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THE AMERICAN JOURNAL OF CLINICAL  HYPNOSIS
Volume 17, Number  1,  July  1974
A New Treatment Approach for Multiple Personalities
RALPH B. ALLISON, M.D.

This paper presents a review of the various treatments tried,
and their apparent effectiveness, in the 14 year course of
treatment by many therapists of a patient with five
personalities.  Effectiveness of treatment before and after the
correct diagnosis was established are contrasted.  Treatment
modalities covered insulin shock, electroconvulsive shock,
drugs. traditional psychotherapy, state hospital and community
hospital milieu therapy, hypno-therapy, conjoint therapy,
desensitization, and the Internal Dialogue. as discovered by the
patient herself.  The evolution of a treatment approach using
one of the patient's personalities as a co-therapist is
described.

Who am I and you and you,
Which of us is really true,
I need you and you need me,
Is that why there is three?

I deny and you reject,
Fulfillment we all neglect,
The face I see is not me,
The eyes of you and yet I see.

Not alike you and you and I,
You curse, you pray, I cry.
Dissociated we all three,
Why can't you and you and I be me?

Such was the plaintive cry of the first patient with multiple
personalities who exposed her complex psychological state to me.
No such patient had ever been presented in Grand Rounds in
training, and my search in the traditional psychiatric texts
gave no help for laying out ground rules for effective therapy. 
Morton Prince's masterpiece about his eight years with Miss
Beauchamp (Prince, 1913) seemed to be more of a daily diary of
her very energetic activities and her constant rebuffing of his
therapeutic endeavors.  Only recently, and after my patient came
for treatment, did two books appear, detailing the content and
progress of years of treatment.  Sybil (Schreiber, 1973) was
reported to be the first such patient to be treated by
psychoanalysis, although the story is replete with the use of
hypnosis, sodium amytal interviews, rides in the country with
her therapist, and other such very therapeutic, but unusual
techniques for any traditional psychoanalyst.  Then Stoller
reported on his 11 years of treatment of Mrs. G., (Stoller,
1973) a woman who had an alternate personality as well as the
greatest array of psychopathology I had ever read about in one
person.  He, too, is a psychoanalyst, and a most flexible and
imaginative one at that.

Of course, I had seen the movie The Three Faces of Eve and I
re-read the book (Thigpen & Cleckley, 1957).  In 18 months of
treatment, the appearance of a new personality did occur, after
significant childhood memories were recalled.  Yet, when I read
Eve's own autobiography (Lancaster, 1958), there were marked
differences in the two stories and just what therapeutic methods
other than recovery of early memories really helped was quite
unclear.  Also, Prince (1913) very strongly pointed out that
fusion of the several personalities was the direction to head,
yet  Thigpen and Cleckley had, as a permanent cure, the creation
of a new and healthier personality.  Which direction should I go?

The literature on this subject is sparse, and there is not even
a heading for this diagnosis in the Cumulative Index Medicus. 
Prince published a summary of 20 cases in 1906 (Prince, 1906)
the design of which was used in a review of all 76 cases known
before 1944 (Taylor & Martin, 1944).  My own search of the
English language literature revealed individual case reports of
only nine cases since 1944, two males and seven females (Thigpen
& Cleckley, 1957; Alexander, 1956; Bowers & Brecher, 1955; McKee
& Wittkower, 1962; Morton & Thoma, 1964; Smith & Sager, 1971;
Ludwig, et al., 1972; Schreiber, 1973; and Stoller,  1973).

Theoretical papers on this particular form of hysteria are even
more rare than clinical reports.  On looking through the early
works on the psychodynamics of hysterical phenomena (Breuer &
Freud, 1956) we find the statement that "after considerable
experience with these phenomena, we think it probable that in
every hysteria we are dealing with a rudiment of what is called
(In French) 'double conscience,' dual consciousness, and that a
tendency to such a dissociation, and with it the emergence of
abnormal states of consciousness which we propose to call
'hypnoid,' is the basic phenomenon of hysteria." A review of the
literature before 1962 and a critical discussion of the various
conceptions of multiple personalities as related to
hypnotizability was presented by Suttliffe and Jones (Suttliffe
& Jones, 1962).

CASE REPORT

So that a very complex story will be more understandable, it
shall be told in the following segments: the course of events
during the ten months she was under my care, past history as it
was reconstructed during  therapy, a survey of  the many 
treatment methods tried before the accurate. diagnosis was made,
a review of the treatment methods applied after correct
diagnosis was made, psychological testing, and completion of 
therapy.

My Ten Months

Elizabeth came for treatment in March, 1972 after she and her
husband, Don. had arrived in town from another state.  She had
recently been released from a state hospital near her home town
and had remarried Don to be able to have her two children with
her.  They came to the West Coast to getaway from all their
relatives and to try to start a new life.

Don brought her to my office, and she presented a most puzzling
picture.  She gave a long history of psychopathology, but yet
appeared very neatly groomed, overly composed, distant and
withdrawn. They had a copy of a discharge summary from the State
Hospital with a discharge diagnosis of schizoaffective
schizophrenia, yet this seemed quite inconsistent with her
appearance and behavior.  She also gave a history of severe
depressions for many years, but with a hyperactive spell
recently after coming to this area.

Since manic depressive illness had been confused with
schizoaffective schizophrenia in several recent patients of
mine, I started her on lithium carbonate.  However, a week
later, she overdosed on that drug and flurazepam.  I
hospitalized her at our local general hospital psychiatric ward
for further evaluation and treatment,

I called in a psychologist to do projective testing. During
interviewing, the psychologist mentioned that she seemed to be
expressing her feelings with alternate sides of her personality.
 With that, Elizabeth started talking about the "she" who was so
depressed and suicidal, while the one who was talking felt quite
differently.  The psychologist determined that she had come
across a person with two different personalities, with
completely different ways of thinking and feeling.  She called
me that evening to report what she had seen.

