Core Studies| Individual Differences| Thigpen and Cleckley: Multiple Personality Disorder

Thigpen and Cleckley (1954): A Case of Multiple Personality

Multiple Personality Disorder (MPD) is a disorder when more than one personality exists in the same individual. Each personality is relatively stable and integrated. It is regarded as a neurosis meaning that it is an illness in which an individual remains in touch with reality  but suffers psychological problems relating to anxiety. The DSM-IV calls MPD a dissociative identity disorder (DID). So, not only is there more than one personality, but personalities can appear totally separate from and may be unaware of one another. Each personality will have different memories, perception and intellectual abilities. An example of this may be wearing glasses of different strengths. When each of the personalities are in control all of their characteristics are present all of the other personalities will effectively 'disappear'.  This is not to be confused with schizophrenia which is a mental disorder marked by some of the following symptoms; delusions, hallucinations, incoherent speech, inappropriate emotions. or lack of emotions. A person diagnosed with schizophrenia is considered by the medical  profession to be problems relating to reality which is a psychosis which is a mental illness in which an individual has difficulty relating to reality.

In our everyday lives our definition to what we class as abnormal changes and is affected by the culture we live in. So some phenomenon may challenge our view of life and so its regarded with scepticism. So things such as supernatural and religious experiences and visions  are ones commonly reported but do not fit into our current explanation of the world so such events are often marginalised and ignored.

A person considered to have MPD is seen as abnormal. This is because MPD challenges our view of people and receives considerable scepticism as a result. Thigpen and Cleckley suggested that their case study is evidence for the existence of this condition.

The Case Study

The Aim

The aim of the study was to provide an account of the case of an individual considered to have MPD. This account is based on the psychotherapeutic treatment of a 25 year old patient known as Eve White.

The Methodology

The method was the treatment of Eve which involved psychotherapeutic interviews and occasional hypnosis with Thigpen and Cleckley (T&C). Family members were also interviewed  to obtain background information. an to corroborate (prove) some of Eve's stories.

The Referral

Eve White was referred for therapy because of severe and blinding headaches which complaints of blackouts although her family were not aware of anything that would suggest a real loss of consciousness or a serious mental confusion. The patient appeared to have a number complex, but relatively unexceptional martial conflicts and personal frustrations. She showed amnesia for a recent trip and the therapists used hypnosis to restore that memory.

The Letter

The first sign of anything unusual was when a letter arrived for T&C some days after the hypnosis. It was written in confident hand and concerned her therapy but at the bottom of the page there was a childish postscript written in different handwriting. On the next visit Eve White denied sending the letter though she remembered having begun one which she had not finished.

The Appearance of Eve Black

During an interview Eve white became distressed and asked whether hearing an imaginary voice indicated that she was insane. Then she had reported that on several occasions heard a voice addressing her. During the conversation Eve White (EW) suddenly put both hand to her head as if in pain and after a moment of silence her hands dropped and the therapist observed a 'quick, reckless smile'  In a bright voice she said ' Hi there, Doc !' The therapist observed a change in posture and personality from a distressed EW to a person who called themselves Eve Black (EB). It almost looked to the researchers as if Eve's whole personality and posture completely changed from the demure and retiring EW to a confident and relaxed person who was more playful and sexually attractive (more feminine and flirty- ‘cause let’s face it having a patient considered as sexually attractive would just be awkward that on the side note lets carry on with the case study!) EB ‘had a childishly more daredevil air and an erotically mischievous glance, a face marvellously free from habitual signs of care, seriousness and underlying stress.’  They also commented on the fact that EB language totally changed and became in the eyes of the therapists a completely different woman. She was referring to EW as she or her as if she was another person. When she was asked for

her own name she replied saying ‘Oh, I’m Eve Black’

On-going presence of Eve Black and her presence During Childhood Years (possible emergence of MPD)

Over 14 months of the on-going therapy for MPD, Thigpen and Cleckley continued with interviews; that lasted of a 100 hours in total and explored the behaviours of EW and EB. Although sometimes EB would appear out of nowhere she could be accessed by the therapists when EW was under hypnosis. EB had been present in some childhood experiences, when she was consequently she was not aware of this at all. EB was often the presence of mischievous events which as a consequence led to EW being punished. For example EW has one childhood experience where she was punished for going into the woods nearby her house despite denying that she had been there. During the therapy treatment EB admitted to being in the woods but  ‘went back inside’ in time for EW to get punished  and some of these incidents, revealed during the therapy were later substantiated in the interviews with her husband and family.

