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The American Journal of Forensic Psychiatry, Vol. 111, No. 4, 1982-83, pg. 181-192 THE MULTIPLE PERSONALITY DEFENDANT IN COURT Ralph B. Allison, M.D. Ralph B. Allison, M.D. has continued the excellent work done in the field of exploring multiple personalities. From my point of view as a forensic psychiatrist, multiple personality theory permits the therapist to apply a "technique" with which to "legitimize" response, - an exploratory probe to allow the patient to use himself as a participant observer and calmly talk about another self that has committed acts considered inappropriate by society. The "multiple personality subject can be opened up, calmed and encouraged to talk more easily about himself (rather than made to feel shame and guilt, - which would distort the interview results). Acceptance of the existence of a second, third... personality momentarily affords the patient a way of shifting responsibility to another self or selves and hence legitimizing otherwise intolerable acts. Treating in another manner a psychiatrist might fail completely to evoke meaningful responses from a forensic patient. There would seem to be many more areas of 'multiple personality' theory still to be explored. In my mind, there is little question, however, that Dr. Allison holds many of the important keys to this important storehouse of information. Leonard R. Friedman, M.D., J D. Boston, Massachusetts ABSTRACT When a forensic psychiatrist determines that a defendant may have multiple personalities, a complex diagnostic workup faces both the psychiatrist and the defense attorney. A case report is presented in which the defendant was found guilty and sane under the ALI rule, in a case of assault and robbery, even after all three of his personalities testified in court. Recommendations are given regarding proper workup, recording of interviews, use of historical data, use of sodium amobarbital or hypnotic interviews and pleading mental incompetency to stand trial As the result of heightened interest in dissociative states, hypnosis, and altered states of consciousness during the last several decades, forensic psychiatrists have had to develop better ways of dealing with defendants who claim amnesia for their offenses. With the adoption of the American Law Institute (ALI) definition of legal insanity in many jurisdictions, a clause has been added under which acts performed in a dissociated state can now be included. The "second leg" of the ALI Rule adds the inability to conform one's conduct to the requirements of the law to the McNaghten Rule definition of insanity. The questions now facing the forensic psychiatrist are: 1. Did the defendant perform the illegal act in mind state A (his usual waking state), or mind state B (an altered state of consciousness but not sleep)? 2. If in B, what is the relationship between the self (or personality) in mind state A and the self in mind state B? 3. Is there an amnesic barrier between mind states A and B? If so, is the barrier total in both directions or is there one-way amnesia only? (is A unaware of B's activity, but B aware of A's activity?) 4. What degree of control, if any, can the self, in mind state A, exert over the actions of the self in mind state B, and vice versa? 5. What are the stimuli which bring a the change from mind state A and B to A? Are strong emotions adequate, sedative drugs or alcohol also required? All these questions must be explored in evaluation of a defendant who has exhibited dissociative behavior during criminal activity. The most extreme and dramatic examples of changing mind states is the condition known as multiple personality. In forensic psychiatry, this condition occupies a very unstable and uncertain status in relationship to the insanity plea(l). Many psychiatrists have a hard believing this condition exists in their patients and, therefore, they find it even harder to believe it could be the correct diagnosis in a criminal defendant where much secondary gain is involved. Coons has written an excellent paper on the differential diagnosis of this condition(2), and anyone faced with this question should study his paper carefully A recent paper published in The American Journal of Forensic Psychiatry (3) presents guidelines for establishing the diagnosis in criminal defendants. In that paper many questions were raised, but left unanswered, about what one does in regard to attorneys and court procedures if multiple personality is believed to exist in a defendant. This paper is meant to try to answer some of those questions. INFAMOUS CASES Whereas the psychiatric and popular literature on multiple personality has featured women such as Miss Beauchamp(4), Eve (5-7) and Sybil (8), the legal cases have usually involved men. William S. Milligan of Columbus, Ohio, manifested 10 personalities and was charged