The next day, I confirmed her impression of two personalities,
Elizabeth and Betsy, and also discovered a third one, Julie Ann.
 Later I was to discover that at that time there was a fourth
one, whom I came to call Beth.  This one actually talked to me
in my interviews at the hospital, but I thought it was
Elizabeth.  Elizabeth talked to the nurses, but Beth never did. 
Much later, I also discovered that there had been present, in
the past, a fifth personality, who I called the dumb 16 old, who
only lasted a few months.

After a week's evaluation, I transferred Elizabeth to another
general hospital with a larger psychiatric ward.  After six
weeks, she came home, allegedly integrated into only Elizabeth,.
whom I then saw on an outpatient basis, along with her husband,
singly and conjointly.  During the following eight months,  I
spent two hours a week with either Elizabeth or Don or both. 
Elizabeth was seen alone 25 times, Don alone 21 times, and they
were seen together nine times.  They made the decision as to
whether to come alone or together, depending on the current
problems.  Don had made it very clear, when they first came,
that he was not going to be left out of the therapy process, and
I was most grateful for his insistence on that principle.  They
have now moved to Texas, where Don got a new job, and I feel we
can now review what has happened and learn something about how
to treat patients with this rare and complex problem of multiple
personalities.

Past History

Elizabeth was born 29 years ago in a Southwestern state, the
second of three children.  Her older brother was the favorite of
her mother. and she then became the favorite of her father. 
When she was three, he went overseas in the Army, and, in her
loneliness, she created an imaginary playmate, who continued as
Beth.  Beth was a very healthy and mentally normal female.  At
three and one-half she created a second imaginary playmate,
Julie Ann, who was more loving, sweet, a good Christian, but
weaker than Beth in coping with the problems of life.  When her
younger brother was born, she was nine years old.  At the moment
her mother first laid the new baby brother in her arms, after
coming home from the hospital, her resentment and hatred were so
strong, she created Betsy to store all the negative feelings. 
Betsy dropped the baby on his head a few weeks later, and was
responsible for all the hostile actions Elizabeth could not
condone in herself.  Betsy evolved into the typical Eve Black
stereotype (Thigpen & Cleckley, 1957), sexually promiscuous,
drug abusing, manipulative, hateful of all humans, selfish and
incapable of  love.

At 15, Elizabeth took an overdose of aspirin in a suicide
attempt and was hospitalized.  An appendectomy was done.  When
she was 16, she was so miserable at home that she was doing very
poorly in school, in spite of high native intelligence.  She
thereupon created a fifth personality, the dumb 16 year old. who
flunked her courses, and finally persuaded her mother to let her
drop out of high school.

Elizabeth then married her first husband, Vick, at age 17, to
get away from home, only to find that he was a transvestite. 
Julie Ann delivered their only child, a daughter, who was born
breech with the umbilical cord around her neck, causing cerebral
palsy.  Vick blamed Elizabeth for the birth injury, and she
accepted the pronouncement.  After three hospitalizations of 13
days, one day, and 14 days for depression, with insulin shock
and six electroconvulsive treatments, she divorced Vick and let
him and his second wife raise the child.

After a six day courtship, Julie Ann married Don for the first
time.  They had a good first year, but she delivered a stillborn
as her first child by Don.  Since she then believed that she was
now fated to have only defective children, Julie Ann gave up any
effective existence, and Elizabeth became more depressed and
hostile towards Don for any little slight.  Don and Beth did
have two children, who are now with them.  After a ethchlorvynol
overdose, Elizabeth was hospitalized in the local state hospital
for the first time from February to May 1971.  Most of the time
Betsy was out, taking psychedelic drugs the attendants passed
out, was gang-raped by the attendants, and linked up with drug
pushers she kept in touch with upon her discharge.  She got
pregnant and had a therapeutic abortion.  She made one suicide
attempt in the hospital.  Discharge diagnosis was hysteria.
While on pass, Don presented her with divorce papers. This was
finalized after her discharge and he got custody of the two
children.  Actually Betsy pushed Elizabeth into making sure Don
got the divorce.

She was readmitted to the State Hospital, because of depression,
from July to November 1971,. and entered into the same
destructive pattern as before.  But this time Elizabeth wanted
to get her two children back, but didn't dare marry Don again. 
So Betsy married Don instead. and they came West.

Treatment Prior to Diagnosis of Multiple Personalities

When she overdosed at 15, her parents were not informed.  Of
course, the appendectomy did not help her mental turmoil.  In
her first three private hospitalizations, insulin shock, and
then EST were used.  EST was the main treatment in the next two
private hospitalizations.  This did not relieve the depression.
It caused more memory problems, blackouts, and her headaches
became worse.  She feels this allowed Betsy to become stronger.

The State Hospital report stated the "patient was placed on
antidepressants which seemed to be of no help.  She was then
given mild tranquilizers and later major tranquilizers. . . .
She attended group therapy and appeared to participate very
well, gaining some insight into her own problems." When
phenothiazines were used in amounts large enough to sedate, she
did worse, since she couldn't function well in any capacity. 
She did do well on perphenazine-amitriptyline (dosage unknown)
in between state hospitalizations.  During the second state
hospitalization, "she was placed in individual and group therapy
and much of her guilt feelings, she was able to express.  She
had had a deformed child and had felt very guilty, feeling she
was responsible for this child.  Gradually, with her therapy,
she became less depressed and became happy.  However. throughout
her hospital stay. she has been capable of dramatic behavior. 
She also found it difficult to make definite decisions about her
future.  At one time, she turned in her 48-hour release request,
but when confronted with unrealistic plans for the future, she
immediately withdrew it and agreed to stay until more concrete
plans could be formulated." No antidepressants of the tricyclic
variety were effective when used alone, and about every one was
tried by one doctor or another.  I first used lithium carbonate
300 mg.  TID. and she liked its calming effect.  She was on
trifluperazine 5 mg.  BID. but refused to take it when she got
home.  She was on no drugs at the time she left this area.

