Identical Twins, Pamela Spiro Wagner (diagnosed with schizophrenia) and Carolyn S. Spiro, M.D. (mentally-well psychiatrist), co-author autobiography

The book is alternately narrated by each sister (1). See both sisters in a video (2). Pamela, writing as Phoebe Sparrow Wagner, summarizes her psychiatric treatment (3).

Pamela, Carolyn, and most of Pamela’s psychiatrists believe that Pamela has schizophrenia. 

But Pamela had auditory hallucinations at least as early as age eleven (1, p. 30-33) and DSM-5, the psychiatric diagnostic manual, does not even discuss schizophrenia that young, remarking only that onset prior to adolescence is rare. In fact, the prevalence of schizophrenia prior to age thirteen is very rare, only 1 in 40,000, while hearing voices that young is much more common in other diagnoses (4). According to DSM-5, one of those other diagnoses is dissociative identity disorder (multiple personality).

Since multiple personality is a posttraumatic disorder, the question arises as to whether the autobiography describes any early childhood experience that would have traumatized Pamela more than Carolyn. It does. When the twins were eleven, Pamela disobeys their father. He tells Carolyn to go to her room and Carolyn reports the following:

“When I hear a smack and the words, ‘I’ll show you,’ I tear back to our bedroom, slam the door, and hurl myself into the closet…I dive into a clean pile of quilts and yank them over me. The hollow closet door doesn’t keep out a thing…Pammy shouting. Daddy Bellowing. Words crashing. Threatening, swearing, slapping, thudding, kicking, crashing, things toppling, breaking, smashing…More clattering, banging, shouting. Heart jumping, thumping, panicking, pumping. Everything spinning. Stop! Water running. Stop! I don’t want to hear. Water running?…Pammy screaming…Where’s Mommy? Mommy! More stamping. Dragging…I grit my teeth, pull clothes and blankets around me. Gotta keep from screaming. What’s going on? Make it stop! Water sloshing. Choking sounds. Is he going to drown her? I hurl myself out of the closet. He has her head under the faucet, soap in her mouth. I throw myself at him. ‘No, Daddy! She can’t breathe. You can’t do this!’…I slap him, kick his shins, bite him like an animal until finally Pammy can wrestle free and run for cover” (1, p. 22).

I doubt that one such event would lead to multiple personality, but it may not have been Pamela’s only traumatic experience with her father.

Pseudonyms

The twins’ family name is their father’s last name, Spiro. At age 25, Pamela, who says, “My father and I still do not speak,” legally changes her last name to Wagner, her mother’s maiden name, declaring, “I feel like my real life has finally begun” (1, p. 160). She later also comes to use the name “Phoebe Sparrow Wagner” (3). And as I’ve discussed in past posts, pseudonyms may be the names of alternate personalities.

1. Pamela Spiro Wagner and Carolyn S. Spiro, M.D. Divided Minds: Twin Sisters and Their Journey Through Schizophrenia. New York, St. Martin’s Press, 2005.

2. Video “Divided Minds: Twin Sisters and Their Journey Through Schizophrenia” https://www.youtube.com/watch?v=lzDPlktZrGI

3. Phoebe Sparrow Wagner. July 13, 2019. “Why I Take Drugs [medications] and Don’t Plan To Stop.” https://www.madinamerica.com/2019/07/take-drugs-dont-plan-stop/

4. Childhood-Onset Schizophrenia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289250/

“Inner Voices: My Journey With Psychosis And Schizophrenia” an autobiography by May-May Meijer: Unexplained Memory Gaps

Both the author’s book (1) and her essay, “What I Have Learned From My Psychosis” (2), describe it as a typical case of recurrent, flagrant psychosis, which is successfully treated with antipsychotic medication, except that the medication does have its side effects and her interpersonal relationships and level of function are never quite as good as before.

However, in addition to psychosis, she also has memory gaps, a symptom typical of multiple personality, not schizophrenia: During her hospitalizations for psychosis, when her sister comes to visit, she speaks to her sister in English only—this is the Netherlands, and their primary language is Dutch—and has no memory for having done so (1, pp. 108, 162). And “My father told me that I also often didn’t remember his visits or my sister’s” (1, p. 221).

