Multiple Personality, Schizophrenia, Psychosis, Dissociative Disorders, Trauma Spectrum Disorders: How are all related? What is the practical conclusion?

Eugen Bleuler, MD, the psychiatrist who coined the term “schizophrenia,” acknowledged that it is a heterogenous “group of schizophrenias.” In that diverse group, he included some patients who actually had multiple personality. But the psychiatrists who were interested in psychosis, per se, were not interested in multiple personality, and so they paid no attention.

Today, psychologists and psychiatrists who do have an interest in both multiple personality and psychosis, have various opinions:

Andrew Moskowitz, PhD, questions the validity of the diagnosis of schizophrenia. He argues that its psychotic symptoms may be traumatic in origin and dissociative—related to dissociative disorders, like multiple personality—in kind. However, “our analysis does not necessarily mean that schizophrenia is best conceptualized as a dissociative disorder. Rather, we hypothesize that some persons develop psychotic symptoms precisely because their capacity to handle traumatic or highly emotional experiences via dissociative mechanisms is limited” (1, p. 529).

Vedat Sar, MD, says that multiple personality may sometimes look quite psychotic for various reasons: a persecutory alternate personality may make the host personality look paranoid; there may be a psychotic alternate personality; the host personality may hear the voices of alternate personalties conversing; the host personality may be mysteriously made to have various emotions and behaviors by alternate personalities who are pulling the strings from behind-the-scenes. He says that a crisis involving various kinds of unrecognized multiple personality symptoms may produce episodes of “dissociative psychosis” (1, p. 540).

Barry Nurcombe, MD, FRANZCP, FRACP, speaking about adolescent psychiatric inpatients, describes “dissociative hallucinosis” as one of the “trauma spectrum disorders” (1, p. 553).

Colin A. Ross, MD, FRCPC, quotes both Bleuler and recently published case histories that purport to be about schizophrenia, but describe clear-cut multiple personality (1, pp. 559-562). He speaks of a dissociative subtype of schizophrenia that is trauma-induced.

Comment: As a practical matter, you should know that some people who are diagnosed and treated as having schizophrenia might be better understood and treated as having multiple personality.

1. Paul F. Dell, PhD and John A. O’Neil, MD, FRCPC (Editors). Dissociation and the Dissociative Disorders: DSM-V and Beyond. New York, Routledge, 2009.

Silberg’s The Child Survivor: Healing Developmental Trauma and Dissociation: Brief quotes showing basic childhood roots of multiple personality

“Eight months after having seen me for an initial assessment, Cameron asked his foster mother, ‘Can you take me back to the lady who knows about voices?’ Children who have developed private worlds with elaborate imaginary friends, voices that talk to them, and secret identities that take over and influence their behavior are deeply relieved when this information is uncovered, and feel a strong and intense bond with the therapist who has finally understood them” (1, p. 35).

“Asking questions about the child’s experiences in five primary domains will allow you to get a comprehensive understanding of the phenomenological world of the chronically traumatized child with dissociative symptomatology” (1, p. 36). The five domains are abridged as follows:

1. Perplexing Shifts in Consciousness: shutdown states, flashback states, sleepwalking, feeling in a fog or not in one’s own body, shifting sense of self

2. Vivid Hallucinatory Experiences: hearing voices; seeing and interacting with ghosts; imaginary friends that take over or influence behavior; feeling older or younger than actual age

3. Marked Fluctuations in knowledge, moods, behavior: feeling one’s moods have a mind of their own; skills & abilities vary; sense of oneself is divided

4. Perplexing memory lapses for one’s own behavior or recent events

5. Abnormal Body Experiences include self-harm, pseudoseizures, pain insensitivity

From page 42 about Imaginary Friends (IF):

Questions About                  Normal    Dissociative

Imaginary Friends (IF)   Preschoolers  Inpatients

IF comes whenever you want   76%        47%

IF comes when you are happy  94%        58%

IF knows things you do not      82%        58%

IF is only a pretend friend        78%        37%

IF makes you do things            37%        74%

IF tries to boss you                   27%        72%

IF does bad and blames you     41%        74%

IF tells you to keep secrets       84%        41%

IFs argue about you                  25%        93%

IFs come when you are angry  41%        79%

You wish IF would go away    17%        58%

1. Joyanna L. Silberg. The Child Survivor: Healing Developmental Trauma and Dissociation. New York, Routledge, 2013.

Joyanna L. Silberg, PhD, psychologist, is an expert on dissociation in children and adolescents, and a past president of the International Society for the Study of Trauma and Dissociation.

Elyn R. Saks The Center Cannot Hold: “The most lucid and hopeful memoir of living with schizophrenia I have ever read” (Oliver Sacks). But is it schizophrenia?

As stated on the front flap, “Elyn Saks is a success by any measure: She’s an endowed professor at the prestigious University of Southern California Gould School of Law. She has managed to achieve this in spite of being diagnosed as schizophrenic and given a ‘grave’ prognosis—and suffering the effects of her illness throughout her life.” The back flap adds that she is also an adjunct professor of psychiatry, a research clinical associate in psychoanalysis, and married. The flaps and back cover also include praise of the book from five eminent psychiatrists.

With all that consensus, if I question the diagnosis, I’ve probably misread the book, don’t you think? However, I’m interested in the distinction between schizophrenia and multiple personality, so here I go again.

The strong case in favor of her diagnosis of schizophrenia is that, for many years, she has had major episodes of, and continual tendencies toward, delusions (e.g., that she has killed many people with her thoughts), plus a lot of crazy, disjointed, nonsensical talk. Moreover, when she finally started taking antipsychotic medication (including Navane, then Zyprexa, and eventually clozapine) her psychotic symptoms were much less—often gone or minimal—but would relapse when she went off the medication.