Individual psychotherapy was tried at the State Hospital by a
student psychologist who fell in love with her.  After he asked
Elizabeth to marry him, Betsy wrote him a nasty letter which
cooled his  ardor. Encouraging the restricted, inhibited
Elizabeth to give up her inhibitions was harmful, since then
Betsy took over, and anything could happen.  Any type of
psychotherapy before the proper diagnosis was known was
ineffectual, since only one personality entered into the
transaction.  Betsy stood by and scoffed or sabotaged, and the
others just didn't know how to help the therapist, since they
were not asked to participate.

Treatments After Diagnosis of Multiple Personalities

During	the most recent hospitalization, the other psychiatrist
chose to ignore the existence of any other personality except
Elizabeth and focused on her as having a variety of  feelings. 
While in the hospital, this seemed to work, and she came to
believe it.  Later, however, she felt this was not the right
approach, since it was like sticking her head in the sand and
not dealing with the realities of the situation.  This type of
patient so avoids the realities of life by not facing them, that
the therapist is not showing an alternative approach when he,
too, is avoiding the fact that there is more than one
personality.  Betsy did not show up with the total hospital
environment suppressing her appearance, but she surfaced upon
discharge and was present at my last meeting with Elizabeth,
trying to masquerade as Beth, but both Elizabeth and I called
her bluff.

One of the big problems was that, since Elizabeth had not
entered into the  latest marriage contract with Don (Betsy 
had), she had a blockade up about Don even touching her, much
less having sexual intercourse with her.  Rarely she permitted
this, and was very unemotional about it.  At those times when
she was emotionally involved, it may have been Beth who was in
charge.  I tried Wolpe's desensitization under hypnosis (Wolpe,
1958), with her visualizing Don coming from a distance closer
and closer, as she remained in the trance state.  This worked to
some degree, temporarily, as did exploration under hypnosis of
early rape scenes in childhood, which set the stage for these
feelings.  However, just when I felt I was going to have a
breakthrough, out would come Betsy to take over and block any
further progress.

When Elizabeth started complaining of headaches again, I knew
Betsy was taking over on occasion, though Don made sure she
couldn't get into any serious trouble.  I then taught her
self-hypnosis, with induction of anesthesia of the hands and
transfer of the anesthesia to the head.  She liked that and did
it frequently at home.  At about the same time,  Betsy came out
in my office on one visit, and I failed to insist she let
Elizabeth take over before leaving, as was my usual rule.  When
Elizabeth came to, she found herself in the car halfway home
sitting beside two dirty hitchhikers.  Only then did she fully
accept the fact that she really had several personalities.  All
before had been lip service.  But once she had let out the
hitchhikers, she knew it was true, and she then took hold of her
own treatment.

The next weekend, I had a call from the Answering Service that
Elizabeth had called while I was out.  I called her, and she
said that she had made no call to me.  A few minutes later, Don
called and said Elizabeth was very upset about the supposed
phone call and wanted him to leave the house for fifteen minutes
to allow her to get to the bottom of it.  I told him to go
ahead, and he set up his tape recorder by his wife's chair.  The
following day he brought in the tape for me to hear and I was
dumbfounded.  After Elizabeth had put herself under hypnosis,
the following conversation took place:

Elizabeth: I'm in control, I'm in total control.  I want to talk
to Betsy.  Betsy.  I want to talk to you.  I'm in control, I'm
in total control.  Can you understand that? I want to talk to
you, but I'm in control.  I want to talk to you, Betsy.  You
have my permission to come out.  That's the only time you can
come out, when I give permission.  That is the only time that
you can come out, when I give permission.  I'm in control, I'm
in total control, but you have my permission to come out.  You
have my permission to come out, Betsy.

Betsy: Yea, what do you want?

E: Did you make that telephone call?

B: No, I told you I didn't make it.

E: I want to know if you made that phone call.  Now someone
made it.  I didn't make it. Now who made it?

B: I didn't make a call.  I told you I didn't.

E: Look, I know you made the call.  I didn't make the call.  If
I had made the call, I would know about it.  Did you make the
phone call?

B: I didn't make the call!

E: Betsy, you're lying. You know you made the call.  Why did you
make the call?

B: I don't have to talk to you anymore, and I don't want to.

E: Betsy, please, come on now.  I want to know why you made the
phone call.  I know you made it.  There's no sense lying about
it, but I want to know why you made it.

B: I didn't make any phone call! And I don't have to talk to
you.  I can come and go as I want to.  This business about you
being in total control! You're not in control and you know it.

E: I am in control.

B: Why didn't you know about a phone call. then?

E: Did you make the phone call? Did you make it?

B: I told you I didn't make any phone call, and dammit, I
didn't.  What are you trying to pull on me. anyway? My God. if
I'd made a phone call, why wouldn't I tell you? Or why wouldn't
you know, better yet?

E: Betsy, if you made that phone call, tell me.  Betsy . . .
Betsy . . . Betsy, . . .Betsy. . I'm in control and I want you
to come out.  I want to talk to you.  Betsy.

B: Why don't you leave me alone? Just leave me alone.  I ain't
bugging you anymore.  Just leave me alone.

E: All night then, why won't you tell me? Why won't you tell me
you made the phone call? It's just that simple.  Just tell me
and I'll leave you alone.

