Tomorrow's World air's MPD section: www.bbc.co.uk/tw link to: http://www.newsweek.com/nw-srv/issue/04_99a/printed/us/st/sc0104_1.htm Unmasking Sybil A re-examination of the most famous psychiatric patient in history By Mark Miller and Barbara Kantrowitz The last day of Shirley Ardell Mason's remarkable life was peaceful. She was at home, in the two-story gray bungalow on Henry Clay Boulevard in Lexington, Ky., that had been her refuge for 25 years. Her breast cancer had spread quickly, but she didn't like doctors and hated hospitals even more. So her friend Roberta Guy arranged for nurses to provide round-the-clock care. On Feb. 26, 1998, Mason must have realized time was short; she asked for Guy, who lived just a 10-minute drive away. But by the time her friend pulled up, it was too late. Mason was dead. A few weeks earlier, Mason had finally divulged her extraordinary secret, confirming what Guy had long suspected: the 75-year-old former college art teacher was the world's most famous psychiatric patient-the real-life model for "Sybil," journalist Flora Rheta Schreiber's 1973 best seller about a woman so abused as a child that she developed 16 personalities, including women with English accents and two boys. The book was made into a 1976 TV movie starring Sally Field and was largely responsible for popularizing multiple-personality disorder-until then, a rare diagnosis. Now, a year after Mason's death, the case is once again in the spotlight with three documentaries and at least as many books in the works. Some people close to Schreiber (who died in 1988), Mason and the psychiatrist who treated her, Cornelia Wilbur, now question the authenticity of Mason's condition. Before the publication of "Sybil," there were only about 75 reported cases of MPD; in the 25 years since, there have been, by one expert's estimation, 40,000 diagnoses, almost all in North America. The book had the blessing of great timing: it hit the public consciousness in the ascending days of feminism, when people were also beginning to grow concerned about child abuse. A quarter century later, by the time Mason lay dying in her bungalow, many experts were disputing the validity of the multiple-personality diagnosis and blaming the book for spawning a bogus industry of therapists who specialize in hidden abuse. At the same time, psychiatric historians and researchers have now begun to try to sort out the facts of the case that started it all. Mason was raised in the small, conservative town of Dodge Center, Minn., the only child of Mattie and Walter Mason, a hardware-store clerk and carpenter; both were strictly observant Seventh-Day Adventists. When "Sybil" came out, dozens of the town's 2,000 residents recognized Mason. "Everything just fit-the description of her mother, of the town, of the old brick schoolhouse kitty-corner from her house," says Wendell Nelson, 58, an antiques dealer. Residents recall a somewhat withdrawn, slender girl with a talent for painting. Betty Borst Christensen, 76, grew up across the street from the Masons. "Shirley was very protected," Christensen recalls. "Her mother didn't let her do much." Mason's second-grade teacher, Frances Abbott, now 93, remembers that Mattie Mason would grab Shirley's hand "in a vise lock" when they crossed the street. "Shirley couldn't get free even if she tried. She was a timid little soul always under Mother's care." Unmasking Sybil: page 2 In the book, Sybil's mother subjects her to horrifying abuse; many people in Dodge Center say Mattie ("Hattie" in the book) was bizarre. "She had a witchlike laugh," recalls Christensen. "She didn't laugh much, but when she did, it was like a screech." Christensen remembers the mother walking around after dark, looking in the neighbors' windows. She apparently had once been diagnosed as schizophrenic. Still, no one claims any direct knowledge of the sexual and physical abuse described in the book. "There is strong evidence that [the worst abuse in the book] could not have happened," says Peter J. Swales, the historian who first identified Mason as Sybil. In 1941 Mason left for what is now called Minnesota State University at Mankato, 60 miles away. She seemed to be on the fast track, says Dan Houlihan, a psychology professor at the school who has studied the case, and she's featured prominently in yearbooks for her first two years. Then she apparently suffered some kind of breakdown and didn't graduate until 1949. She met Wilbur, the psychiatrist, in Omaha after another such collapse; in the early 1950s she moved to New York, where Wilbur then lived, and became her patient. Their therapeutic relationship lasted more than a decade. In the book, the story has a happy ending, with a dramatic breakthrough in 1965 that allows a fully integrated Sybil to emerge ready to begin an independent life. The real story is more complicated. According to Swales, the therapy ended in 1965 in part because