with rape performed by the female Lesbian one of them (9). He was found not guilty by reason of insanity and is now hospitalized in Dayton, Ohio. Kenneth Bianchi, who manifested two alter-personalities (one a lust murderer and the other an adolescent psychologist) pleaded to two murders in Bellingham, Washington, and five murders in Los Angeles, California. He is now doing prison time in Los Angeles(10). Paul Miskimen was found not guilty by reason of insanity for the murder of his wife in Sacramento, California(l1). All psychiatrists involved in that case agreed that the murder was committed by his alter-personality while in a co-conscious state, and that Paul had no capacity to stop the killing. This is the first case known where the act of an after-personality led to a successful insanity defense in the case of murder. (He is currently in Napa State Hospital.) Esther Minor is the sole female defendant to be reported in the literature(12). She was found not guilty of forgery in a San Bernardino, California court because her alter-personality, Raynell Potts, admitted writing the bad checks. The insanity issue was not an issue in this case. In 1977, five of my own cases were briefly reported in a newsletter(13). Since that publication is not generally available now, the case summaries are repeated here. " 1) Nineteen-year old man, arrested for arson, found guilty and sent to prison. On release, he and his family filed a civil law suit in which he tried to prove incompetency to file earlier. He showed an alter-personality that set fires and had periods of amnesia. The Judge concluded that he was competent after my testimony. Later he killed two people and is on death row with first and second degree convictions. Multiplicity was never raised an issue In these trials. For further details, see chapter 7, Minds in Many Pieces (14). "2. Thirty-three year old woman had been convicted previously of felony bad checks. Alter-personalities became apparent in treatment, while on probation. So she could offer input in probation planning, I arranged a conference with the judge, the patient and me, during which a helper personality came out and discussed the situation. At a court date later, when an attorney disputed the diagnosis as unproven, the Judge could say, "I saw it. I believe it. The question is settled." (For her view, see her autobiography (15).) "3) Fifty-year old man robbed a bank here and in Reno. A psychiatrist in Reno recognized multiplicity, treated him for one year, fused him and returned to Federal Court. At trial, videotapes of the personalities were shown. Verdict was not guilty by reason of insanity. He returned here for trial and Judge found him not guilty by reason of insanity. "4) Forty-two year old man I treated to fusion. Before fusion, his bad personality had been arrested for drunk driving and refusal to take alcohol test. In trial after fusion, I age regressed him six months and brought out two pleasant alter-personalities who told about the bad one. The Judge was convinced and found him not guilty because of no physical proof of intoxication. The man still lost his license since he didn't want to fight it out in court near home. (see his autobiography (16). "5) Forty-one year old man with 20-year history of writing bad checks was charged with embezzlement of $17,500 from employer. In treatment elsewhere, therapist found an alter-personality who took the money. When I saw him in consultation, I got rid of the bad one and we later went to trial. Testimony before jury was all verbal. Even though he had paid all the money back, he was found guilty. His attorney felt the jury was not convinced that he had been multiple, in spite of a very convincing history of repeated blackouts with stupid illegal behavior. CASE REPORT This previously unreported case is presented to illustrate, in some detail, the problems and pitfalls that can occur in presenting a defendant with multiple personalities to a court of law in a non-capital felony case. This case was complicated by the fact that I had to play two roles with the defendant. My position included treating any prisoners in jail needing psychiatric help, of which he was one. Since I was the only psychiatrist with good rapport with him, I was court appointed to assist his defense attorney in preparing the defense. Another important factor was that the defense attorney was new to law practice and this was his first insanity case. Anthony J. was a 20-year old single black man who was first seen by me in the local county jail during the weekly psychiatric sick call. He was suicidally depressed and terribly perplexed over how he had gotten into so much trouble. Originally from New England, he had been in much legal trouble there, ever since he had been taken from the custody of his mother, a prostitute, and placed with a white family. During his first county jail