Both Psychotic and Cogent

My first quibble with the diagnosis is that I don’t see how a person with schizophrenia can be flagrantly illogical and delusional during the same period of time in her life that she produces an excellent, fifty page, legal article (unless Hyde was the crazy one, and Jekyll wrote the article):

“In one [psychotherapy] session with [a psychologist-psychoanalyst], I was frantically pacing from one side of his office to the other, growing more agitated as my thoughts became more violent. ‘I’ve killed people and I will kill again,’ I announced. I was almost growling at him. ‘Who else is in the office with us? Are you human?’ “ (1, p. 134).

Meanwhile, “In [law school], I was assigned to prepare my first legal memo. Its purpose was to explain a very specific area of law, in a succinct, cogent manner…the length was to be no more than fifteen pages…I worked on the memo day and night…And when I was finished, my paper was nearly fifty pages in length. I later learned that the person in charge of grading papers thought that it was one of the two best pieces of work turned in by anyone that year…something inside me pushed me farther than I was supposed to go…” (1, pp. 134-135).

Diagnostic Controversy

Over the years, Saks’s doctors have not always diagnosed schizophrenia. Some had previously said that she had depression or schizoaffective disorder or atypical psychosis. A history of disagreement about diagnosis and of changing a patient’s diagnosis is much more common in cases that are eventually revealed to be multiple personality than in cases of schizophrenia.

Clinically Atypical

In the psychotherapy session quoted above, Saks’s disconnected thoughts could be called “loose associations,” a supposedly classic symptom of schizophrenia, but they strike me as inauthentic; not faked—there is no reason for her to fake—but not the way I have ever heard any of my own schizophrenic patients talk.

(However, if Saks was not quoting therapy transcripts, but only recreating what had been said, perhaps what I find inauthentic is only her retrospective version of what she had said.)

Suggestive of Multiple Personality

Saks occasionally says and does things that people unfamiliar with multiple personalty might take as evidence of schizophrenia, but which might not be. For example, she says, “I started to sense that the others—the beings who never seemed far off when I got sick—were in the office with me. An evil presence, and growing stronger. Why are they here? Are they trying to take over my mind? Why do they want to hurt me?” (1, p. 249). This could be schizophrenic delusion, but it could also be the host personality’s experience of rival alternate personalities who want to get her out of the way by getting her hospitalized.

That is how Dostoevsky’s The Double ended, with the regular personality carted off to the mental hospital while the alternate personality took his place in everyday life. Alternate personalities have such a sense of their separate existence that they sometimes even think that they can kill the host personality while they themselves remain alive.

“Another command (or thought, or message) I continually received was to hurt myself…So I burned myself—with cigarettes, lighters (easily come by…) electric heaters, boiling water. I burned my flesh in places on my body that I thought people would never see…” (1, p. 85). I previously discussed self-mutilation caused by persecutor personalities (search posts) in my post on Gillian Flynn’s novel Sharp Objects.

Saks says that one of her doctors “didn’t want me to cover my face with my hands during our sessions, something I’d done with all my analysts to help me feel safe and contained” (1, p. 322). As I discussed in a previous post about Charlotte Brontë—who was described as repeatedly seen to turn her face away from the person she was speaking to at school before she suddenly changed from reticent to talkative—people with multiple personality may want to hide the switch from one personality to another, which they think will be detected if their face is seen at the moment of the switch. It sounds to me like Saks was hiding her personality switches during therapy sessions.

Schizophrenia or Multiple Personality

Saks, who once wrote a book on the law and multiple personality, is familiar with it, and in interviews, she always emphasizes that she has schizophrenia, not multiple personality. And since her memoir has nothing definitive in regard to multiple personality, she may be right.

Her positive response to medication does not necessarily prove that she has schizophrenia. The medicine may help by shifting the balance of power among her personalities, making it harder for problematic alternate personalities to take over. I learned about this possibility when the host personality of a patient of mine with multiple personality would “misplace” her antidepressant medicine from time to time. Her alternate personality later admitted to me that she would hide the medicine, because when the host took it, it would be harder for the alternate personality to come out.

So is Saks a very high-achieving person with schizophrenia or a very high-achieving person with undiagnosed multiple personality? I am undecided.

1. Elyn R. Saks. The Center Cannot Hold: My Journey Through Madness. New York, Hyperion, 2007.

Jane Eyre (post 9 postscript): The Brontë sisters may have chosen the pseudonym “Bell” to sound an alarm about what had happened in their family

The speculation I’ve seen about how they chose their pseudonym involves what real person they knew who had such a name. But the choice of pseudonym may have been simpler than that: a bell sounds an alarm.

Jane Eyre (post 9) had to be written by Currer Bell, not Charlotte Brontë, because it would have portrayed the latter as coming from an immoral family

At the time Jane Eyre was written, Charlotte Brontë’s father had been blind (for which she had taken him to have cataract surgery). So for Charlotte Brontë, herself, to have written a novel in which a woman who looked like Charlotte Brontë (Jane Eyre) married a man old enough to be her father who had become blind (Rochester), would have looked like a novel about incest. Moreover, before the novel’s protagonist marries her “father,” she has to resist intense pressure to marry her “brother.”

I do not know, and am not saying, that there was incest in the Brontë family. Nor am I saying that Charlotte Brontë wrote the novel, but then realized what I said above about how it would look, and so concocted a pseudonym for appearances. What I am saying is that the regular Charlotte Brontë personality would not have written such a self-incriminating story in the first place. Such a story had to have been written by an alternate personality who would not have been embarrassed by it, such as Currer Bell, who was not a member of a family like that in the novel: with a small, plain, young woman, a blind father, a gone mother, and a wayward brother.

