心理学与生活-第80章

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At　any　given　moment；　there　is　only　one　personality　interacting　with　the　environment。　

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Interestingly；　the　personality　that　presents　for　treatment　often　has　little…if　any…knowledge　of　the　
multiples…they　just　are　aware　that　something　is　a　little　unusual。　

Onset　of　dissociative　identity　disorder　is　usually　during　childhood；　but　may　not　be　diagnosed　
until　adulthood。　The　disorder　is　chronic；　and　the　degree　of　impairment　varies　from　mild　to　
severe。　In　nearly　all　cases；　the　disorder　is　preceded　by　abuse；　often　sexual　in　nature；　or　from　some　
other　form　of　severe　emotional　trauma　during　the　childhood　years。　The　disorder　is　seen　three　to　
nine　times　more　frequently　in　females　than　in　males。　

There　is　some　indication　that　the　incidence　in　first…degree　biological　relatives　of　dissociative　
identity　disorder　is　higher　than　that　in　the　general　population。　Interestingly；　a　child　is　often　the　
first　to　notice　the　presence　of　multiples　（e。g。；　“I　have　2　mommies；　but　it’s　okay　because　they　both　
love　me。”）　

This　dramatic　form　of　reaction　is　well　illustrated　by　the　widely　publicized　case　of　Eve　White。　Eve；　
25　years　old　and　separated　from　her　husband；　had　sought　therapy　because　of　severe；　blinding　
headaches；　frequently　followed　by　“blackouts。”　During　one　of　her　early　therapy　sessions；　Eve　
was　greatly　agitated。　She　reported　that　she　had　recently　been　hearing　voices。　Suddenly　she　put　
both　hands　to　her　temples；　then　looked　up　at　the　doctor　with　a　provocative　smile　and　introduced　
herself　as　“Eve　Black。”　

It　was　obvious　from　the　voice；　gestures；　and　mannerisms　of　this　second　Eve　that　she　was　a　
separate　personality。　She　was　fully　aware　of　Eve　White’s　doings；　but　Eve　White　was　unaware　of　
Eve　Black’s　existence。　Eve　White’s　“blackouts”　were　actually　the　periods　when　Eve　Black　was　in　
control；　and　the　“voices”　marked　unsuccessful　attempts　of　Eve　Black　to　“e　out。”　With　
extended　therapy；　it　became　evident　that　Eve　Black　had　existed　since　Eve　White’s　early　
childhood；　when　she　occasionally　took　over　and　indulged　in　forbidden　pleasures；　leaving　the　
other　Eve　to　face　the　consequences。　This　habit　had　persisted；　and　Eve　White　frequently　suffered　
Eve　Black’s　hangovers。　After　about　eight　months　of　therapy；　a　third　personality　appeared。　This　
one；　Jane；　was　more　mature；　capable；　and　forceful　than　the　retiring　Eve　White。　She　gradually　
came　to　be　in　control　most　of　the　time。　

As　the　therapist　probed　the　memories　of　the　two　Eves；　he　felt　sure　that　some　shocking　event　must　
have　hastened　the　development　of　these　distinct　alternate　personalities　in　the　disturbed　child。　In　
a　dramatic　moment；　the　climax　of　therapy；　the　missing　incident　became　known。　Jane　suddenly　
stiffened　and　in　a　terrified　voice　began　to　scream；　“Mother　…　Don’t　make　me　…　I　can’t　do　it！　I　
can’t！”　When　the　screams　subsided；　a　new　personality　took　over。　She　was　able　to　recall　the　
shocking　event　that　lay　at　the　bottom　of　the　personality　dissociation。　At　the　age　of　six；　Eve　White　
had　been　led　by　her　mother　to　her　grandmother’s　coffin　and　been　forced　to　place　a　goodbye　kiss　
on　the　dead　face　（Thigpen　&　Cleckley；　1954；　1957；　Thigpen；　1961）。　

“Eve”　has　since　revealed　herself　to　be　Chris　Sizemore；　a　Fairfax；　Virginia；　homemaker。　She　has　
manifested　twenty…one　different　personalities　over　the　past　two　decades。　As　new　personalities　
manifested；　they　did　so　in　sets　of　three；　each　very　different。　Eve’s/Chris’s　last　split　selves　“died”　
in　1974；　leaving　Chris　ready　to　make　it　on　her　own　（Sizemore　&　Pitillo；　1977）。　