incarceration at age 18, he had tried to kill himself and was hospitalized in a psychiatric ward for several weeks. Once he was jailed in New York City under the name of John Grace. He had total amnesia for that arrest and booking and had been told he was quite hostile and uncooperative during the booking procedure. Finally, he was sent by the Court to a residential treatment center in Maine, from which he ran away, hitchhiking to California. He found his way to a central valley city where he worked at various jobs. He had amnesia for most of his trip to California, as well as for many blocks of time back East. After a year in California, he agreed to drive a friend to southern California. Both were high on LSD. His car down on the freeway and they hailed a passing motorist. They tried to get a ride into town, but the motorist, noting their drugged states, refused. Anthony then grabbed the car keys from the motorist. The motorist snatched his key back, drove to the next town and reported the incident. Police arrested Anthony and his friend on charges of forcible theft of the car keys. Anthony took full responsibility for the crime, even though he had blacked out when the motorist refused to give him the keys. He was sentenced to 5 years in state prison. While awaiting sentencing, his auto license number was run through the police computer. Thus it was discovered he was wanted in our county, which neighbors his county of residence. The charge was theft and assault involving the wife of the assistant county health officer. His car had been parked outside the victim's home when the incident occurred, and neighbors had reported the license number to the police. Our detective visited him in jail, where he gave a full confession of the crime, which was tape-recorded. After being sentenced to prison, he was transferred to our county jail to face these charges, and it was then I first met him. A few days later at his arraignment, while listening to the district attorney describe his criminal deeds, he felt he would be locked away for life. He blacked out and, the next thing he knew, he found himself running out of the river on the other side of town facing the drawn guns of several deputies. He had tricked a deputy at the courthouse into letting him get to an unlocked door and then he took off running, trying to look like one of the local joggers. I had already left word at the public defender's office that Anthony had serious problems but gave them no details. Since the public defender had witnessed the escape from the courtroom, another attorney was appointed to defend Anthony. I was appointed to be the psychiatric consultant to the attorney. For the next 5 months we tried to unravel the mysteries and prepare ourselves for trial. Since there was no doubt about his escaping from court, I used that incident to determine if an alter-personality existed. I asked him to recreate his feelings as he sat in the courtroom that day. As he did this, I asked him to let whatever took control of his body then, take control now. After a few minutes of facial twitching, his eyes opened, and he greeted me as if he had never seen me before, using very crude street language. He identified himself as John Grace and claimed to know nothing about any Anthony. He admitted to planning and executing the escape. At first he denied responsibility for the assault and robbery, but in a subsequent interview he admitted to that offense. He and his girlfriend had been going door to door pretending to raise money for a fictitious black charity. What they were really trying to do was to find the most racially prejudiced person on the block. The doctor's wife's comments seemed to him just like the welfare worker who had taken him away from his mother. This was enough for him to push his way into her house, knock her down and take her wedding rings from her. The assault was meant as a degradation of her as a representative of all the white people who had put him down when he was living back East. I tried to persuade the defendant's attorney to plead him incompetent to stand trial, so he could be sent to a state hospital for treatment. Anthony had amnesia for the criminal acts, was quite depressed, and John told the truth only when it pleased him. He denied confessing to the detective while in the other jail. The attorney disagreed with me, saying, "I get along with him fine. I can get all the history I need. He can change personalities in my office with me alone, and I can't see why he can't stand trial." I later learned that what had happened was that the attorney had met a third personality, Alexander, a rescuer. He supplied the attorney with all the information Anthony and John did not have. Alexander had given the confession in his attempt to get the matter straightened out. I was usually talking with John or Anthony, and the attorney usually conferred with