Jane Eyre (post 8): Jane gets suggestions from “the monitor”—Saul Bellow from the “commentator within”—only experienced by people with multiple personality

Near the end of Jane Eyre, Jane distinguishes between her own ideas and the suggestions she gets from “the monitor”:

     “ ‘My journey is closed,’ I thought to myself. I got out of the coach, gave a box I had into the ostler’s charge, to be kept till I called for it; paid my fair; satisfied the coachman, and was going: the brightening day gleamed on the sign of the inn, and I read in gilt letters, ‘The Rochester Arms.’ My heart leapt up: I was already on my master’s very lands. It fell again: the thought struck it:—

     ‘Your master himself may be beyond the British Channel, for aught you know: and then, if he is at Thornfield Hall, towards which you hasten, who besides him is there? His lunatic wife: and you have nothing to do with him: you dare not speak to him or seek his presence. You have lost your labour—you had better go no further,’ urged the monitor. ‘Ask information of the people at the inn; they can give you all you seek: they can solve your doubts at once. Go up to that man, and inquire if Mr. Rochester be at home.’

     The suggestion was sensible, and yet I could not force myself to act on it…” (1, p. 360).

In Saul Bellow’s 1966 Paris Review interview, he says:

“I suppose that all of us have a primitive prompter or commentator within, who from earliest years has been advising us, telling us what the real world is. There is such a commentator in me. I have to prepare the ground for him. From this source come words, phrases, syllables; sometimes only sounds, which I try to interpret, sometimes whole paragraphs, fully punctuated. When E. M. Forster said, “How do I know what I think until I see what I say?” he was perhaps referring to his own prompter…

“When I say the commentator is primitive, I don't mean that he's crude; God knows he's often fastidious. But he won't talk until the situation's right. And if you prepare the ground for him with too many difficulties underfoot, he won't say anything. I must be terribly given to fraud and deceit because I sometimes have great difficulty preparing a suitable ground. This is why I've had so much trouble with my last two novels. I appealed directly to my prompter. The prompter, however, has to find the occasion perfect—that is to say, truthful, and necessary. If there is any superfluity or inner falsehood in the preparations, he is aware of it…”

No, all people don’t have this. These personified, rational voices are the voices of alternate personalities. Only people with multiple personality may hear the voice of, and get suggestions from, a “monitor” or a “commentator within.”

1. Charlotte Brontë. Jane Eyre. New York, W. W. Norton, 2001.

Jane Eyre (post 7): Bertha Mason misbehaves because she is “prompted by her familiar”—the alternate personality of her multiple personality disorder.

Rochester says that his wife, Bertha Mason, “is prompted by her familiar to burn people in their beds at night [himself], to stab them, to bite their flesh [her brother]…” (1, p. 257).

Who or what is Bertha’s “familiar”? What is a “familiar”?

According to Wikipedia, familiar spirits, sometimes referred to simply as “familiars,” are supernatural entities. “When they served witches, they were often thought to be malevolent, while when working for cunning-folk they were often thought of as benevolent…The former were often categorized as demons, while the latter were more commonly thought of and described as fairies.”

Some familiars take animal form, such as a witch’s black cat. Other familiars take human form, common in Western Europe. According to one definition, “A familiar spirit (alter ego, doppelgänger, personal demon, personal totem, spirit companion) is the double, the alter-ego, of an individual.”

Accounts of familiars were often striking for their “ordinariness” and “naturalism.” Familiar spirits “were often given down-to-earth, and frequently affectionate, nicknames. One example of this was Tom Reid, who was the familiar of the cunning-woman and accused witch Bessie Dunlop.”

Now, if I were to translate “familiar” to modern, psychiatric terminology, I would say that it refers to alternate personality, as in multiple personality. And since Bertha Mason’s multiple personality causes her distress and dysfunction, it would be multiple personality disorder.

1. Charlotte Brontë. Jane Eyre. New York, W. W. Norton, 2001.

Jane Eyre (post 6): Jane’s metaphors—in which personified forces and voices manipulate and control her behavior—are a literary use of multiple personality.

In a previous post (search: metaphors), I used the phrase “subjectively experienced metaphors” to refer to metaphors that are based on the author’s subjective experience.

When an author uses metaphors of personified forces and voices that manipulate and control the person’s behavior—in the way that alternate personalities pull the strings from behind the scenes in multiple personality—it suggests that the author has multiple personality.

“But what is so headstrong as youth? What is so blind as inexperience? These affirmed that it was pleasure enough to have the privilege of again looking on Mr. Rochester, whether he looked on me or not; and they added—‘Hasten! hasten! be with him while you may: but a few more days or weeks, at most, and you are parted with him for ever!’” (1, pp. 207-208).

“An impulse held me fast,—a force turned me around. I said—or something in me said for me, and in spite of me:—‘Thank you, Mr. Rochester, for your great kindness. I am strangely glad to get back again to you, and wherever you are is my home—my only home’” (1, p. 209).

“I stopped my ears against the voice that kept warning me of near separation and coming grief” (1, p. 210).

Rational voices are the voices of alternate personalities.

1. Charlotte Brontë. Jane Eyre. New York, W. W. Norton, 2001.

Schizophrenia vs. Multiple Personality (post 2): If they both have hallucinations and delusions, why is the former psychotic and the latter not?

In the psychiatric diagnostic manual, schizophrenia is in the chapter “Schizophrenia Spectrum and Other Psychotic Disorders” (1, pp. 87-122). Whereas, multiple personality (called “dissociative identity disorder”) is in the chapter “Dissociative Disorders” (1, pp. 291-307). (“Dissociation” refers to altered states of consciousness and compartmentalization.)

Schizophrenia is a psychosis, because the person thinks that his hallucinations and delusions are objectively real and true.

A person with multiple personality is more like a novelist. He may hear the voices of his alternate personalities or characters, and see them in “waking dreams”—and these hallucinations may be experienced as “more real than real”—but he ultimately understands that other people don’t see and hear these things, and that the personalities are not really separate people. So it might be more accurate to call them pseudohallucinations and pseudodelusions.