Eve Blacks personality and relationship to the husband and daughter

EB was irresponsible and shallow, looking for pleasure and excitement and concealed identity from EW and husband and daughter. EB also denied marriage to EW husband which she despised and denied any relationship to EW daughter. EW was beaten by husband after shopping habits which plunged the family into debt. She denied knowledge of the purchases, even when they were found in her house. EB confirmed that she had indeed brought and hidden the clothes and was unmoved by the impact this had on the relationship between EW and her husband. Some differences in normal behaviour such as random aggressiveness were recorded by family members and husband.

Personality Testing

Both EW and EB were given personality testing …

Test	EW	EB
IQ	110	104
Memory Function Test	Far Superior
Rorscach Test (ink blot)	Repressive (anxious,  obsessive-compulsive traits, rigidity, inability to deal with hostility)	Regressive (much healthier but with a hysterical tendency)

Negotiating Time out

The goal at the end of the therapy was to leave Eve with only one personality, however this was a proven task as EB could not be hypnotised, had no sympathy for EW and didn’t cooperate with the therapists. It was found that EB admitted to be the cause of the headaches and the imaginary voices plus erasing some of EW memory. As EW became more aware of the presence of EB she was able to prevent her ‘coming out’ on occasions, so negotiation was necessary for EB to get more time out, which allowed EW to gain more control over EB and began to excel in work and also left her husband.  In effect of this all the headaches and blackouts disappeared and everything seemed to be on track.

The Emergence of Jane

After 8 months EW headaches started to reoccur, she experienced more blackouts. EB denied responsibility, generally EW seemed disorientated and confinement was considered.  Therapists could more easily call out the personalities wanted to be studied at a given time and childhood experiences were investigated under hypnosis. During an one episode EW appeared to relax into a sleepy state then after a while her eyes opened and she stared blankly around the room, with a changed mannerism she ask the therapist in a husky voice ‘Who are you?’ it appeared that a third perosonality who called them seleves jane emerged. Jane was fully aware of both of the other persnaloties but neither of them were aware of her. Jane seemed more responsible than EB and was more interesting than EW.

Testing the tree Personalities and the differences between them

The three perosonalities underwent electroencephalograms (EEG’s) and they were clearly diffrenent readings. EW and Jane showed 11 cycles per second whilst EB showed 12.5 cycles per second,

The differences in perosonalities will be shown in a table below.

Eve White	Eve Black	Jane
-         Stressed , denial of occurrences that ended up in a punishment -         Demure and retired	-         No sympathy for EW -         Denied responsibility of blackouts at one point -         Denied marriage to EW husband and relationships to EW daughter -         Carried herself in a better mannered became more attractive, flirty and calm. -         Allowed EW rot take responsibility for her wrong doings.	-         Fully aware of the other two personalities -         Most reasonable out of the other two personalities

‘Killing off’ the personalities

Therapy continued of  all three of the personalities. Jane was aware of both personalities and had some control over EW and began taking over the tasks. But she couldn’t displace EB but could determine when she was lying. Therapists believed that Jane was the personality most likely to bring a solution to the troubled mind and her growing dominance over the other personalities appeared to be the appropriate solution. Thigpen and Cleckley do point out that ‘we have not judged ourselves as wise enough to make more active decisions’ about how drama would develop, and they note problems with ‘killing’ one or more of the personalities.