Alexander. During the five months prior to trial, Anthony came to know and accept the other two personalities. His memory of many of the past events improved as I fed back to him what I learned and as he felt less frightened to know the truth. We made videotapes while the different personalities were out. Anthony was taught how to talk to John in internal dialog method (17). Records were secured regarding his schooling, medical and psychiatric treatment and his behavior in the therapeutic center in Maine. This data was shared with both Anthony and John. Frequently, there were reports of him arguing and fighting with teachers. Anthony denied ever fighting with teachers, but admitted to blackouts after a mild argument. John readily admitted to taking over at that point and engaging in fisticuffs which led to Anthony being punished, but not knowing why. In contrast, Anthony remembered the psychiatrist who treated him after his suicide attempt in jail, but John had no memory of having talked to that particular psychiatrist at all. On the other hand, Anthony was very unclear as to the reason for his suicide attempt, while John very clearly reported that it was a time during which he felt completely rejected by his family because none of them would bail him out of jail. Anthony completed the California Psychological Inventory (CPI), which was computer-interpreted by Behaviordyne, Inc. Their program is unique, in that the CPI, which has many questions in common with the Minnesota Multiphasic Personality Inventory (MMPI), reports MMPI scales as well as CPI scales from the CPI answer sheet. It showed a hysteria score of 66.5 (normal=48-52). In my experience, all those patients who scored higher than 55 eventually proved to have multiple personalities. The readout indicated that "he has built his way of life around the defense mechanism of dissociation, repression, denial and conversion... By focusing on one bodily sensation or another, he gives himself conversion symptoms ... He may also have dissociative reactions, spells of mood or behavior differing from his usual self. . . He is hysterical in character... he makes himself unaware of those impulses of his that would distress him if he were aware of them. He is naively unaware of his sexual, hostile, and dependent motives even while he's putting them into action." Diagnoses in order of preference were: "295.3 Psychosis, schizophrenia, paranoid type, with dissociating (hysterical) features. 300.1 Psychoneurosis, hysteria, conversion reaction with pseudo-neurological symptoms such as pains. There is some possibility that dissociative reaction may also be present. 300.1 Psychoneurosis, hysteria, manifested by conversion reaction. anxiety reaction. or dissociative reaction, in a dissociating (hysterical personality.)" I was unable to get Anthony's cooperation in getting John to take the CPI. Because Anthony claimed his IQ had been found to very high in school, he was given the Slosson Intelligence Test with a resulting IQ of 90. No other tests were given mainly due to his reluctance to cooperate in any kind of formal testing procedure. In regard to the mention of conversion symptoms on the CPI, it should be noted that Anthony regularly reported for medical sick call with aches and pains, none of which had any organic causation. Since the defense attorney decided plead him not guilty and not guilty by reason of insanity, two court-appointed psychiatrists came to see him in jail. The defense attorney did not talk to them about the case or show them the videotapes. They just came to the jail, talked to the prisoner and wrote their reports. During both interviews, Anthony gave his history and then John broke in later, introduced himself and tried explain how he (John) was the tough guy while Anthony was a weakling and a sissy. One examiner accepted that Anthony had at least two personalities and was legally insane by the ALI rule. The other examiner wrote a report that was more of a diatribe against Anthony than a psychiatric report and basically recommended locking him up forever. He stated that Anthony was not at all typical of multiple personality patients he had know. (He had seen 2 cases 15 years before, both white middle-aged females.) At the time of the trial, the attorney waived a jury trial and only the Judge heard the case. Anthony took the stand testified that he didn't remember committing the crimes charged. Then, at his attorney's request, he closed his yes, and John Grace came out to testify how he committed the crimes, throwing snide, nasty comments at the Judge and district attorney along the way. Then John would give way to Alexander, who would calmly and patiently explain why John did the things he did and how John kept it all secret from Anthony. As expected, the Judge found him guilty on all counts. He also found him sane at the time of the offenses. The