B: If I'd made a lousy phone call, I'd tell you just to get
you off my back.  But I didn't make . Now let me tell you,
dammit, I didn't make it.

E: All right, but you've lied about everything, Betsy, you've
lied about everything.  I don't believe you didn't make that
phone call and I'm going to find out one way or another why you
made the phone call.  I'm going to find out what's going on. 
Now that I'm in control.  I can turn you on and off anytime I
want to.  You don t have to come out unless I want you to come
out.  The only time you can come is when I wish for you to.

B: You know that's a pack of lies.  I can come out any damn
time I please.  Shit, why should I want to come out anyway
around this lousy place.  Man, there ain't nothing  going on
that I want to have anything to do with.  Let me tell you
something.  Let me tell you one goddamned lousy thing, and you'd
better listen to it.  The next time I do come out. it's gonna be
'cause I want to come out and you're not going to know a thing
about it.  All of this crap about being in control.  You're in
no more control now than you ever was, and you know it!

E: Betsy, I'm in control, 'cause I know of a lot of things that
have happened that you're not even aware of.

B: You don't know a goddamned thing and you know it!

E: Go on, go on. but I could tell you things that Dr. Allison
told me that has happened, and you're not even aware of.  How
did that happen?

B: Ah, Dr. Allison lies like everybody else.  He's just trying
to make me sick, make me have doubts about it, that's what he's
trying to do. But I know where I stand, and you know where I
stand.

E: Yea, Betsy, I know where you stand.  You stand right where I
want to put you and I'm putting you away.  I am putting you
away.  You are going to be so far away that you can't come out,
ever!

B: Ha, ha, ha, You really have yourself believing that., don't
you? You've really got yourself believing that you've got this
thing licked.  You haven't, you haven't got anything licked. 
One lousy phone call got you so upset that you called me out. 
Me, mind you, you called me out to talk to. One phone call and
if that gets you so upset, then you're not in full control, and
you know it.

E: OK Betsy, one phone call, sure it upset me.  OK. you know
about it, it upset me. but I'm not letting it take control.  One
little thing that happened that I don't know about but I'm not
going to let it bother me.  OK, I was able to call you out at
will, and I can put you back when I want to.  Do you understand
that?  I can put you back anytime I want to.

B: You can't put me back anywhere! If I wanted to come out, I'd
come out.  But I'm just sick and tired of the whole thing.  It's
just a drag anymore. The whole mess, the whole goddamned mess is
a drag.  I want to tell you something, lady.  If I wanted in, 
I'd come in.  But I'm just biding my time.  I'm going to come in
when I want to, when I have the opportunity that suits me the
best, and then, lady, you ain't gonna have nothing to say about
it, one way or the other, you am t gonna have nothing to say
about it. Because, you know and I know, you know that I'm in
control.  That crap about you being in control, who'd believe
it? Dr. Allison doesn't believe that shit.  You're really a
pathetic sight.  I'm sick and tired of even having anything to
do with you.  I'm sick of the whole lousy goddamned mess.  I'm
sick of it! I hate the sight of you.  You make me sick.  You and
your goddamned Puritanical ideas.  It makes me sick! I don't
want to talk to you anymore.  I can come and go when I want to.

E: Betsy . . . Betsy . . . Betsy . . .Betsy. . . . I want to
talk to you.  I am in control and I say I want to talk to you. 
Betsy.

B: Dammit, leave me alone.  I'm so sick of you whining and
bawling and crying and going on that I could just die.  You
know, as a matter of fact, that's not such a bad idea after all.
 All these years you've tried to do us away.  All these years
and I've stopped you.  Yea, you can thank me for that.  I'm the
one that saved us, not you.  Shit! You'd  have had us in the
grave a long time ago, but I'm the one that always pulled us out
of it, not you.  And then you say that you're the strongest. 
Dammit! Well, I've got just one good mind to let you do it. 
I've got just one good mind to let you do it.  I'm sick of it.
too.  You know I am just as sick as you are of the whole mess. 
I want out of it, too.  But I'll be damned if I'll let you take
over. If I can't have it, you're not going to have it. Anyway, I
could have it if I wanted to, mind you, but I just don't want to
anymore.  I'm just tired. you know.  One gets pretty tired after
a while and I get tired of battling.  It ain't worth it.  It
ain't worth it.

E: Betsy.  I want to ask you one more time.  Did you make that
phone call?

B: Jesus Christ! I told you ten times already I didn't make a
phone call!

E: Betsy, don't lie to me.  I know your thoughts and I know your
mind.

B:  You  don't   know a goddamned thing.

E: You might as well quit your cursing and your anger, 'cause
you're not upsetting me. I'm not letting you upset me.  I'm in
control and I'm not letting you upset me.  Do you understand
that?

B: Do you understand that? [teasing] You know, you really, you
don't think I get around anymore.  Shit, that's the only reason
I keep you around.  You're laughs, you are laughs, that's the
only reason.  Ha. ha, ha! Honey, look at yourself.  Your hand
shakes, what happened? I talked to somebody, sure I did, but I
didn't make any phone calls, and you didn't make any phone call.
 You know what's wrong with you? Your mind is going, lady, it's
really going.  You're so wound up that your mind is slipping
right out of it.  And you might say that you're my only real
help.  Because you are helping me to gain everything I wanted,
that is, if I want it anymore, which I'm not so sure I do.  But
it sure is going to be accomplished, because you're the one that
did it.  You don't know the tricks that are being played on you.
 That phone call.  That Dr. Allison, he's a pretty smart person,
he's pretty smart, all right.  But he makes a phone call to you
-- us -- that you've made a phone call.  Well, you know you
didn't, and I know I didn't, but you buy it, and I'm not. that's
the whole difference.  You're so damned gullible you're buying
it.  That's really hilarious!