The　appearance　of　additional　personalities　after　the　“cure”　of　re…experiencing　the　event　that　
supposedly　hastened　the　neurosis　calls　into　question　the　claim　of　a　cure。　Some　clinicians　believe　
that　all　cases　of　dissociative　personality　reflect　the　efforts　of　highly　suggestible　patients　to　please　
their　therapists。　To　develop　a　dissociative　personality　requires　imaginative　involvement　with　
fantasy；　and　such　imagination　is　a　good　predictor　of　hypnotic　suggestibility。　These　patients　are　
invariably　responsive　to　hypnotherapy。　The　concern　is　that　they　may　also　be　so　suggestible　as　to　
reconstruct　their　scripts　to　fit　what　they　believe　the　therapist　would　like　to　hear。　

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CHAPTER　15：　PSYCHOLOGICAL　DISORDERS　

Digging　for　the　Roots　of　Schizophrenia　

It　is　estimated　that　one　person　out　of　100　either　has　chronic　schizophrenia；　or　has　had　one　or　
more　acute　episodes　of　schizophrenia。　This　rate　of　incidence　seems　to　be　fairly　constant　from　
society　to　society　and；　it　is　believed　by　some；　to　have　persisted　over　centuries。　

Some　types　of　schizophrenia　provide　the　stereotype　that　people　associate　with　“insanity；”　
“madness；”　or　“lunacy。”　Untreated　schizophrenics　can　be　unrestrained　in　their　behavior；　
discarding　clothing；　attacking　others　for　no　apparent　reason；　urinating　and　defecating　in　
inappropriate　places；　and　masturbating　in　the　presence　of　others。　They　may　hear　voices　and　have　
delusions　of　grandeur　and　persecution。　They　may　maintain　a　bizarre　posture　for　hours　or　days。　
They　may　speak　in　a　language　that　cannot　be　understood　（clang　associations　or　“word…salad”）；　or　
withdraw　so　pletely　that　they　go　for　long　periods　without　speaking。　Their　emotional　
responses　can　be　grossly　inappropriate：　laughing　at　death　and　tragedy；　and　crying　when　good　
fortune　occurs。　

The　cause　of　schizophrenia　is　not　known。　Scientists　may　be　getting　closer　to　an　answer；　but　if　the　
lesson　of　history　is　heeded；　they　will　be　cautious　before　claiming　that　the　culprit　has　been　
identified。　Others　have　thought　they　had　the　answer　to　the　riddle　of　schizophrenia　only　to　have　
their　explanations　disproved。　

The　first　evidence　of　efforts　to　treat　mental　illness；　probably　schizophrenia；　was　actually　an　
archaeological　find。　Archaeologists　found　skulls　with　holes　bored　into　them；　an　ancient　“remedy”　
for　a　variety　if　problems；　called　trephining；　had　been　performed　on　these　individuals。　We　do　not　
know　what　effect　this　treatment　was　supposed　to　have；　some　have　speculated　that　it　was　to　
relieve　pressure　or　to　allow　the　brain　to　cool　off。　

During　the　era　of　Greek　dominance　of　the　ancient　world；　physicians　looked　toward　biological　
causes　of　mental　disorders。　Hippocrates　suggested　that　disorders　resulted　from　an　imbalance　of　
body　fluids；　and　prescribed　rest　in　tranquil　surroundings　and　good　food。　This　was　an　
enlightened　view；　inasmuch　as　the　world　at　the　time　generally　favored　the　idea　of　demonic　
possession。　After　the　fall　of　the　Roman　Empire　and　the　onset　of　the　Dark　Ages；　the　idea　of　
demonic　possession　prevailed　as　the　explanation　for　schizophrenia　and　other　severe　mental　
disorders。　Treatment　was　aimed　at　making　the　schizophrenic’s　body　a　very　unfortable　place　
for　the　demon　to　live。　The　patient　was　fed　dreadful　concoctions；　chilled；　and　physically　abused　to　
encourage　the　demon　to　depart　the　premises。　

In　the　late　Middle　Ages　and　into　the　17th　century；　the　demonic　possession　explanation　evolved　
into　witchcraft　theory。　An　important　difference　between　these　views　is　that　in　demonic　
possession　the　demon　was　believed　to　move　in　uninvited。　In　witchcraft；　however；　the　demons　
were　supposedly　invited　in。　Thousands　of　mentally　ill　people；　probably　primarily　schizophrenics；　
were　tortured　and　killed　in　the　16th　and　17th　centuries。　The　idea　that　mental　disorders　
represented　punishment　by　God　or　deliberate　association　with　evil　persists　with　some　to　this　day。　