defense attorney believed the Judge felt that Anthony did not qualify under the second leg of the ALI rule, because he showed control of the ability to change personalities on the stand. The attorney believed the Judge felt that, if Anthony could control which personality was testifying, then he should have been able to control which personality was assaulting the doctor's wife. The fallacy of this line of reasoning was that we had spent 5 months teaching him that control, both for his safety in jail, where John Grace antagonized jailers and other prisoners alike, and so he could demonstrate his mental illness in court. What the Judge may have failed to realize was that, at the time of the offenses, Anthony did not know of the existence of the other two personalities, that they came out in response to certain emotions in Anthony, and that Anthony had no control over when they might come out. When Anthony was sent to prison, he was assigned to the psychiatric treatment center. The Director of Research was asked to look into his case and he assigned him an individual psychotherapist while he participated in one of the group treatment programs. John Grace continued to act out, mainly against white female supervisory personnel. Anthony did come to accept John's anger as his own and, after about a year in prison, came to believe that John and Alexander no longer existed. He has improved in his self respect and he now takes full responsibility for his actions. He now has the ability to set goals for himself, one being marriage and the other further education. DISCUSSION OF THE CASE This case illustrated pitfalls of having a multiple personality defendant testify prior to his fusion. To substantiate the diagnosis I had to use various confronting techniques which are used in initial phases of psychotherapy to enable any such patient to become aware of his alter-personalities. The attorney needed all the facts he could get from Alexander, the observing personality, and these facts were then relayed to Anthony, thus blurring self-imposed boundaries between them. In jail, Anthony frequently would black out when John came out to pick fights with certain deputies he disliked. Afterwards, Anthony would ask me to find out what had happened and why. So I would interview John and report my findings back to Anthony. All of this was designed to give Anthony more control over his angry behavior so as to preserve the health and safety of the deputies and the other prisoners. Yet this increased control, which came about gradually, worked against his legal interests in court. If the Judge had only had him testify when he was first incarcerated, he would have realized that Anthony was not able to control John at all. Anthony did not even consciously know John existed, but defense mechanisms of denial, dissociation and repression kept John's hostile energy high, and periodically John had to let off steam. When he did, someone got hurt. The failure of the defense to share with the two court-appointed psychiatrists all the data about his past school and psychiatric history, and the videotapes of Anthony switching personalities, definitely set the stage for a "battle of the experts." The dissenting psychiatrist in this case may not have agreed with my interpretations of the data but he would have had to explain his reasons under cross-examination. Fortunately, in this case, the adverse examiner showed such extreme bias against the defendant that neither the Judge nor the district attorney appeared to pay much attention to his opinions. The final item to be noted is that, since so few offenders who have this problem are likely to be found legally insane, some adequate treatment must be found in prison. This disorder does not disappear with the passage of time alone, and further criminal acting out can be guaranteed if the prisoner is not confronted with the psychological reality and aided in changing the psychodynamic forces within him. GUIDELINES FOR EVALUATION OF THE MULTIPLE PERSONALITY SUBJECT AND PREPARING THE DEFENDANT FOR COURT In the prior paper(3), I posed a number of questions which always arise when the diagnosis of multiple personality is, entertained by the defense attorney and any examining psychiatrist. I will try to deal with these questions here, drawing on experience with all such defendants I have examined. 