E: Betsy .       Betsy

Then a new voice appeared, calm and reasonable.

NEW VOICE: I hear you.  I'm trying to help you, but I'm warning
you, listen clear, listen clear.

E: Betsy?

N.V.: No.

E: Who am I talking to"

N.V.: Listen to me.  I'm trying to help you.  I've been trying
to help you, but you won't listen to me.

E: Who are you?										

N.V.: I told you about the babies.  I told you what Betsy was
trying to do, what she had done in the past.  The only way for 
you to gain complete control and get rid of her is to hate her
so bad, to hate her so bad, that you can completely control her,
and you can.  I'm trying to help you,. don't you understand. 
I'm trying to help you.  Betsy is out to completely destroy you,
and I'm warning you, she can do it if you don't try harder.  You
can, you know you can.

E: Who am I talking to? Who? Julie Ann?

N.V.: No. No. Just please listen to me.  I've got information,
I've got so much information if you'll just listen to it.

E: Who are you?

N.V.: Do you want to talk to me or not?

E: Yes, but I want to know who you are.  Did you make the phone
call to Dr. Allison?

N. V.: Yes, I made the phone call.

E:  Why? Why did you call him? I thought it was Betsy.

N.V.: No. No. I made the phone call.

E: But why?

N.V.: I'm trying to help you.  Betsy's not aware, she doesn't
know me.  But you know, I know, I know you, I know Betsy, I know
Julie Ann.  I know everything that's happened.  I know
everything that you don't know.  I know how to get rid of Betsy.
I know why Julie Ann went away, and I'm your only hope.  If
you'll just listen to me. I'm just trying to help you.  Because
I'm strong.  I'm strong but I have to have your confidence and I
have to have your belief in me that we can, you and I, get rid
of Betsy for good.  I mean from now on, so she can never return
again, 'cause she doesn't know me.  She's not aware of me.  She
doesn't know about the phone call.

E: What were going to tell Dr. Allison? Why did you call him? I
don't understand.  I'm confused,  I'm so confused.  I want to
know why.

N. V.: Because, if Dr. Allison knows, if he knows there's two of
us against Betsy, then he'll be able to help you better.  He'll
be able to help you overcome, to overcome Betsy, because she is
just one piece of you, and it's a completely bad piece, and 
we're going to get rid of it.

E: But I don't want any more people.  I just want me.  I just
want one personality.

N.V.: But don't you understand'? If you and I work to help you.
we  will be one. not two but just one.  But see.  I'm the side. 
I'm the part that can help, if you'll just let me.  I'm the part
that you fight.  You fight me.  You put all your energies to
fight me when you should be fighting Betsy.  You can get rid of
her.  You know that, by talking to her, that you're stronger
than she is.  But you don't believe you are.  You don't believe
it.  And I know, I know you're stronger.

E: I'm scared.  I'm so scared. [sobbing] How do I know if I can
believe you? I don't know anything anymore.  I'm so confused and
mixed up.

N. V.: Elizabeth, please trust me.  Believe that I am trying to
help you and by helping you, I help myself.  Then we can become
one and have all the things we want, the good things, the things
you know are right, the things that I know are right.  We can
get rid of her, just knowing that I'm here.

E: God help me!' [crying]

N.V.: Elizabeth, I'm going to be with you and if you can just
try to think strong thoughts and hate the kind of a person that
Betsy is and the things that Betsy has made us do, hate all that
she stands  for, which is the Devil itself.  Hate it all and
then you and I can become one and be one solid person, solid in
every way.  Don't be frightened of her.  Do whatever I say, to
show your feelings, to care, to let yourself go, to let yourself
be.  Let me please come out.  I'm strong.  Elizabeth.  I'm very,
very strong, but you have to want that strongness, you have to
want it but let me through, please.

E: OK [crying] OK, but will you come out when Dr. Allison talks
to me? How can I get you to come out when I want you?

N.V.: Elizabeth, I won't come out like Betsy does.  I'm not
going to press myself, push myself, because this is something
you've got to want to do.  You've got to want it yourself.  But
I will be there to help you.  I've got the strength, all the
strength that you need, if you'll just allow it.  Just let
yourself accept it, that you are all the things that Betsy
isn't, and that we are two against her one, and that we can
become one solid person, that loves, that cares, that knows God.

E: I can't think about God anymore! It's too hard to think about
It anymore.  Why did He let this happen, all this confusion,
heartache? I'm scared. 

N.V.: Elizabeth, you let this happen, you let this happen
through all your fears and all the things you did that you see
as bad.  You never let yourself see good.  But God's there,
Elizabeth.  He stands by.  He's there.  You could accept Him.  I
have. 

E: Why, why did Julie Ann go away? Why? She was the good one.
Why did she go away'? She's the one I wanted to be.  Why did she
go away? [crying] 

N.V.: Because she's not strong enough, Elizabeth.  She's not
strong enough.  She let people hurt; they hurt her so bad, she
couldn't fight the world.  She didn't know how.  She knew God. 
She knew His love and His mercy, but she was too weak.  She hurt
too bad.  She couldn't withstand the pressures and the pain. 
But you and I can. 

E: Please come out whenever Dr. Allison needs you to help.

N. V.: I am there. Elizabeth, if you will just let me be. I'm
there, I've always been there.  But I need your strength as much
as you need mine.  I'm just a part of it, and you're just a
part.  But together we can be the whole. 

E: I'm tired.  I'm so tired.