Wilbur had decided to take a job outside New York. Mason did go on to hold several jobs, but she never strayed far from her former therapist. At that point, "Wilbur and Shirley virtually merge," Swales says. "She won't make a decision without Wilbur." Mason never married and had no children. There's no doubt that Mason had very serious emotional problems, but how true was her story? She once recanted her allegations of abuse in a letter to Wilbur in the 1950s during therapy in New York-although Wilbur believed the letter simply indicated her patient was in denial. She never recanted again; in fact, Mason told a psychiatrist friend just months before her death that "every word in the book is true." But even if Mason was abused, did she really split into 16 identities, which Wilbur claimed to be able to summon at will? Some researchers say that Mason probably wasn't a "multiple" before she met Wilbur. A psychiatrist who worked with the patient he will refer to only as Sybil says that she was a "brilliant hysteric," highly hypnotizable and extremely suggestible. The doctor, Herbert Spiegel, still in private practice in New York, believes Sybil adopted personalities "suggested" by Wilbur as part of the therapy, which depended upon hypnosis and heavy doses of sodium pentothal. Eager to be helpful, Mason read the psychiatric literature on MPD, including "The Three Faces of Eve." "She didn't start out a spontaneous multiple, but she took on the clinical characteristics of one through the interaction with her therapist," Spiegel says, adding, "It was nothing fraudulent. They really believed this." Skeptics argue that in the dance of psychoanalysis between patient and doctor a kind of mutual delusion, a folie à deux, can develop. The full truth may not be known until Wilbur's archives are opened in 2005. Unmasking Sybil: page 3 Whatever the course of the therapy, it does appear to have helped Mason. In 1973, thanks to profits from the book, in which all three women-author, psychiatrist, patient-shared, she moved to Lexington, where Wilbur had settled to teach at the University of Kentucky. Her home was near Wilbur's grander mansion. Sometime in 1990, Wilbur diagnosed Mason with breast cancer. Because of her fear of hospitals, she decided against treatment. The disease went into remission, but the next year Wilbur developed Parkinson's. Now Mason cared for her former therapist, moving in to do it. Guy worked for a nursing agency and was hired to help. Eventually all three became close, and Guy joined in crossword puzzles and the Scrabble games that Mason and Wilbur loved to play. From time to time, other people working in the house would notice the many copies of "Sybil" in the library and speculate that Mason was the patient. They quickly lost their jobs. After Wilbur died in 1992, leaving her former patient $25,000 and all "Sybil" royalties, Mason became even more reclusive. She had long since cut off contact with most of her old friends and her family. Guy took on her banking and shopping at a health-food store because Mason was a vegetarian. In her last few years, Guy says, Mason spent most of her time taking care of her cats, gardening and painting until arthritis made it too difficult to hold a brush. Despite painful memories of the repressive church in Minnesota, she remained devoted to her Seventh-Day Adventist faith. "She was happy," Guy says. In the summer of 1997, the cancer came back. Once again Mason declined medical treatment, telling Guy she had had "enough trauma in her life." She began giving away her books and paintings to friends and shredding her personal papers. She left most of the rest of her estate to a Seventh-Day Adventist TV minister. "She was not afraid of dying," Guy says. Psychiatrist Leah Dickstein, a friend of Wilbur's and Mason's, spoke with her near the end. "She said she was at a point where she had forgiven her mother. She let that anger go." Split Personalities or Suggested Poses? Shirley Mason was the real woman behind the famous book and TV movie "Sybil." Her alter egos: Sybil: The 'real' patient, Sybil was 'extremely suggestible' Victoria: Warm and cultured, claimed total recall Peggy Lou: Assertive and eager, but obstinate and quick to anger Peggy Ann: More tactful than Peggy Lou, also more fearful Mary: The most religious personality; a maternal homebody Marcia: A fiery painter and writer; British accent Vanessa: Attractive and dramatic, Vanessa scorned religion Mike: A proud, swarthy carpenter; wanted to 'give a girl a baby' Sid: Also a carpenter, but fair-skinned and less outspoken Nancy: Paranoid; obsessed with Armageddon and conspiracy Sybil Ann: Pale, timid and extremely lethargic; the defeated Sybil Ruthie: A toddler, the Ruthie personality was poorly developed Clara: Very religious; critical and resentful of Sybil Helen: Timid, afraid, but determined 'to be somebody' Marjorie Serene and quick to laugh, enjoyed