Thigpen And Cleckley - A Case Of Multiple Personality

With MPD patients tend not to recall memories of the other personality; a person with different sides always remembers what the other sides do, think and say.

The results of the Ink Blot test come from the interpretation of the psychiatrist which could be open to bias.

• the use of standardised measures is objective/scientific,
  
• not subjectiveallows comparisons/generalisations to be made with others on a standardised scale
  
• standardised tests are said to be reliable and valid
  

• data may be unique and not comparable with that of others
  
• participants may provide socially desirable responses, not give truthful answers
  
• researchers have to be careful about use of leading questions; this could affect the validity of the data collected
  
• participants may respond to demand characteristics
  

• Thigpen reports that 'we were puzzled by a recent trip for which she had no memory’. Apparently Eve White went shopping and bought lots of expensive clothes. She denied doing this when the clothes were delivered
  
• A letter from Eve White appeared at the therapist’s office. The letter concerned her therapy and was written in her usual handwriting, but at the bottom of the page there was a paragraph that looked like a child had written it.Eve White denied sending the letter, though she recalled having begun one, which she never finished and thought she had destroyed.
  
• Eve White disappeared into the woods, which were forbidden territory, when she was 6 years old and on her return denied it and was severely punished. According to Eve Black this was a prank to get Eve White into trouble
  

An independent expert gave Eve 4 psychological tests:

Psychometric tests:

• The Wechsler-Bellevue Intelligence Scale (now known as the wechsler adult intelligence scale/WAIS)
  
• The Wechsler Memory Scale
  

Projective tests:

• Drawings of human figures
  
• Rorschach (ink blot) test (a projective test, in which the testee supposedly projects unconscious feelings an wishes into their interpretations of a series of ambiguous drawings – resembling ink blots
  

The physiological test: an electroencephalogram (EEG) was also used

• Wechsler-Bellevue Intelligence Scale: Eve White scored 110. Eve Black scored 104
  
• Wechsler memory test: Eve White’s memory function was far above her IQ, while Eve Black’s was on the same level as her IQ.
  
• Rorschach (ink blot) test: Eve Black’s record was by far the healthier of the two, showing a hysterical tendency. Eve White’s showed anxiety, an obsessive-compulsive tendency, rigidity and an inability to deal with her hostility.
  
• A comparison of the projective tests indicates repression in Eve White and regression in Eve Black
  
• EEG Eve Black: Showed evidence of restlessness and muscle tension Normal to slightly fast basic alpha rate of 12.5 cycles per second and . Eve White & Jane: Normal basic alpha rate of 11 cycles per second. Slightly fast EEG records are sometimes (but not consistently) associated with psychopathic personality.
  

According to DSM–IV- TR the diagnostic criteria for dissociative identity disorder are:

1. The presence of two or more distinct identities or personality states (alters) each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and the self
   
2. At least two of these alters recurrently take control of the person’s behaviour.
   
3. Inability to recall important personal information that cannot be explained by normal forgetting
   
4. The disturbance is not due to physiological effects of substance abuse or a general medical condition.
   

• The projective test indicated regression in Eve Black and in Eve White. The dual personality seemed to be the result of a strong desire to regress to an early period of life, namely the one before marriage (Miss Black was actually the maiden name of Mrs White). So these were not two distinct personalities with completely different ways of thinking, but rather one personality at two stages of her life.
  
• The Rorschach and drawings indicated conflict and resulting anxiety in Eve White’s roles of wife and mother; she regressed in order to avoid the guilt associated with the hostility she felt about these roles. Since eve black was free from marital conflicts, she had escaped from the impossible situation Eve White found herself in. She felt contempt for Eve White who allowed herself to get into such a situation due to lack of foresight and cowardice
  

The aim of this article was to provide an account of the psychotherapeutic treatment of a 25-year-old woman who was referred to Thigpen and Cleckley because of 'severe and blinding headaches’ she also mentioned having ‘black-outs’.

The receipt of a letter marked the beginning of the treatment for her DID.

• Evidence 1: Thigpen reports that 'we were puzzled by a recent trip for which she had no memory’. Apparently Eve White went shopping and bought lots of expensive clothes. She denied doing this when the clothes were delivered
  
• Evidence 2: Thigpen received a letter. It had apparently been written by Eve, but some ambiguous words at the end suggested someone was playing a prank. Not only was the handwriting different, but also the tone changed from serious to light—hearted. On her next visit Eve remembered the starting the letter but not having sent it.
  
• Evidence 3: On one of the interviews she formulated a question: Did the occasional impression of hearing an imaginary voice indicate that she was "insane"?’ Apparently she had heard a voice talking to her on several occasions
  
• Evidence 4: Miss Black could ‘come out’ when asked. Miss Black had been part of Mrs White's 'body' since early childhood and a number of events that happened were confirmed by the family. For example, Eve White disappeared into the woods, which were forbidden territory, when she was 6 years old and on her return denied it and was severely punished. According to Eve Black this was a prank to get Eve White into trouble
  

During one of the interviews, Eve White who was normally very self-controlled became distressed and asked whether hearing an occasional imaginary voice made her insane. She reported that she had on several occasions over the last few months briefly heard a voice addressing her. During this conversation Eve White, as if in pain suddenly put both hands to her head. After a tense moment of silence her hands dropped, and the therapist observed a quick, reckless smile and in a bright voice she said: Hi there, Doc! To the therapist it seemed that the usually conventional and retiring Eve White had changed into a carefree person. She also seemed to have a very different physical presence in terms of manner, gestures, and eye movements. When asked her name she immediately replied that she was Eve Black.

Interviews with the patient continued for over 14 months and totalled approximately 100 hours

• The therapists found that although Eve Black could sometimes pop out unexpectedly, the therapists could only call her out when Eve White was under hypnosis.
  