Although a person with multiple personality has various personalities who are totally convinced that they are separate, autonomous people, the person’s regular, “host” personality sees life in an ordinary way. Indeed, the host personality often has no awareness that there are any other personalities. Or, if he is aware of other personalities, he may think of them in other terms, such as a “guardian angel” or “muse.” But most often he knows nothing about it. He might occasionally notice a memory gap, but it usually does not cause a problem; it makes no sense; there is nothing he can do about it; he suspects it happens to everyone; so he just ignores it.

But, you might wonder, doesn’t a person with multiple personality look crazy? Doesn’t switching from one personality to another look bizarre? It would, if that were the way a person with multiple personality usually looked. But that kind of behavior is seen only a) in a demonstration interview, in which, for educational or other reasons, a person who knows he has multiple personality is intending to put his personalities on display, or b) in therapy for multiple personality. Otherwise, you will usually not know that a person has multiple personality from their overt behavior.

Why won’t you know? First, you are most likely to be seeing only the host personality (see above). Second, if alternate personalities do come out, they almost always do so incognito. That is why you need clues to suspect that a person has multiple personality, such as a puzzling inconsistency and a history of memory gaps.

Once you do discover the alternate personalities, and they know that you know, and especially once you know their names, then it all becomes quite overt and obvious. The diagnosis is not, stress not, a psychoanalytic interpretation. It is observed. It is made when you have knowingly seen the personality switches and actually conversed with the alternate personalities.

But this blog is not primarily about mental illness and diagnosis, which I discuss occasionally only to clarify certain concepts. What interests me is that for every person who has the mental illness, multiple personality disorder, there are probably thirty people who have a normal version.

1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]. Arlington VA, American Psychiatric Association, 2013.

Jane Eyre (post 5) looks in a mirror and paints a self-portrait. But if she has the mirror, why does she need the portrait? Why would the mirror be unreliable?

Jane has saved Rochester’s life in a fire. He has praised her. So she has fantasized that he might want to marry her. But she knows better, and to bring herself back to reality whenever she gets her hopes up, she paints “Portrait of a Governess, disconnected, poor, and plain” (1, p. 137).

But why couldn’t she just look in the mirror whenever she needed to be reminded that she is plain? Regular readers of this blog know the answer, since mirrors have been mentioned in so many previous posts in regard to multiple personality, from Poe’s “William Wilson” to Garcia Marquez’s “Dialogue with a Mirror” to Putnam’s Diagnosis and Treatment of Multiple Personality Disorder.

In short, people with multiple personality may sometimes see one or another of their alternate personalities when they look in the mirror. And alternate personalities often look different from each other. [added Nov. 1, 2015: See post 1, which mentions that when Jane was in the red room, she looked in a mirror and saw, not herself, but a strange being.]

If Jane had multiple personality, then when she would look in the mirror, sometimes she might see an alternate personality who is pretty.

If Jane did not have multiple personality, she would not have needed the self-portrait of her plain self, and could have dispelled any fantasy by simply looking in the mirror.

1. Charlotte Brontë. Jane Eyre. New York, W. W. Norton, 2001.

Schizophrenia vs. Multiple Personality: If they both have hallucinations and delusions, why are multiples more likely to have relationships and get married?

Many people think of multiple personality as the worst kind insanity, since they don’t even know who they are (this personality or that personality) and they may do things they don’t even remember (one personality has a memory gap for the time that another personality was out). Moreover, they occasionally hallucinate their alternate personalities; e.g., in mirrors, or when they hear the voices of their “characters.” And alternate personalities (and characters) have the delusion that they are people in their own right.

So, if people with schizophrenia also have hallucinations and delusions, what’s the difference?

One of the key factors that leads a psychiatrist to diagnose, or not diagnose, schizophrenia is the person’s interpersonal engagement. For example, in a recent post about Lucy, the patient that Christopher Bollas diagnosed (possibly misdiagnosed) with schizophrenia, Lucy was described as having initiated contact with Bollas and as having asked him to psychoanalyze her. And then she engaged in psychoanalysis with him for more than five years (by telephone, long-distance!). However, the kind of person that most psychiatrists would diagnose as having schizophrenia would never do all that. Schizophrenics (not on medication or only in the early stages of the illness) tend not to initiate and maintain complex interpersonal relationships.

To illustrate how allegedly crazy Lucy was, Bollas described how one telephone session was interrupted while Lucy, according to Lucy, was chased around her house by a dragon. (Lucy had been described by Bollas as a 55-year-old writer, and I wonder if she wrote children’s books, and one of the characters was a dragon.) But Bollas did not panic. He did not try to alert Lucy’s family or neighbors. He waited, and when Lucy got back on the phone, he interpreted Lucy’s hallucinated dragon as having been prompted by the wording of one of his previous comments. In short, neither the nature of Lucy’s relationship with Bollas nor his reaction to her hallucination suggests the condition that most psychiatrists would call schizophrenia, but rather something that features a vivid imagination and is interpersonally engaging.

Psychiatrists may be very dedicated and emotionally involved in helping people with schizophrenia, but there is relatively little risk of their emotional entanglement with particular patients, because one of the features of schizophrenia is its interpersonal deficits. Moreover, the hallucinations and delusions tend to be nonsensical or bizarre, not metaphorical or mythological like dragons. (And, of course, needless to say, schizophrenics never have alternate personalities or memory gaps.)

In contrast, people with multiple personality tend to be emotionally engaging. Although they can be loners, or an angry personality may tell you to get lost, multiples are often emotionally engaging, which is why they are often married, some more than once. Indeed, professional training in how to treat multiple personality routinely includes cautionary advice on how the therapist can avoid getting emotionally entangled and enmeshed. And the hallucinations and delusions of multiples are of the kind that, the more you know what is going on, the more they make sense (the way fiction makes sense).