This soft, calm 'reasonable voice belonged to the personality I
chose to call Beth, and was her first appearance on the scene
when I was aware of her as distinguished from Elizabeth.  This
was also the first instance of what I now call Internal Dialogue
Therapy, which Elizabeth used repeatedly at home.  Elizabeth and
Beth would calmly discuss how to handle such problems as her
mother's forthcoming visit.  Beth never took over unless
requested and politely left when her task was done.  She always
knew what Betsy and Elizabeth were thinking and doing.  She was
the one who clarified the history for me as to who did what and
when.  If she did not consciously know the answer, I would put a
pen in her hand and ask her to write the question, then to let
the hand write the answer automatically.  She would develop a
blank stare, the hand would start moving and the answer would be
then written on the paper.  Elizabeth felt that as she came
first of all the personalities, she was going to continue in
existence as the only one.  By establishing a ready means of
communication with Beth, she was able to fulfill her vow to
herself.

In the office, my main co-therapist was Beth.  I would call her
out to advise both Don and me as to how Elizabeth was feeling
about the subject under discussion and how we might best help
her.  A sample of such a therapy session is recorded below.

Both Don and Elizabeth were being seen together.  Don brought up
the question of why Elizabeth seemed depressed today.

E: I'm really not that depressed right now.  I have been all
day.  I wasn't going to come up here today, but I had a talk
with myself.  I decided that instead of sitting here thinking
about it,  I would get out and get over it.

Dr.  A: Do you mind if I try to find out what it is that you're
depressed about, since you were in a good mood yesterday? . . .
So why don't you go into a trance while I count to 5? 1, 2, 3,
4, 5. Now I'd like to talk to Beth and see what's behind this.
[Her eyes open.] What might the depression be due to?

Beth: Well, she's been pretty depressed because of me. She
doesn't like me to do things.  She just wants me to butt out. 
She thinks she can handle it by herself and I'm not so sure she
can.

Dr.  A: Well, how do you think we can work at this?

Beth: I'm at the point now where I don't know what to do. 

Dr.  A: You've been throwing in some good concepts here and
there and trying to present some good ideas for her to have?

Beth: Yea.  I just put the thoughts there.

Dr.  A: You just introduce the idea and let her think about it?

Beth: Yea, but sometimes she gets carried away with this.  I put
the thought there and she builds on it and she thinks it's her
original thought, and she thinks then she doesn't have any need
for me.  It backfired, in a way  I don't really know if that's
good or bad.

Dr.  A: Are you worried about your existence?

Beth: I don't want to exist. just as me. [Yet], I don't want to
go out of existence.

Dr.  A: You were created as a partner, and I would suspect you
have been very helpful at those times when she let you
contribute some constructive ideas.  But if she has the
constructive ideas of her own free will. then you're not needed
for these kinds of events.  You are a part of her, you become a
part of her operation, of her personality, which I hope would
not appear to be a loss on your part at all, since you continue
to live in her that way.

Beth: Sometimes I think about that, that she can pretty well
dismiss me if she wants to, as far as my being able to actually
do anything.  She does and she can.  I can think.  I know what's
going on.  I don't seem to be able to do a lot about it except
to think my thoughts.  I can't act on them.

Dr. .A: But she has handled things well this last week, so there
was no reason for her to ask help from you or anybody else.

Beth:   That's  true.

Dr. A: You were there,. available, if needed.

Beth: That's true.  I've been confused this last week as to what
to do, to know where to go.

Dr. A: That's what we're here to discuss.  We're trying to see
if there is any need at the present time that she hasn't been
able to handle quite adequately by herself.  This depression -
is it due to some specific guilt or fear?

Beth: I'm not really aware of anything concrete.  I don't really
know why she's depressed.

Don: Do you feel like it might be because of her attitude
towards me?

Beth: Maybe.

Dr. A: Has there been some particular attitude you know was
present that Don isn't aware of?

Beth: Most of the time she feels better towards Don than she did
before, but there's still times she has the resentment and she
doesn't want to have it, and it depresses her.

Dr. A: We had an obvious situation yesterday, the attempted
suicide of your younger brother.  Could you clarify just how
she's reacting to that'.

Beth: Oh. it's bothered me, too. 

Dr. A: Previously you said the only historical material she
allowed herself to remember about her brother was when he was a
couple of months old and she dropped him on his head. and felt
horrible about it.  She told me she didn't want to remember
anything more from that period of time.  And she felt bad about
her brother's suicide attempt, but there is not much she can do
to help him.  Now you know everything that she has done with her
brother and how her parents treated her. I'm just wondering
about your reaction to your brother's attempted suicide, knowing
all that had gone on with the brother.  Has knowing all this
made your reaction any different than hers?

Beth: I don't feel guilty because it was something I wasn't in
control of.  Had that been what caused part of this problem,
it's not something that I could do anything about now..  .  .

Dr. A: Now Elizabeth wasn't responsible for the harm that came
to him, either.

Beth: No, but she still feels that she was.

Dr.  A: She still takes responsibility for what Betsy, was
doing?

Beth: She still takes the responsibility for everything that
Betsy ever did.

Dr.  A: I know that when you were at [the other hospital] she
had come to the point of not taking on all the guilt of the
things Betsy did, and I felt that was a constructive direction.

Beth: I don't think she ever got to that point actually.  She
was trying to.  She wanted to leave the hospital.  She wanted to
go home to the kids, and she knew this was what was expected of
her, and she more or less went along with it, and she thought
eventually that it would come.  She still feels very guilty
about everything Betsy has done and she's got to the point now
where she doesn't believe any of this.

Dr.  A: Any of what?

Beth: Of the personalities - me and Betsy - she figures she just
thought it all up so she can put it all back.  It's not very
reasonable. but that's the way she. . . .

Dr.  A:  It's not very simple.

Beth: But she's not able to do that, she can't.

Dr. A: How can you - I'm  going, to lay it on you - start
dissolving this guilt that Elizabeth is carrying around.  That's
what seems to be the main bad feeling that makes her do other
things that cause trouble.