Conclusions

Thigpen and Cleckley offer no explanations, other than simply their explanation and a request for further research into MPD.

Evaluation

What were the strengths of T&C method?	-         Psychometric testing used by T&C allowed for an easy comparison between the diffrenent personalities -         Filming their interviews and hypnosis allowed for a lot of ricj and detailed analysis to occur
What were the weaknesses of T&C method?	-         Only one person considered to have MPD was studied. -         Hypnosis could have caused severe psychological damage such as retrieving information that was considered as a bad memory etc that the participant did not want to revisit.
How representative was the sample in T&C study?	-         Only one person being studied is not reflective to the rest of the population however only a small percentage of the population suffer with MPD which could be considered as a representative sample from that point of view
What type of data was collected?	-         Both qualitative and quantitative data was collected. Qualitative data was recorded by the comments made during interviews and qualitative data was recorded during the IQ tests .
How useful was the research?	-         Hypnosis could be seen as an appropriate way of treating MPD and also T&C method could be a development point for the training of therapists.

Individual Differences Approach| Section C

Individual Differences Section C

The Assumptions

The main assumption of the individual differences approach is that to understand the complexity of human behaviour and experiences, to do this it is necessary to study the differences between people rather than those things that we have in common. For example we may identify different personality traits by using IQ tests which allows us to see the similar characteristics, however despite this we all have a set of unique life experiences which shape us into the people that we are.

Explinations for everyday problems using the Individual Differences Approach 

How does the individual differences approach explain abnormality?

The individual differences approach would suggest that that abnormality could be due to our life experiences that shape us into the people we are, for example being classified as being insane or mentally ill would attach a label of abnormality to a person alienating them from the rest of the society. Rosenhan suggested that a person would be classed as abnormal due to the labels attached to having a mental illness. For example in his study even though all of the researches acted normal upon admittance to the psychiatric hospitals they were still deemed as insane and had to remain institutionalised between 11 to 52 days.

How does the individual differences approach explain an addiction to gambling?

The individual differences approach would suggest that addiction to gambling is caused due to the differences between individuals rather than the commonalities between individuals. For example people who gamble are only a small minority of the rest of the society which make us different. Griffiths would suggest that gambling addition is due to the personalisation of the machine that the gamblers use. For example if the gamblers were to lose they were more likely to blame the situation on not concentrating or if they were to lose they would feel like the machine is rewarding them for the hard work which is what makes gambling addictive.

How does the individual differences approach explain multiple personality disorder?

The individual differences approach states that it is our life experiences that shapes us who we are therefor multiple personality disorder is a product of our life experiences, such as being punished for something as a child. Thigpen and Cleckley suggested that multiple personality disorder patients have created different personalities as a coping mechanism when being punished. For example eve white from their case study would be the personality that got punished when Eve Black did something naughty such as going into the forbidden woods as a way of avoiding being punished.

 Similarities and differences between the studies in the individual differences approach

Similarities and differences between Thigpen and Cleckley’s case of multiple personality disorder and Rosenhan’s sane in insane places:

One similarity would be that both Rosenhan and Thigpen and Cleckley have ethical issues. Rosenhan’s patients had to follow the hospitals procedures such as taking medicine whilst they were institutionalised which could have made them believe that they were insane and could have potentially put them in harmful situations. Thigpen and cleckley used hypnosis as one of taw ways of interviewing a personality which could have potentially brought back experiences and memories that Eve did not want to remember which puts the participants in harm. Another similarity is that both Thigpen and Cleckley dealt with psychiatric problems. Thigpen and cleckley studied the issue of multiple personality disorder, where as Rosenhan studied the labelling of people suffering with schizophrenia in psychiatric hospitals.

A difference between Thigpen and Cleckley and Rosenhan is the experimental method they used. Rosenhan did a participant observation where the researchers being the participant recorder how they were treated in psychiatric hospitals when they were acting sane, whereas Thigpen and Cleckley did an in-depth case study on one individual.