Charlotte Brontë’s Jane Eyre (post 4): Two of Jane’s alternate personalities—empathic (when her friend dies) and emotionless (first interview with Rochester)

In the first quarter of the novel, I have found the two most memorable scenes to be, first, when Jane’s friend at the boarding school dies, and second, the first extended conversation between 18-year-old governess Jane and her new employer, Mr. Rochester, who is described as twice her age, but not middle-aged.

At the boarding school, half the children are sick, and some are dying. Jane hears that her occasional, but true, friend, is quite ill. Jane visits her friend, and finds her all alone in her sick bed. Jane gets into bed with her, so that her friend will not be alone. And when Jane awakens the next morning, her friend, lying next to her, has died.

In the first extended conversation between Jane and Rochester, what I find most striking is how Jane stays on a factual, emotionless plane, no matter how hard Rochester tries to provoke an honest emotional response. My first thought was that Jane was acting that way due to class and gender hierarchy, and that she was just trying to avoid problems. But she is not described as having emotions hidden behind an emotionless front. No, she seems genuinely attuned to only matters of fact.

Now, it is easy to rationalize this inconsistency in the way Jane’s personality is portrayed. The above two situations are different in many ways. But we have the concept of personality, because there is usually a basic continuity. We don’t expect a girl who is very empathic at age eight to be very unempathic at age eighteen.

However, in multiple personality, such discrepancies between alternate personalities are typical. A person has only so much of any quality—e.g., empathy—and if one personality has more than its share, another personality will have less.

Charlotte Brontë’s Jane Eyre (post 3): Jane is unattractive, but she sees with her mind’s eye, and hears with her inward ear, continuously narrated tales

“I ever wished to look as well as I could, and to please as much as my want of beauty would permit. I sometimes regretted that I was not handsomer: I sometimes wished to have rosy cheeks, a straight nose, and small cherry mouth; I desired to be tall, stately, and finely developed in figure; I felt it a misfortune that I was so little, so pale, and had features so irregular and so marked” (1, p. 84).

The above is, more or less, how Charlotte Brontë looked, and how she felt about how she looked, in real life. I quote it because it shows the autobiographical authenticity of the text, including what follows.

“Then my sole relief was to walk along the corridor of the third story, backwards and forwards, safe in the silence and solitude of the spot and allow my mind’s eye to dwell on whatever bright visions rose before it—and certainly, they were many and glowing; to let my heart be heaved by the exultant movement, which while it swelled it in trouble, expanded it with life; and best of all, to open my inward ear to a tale that was never ended—a tale my imagination created, and narrated continuously; quickened with all of the incident, life, fire, feeling, that I desired and had not in my actual existence” (1, p. 93).

Note that she does not say I imagined, but rather that my imagination created. That is, her subjective experience is that she, her regular self, does not create. Her job is to allow her mind’s eye to see, and her inward ear to hear, what an independent agency (an alternate personality) creates and provides to her. She calls that alternate personality “my imagination” only to indicate that what she experiences, subjectively, as an independent agency, is, objectively, a product of her own mind.

1. Charlotte Brontë. Jane Eyre. Edited by Richard J. Dunn. New York, W. W. Norton & Company, 2001.

Christopher Bollas’s New York Times essay “A Conversation on the Edge of Human Perception” portrays schizophrenia as a nonspecific, imaginative, debatable diagnosis.

Bollas, a psychoanalyst, says that psychiatrists are wrong to emphasize medication as the mainstay of treatment for people with schizophrenia. Bollas says, “Talking to an empathetic other is curative. We all know that.”

As an example, he says that Lucy, a 55-year-old writer, phoned him from thousands of miles away to ask if he wanted to psychoanalyze her, long-distance. He agreed. So they had therapy sessions by phone at 8 o’clock in the evening, five nights a week. “By the end of the fifth year of our work, Lucy was no longer hallucinating and she was no longer dwelling in past memories…”

Here is a link for the essay, to read it yourself:

http://opinionator.blogs.nytimes.com/2015/10/17/a-conversation-on-the-edge-of-human-perception/?_r=0

Now, it may be that if I knew more about Lucy, I would agree with Bollas’s diagnosis, but based on what is in the essay, I would hesitate to diagnose Lucy as having schizophrenia. In my opinion, just having hallucinations, especially about mythical figures, and more especially if the hallucinations are affected by the power of suggestion, and even more especially if they occur in a writer, do not confirm a diagnosis of schizophrenia. But the diagnostic criteria for schizophrenia are so nonspecific that I can see how Lucy could be misdiagnosed.

Oct 21, 2015: I should add that Bollas's whole scenario for Lucy is inconsistent with what most psychiatrists would call "schizophrenia." You would not expect a person who truly has schizophrenia to seek someone out with a request to be analyzed, and then stick with that for five-plus years. One of the main things impaired in schizophrenia is interpersonal relatedness, and persons with schizophrenia don't seek to increase interpersonal relations and have someone intrude into their issues. Moreover, true schizophrenic hallucinations and delusions tend to be nonsensical or bizarre, not metaphorical or amusing, no matter how empathic the therapist is.

Charlotte Brontë’s Jane Eyre (opening, post 2): Jane is puzzlingly inconsistent and has a memory gap, the two cardinal clues to multiple personality.

The text does not give any common sense explanation for why, in the opening pages of this novel, Jane suddenly changes from being habitually obedient to intimidatingly assertive.

The narrative could have made the change plausible. It could have said she was getting older; she had read a story in which a character was assertive; an urge to fight back and speak up had been building up in her for some time; and it now finally came out with the latest provocation. But the narrative does not say anything to make Jane’s sudden personality change plausible. The change just happens, suddenly and inexplicably. It defies common sense. It is puzzling.

Then there is the episode of Jane’s disturbed behavior in the red room. The narrator, Jane, can’t tell us what she had been thinking or how she had behaved during this episode, because she has amnesia for it, a memory gap. All we know is that the person who evaluated her mental state after the episode thought it necessary to ask her if she knew who she was.