Beth: Well, I've tried at times to put the thought in that she
wasn't guilty of these things and that, even if she was, she
could be forgiven for them.  Forgiveness would take away a lot
of it.  But she even screams back at me.  "I'm guilty.  I did
it, it's my fault!"

Dr.  A: Isn't  it about time she considered that she has paid
her debt?

Beth: She's come to the point that she knows that she hasn't
really got the right to blame herself. but she has the need.

Dr.  A: . . . There comes a point where bygones are bygones. 
You know her better than anybody else.  If there is a new
concept, a new way of  looking at it, the way you would look at
it, that would be more acceptable than anything I could say.

Beth: Well, personally, I think that if she could allow herself
to pray like she used to, because she believes strongly in God,
and Christ, and the Bible, and all the teachings, and she knows
there is forgiveness.  If she could ever just pray once, really
pray about what she feels, I feel that she'd feel better about
herself. .  . .

Don: I'm in complete agreement.  I've wanted to go [to church]
but every time she doesn't want to.

Beth: She has to make up her mind.  I can give her thoughts but
she rejects a lot of that, too.

Dr. .A: . . . There might be a way to let that religious
capability we have come out in some more natural way [other than
in traditional church attendance.]

Beth: I do know one thing.  Every church service that I ever
attended, there was one particular thing in the preacher's
sermon that she felt he was preaching at her, and she got really
paranoid about it.

Dr.  A: There has to be an attitude change, if  it [a sermon]
doesn't make sense, I've got as good a mind as any to evaluate
it.  This is the kind of attitude change you have to go through
as you grow up. because if you're going to buy everything any
body says. you'll be conned.

Beth: This is one of Elizabeth's needs.  She takes what
everybody else says as Gospel.  She doesn't think enough of
herself to think "Well. my opinion is as valuable as theirs." I
know one incident when she was 16.  Dad's best friend was the
preacher in the church, well thought of, everybody liked him and
he made a pass at her.  He came to school, he called her out of
class. asked her if she'd do some typing for him, at the same
time, asked if she'd go out with him.  Well, she didn't want to
say anything to her folks.  She did try to get them to see it
was an odd thing for a preacher to come to school and call you
out of class.  Of course, everybody, when she got back to class
they asked her about it.  Of course they all made something out
of it, and she wouldn't go into details about it, and she never
told her folks.

Dr.  A: Did she do anything to be ashamed of?

Beth: O, no, but after that she couldn't hardly go to church.

Dr.  A: You can see that could pretty well foul up her trust in
preachers.

Beth: Whenever she brought it up to her parents, and she tried
to get them to think about it was wrong for him to do, they just
said, "Well. he just used poor judgment." They just dismissed it
at that.  But it was pretty bad.

Dr.  A: These are the kinds of experiences that can happen in
the organizational church and we all have to learn to separate
out individuals that we're dealing with and the ministers and
the beliefs they are trying to get over.  As a child, the two
will be fused together, he who believes it is that which he
believes.  As adults, we know better.

Beth: That's what I believe.

Dr. A: If you can throw these kinds of corrections in when you
see this kind of

thinking going on .  .  .

Beth: One thing I would like to do is buy a Bible.  We don't
have a Bible in the house.

Don: This last week, do you feel that what I have done and said
has been of any help?

Beth: I don't think there has been anything wrong with what you
have done.

Don: Is there any way, maybe when she's asleep, that you can
come out and give me an idea of how to help you handle the
situation?

Beth: I won't go against what she feels.

Don: What I mean is, if she's in a receptive mood towards me.

Beth: But she's going to have to let me in enough to convince
her.  I'm not going to tell her what she doesn't want to know.

Don: I don't want to say the wrong thing.

Dr.  A: I appreciate your feelings, but you may be
underestimating your own judgment and intuition.  It's available
to you, if you relax and do what comes naturally.  I'll give you
all the help I can here, but it is going to come to you as a
feeling it's the right thing to do, and if you trust that
feeling I don't think you'll have too much trouble.  You never
got feedback, to know whether or not it was the right thing to
do.

Don: That's what I need.

Dr.  A: We can get feedback now, but as far as a decision you
have to make on the scene.   .  .  .I think that you base it
upon what you think is right, and that's different in every
situation.  At times of crisis you've had to make a decision and
every time you've made it. something has worked out to
everybody's improvement.  I think you've got the capacity there
though you may not trust it.  I think it's in her, too.  I'm
counting on it being in me.

Beth: This is the only way I'm able to do it. This is all I can
do.

Don: I can never get  her to believe I'm not fed up.  I never
loved anybody like I've loved you, not just a personal love but
love as the mother of our children.

Dr. A: Don. you don't need to ask her questions if she isn't
immediately available.  You've got answers up here. [Pointing to
my head.] They may be very vague hunches but operate on what
you've got.  Elizabeth has got her own self-interest at heart. 
She knows you are looking after her, too.  Whatever message she
gives you on how to look after her, take what you get.  You also
have to evaluate what's best in looking after her from what you
know and how you size it up.  But don't avoid paying attention
to that voice that tells you the right thing to do.

Don: You remember when we were getting back together, the kids
said their prayers.  Do you think she resented that or would
that be helpful?

Beth: Oh, no, she didn't mind.  It's just that mothers forget.

Don: When we first went back, we first said prayers.  It seemed
she continually tells me I'm real wrong, I bulldoze.

Beth: I'll have to tell you this much.  Sometimes you do just
that.

To end the discussion with Beth, all I did was to tell her that
it was time for Elizabeth to come back.  She closed her eyes,
relaxed and in a few seconds, when the eyes opened, I found
Elizabeth talking to me again, with full, partial, or no memory
of what had been said by Beth.