parties and travel The Blonde: A nameless teen, fun-loving and carefree With Margaret Nelson in Dodge Center Newsweek, January 25, 1999 http://www.nybooks.com/nyrev/WWWarchdisplay.cgi?19970424060F Sybil-The Making of a Disease: An Interview with Dr. Herbert Spiegel MIKKEL BORCH-JACOBSEN April 24, 1997 Only seldom can we date the emergence of a psychiatric syndrome with such precision: Multiple Personality Disorder (or MPD, as it is known to psychiatrists) was born in 1973 with the publication of Flora Rheta Schreiber's book Sybil.1 Not that Sybil was the first book ever devoted to a case of multiple personality, far from it: Sybil belongs in fact to a well-established genre that includes, among others, Théodore Flournoy's From India to the Planet Mars (1899), Morton Prince's The Dissociation of Personality (1906), Corbett H. Thigpen andHervey Cleckley's The Three aces of Eve (1954)-not to mention Stevenson's Dr. Jekyll and Mr. Hyde (1886). But Schreiber's book was, as Ian Hacking points out,2 the first one that firmly tied multiple personality to child abuse, a notion that had gained widespread recognition in the 1960s and that was to become an essential feature of present-day Multiple Personality Disorder. As the psychiatrist Frank W. Putnam writes in his authoritative textbook on MPD: "It was not until the 1970s, that the first reports clearly connecting MPD to childhood trauma began to appear in single case histories. Among the first and best-known was the case of Sybil, treated by Cornelia Wilbur and dramatized by Schreiber."3 A journalist specializing in psychiatric issues and a regular contributor to Science Digest, Flora Rheta Schreiber described in her book the strange case of a young woman, "Sybil," who had developed no fewer than sixteen separate personalities in order to cope with severe physical and sexual abuse. In addition to having been exposed to her parents' love-making in classic Freudian style, Sybil had suffered bizarre and perverse sexual abuse at the hands of her mother, in a manner that is more reminiscent of Freud's earlier "seduction theory." The mother, for instance, would have her watch while she was masturbating other young children; she would force odd objects into Sybil's vagina, or again, hang her in the air, insert an enema tip into her urethra, and fill the bladder with ice-cold water. Sybil, the main personality, had no memory of all of this, but her other "personalities" did, and they dutifully informed Sybil's New York psychiatrist, Cornelia C. Wilbur, in the course of a treatment that relied on hypnosis, "abreaction"-the cathartic release of anxiety through reliving intense experiences-and the administration of heavy doses of countertransference. As a result of this unorthodox treatment, which Schreiber described generously as "the first psychoanalysis of a multiple personality,"4 Sybil's sixteen selves eventually fused, thus forming a seventeenth and cured self. "The New Sybil" was born, after hard psychoanalytic labor that took, according to Schreiber, eleven years and 2,354 office sessions.5 Although names and facts had to be disguised for the sake of confidentiality, Schreiber insisted that her book was based on empirical data, such as Dr. Wilbur's case notes and tape recordings of analytic sessions, Sybil's diaries and correspondence, and family and hospital records. This gothic tale of abuse was no fiction, as Dr. Wilbur warned in the book when Sybil compared herself to Dr. Jekyll and Mr. Hyde: "Dr. Wilbur slapped her hand in her fist. 'That's not a true story,' she said. 'It's pure fiction. You are not at all like Dr. Jekyll and Mr. Hyde. Stevenson wasn't a psychoanalyst. He created these two characters out of his literary imagination. As a writer he was concerned only with spinning a good yarn.'"6 The New York Times soon ranked Sybil among the ten best-selling nonfiction books of the year, and the book was quickly turned into a Hollywood movie with Joanne Woodward, the former cinematic incarnation of The Three Faces of Eve, in the role of Cornelia Wilbur. Schreiber was deluged with letters from women thanking her for helping them understand that they were "multiples,"7 and it was not long before pioneering psychiatrists like Ralph B. Allison, George Greaves, and Eugene Bliss started finding cases of multiple personality among their patients. Within a few years of the distribution of Sybil, there appeared a number of best-selling biographies of multiple personalities clearly modeled on Schreiber's book: The Five of Me (1977), Tell Me Who I Am Before I Die (1978), Michelle Remembers (1980), The Minds of Billy Milligan (1981), to name only a few. As Frank W. Putnam writes: The case of Sybil...is the one most often credited with reintroducing the public and the mental health professions to the syndrome of multiple personality.... The book Sybil, with its graphic treatment of the amnesias, fugue episodes, child