Thus, the novel opens with a description of the main character as having puzzling inconsistency and a memory gap, which, as discussed previously in this blog, are the two cardinal clues that a person has multiple personality. If the author was not intending to portray Jane as having multiple personality, and if multiple personality, per se, plays no part in the novel’s plot or character development, then this would be what I call “gratuitous multiple personality,” a reflection of the author’s own psychology.

Charlotte Brontë’s Jane Eyre (opening): Ten-year-old Jane—habitually obedient, self-doubting—switches to assertive, intimidating, alternate personality.

Jane Eyre, an orphan—living with cousins who bully and abuse her, and a widowed aunt (from the other side of the family) who doesn’t love or protect her—describes herself as “habitually obedient” (1, p. 8), with a “habitual mood of humiliation, self-doubt, forlorn depression” (1, p. 13).

However, when she was being taken to be locked in the red-room, her late uncle’s room, for punishment, “I resisted all the way, a new thing for me…The fact is, I was a trifle beside myself; or rather out of myself as the French would say” (1, p. 9). In this room’s mirror, she sees “a strange little figure there gazing at me” (1, p. 11). (Search “mirror” or “mirrors” in this blog for discussions of how typical it is for persons with multiple personality to occasionally see other people when they look in a mirror.) And after being left alone in this room, “I suppose I had a species of fit: unconsciousness closed the scene” (1, p. 14). The next thing she remembers, she was back in her own bed in the nursery.

Did she have an epileptic seizure, or was it a multiple personality memory gap (for the time that another personality had been out and in control) (search memory gaps in this blog)? It is more likely the latter, since there is no mention of a history of epilepsy, and when she is acting normally again, she is asked by someone who has met her before, “…your name is Jane, is it not?”(1, p. 18). This suggests that, during the time of her memory gap, she had not responded to her usual name and/or had used a different name, which would be consistent with having been, during that time, an alternate personality who does not call herself “Jane Eyre.”

After that unremembered episode, she does not switch back to her habitually obedient personality, but now manifests a personality who physically defends herself against her older, abusive cousin, and who is so assertive that her aunt is physically intimidated: all of which is seen as being very out-of-character for her.

In short, the opening of Jane Eyre describes Jane as having at least three personalities: first, the regular, habitually obedient, depressed Jane; second, a personality who has evidently created a disturbance, but is not described, because Jane, the narrator, has amnesia for that personality; and third, assertive Jane, a protector personality, who has now decided to come out when obedient, depressed Jane is threatened.

1. Charlotte Brontë. Jane Eyre [1847/8], a Norton Critical Edition, Third Edition, Edited by Richard J. Dunn. New York, W. W. Norton & Company, 2001.

Elizabeth Gaskell’s The Life of Charlotte Brontë: Brontë describes her creative process; Gaskell describes Brontë’s switch to talkative alternate personality

Alternate Personalities Dictate

“…imagination is a strong, restless faculty, which claims to be heard and exercised: are we to be quite deaf to her cry, and insensate to her struggles? When she shows us bright pictures, are we never to look at them, and try to reproduce them? And when she is eloquent, and speaks rapidly and urgently in our ear, are we not to write to her dictation?” (1, p. 255).

“When authors write best, or, at least, when they write most fluently, an influence seems to waken in them, which becomes their master—which will have its own way—putting out of view all behests but its own, dictating certain words, and insisting on their being used, whether vehement or measured in their nature; new-moulding characters, giving unthought of turns to incidents, rejecting carefully-elaborated old ideas, and suddenly creating and adopting new ones. Is it not so? And should we try to counteract this influence? Can we indeed counteract it?” (1, pp. 260-261).

Brontë Switches Personalities

At school in Brussels:

“…Emily hardly ever uttered more than a monosyllable. Charlotte was sometimes excited sufficiently to speak eloquently and well—on certain subjects; but before her tongue was thus loosened, she had a habit of gradually wheeling round on her chair, so as almost to conceal her face from the person to whom she was speaking” (1, p. 162).

When Switching Personalities:

“…Women will frequently turn their faces away, momentarily shield their faces with their hands, or let their hair fall over their faces during the moment of switching” (2, p. 121).

1. Elizabeth Gaskell. The Life of Charlotte Bronte [1857], Edited by Elisabeth Jay. Penguin Books, 1997.

2. Frank W. Putnam MD. Diagnosis and Treatment of Multiple Personality Disorder. New York, The Guilford Press, 1989.

Charlotte Brontë’s pseudonym, Currer Bell, was the name of a male alternate personality in charge of her writing, not a sign of feminism or shyness

I am reading Elizabeth Gaskell’s The Life of Charlotte Brontë, and have reached the year 1850, by which time the author of Jane Eyre is well known to be Charlotte Brontë and not “Currer Bell.”

Yet, at the end of a private letter dated January 19, 1850, she signs “Currer Bell” (1, p. 316). And in a letter of March 16, 1850, she refers to Currer Bell as though he were some real other person: “One thing, however, I see plainly enough, and that is, Mr. Currer Bell needs improvement, and ought to strive after it; and this (D.V.) [God willing] he honestly intends to do—taking his time, however, and following as his guides Nature and Truth” (1, p. 320).

For biographical context on her use of pseudonyms, I quote from The Oxford Companion to The Brontës:

“All four Brontës published under pseudonyms, a continuation of their childhood habit of writing in fictitious authorial voices…and they subsequently published all their novels under these pen names, even Villette (1853), which was released long after Charlotte’s identity had become widely known…Charlotte herself used her pseudonym in professional correspondence with people she had not actually met; ‘Currer Bell’, she explained to Williams in 1848, ‘is the only name I wish to have mentioned in connection with my writings’…Charlotte’s favorite juvenile pseudonym was Charles Townshend…At age 13, she had adopted the prose persona of Captain ‘Andrew’ Tree and was signing her poems as Arthur Wellesley…” (2, p. 407).