We　finally　experienced　a　breakthrough　in　the　treatment　of　schizophrenia　in　the　late　1950s。　It　was　
noted　that　a　drug　given　to　French　soldiers　in　the　Indochina　War　had　a　side　effect　of　calming　
severely　wounded　soldiers。　The　physician　who　noted　this　was　instrumental　in　having　the　drug　
tested　to　treat　schizophrenia。　It　worked；　dramatically　reducing　the　symptoms　of　schizophrenia　in　
the　majority　of；　but　not　all；　schizophrenics。　

The　search　for　the　cause　of　schizophrenia　now　focused　on　what　the　drug　does　to　reduce　
schizophrenic　symptoms。　In　1963；　a　Danish　scientist　linked　antipsychotic　drugs　with　the　

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neurotransmitter　dopamine。　The　original　form　of　the　dopamine　hypothesis　was　that　
schizophrenia；　or　at　least　one　form　of　it；　was　the　result　of　excessive　dopamine　activity　in　the　
brain。　It　was　soon　realized　that　this　hypothesis　is　an　oversimplification；　and　as　other　
neurotransmitters　became　involved；　the　hypotheses　became　more　plex。　

Other　explanations　have　been　suggested。　In　1977；　hemodialysis　was　reported　to　lead　to　dramatic　
improvement　in　a　significant　number　of　schizophrenics。　Studies　sponsored　by　the　National　
Institute　of　Mental　Health　（NIMH）　failed　to　support　the　idea　that　schizophrenia　is　related　to　
contaminated　blood。　It　has　also　been　suggested　that　viral　infection　plays　a　role　in　schizophrenia。　
Perhaps　the　cause　is　a　slow…acting　virus　that　takes　years　to　flare　into　an　active　infection　that　
produces　schizophrenic　symptoms。　

Fetal　brain　damage　during　the　first　trimester　of　pregnancy　has　been　suggested　as　a　factor　that　
predisposes　people　to　schizophrenia。　A　study　of　50　male　schizophrenics　showed　that　they　were　
much　more　likely　than　non…schizophrenics　to　have　minor　physical　abnormalities　that　presumably　
resulted　from　the　same　interruption　of　fetal　development　Additionally；　there　is　a　great　deal　of　
evidence　from　family　and　twin　studies　to　support　the　idea　of　a　genetic　ponent　in　
schizophrenia；　although　a　genetic　marker　has　not　been　identified。　

Research　on　psychosocial　causes　also　continues。　Many　mental　health　professionals　take　an　
interactionist　view；　the　position　that　schizophrenia　results　when　biological　vulnerability　is　
bined　with　adverse　environmental　circumstances。　Some　psychologists　have　pointed　to　
intrafamily　problems；　and　some　parents　have　been　labeled　“schizophrenogenic”　because　they　
presumably　increase　the　probability　of　schizophrenia　in　their　children。　Stress　has　also　been　
suggested　as　a　causal　factor　in　schizophrenia。　Research　has　led　scientists　to　the　conclusion　that　
schizophrenia　is　probably　not　a　single；　unitary　disorder；　but　that　there　are　schizophrenias；　which　
have　several　or　many　causes。　

Alien　Abductions　and　Out…of…Body　Experiences　

In　recent　years；　much　publicity　has　been　given　to　people　who　claim　that　they　were　abducted　by　
aliens　while　lying　in　their　beds；　sleeping。　Most　scientists　are　skeptical　of　such　claims；　and　many　
believe　that　these　experiences　may　reflect　some　type　of　REM　sleep　dissociative　experience。　Two　
other　well　publicized　types　of　dissociation　are　the　so…called　〃out　of　body〃　and　〃near　death〃　
experiences。　Most　people　claiming　to　have　had　these　experiences　appear　to　be　otherwise　rational　
individuals　who　would　make　believable　witnesses　in　any　courtroom　（if　they　were　discussing　
almost　any　other　topic　but　this　one）；　and　they　appear　to　be　truthful　in　their　belief　that　what　they　
experienced　was　real。　While　clearly　something　has　happened　to　them；　what　might　it　be？　
Although　it　is　remotely　possible　that　they　were　abducted　or　have　somehow　left　their　body；　the　
lack　of　any　substantial　confirming　evidence　has　left　scientists　doubtful　of　such　claims。　If　the