple personality see a movie like Sybil, they see someone afflicted with something that they would never want to have. To them, it looks crazier and more frightening than even a psychosis like schizophrenia.

Real psychiatric patients think: In schizophrenia, you may have hallucinations and delusions, but at least you know who you are and what you are doing. Whereas, in multiple personality, you literally don’t know who you are (are you this personality or that personality?) and you literally don’t know what you are doing (due to amnesia for what other personalities have done). Being like Sybil would be the worst and craziest psychiatric condition that they could imagine.

In the real world, for every patient who didn't have multiple personality but wanted to be like Sybil, there were a thousand patients who did have multiple personality, but who saw Sybil and fled from the diagnosis.

Why, then, were more cases diagnosed in the twenty years following Sybil (1973)? It was not because of Sybil, [whose impact on American culture was trivial]. There were [four] other trends of much greater influence. First, in the 1970s, there was an exponential increase in verified cases of child abuse. Second, there was the “second wave” of feminism. Third, a number of astute clinicians chanced upon the diagnosis and pursued the issue. [added January 17th:] Fourth, Freudian psychology—whose single-consciousness model of the mind had made multiple personality seem logically impossible—was losing its influence. Those were the years that American psychiatry abandoned psychoanalysis in favor of psychopharmacology (treatment with medication).

I, myself, did not diagnose multiple personality until 1987, more than a decade after Sybil. Multiple personality had been barely mentioned in my psychiatric training in the 1970s, when the big thing in American psychiatry had been lithium and bipolar disorder. Sybil (1973) had not caused me or any psychiatrist that I knew to diagnose multiple personality. Indeed, I and most American psychiatrists in the 1970s and 1980s thought of multiple personality as something that they were never likely to see (if we ever thought of it at all, which we rarely did).

As an American psychiatrist who was in American psychiatric training at the time Sybil was published, I can tell you that it had virtually no impact on American psychiatrists. Following the publication of Sybil, and to this day, I would guess that less than one percent of American psychiatrists have ever made the diagnosis. It is in the American psychiatric diagnostic manual because of scientific studies, not because it has ever been widely diagnosed in American psychiatry.

I have previously touched on why so few American psychiatrists make the diagnosis. It has to do with how American psychiatrists are trained, a subject I will come back to.