There is no indication that she discussed these memory gaps with her psychiatrists. As I have been saying in previous posts, patients usually don't volunteer this information, and psychiatrists usually don't know enough to ask.

1. May-May Meijer. Inner Voices: My Journey With Psychosis And Schizophrenia. Translated from Dutch to English by Karen Loughrey, Kumar Jamdagni, and May-May Meijer. Netherlands, Amsterdam Publishers, 2019.

2. May-May Meijer. “What I Have Learned From My Psychosis.” April 14, 2019. https://www.madinamerica.com/2019/04/learned-from-psychosis/

Most Psychiatrists Do Not Have An Informed Opinion About Multiple Personality: Another Reason

I have a number of past posts on why most psychiatrists miss the diagnosis of multiple personality: They are clueless, because the mental status examination that they are taught to use fails to inquire about memory gaps (search “mental status”).

But there is an important additional reason that most psychiatrists ignore, and may be prejudiced against, multiple personality: The primary treatment of multiple personality is a certain kind of psychotherapy (1), not medication.

And as you can see from the following recent article in Psychiatric News (newspaper of The American Psychiatric Association), most psychiatrists nowadays do not know or do psychotherapy: “Should Psychotherapy Be a Psychiatric Subspecialty?” https://doi.org/10.1176/appi.pn.2020.3b6

Added April 11, 2020: It is not just most psychiatrists who don't have an informed opinion about multiple personality. It is also academic and social psychologists, who do not usually do psychotherapy. It is also clinical psychologists and other psychotherapists who do psychotherapy, but have never learned how to diagnose and treat multiple personality, because it is a subspecialty that is not included in most professional training.

Multiple personality disorder (renamed dissociative identity disorder) is in the official diagnostic manual, DSM-5 (and was in DSM-III and DSM-IV previously), because professionals who do know its diagnosis and treatment have published peer-reviewed studies to prove its validity.

1. Frank W. Putnam, M.D. Diagnosis and Treatment of Multiple Personality Disorder. New York, The Guilford Press, 1989.

Irony in Margaret Atwood’s promotion of book tours

Because of the pandemic, Atwood, a Canadian novelist, has suggested that Canada replace in-person book tours with virtual book tours.

The irony, as noted in past posts, is Atwood has written that writers have two distinct selves, the one who handles public life and the one who writes the books. And, she has said, since it is the former who handles public events like book tours, people attending such events never actually get to see the one who wrote the book.

You should be so skeptical that you will need to read about all 240 writers discussed here

Why read all past posts on the 240 writers (and related subjects) I have discussed over the last seven years?

Why not limit yourself, let’s say, to reading Marjorie Taylor’s study of 50 anonymous writers

https://cpb-us-e1.wpmucdn.com/blogs.uoregon.edu/dist/7/8783/files/2014/07/TaylorHodgesKohanyi-130mpe0.pdf

plus my posts on the 10-50 writers with whom you are most familiar, and associated subjects, selected from my name and subject indices?

Because, if you have an ordinary amount of skepticism, you will need to read about literally hundreds of diverse writers before you are convinced that 90% of fiction writers actually do have real multiple personality (the creative trait, not the clinical disorder), and you begin to realize that if this is true of 90% of fiction writers, it may also be true of up to 30% of the general public (which would be a new view of normal psychology).

I know that if I hadn't explored 240 diverse fiction writers, I would never have believed those conclusions.

Added March 22, 2021: What I mean is that, if, like most readers of this blog, I hadn't had clinical experience diagnosing and treating multiple personality, then I might need to read about hundreds of writers before believing it. The great obstacle for most readers of this blog is that they have never seen the indisputable condition themselves. The reason I added the subtitle to the blog about memory gaps is that that is the most likely key for a person to discover multiple personality. I know that I was shocked the first time I asked a puzzling person if they had memory gaps and they said yes. Then of course I had to ask questions about that, which led to meeting an alternate personality, which is what convinces you that this is something objective, and not just an interpretation.