If her motivation for using a male pseudonym was to be taken seriously in patriarchal, male chauvinist, Victorian England, why had she used it in childhood, when public response was not at issue, and why did she continue to use it as an adult in both private correspondence (related to her writing) and for novels, after her true identity was well known? And why, in her letter of March 16, 1850, did she speak of “Currer Bell” as though he were another, real person?

As I have argued in past posts related to other writers (search pseudonyms in this blog), an often ignored reason for novelists to use pseudonyms is that they may have alternate personalities who want to publish. In the case of Charlotte Brontë, it appears that the personality (or personalities) who did her creative writing had always, since childhood, had a male self-image.

I do not know why her writing personalities were male. Perhaps because, even as a child, it was obvious to her that male authors would be taken more seriously. Perhaps because her mother died when she was five, leading her to think that males had a better chance in life. Or perhaps she wanted to please her father. In any case, the issue in this post is why authors use pseudonyms: It may indicate the presence of an alternate personality.

1. Elizabeth Gaskell. The Life of Charlotte Brontë [1857], Edited by Elisabeth Jay. Penguin Books, 1997.

2. Christine Alexander and Margaret Smith. The Oxford Companion to the Brontës. Oxford University Press, 2006.

Childhood trauma is more common, and its effects, both physical and mental, are more diverse and pervasive than current literary theory appreciates

Literary theory already includes trauma studies (1). And many people have heard that holocausts, wars, torture, natural disasters, serious illness, injuries, and child abuse may increase the chances of having anxiety, depression, addiction, and identity problems.

But most people are not aware that childhood trauma, serious enough to have serious consequences, is relatively common:

http://www.cdc.gov/violenceprevention/acestudy/prevalence.html

Moreover, most people do not appreciate the diversity of the consequences:

http://www.cdc.gov/violenceprevention/childmaltreatment/consequences.html

Thus, when anyone is known to have had either childhood trauma or something that is more common in people who have had childhood trauma—depression, bipolar disorder, etc.—you have to consider whether they also have one of the other things that is more common after childhood trauma: multiple personality (whose two most common clues are a puzzling inconsistency and memory gaps, which, to find out about, you have to ask).

1. Gregory Castle. The Literary Theory Handbook. Wiley Blackwell, 2013.

Marcel Proust’s “In Search of Lost Time”: Aside from “lost time,” the “episode of the madeleine" is consistent with the author’s multiple personality

In a past post, I pointed out that persons with multiple personality typically have memory gaps (one personality’s amnesia for the period of time that another personality has been out and in control), and that they often refer to their memory gaps as “losing time” (so that the title of Proust’s book flags his multiple personality).

I should also point out that the famous “episode of the madeleine” is consistent with multiple personality, since it illustrates how one typically prompts a switch from one personality to another.

The basic principle is this: If you want to prompt a switch to a specific alternate personality, introduce something that is particularly relevant to that alternate personality. For example, suppose, in my discussion of memory gaps with a woman, her regular, “host” personality tells me that she had once found a new green coat in her closet, but had no memory of how it got there. The host’s typical attitude has been to ignore the coat (since one personalty typically ignores another personality’s business). But if I insist on discussing the coat, and if I persist in discussing it with her, even though I see that the discussion is making her increasingly uncomfortable, at some point I will see a sudden change in her demeanor (a sign of a personality switch), and the alternate personality related to that coat will be happy to tell me all about how she got the coat, for which that alternate personality has complete memory.

Memory gaps: You assume that you have never known anyone who has multiple personality, but you never ask about memory gaps, the way to find out.

There are two kinds of people in this world: those who think they have never met a person who has multiple personality, and those who casually ask people if they ever have “memory gaps” or “lose time.”

Although there are some people with multiple personality who know it, but don’t want you to know it, and who won’t admit their memory gaps, most people with multiple personality don’t know the significance of their memory gaps, assume that everyone probably has them, and will acknowledge them if you ask casually.

When a person acknowledges memory gaps, it is often wise to drop the subject for the time being. If they want to discuss the significance of their memory gaps, let them bring it up. Some people with multiple personality are happy to finally find someone who is interested. Other people with multiple personality don’t want to know.

For further discussion of memory gaps, search it in this blog.

How can novelists have real multiple personality—not just something that superficially resembles multiple personality—yet not be mentally ill? Here is how.

Let me make an analogy about two groups of people who have heard strange music in their head since they were children. To put it bluntly, everyone in both of these groups hallucinates (music). However, the people in Group A, through no fault of their own, have always been dysfunctional, because their music hallucinations have always distracted them, and kept them from accomplishing much in life. Whereas, the people in Group B, inspired by their musical hallucinations, have become composers, some quite good. In short, both groups really do have hallucinations, but the people in Group A have an illness, while the people in Group B do not.

Multiple personality disorder (the mental illness) comes in a very wide range of function and can be misdiagnosed as almost anything. Some are so dysfunctional that they are misdiagnosed as having schizophrenia. Others appear to have bipolar disorder, because one personality is depressed and pessimistic, while another personality is outgoing and optimistic. And there are many other people with multiple personality disorder who do have a genuine mood disorder, such as depression, which affects most of their personalities, but only the depression gets diagnosed.

Clinically, the most practical way to screen for multiple personality is to ask the person if they ever have memory gaps or lose time, since one personality may have amnesia for the period of time that another personality has been out and in control. Neither schizophrenia nor bipolar disorder nor depression nor any other psychiatric condition—only multiple personality—has a history of sober memory gaps (if someone claims alcoholic blackouts, which may be due to a personality who drinks, ask if they have ever had a “dry” blackout, even a relatively short one, since another alternate personality may not drink).

But multiple personality disorder—which is a “disorder,” because it causes distress and/or dysfunction—represents only a small fraction of the people who have multiple personality, as shown by all the novelists who have multiple personality (see this blog), but who are not mentally ill.