Similarities and differences between Rosenhan on being sane in insane places and Griffiths on gambling behaviour on fruit machines

One similarity between Rosenhan and Griffiths is that both studies were high in ecological validity. Rosenhan’s study was high in ecological validity as pseudo patients were observing behaviour in real psychiatric hospitals in California and were looking at an issue that is relevant in how institutions were run. Griffiths studied the behaviour of real gamblers in a real everyday arcade setting. Another similarity is both studies collected quantitative and qualitative data. Rosenhan collected quantitative data by how many psychiatrists and nurses thought that real patients were pseudo patients admitted to their hospitals and quantitative data that was collected by researchers of the behaviours and comments made by nurses and staff in their hospitals where as Griffiths collected quantitative data from total plays, total time , play rate, end stake wins the win rate in time and win rate in plays by each individual in normal condition and the qualitative comments made by the participants in the thinking aloud condition.

A differences between Rosenhan and Griffiths is that Rosenhan dealt with something that is already classed as a psychiatric problem such as the labels given to a person that was insane but is back to being sane in the case of schizophrenia and Griffiths deals with addiction which is something that could potentially become a psychiatric problem in the future.

Similarities and differences between Griffiths on gambling behaviour on fruit machines and Thigpen and Cleckley on multiple personality disorder

One similarity between Griffiths and Thigpen and Cleckley is that both studies collected both quantitative and qualitative data. Griffiths collected quantitative data from total plays, total time , play rate, end stake wins the win rate in time and win rate in plays by each individual in normal condition and the qualitative comments made by the participants in the thinking aloud condition. And Thigpen and Cleckley collected quantitative data by carrying out IQ tests on each of the personalities studied and qualitative data by the comments made under hypnosis therapy. Another similarity is that both studies looked at natural phenomenon. Griffiths looked at gambling behaviour and Thigpen and Cleckley studied a person suffering with multiple personality disorder.

One difference between Griffiths and Thigpen and Cleckley is that both used a different experimental method. Thigpen and Cleckley used a case study method where one patient is studied in detail over a long period of time whereas Griffiths used a field experiment where he controlled variables in a natural setting which in this case was the arcade. Another difference between Thigpen and Cleckley and Griffiths is that Thigpen and Cleckley studied something that is a psychiatric problem which is multiple personality disorder whereas Griffiths studied something that has a potential to be a psychiatric problem which is gambling.

Strengths and weaknesses of the individual differences approach

One strength of the individual differences approach is that it can provide useful information in improving the experience of people with mental health problems. This is a strength because it can lead to a revision of the way that people are diagnosed and treated. For example in Griffiths study the information collected from the study could guide us in what causes gamblers to become addicted and how to stop this process from happening in the first place. Another strength is that the individual differences approach has been the development for using psychiatric tests to measure the differences between individuals in the qualities such as personality and intelligence. This is a strength because psychometric tests provide a reliable and quantitative data which can be easily analysed and therefore similarities and differences between individuals can be discovered. For example in Thigpen and Cleckley’s study  they showed us  how the different personalities of eve white  had different IQ levels which allowed us to see a significant differences between these personalities. One weakness of the individual differences approach is that it can rely too heavily on dispositional explanations at the expense of situational explanations. This is a problem because behaviour can therefore can therefore be attributed solely  to a person’s own characteristics or disposition to external factors such as the situation a person is in are ignored.  For example  in Thigpen and Cleckley’s study they claimed that the 3 faces of eve were significantly different however to an insignificant witness the video evidence 100 hours  often makes the differences of personalities easy to identify however they may not be that easy to identify in a different environment in real life. Another weakness with the individual differences approach is the ethical approach is the ethical issues raised with labelling people as being different. This is a weakness because labelling people as different or abnormal can have negative effect on individuals. For example in Rosenhan’s study those pseudo participants who stayed in the psychiatric hospitals for 52 days could have ended up believing their labels and believe that they actually suffered with the psychosis.