• Similarly, after a few hypnotic sessions the therapists could request Eve Black to let them speak to Eve White.
  
• After more sessions they found that hypnosis was no longer needed for obtaining the changes.
  

• The major method of treatment seemed to be simply talking to one or other personality especially trying to encourage them to talk about childhood memories
  
• There is no reference to the use of medication
  

Thigpen and Cleckley were astonished to learn (from a distant relative) that Eve had been married before. Eve denied all knowledge. Eve Black eventually admitted that she was the bride: although there was no formal record of a marriage, she did live with a man during a period when she was largely in control.

She had no wish for sex, but often enjoyed denying her husband his conjugal rights. In turn, he beat her savagely but she avoided most of the pain by ‘going in’ and leaving Eve White to feel the blows. She was able to ‘pick out’ or erase certain items of memory of Eve White, including that of the beatings. This explains why Eve White did not remember.

After eight months of treatment Eve White seemed to be making progress. Her blackouts had ceased and she was working well at her job (as a telephone operator) and was reaching some acceptable solution to her marital problems.

However as the treatment progressed, Eve White’s headaches returned and so did the blackouts. Eve Black denied all responsibility and said that she also experienced lack of awareness during these blackouts.

Eve White’s general state of mind was deteriorating and confinement was considered. It became easier for the therapist to call up whichever personality he wanted to examine, and childhood experiences were investigated under hypnosis. During one such episode, Eve White was discussing a very early recollection of being scalded by water from a washbasin and sustaining a painful injury as she spoke, her eyes closed, her speech stopped, and her head dropped back on the chair she appeared to relax into a sleepy state.

After two minutes, her eyes opened, blankly staring about the room trying to orient herself. When her eyes finally met those of the therapist, slowly, with an unknown husky voice and immeasurable poise, she said, Who are you??

The therapists believed that another personality had emerged who called herself Jane. The other personality, they argued, was more responsible than Eve Black and more confident and interesting than Eve White.

• Having been able to work with the three personalities for several months the therapists concluded that if Jane could take possession of the personalities the patient would regain full health and find her way to a happy life.
  
• Jane had awareness of both Eves thoughts and behaviour but did not have complete access to their memories prior to her appearance.
  
• Jane had learnt to take over many of Eve White’s tasks at home and work to help Eve White and showed compassion to Eve White’s daughter. However, although the therapists could work with Jane to determine whether Eve Black had been lying, Jane had not found a way to displace Eve Black, or to communicate through her.
  
• It was decided the Jane was the person most likely to bring a solution to the troubled mind, and that her growing dominance over the other personalities to be an appropriate resolution.
  

• Thigpen and Cleckley argue that the three personalities had become split off from a once unified whole.
  
• According to the authors: What we mean by multiple personality begs the question of what we mean by personality. If Jane could have remained in full possession of that integrated human functioning called personality, Eve would probably have regained full health, adjusted satisfactorily and found her way to a happy life.
  

• Case studies are particularly useful in revealing the origins of abnormal behaviour. Through building up a long and detailed case history, case studies can be used as an aid to understanding and helping the client. Such research can also be called action research as the researchers involvement is consciously trying to change the person’s behaviour.
  
• A major strength of this case study was that it provides lots of data. It contained an in-depth picture producing rich qualitative data (e.g. the interviews and hypnosis) and also lots of quantitative data such as the results from the psychometric tests.
  
• Thigpen and Cleckley also involved Eve's relatives to help verify certain recollections, and to add information, and in this way throw light on the case. They also asked independent experts to give a variety of tests including an EEG test, psychometric tests and projective tests.
  

• Case studies only relate to one individual and we have to be careful generalising from the findings.
  
• We have no way of assessing how typical this individual is of other people with multiple personality and therefore we have to ask whether this study is unique to Eve or whether we can generalise it to other cases.
  
• If the study is retrospective (if the individual is asked to look back over his/her life) then memory may not be accurate and indeed, people may deliberately mislead the researcher. The data may therefore be unreliable.
  
• The close relationship between researcher and participant may introduce bias. For example, in this case study, the moment that Eve Black appears can be seen in a different way to that described by the therapist. For example as Eve crossed her legs the therapist noted from the corner of his awareness something distinctly attractive about them, and also this was the first time he had received such an impression. For the therapist this as a change in her personality, but more objectively it could be explained as a change in his perceptions of her.
  
• There are many ethical issues to consider in this study. Firstly it could be considered whether Eve White was treated more of a subject than a patient.
  
• The therapists also recognised the dilemma of deciding what their involvement should be in helping their patient when they noted that we have not judged ourselves as wise enough to make active decisions about how the drama should develop, when they note the moral problems with killing one or more of the personalities.
  

• It is possible that the therapists could have been conned by a successful actress. Thigpen and Cleckley did recognise this but asserted that the performance could not have continued for so long and so consistently.
  
• However, the diagnosis of MPD is very unreliable. For example, there are many more cases reported in the US than say the UK. This perhaps demonstrates that some psychiatrists are more likely to diagnose MPD than others. Interestingly, women are more likely to be diagnosed than men. An argument that is gaining popularity is that psychiatrists such as Thigpen and Cleckley are actually creating multiple personality by unwittingly leading their patients into believing that they have the condition.
  
• The case study of Eve was made into a movie, The Three Faces of Eve. The public did not hear anything else about the case until 1975 when Eve revealed that she had approximately 22 personalities some of which she experienced before and some after the therapy. She believed that fragmentation of her personality had been to protect herself from things she could not bear.
  
• In 1977 Christine Sizemore (Eve’s real name) with her cousin, wrote I’m Eve and revealed herself as the famous Eve in TV interviews