1. THE WORKUP: As much psychological and neurological evaluation should be done as one would do for a private patient with the same history. Psychometric testing by a competent psychologist will add important facts and also will add another expert witness to buttress the defense, should he agree with the diagnosis. If it is possible to administer identical tests to contrasting personalities, this adds to the validity of the diagnosis. When a psychologist is not readily available, my preferred objective test is a CPI, through the Behaviordyne computer. The MMPI would work as well on that computer program since it is mainly the hysteria scale one would look at. The Rorschach test should be done and read according to Wagner's criteria for multiple personality(18). Wagner's criteria for interpreting the Rorschach test needs more validation, but so far it seems to be accurate in both sexes in the small number of multiple personality clients who have taken it. If the Rorschach is given to both the original personality and to the offending alter-personalities, there will be found to be major differences as well as major similarities. In the Bianchi case, the two sets of Rorschach test results were sent for blind interpretation to two different psychologists, each a renowned expert. In the first instance, the two protocols were sent with no mention that one man took them in two different states of mind, just with two separate names at the top of the page. They were read as having been done by two separate individuals, one quite mentally normal and one a violent sex sadist. The other expert was told that two protocols were done by one man at two different sittings. That expert reported that, whereas they looked superficially different, there were many subtle similarities which showed the same persona took both tests, but one time he was in an angry mood. There is no way I know of for an interpreter who gets two protocols for blind analysis to avoid getting one message or another. If two protocols are received with no explanation, one will assume two people took it. If the transmittal letter states one person took it, then that fact will be a part of the interpreter's bias. Fortunately, Wagner's method of interpreting the Rorschach of the primary personality avoids this problem. It would also be wise to get an electroencephalogram and CT scans of the brain on these defendants. If either is abnormal, then a neurological consultation should be secured to rule out temporal lobe or psychomotor seizures (now called complex partial seizures) (19) or a brain tumor. 2. RECORDING OF PSYCHIATRIC INTERVIEWS: As soon as anyone dealing with a client has a suspicion that a dissociative disorder may be involved in the criminal act, all diagnostic interviews should be audiotaped and videotape recorded. In a capital case, this should be an absolute rule. In cases of non-violent felonies, audio tapes may be sufficient if made with a lapel microphone so that each voice is clearly heard. The audiotapes must be transcribed, so that everyone can have access to the data. Each examiner should view all prior videotapes before seeing the defendant so s/he will know what has happened to the defendant as a result of prior examinations. Each examiner has a tremendous impact on these defendants, and the defendant is different after each interview. The next examiner needs to know what has happened to bring about this difference in the defendant. 3. HISTORICAL DATA COLLECTION: Records from schools, social service agencies, hospitals, doctors and mental health centers can be very valuable in bringing to light behavior which could either support or weaken a presumptive diagnosis of multiple personality. An ability to discuss details of events not connected with the offense would mitigate against the diagnosis. However, many patients with this disorder complain that they cannot remember many years of childhood. Asking them to explain more about what is reported in written records can show if there is amnesia for episodes where secondary gain is non-existent. Much collateral information out family dynamics may have been recorded and this would aid the examiner in understanding what kind of a life the defendant has really led. 4. SODIUM AMOBARBITAL OR HYPNOTIC INTERVIEWS: These methods can be used to discover what the defendant did at the time of the offense for which he claims amnesia. From the legal point of view, there is the right to privacy of one's unconscious mind, which hypnosis or sodium amobarbital would violate. in a case where the physical evidence is not strong enough to convict the defendant on its own merits, the defense attorney may advise leaving the situation as it stands to avoid the defendant being put in the position of testifying against himself. But if the evidence leaves little doubt that the defendant did the act charged, then the greater benefit will be from finding out how the defendant's mind worked at the time of the offense. If the uncovering interview is done by a psychiatrist secured by the defense attorney, then all information revealed is covered by the attorney-client confidentiality privilege and can be kept secret from the prosecution. This is not so in the case of a court -appointed examiner, who will be reporting to the court and to both attorneys. The court-appointed psychiatrist does not have the right to invade the patient's subconscious