Clueless: Joel Conarroe, Emily Fox Gordon, and NYTimes Book Review Editor on why Joyce Carol Oates omitted 47-year marriage from her memoir

In his letter to the editor (Oct. 4), Joel Conarroe supports Joyce Carol Oates against Emily Fox Gordon’s book review (Sept. 20) of Oates’ memoir, “The Lost Landscape” (2015). Gordon had felt that it was wrong for Oates to omit her 47-year marriage. Conarroe feels that the memoir is “a generous gift” and that Gordon should have been more “thoughtful.” Meanwhile, the editor of the Book Review evidently thinks that Gordon and Conarroe each have a point. But all of them are clueless.

The key to understanding why Oates left her 47-year marriage out of her memoir is found in her previous memoir, “A Widow’s Story” (1), where Oates’ wife/widow personality (the main narrator) distinguishes herself from the other “Joyce Carol Oates” writing personalities as follows:

“In our marriage…I walled off from my husband the part of my life that is ‘Joyce Carol Oates’—which is to say, my writing career [he never even read her novels]…but then, I [the wife/widow personality] have walled myself off from ‘Joyce Carol Oates’ as well.” (1, pp. 123-125).

 “ ‘Joyce Carol Oates’ doesn’t exist [to the wife personality, who has amnesia for the ‘Joyce Carol Oates’ writer personalities], except as an author-identification” (p. 170) and “I’ve come to think of my ‘self’—my ‘personality’—as an entity that collapses when I am alone and unperceived by others; but then, as if by magic, when I am with other people, my ‘personality’ reassembles itself” (p. 233).

That is, her wife/widow/social personality is distinct and walled off from her “Joyce Carol Oates” writing personalities. Her social personality vanishes when her writing personalities take over in private, but then comes back when she is with other people. The personality who lived the marriage wrote “A Widow’s Story,” but “The Lost Landscape” was written by her other “Joyce Carol Oates” writer personalities, who live the writing life and are not involved in the social life and marriage.

If these were just two roles, then they would have a common memory bank and would know each other’s business. But since they are distinct personalities, they are separated by a wall of amnesia.

This is easier to understand if you read my post from last month on Oates’ multiple personality. Just search Oates in this blog.

1. Joyce Carol Oates. A Widow’s Story: A Memoir. New York, ecco/HarperCollins, 2011.

Creativity & Bipolar Disorder, Bipolar Disorder & Childhood Trauma, Childhood Trauma & Multiple Personality, Multiple Personality & Creativity

In the perennial discussion of creativity and mental illness, one of the most popular mental illnesses is bipolar disorder, and one common example is Ernest Hemingway. So where do I get the nerve to suggest, as I have in past posts, that Hemingway may have also had multiple personality, and that his creativity may have been more related to multiple personality than bipolar?

This post is not about Hemingway, but about, first, why a person might have both bipolar disorder and multiple personality, and, second, why the latter may be more relevant to their creativity.

The fact is, both bipolar disorder and multiple personality correlate with a history of childhood trauma. This is common knowledge in regard to multiple personality, but not as widely known about bipolar disorder, so let me provide links to two studies which report that correlation:

http://www.ncbi.nlm.nih.gov/pubmed/24229750

http://www.ncbi.nlm.nih.gov/pubmed/25597794

I am not saying that childhood trauma is the one and only cause of either bipolar disorder or multiple personality. All I am saying is that childhood trauma makes both conditions more likely. And when people point to the bipolar disorder of Hemingway, they almost always neglect his multiple personality.

As to creativity, I refer you to my many past posts about the multiple personality of great novelists, and how it is an integral part of their creative process.

Emily Fox Gordon’s New York Times Book Review of Joyce Carol Oates’ “Lost Landscape” misses the alter egos and amnesia of Oates’ multiple personality

TO THE EDITOR:

In her review of Joyce Carol Oates’ memoir “The Lost Landscape” (Sept. 20), Emily Fox Gordon uses the terms “doppelgängers" and “mirror-self,” suggesting a theme of alter egos.

      Gordon also mentions the chapter “Happy Chicken 1942-1944, which is narrated by Oates’s favorite Rhode Island Red (an arch conceit, but it works)…”

      Let me connect alter egos with Happy Chicken. On page 27 of the memoir, the narrator talks with Joyce:

“Grandma was the one, you know. The one who killed the chickens.”

“No! I did not know.”

“Of course you must have known, Joyce. You must have seen—many times…”

“No. I didn’t know. I never saw.”

“But…”

“I never saw.”

Since Joyce had amnesia for part of those events, the story had to be narrated by an alter ego (an alternate personality), who remembered everything.

KENNETH A. NAKDIMEN

P.S. Gordon says Oates “…found happiness in her engagement and marriage to Raymond Smith [for forty-seven years]. But, oddly enough, no sooner does Oates introduce him to the reader than she abruptly pulls down the narrative curtain. ‘I am sorry,’ she writes, ‘but I am not able to write about Ray here.’ ‘Oh,’ thinks the startled reader, who had been following along sympathetically, ‘I hadn’t meant to pry.’ ”

Now, why, in a memoir about her whole life, was Oates “not able” to discuss anything—and there must have been many good things—about her marriage of forty-seven years (not to mention her remarriage)?

I cannot overemphasize how typical this is for the way persons who have multiple personality tell you their life story. Why? Because each of the person’s personalities may know of, but does not actually remember, the parts of the person’s life that were conducted by other personalities. And, evidently, in Oates’ case, the personality in charge of writing this memoir is not the personality who was in charge of the marriage.

So when the personality in charge of writing this memoir says that she is “not able” to talk about the marriage, she means exactly what she says.

NOTE: Please read Oates’ description of her multiple personality—in quotations from her published nonfiction Journal and other published nonfiction—in last month’s post.