MULTIPLE PERSONALITY DISORDER IN THE WORK-PLACE by Ralph B. Allison,M.D. Published in the American Journal of Forensic Psychiatry, 11:65-67, 1990 Anyone of you may become involved in a forensic case where the question may be, "Does the defendant have Multiple Personality Disorder (MPD)?" My most recent case is an illustration of how five different doctors were pulled into this one case, each one having a different point of view. The Case The business office of a major California corporation discovered that some employee was forging vouchers for payment of inservice training to a California company, but inserting an address which was out-of-state. Security officers discovered that the address was that of the sister of one of their employees, Mrs. X, who had the duty to create such vouchers. When called in for questioning, she denied any knowledge of the matter, but admitted that the evidence pointed straight to her. After the meeting, she told her supervisor that she was sure she would lose her job and family and go to jail. He drove her home and reassured her that she had not been fired. She came back to work the following morning as usual. Shortly after her arrival, the security officer's office received a call from what may have been an alter-personality of hers saying, "Mrs. X did it but Miss Betty made her do it." An hour later, Mrs. X became upset about another missing voucher, fainted and started talking in another voice. This voice said, "I've got you, you bastard; I'm going to get even with you; I told you so." She went on like that, writhing on the floor like a cat while an ambulance was called. The paramedics took her to a hospital emergency room, where the doctor called for a psychotherapist, whom I will call Dr. #1. Dr. #1 reported talking to three different personalities. The only psychological test he gave was the MMPI, which showed no evidence of dissociative disorder or hysteria, but indicated possible psychosis. He was convinced that she had MPD and learned that one of the alter-personalities, Miss Betty, had forged the vouchers in question. Four weeks after her last day at work, Dr. #2, the company medical director, sent a letter to Dr. #3, a private psychiatric consultant. Dr.#2's letter stated, "a company security investigator met with Mrs. X to confront her with evidence that she had defrauded the company of $10,000. Mrs. X was given overnight to think about what she wanted to do, such as resign, return the money, prove innocence, etc.... Is she disabled, or is this as unreal as it seems?" There are several falsehoods in this letter, which we could assume Dr. #3 would take as authoritative. First, she had not succeeded in cashing any of the false vouchers, so she had not defrauded the company of any money and had none to pay back. Secondly, she had never been given an ultimatum by anyone, according to written statements by the investigators and her supervisor. The tone of the letter makes it clear that the company's medical director wanted the psychiatric consultant to say that she was malingering. He clearly was not interested in an impartial professional opinion. Dr. #3, the psychiatric consultant, saw her and considered her disabled but not multiple. He felt that her story was "inconsistent with the typical case histories of true multiple personalities." That may sound scientific but those with extensive experience with multiples repeatedly say that there is no "typical multiple" against which to measure all others. However, he did not call her a malingerer, either. Eight months after leaving work, Mrs. X was seen on referral by Dr. #1 by Dr. #4, a professor of psychiatry in a medical school, who was experienced in using hypnosis and treating multiples. He supported Dr. #1's diagnosis of MPD and reported finding evidence of six alter-personalities. His version of the crime was that "Betty came out and erased material on the computer in anger and then altered one of the accounts." This is not what really happened, and it is unknown where he got this alleged information. Also, he only interviewed the patient and secured no tests of any type. Mrs. X was fired when a handwriting expert concluded that she had written the signatures on all of the vouchers in question. Three years later she wanted to go back to work, claiming that her MPD had been cured in therapy with Dr. #1. He was very much on her side and berated company personnel for treating his patient so rudely. The union representative had become involved and had arranged for a hearing with a labor arbitrator. Dr. #3 had continued to see her for evaluations and still considered her a non-multiple but suffering from numerous psychiatric symptoms. So three years after the case started, Dr. #5, yours truly, became involved at the request of the company's attorney, who was preparing for the arbitration hearing. I read all of the documents, which included detailed reports by every company member involved and reports by all the doctors. The attorney's first request was for me to tell him whether or not Mrs. X had suffered from MPD three years ago. I found that to be impossible. We then discussed how the attorney could cope with the case most appropriately. He finally decided to use the same method used in a bifurcated criminal trial. The first hearing would deal strictly with the alleged misdeed of forging vouchers. The second hearing would deal with her alleged illness and her recovery from it. Fortunately for all doctors involved, Mrs. X's husband died shortly before the first hearing was scheduled, and she decided to cancel the hearing. She accepted a small amount of money from the company in exchange for an agreement never to return to work for that company. 

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