mind unless the defendant has voluntarily given up that right, with the agreement of his attorney. Usually a defendant is amnesic of whatever he said or did in a trance. The defendant should view the videotapes as soon as he is emotionally able to do so. Only then can a defendant become competent to stand trial, knowing what evidence he has provided during the trance state. Before going to trial, the defendant should get over the shock of seeing a nasty, foul-mouthed personality take over his body and admit committing the crimes which the defendant believes he would never do. 5. PLEADING MENTAL INCOMPETENCY TO STAND TRIAL: Amnesia for the offense alone is usually not sufficient grounds for being found incompetent to stand trial (20). So long as the defendant is otherwise able to behave appropriately in court, permanent amnesia would not preclude him going to trial. Temporary amnesia, especially of a histrionic type, as in a fugue state or multiple personality, would be grounds for postponing the trial until an attempt has been made to help the defendant regain memory of the events surrounding the offense. This should be done in a therapeutic environment. If a judicial finding of incompetency is needed to gain such a postponement, then that should be sought. However, there may be cases in which it would be to the defendant's legal disadvantage to regain memory of the offense. If there is inconclusive physical evidence that he was responsible for committing the illegal act, and only he could provide further clues to strengthen the case against him, then his lawyer may advise that he keep his amnesia intact and hope the prosecution will fail to prove its case against him. However, on the general principle that it is better for any individual to know what he is doing at all times, defendants should be given the opportunity to regain whatever memory is possible and to discover why they have amnesic spells. This, of course, presumes that there is a place where such psychiatric help is really available. Competent one-to-one therapy would be needed to safely lift the lid of repression that causes histrionic amnesia. This must be available or the delay in getting to trial is just a waste of time. CONCLUSION Defendants who have amnesia for their crimes may have committed the illegal acts while the body was under the control of a dissociated, previously created, alter-personality. When the history indicates repeated episodes of unusual behavior during amnesic periods, a diagnosis of multiple personality should be entertained. Further workup is recommended, with school and medical records being secured. Psychological and neurological testing should be done. If the physical evidence shows clearly that the defendant did commit the acts charged, then the defense attorney has the option of arranging for trance induction either by hypnosis or sodium amobarbital. All such sessions should be audiotaped and videotaped so all future examiners, as well as the prosecutor, judge and jury can become fully aware of what actually happened in the trance state. The defendant must be shown the tapes before they are shown in open court so he can emotionally react to them in a safe setting. In most cases, the defendant should not testify in court prior to personality integration since there is no way of knowing which personality will testify when, and confusion can be guaranteed. If the judge and jury are convinced that the defendant did have alter-personalities, and that an alter-personality did the act charged, and that the patient has fused all of these personalities into one non-dangerous self, then there is a fair to good chance that the defendant will be found not guilty by reason of insanity. He will then be allowed to continue in the treatment that has already proved successful. In this way both the client and society will have benefited. Editor's note: Since the writing of this article, a California Supreme Court decision was rendered -- The People v. Donald Lee Shirley. Briefly, the decision was that the testimony of a witness who has undergone hypnosis for the purpose of restoring his memory of the events in issue is inadmissible as to all matters relating to those events, from the time of hypnotic session forward. (March, 82) An additional memorandum we recently received from Dr. Martin Reiser, Director, Behavioral Science Services, Los Angeles Police Department states: "The per se decision against hypnotically aided testimony by the California Supreme Court will have a chilling effect on the use of investigative hypnosis by police in major crime cases. They will likely use it only in dead end cases with nothing to lose. The ruling is being appealed by the District Attorney's Association and we are also exploring legislative remedies. " (April 5, 82) REFERENCES 1. Pollack S: ALI Insanity in the Insanity Plea. Los Angeles, University of