abuse, and conflicts among alters, served as a template against which other patients could be compared and understood.... Schreiber's account is both detailed and accurate enough to serve as mandatory clinical reading for students of MPD.8 Thanks to the efforts of Putnam, Bennett G. Braun, and Richard P. Kluft, the diagnosis of "Multiple Personality Disorder" was eventually included in the 1980 Diagnostic and Statistical Manual of Mental Disorders, Third Edition, the authoritative psychiatric diagnostic manual, known as DSM-III, and it soon became widely accepted, although in the DSM-IV (1994) the name has been changed to Dissociative Identity Disorder (DID).9 Among the results has been a general redefinition of psychotherapeutic practice in terms of "trauma" and "dissociative disorders" (and also bitter battles in court around cases of memories of sexual or satanic ritual abuse recovered during therapy). Some proponents of the new diagnosis have claimed in the press and on television that one to three percent of the general population is suffering from MPD.10 One may disagree with these estimates, but certainly not with the fact that we are faced with a major threat to mental health. What became of the three main characters of this success story? Flora Rheta Schreiber subsequently wrote a second best-selling book, this time on the Philadelphia cobbler Joseph Kallinger, a serial killer whose crime spree she claimed was the result of child abuse.11 She was unsuccessfully sued by the families of Kallinger's victims12 and died shortly thereafter. After the end of Sybil's treatment, Cornelia C. Wilbur moved on to a medical position in psychiatry at the University of Kentucky, Lexington, where she conducted research on multiple personality, dissociation, and altered states of consciousness with Arnold Ludwig and others. She died in 1992, after a career as a cult figure within the MPD movement. As to the elusive Sybil, all efforts to crack the wall of secrecy that surrounds her have been in vain so far. Some say that she holds an academic position in an art school, others that she owns an art gallery somewhere in the Midwest. In 1987, in response to an inquiry from a reader, the Boston Globe reported that Dr. Wilbur "confirms that Sybil is indeed alive."13 With Schreiber and Wilbur now gone, very few people are left who seem to know her true identity. One of them is Herbert Spiegel, M.D., coauthor with Abram Kardiner of an important book on traumatic war neuroses14 and a recognized specialist in hypnosis. Although bound by medical confidentiality, Dr. Spiegel was willing to discuss with me his memories of Sybil, whom he knew well at the time when she was in treatment with Cornelia Wilbur. What follows is a transcript of the interview I had with him in his New York City office in May 1995. MIKKEL BORCH-JACOBSEN: How did you meet Cornelia Wilbur? HERBERT SPIEGEL: I didn't know her very well. I had seen her at meetings at the American Academy of Psychoanalysis, and she knew that I had done a lot of work with hypnosis. I got a phone call from her one day, telling me that she had a patient that she had been treating as schizophrenic and she had a peculiar feeling that this was not schizophrenia at all. She asked me if I could examine the patient and help her clarify the diagnosis. MBJ: That was Sybil? NOTES: 1 Flora Rheta Schreiber, Sybil (Regnery, 1973). (back) 2 Ian Hacking, "Multiple Personality Disorder and Its Hosts," History of the Human Sciences 5 (1992), No. 2, p. 8. (back) 3 Frank W. Putnam, Diagnosis and Treatment of Multiple Personality Disorder (Guilford Press, 1989), p. 47. (back) 4 Flora Rheta Schreiber, Sybil, second edition (Warner Books, 1974), p. 13. Schreiber forgets Anna O., the arch-patient of psychoanalysis, who was a clear case of dual personality. See Mikkel Borch-Jacobsen, Remembering Anna O: A Century of Mystification(Routledge, 1996). (back) 5 Schreiber, Sybil, p. 15. (back) 6 Schreiber, Sybil, p. 115. (back) 7 Interview with Brett Kahr, director of the British Institute for Psycho-History and organizer of the Flora Rheta Schreiber Memorial, London, April 1993. 8 Putnam, Diagnosis and Treatment of Multiple Personality Disorder, p. 35. (back) 9 Myron Boor, "The Multiple Personality Epidemic:Additional Cases and Inferences Regarding Diagnosis, Etiology, Dynamics, and Treatment," Journal of Nervous and Mental Disease 170 (1982), pp. 302-304. (back) 10 Richard J. Loewenstein, in the French TVdocumentary by Ilan Flammer, "La mémoire abusée" (Arte, 1994). (back) 11 Flora Rheta Schreiber, The Shoemaker:The Anatomy of a Psychopath (Simon andSchuster, 1983). (back) 12 See "Kallinger Victims Lost Privacy Suit over Book," Philadelphia Inquirer, February 19, 1988, p. B7. (back) 13 "Ask The Globe," Boston Globe, August 13, 1987, Section:National/Foreign, p. 40. (back) 14 Abram Kardiner and Herbert Spiegel, War Stress and Neurotic Illness (Hoeber, 1947).