Southern California, 1980, p. 58 2. Coons PM: Multiple Personality: Diagnostic Considerations. J Clin Psychiatry 41 :330- 336, 1980 3. Allison RB: Multiple Personality and Criminal Behavior. Am J Forensic Psychiatry: Vol 2, Issue 1, 1981 4. Prince M: The Dissociation of a Personality. London, Longmans Green, 1913 5. Thigpen CH and Cleckley HM: The Three Faces of Eve. New York, McGraw-Hill, 1957 6. Lancaster E: The Final Face of Eve. New York, McGraw-Hill, 1958 7. Sizemore CC and Pittillo ES: I'm Eve. Garden City, New York, Doubleday, 1977 8. Schreiber FR: Sybil, Chicago, Regnery, 1973 9. Multiple Personalities: Looks at the 10 Faces of an Ohio Rapist. People Weekly, Jan 8, 1979, p. 46 10. Farrell B: Stalking the Hillside Strangler. New West, March 10, 1980, pp. 19-32 11. Wilson W: Planner found legally insane in wife's strangulation slaying. Sacramento Bee, April 18, 1980, p. 1 and 24 12. Ashby A: Esther Minor: Multiple Personalities in Court. Forum 6: 3-30,1 979 13. Allison RB: The Multiple In Court. Memos on Multiplicity 1: 8-9, 1977 14. Allison RB and Schwarz T: Minds in Many Pieces. New York, Rawson-Wade, 1980, pp. 161-179 15. Peters C and Schwarz T: Tell Me Who I am Before I Die. New York, Rawson-Wade, 1978 16. Hawksworth H and Schwarz T: The Five of Me. Chicago, Regnery, 1977 17. Allison RB: A New Treatment Approach for Multiple Personalities. Am J Clin Hypn 17:15-32, 1974 18. Wagner EE and Heise MR: A Comparison of Rorschach Records of Three Multiple Personalities. J Pers Assess 38:308-331, 1974 19. Massey EW and Riley TL: Pseudoseizures: Recognition and Treatment. Psychosomatics 2 1: 987-997, 1980 20. McGarry AL: Psycholegal Examinations and Reports, in Modem Legal Medicine, Psychiatry and Forensic Science. Edited by Curran WJ, McGarry AL, Petty CS. Philadelphia, FA Davis, 1980, p. 759 Ralph B. Allison, M.D. is a noted expert and writer on Multiple Personality disorders. He is staff psychiatrist at the California Men's Colony, Son Luis Obispo, California. COMMENTARY ON DR. ALLISON'S ARTICLE After reading this very nicely written clinical paper by Ralph Allison, M.D., regarding his experiences with Multiple Personality, and how to handle this most unique problem, I really feel like a general practitioner. In an agrarian area without even a hospital. I must say that I am very envious of Dr. Allison's position and all that goes with it, including his access to time, money and facility. I have to compare this to Texas where we have one hospital for the entire state for the housing and treatment of the criminally insane. I have never known the very competent staff at this hospital to take more than one month to evaluate someone that we have evaluated here and found incompetent to stand trial, then sent to the hospital. Our private or state institutions cannot, unless they are deceived, admit a person with a mental illness if they are charged with an offense. Over a period of several years that I have been in forensic psychiatry, I have seen several very unusual and rare insanity defenses in Texas and surrounding states, but up to this point, to my knowledge, we have not had one of Multiple Personality. It goes without saying, however, that this is possible in the future, but with our limited facilities at present, it is doubtful. Several things intrigue me about this defense. First is the one concerning incompetency to stand trial; which personality does one examine for competency? and does one examine all as they appear? and, if so, which one was used? The second thing that comes to mind is the Constitutional Rights that an individual has. Would each one of the "personalities" have to waive their rights or would one be sufficient? We already have such a backlog of cases pending appeal in our various courts due to "rights" of the individual, that I personally feel it could take years for the Courts to issue a ruling of opinion on these issues. Over the years, I have seen a couple of cases of, what I considered to be, multiple personality, and I have been involved in the treatment program. However, these individuals had not been charged with a crime, thus they were able to be committed to a private facility for long term intensive therapy. Unless the laws and facilities change appreciably here in Texas, I cannot see that it would be feasible, both from an economical and practical standpoint, for us to be able to diagnose and consequently treat a criminal with multiple personality. Thank you very much for asking me to comment on this very interesting and well written article. E. Clay Griffith, M.D. Dallas, Texas Note: Dr. Griffith is a psychiatrist who has appeared as an expert witness in more than 3, 000 criminal and civil cases. He will be present at our February symposium in Santa Barbara and serve as Chairman of the "Criminal Low and Psychiatry" section. 



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