Another very important step Elizabeth took shortly before
leaving the area was to be re-baptized in her church.  She had
felt dirty and sinful when baptized as a child.  Only when she
started talking with Beth did she finally come to accept herself
as worthy to be a child of God and a member of His church.

Psychological Testing

Test results at the state hospital were summarized as follows:
"On the WAIS the patient achieved a full scale IQ of 110,.
indicating functioning at the 'bright normal level.'  There is
no apparent organic brain involvement.  Extreme impulsivity is
noted, indicative of a low tolerance for frustration and
suggesting that acting-out behavior is probable.  Also revealed
are severe depression, strong guilt feelings, anxiety, marked
sexual conflicts and strong feelings of inadequacy and
inferiority.  There are also egocentric and psychopathic traits
as well as some paranoid ideation, schizophrenic signs and a
loose control of intellectual functioning.  The total testing
suggests schizophrenia, schizoaffective type, depressed."

The psychologist, Catherine Field, Ph.D., reported as follows:
"The Bender-Gestalt, Figure Drawing and Rorschach tests were
administered.  Present test results were very poor quality,
indicating profound disturbance and contained schizophrenic
signs. The Rorschach record is much too scant to reveal
dynamics; the patient rejected three out of ten cards, produced
only three acceptable popular responses, with the remaining
seven concepts showing inappropriate affect, disintegration and
dissociation.  The patient's drawings were poorly executed,
infantile productions with inconsistency, ambivalence and
occasional break with reality evident.

"The clinical picture is clearly that of multiple personality.
without evidence of organic etiology.  Dissociation appears
frequent and severe enough to account for schizophrenic test
productions."

Each personality completed a Minnesota Multiphasic Personality
Inventory and each answer sheet was interpreted by a computer.
Elizabeth, Betsy and Julie Ann did theirs during my
hospitalization.  Beth took hers shortly after I learned of her
existence.  Behaviordyne, Inc. of Stanford, California
interpreted that done by Elizabeth.  The readout indicated that
the preferred diagnostic label was 301.5 Personality Trait
Disorder,  Dissociating (Hysterical) Personality.  The summary
indicated that the statements that can be made most clearly
about Elizabeth are as follows:

"She uses the defense of repression, and is a hysterical
personality.  She is naively unaware of her own motives.  She
denies any hostile or aggressive urges. She dramatizes her
feelings of passivity and helplessness.  Her moods may fluctuate
unpredictably.  

"She is highly trustworthy.  She follows the rules scrupulously.
 She does not manipulate or exploit people.

"She is rather changeable and unpredictable person.  She is
Puritanical in some ways and not at all so in other ways.  She
makes decisions quickly, and she changes her mind quickly, too. 
She trusts people, and then sometimes finds that they disappoint
her.  She is somewhat naive or immature person who seems
sensitive to people giving or not giving things to her.  At
times she can be jealous, and at times, greedy.  She feels that
she is disabled by things that happened to her.  She denies the
conventional religious beliefs, and yet she seems to regard the
events of her life as acts of God, that is, produced by some
higher power and hence not something that she herself need feel
responsible for."

The other three MMPI's were interpreted by the Institute of
Clinical Analysis, Glendale.  California.  The diagnostic
impression for Betsy was Personality Disorder, Behavior Problem.
 Description was as follows: "She may be accident-prone due to
[her] propensity for thrills and impulsiveness. [She is]
charming, manipulative, morally lax and expedient. [She is]
unreliable in carrying out a treatment program and very often is
financially undependable.

"There is a background of confused parental identification with
a pronounced disrespect for authority figures who symbolize
parental control. [She is] strongly non-conforming and reacts
aggressively when frustrated.  Unresolved hostilities are
acted-out with a persistent tendency to have trouble with the
law.  Behavior is strongly rationalized resulting in little real
acceptance of personal responsibility.

"Schizoid dynamics are likely.  Anxiety is partially
externalized through somatization.  Some hysteroid repression is
noted.

"Patient's positive traits are described as adventurous, frank,
individualistic, socially forward, enthusiastic, generous,
fair-minded, and verbally fluent.

"Defense mechanisms . . . acting-out, intellectualization,
projection, reaction formation."

There was no diagnostic impression given for Julie Ann.  Her
personality description is: "Over-sensitivity to criticism or
belittlement with hostile reaction to rejection . . . Touchy,
resentful, and suspicious.  Attempt is made to hide underlying
dependency, submissiveness, and lack of confidence.  There is
more than average concern about the propriety or worthiness of
aggressive impulses.

''Patient's positive traits are described as compliant, socially
perceptive, persevering, cooperative, trusting, introspective,
and grateful.

"Defense Mechanisms . . . Intellectualization, projection."

The MMPI report on Beth was as follows: "Summary . . . This
pattern is essentially within normal limits and would serve to
verify or clarify other evidence of normalcy.  Self-appraisal
seems too faultless and suggests more coping problems than is
admitted by the subject.  This signifies a strong will that does
not easily tolerate interference or strict control.

"A facade of  'goodness' tends to confound realistic appraisal
and value judgments.

"Patient's positive traits are described as adventurous, frank,
individualistic, socially forward, enthusiastic, generous,
fair-minded. and verbally fluent."

So it appeared that Beth was a normal female psychologically. 
One has to wonder how she could exist then, if she is but a part
of such a disturbed total personality.  She certainly did appear
normal to me, unaffected by the years of family turmoil,
emerging first as a normal imaginary playmate, and capable of
being all those characteristics needed to make Elizabeth
complete.

Completion of Therapy

		Only  when  Elizabeth   took   her   daughter to enroll in
kindergarten did she really decide to get well.  She then
realized that her daughter needed both a mother and a father,
and she had to get well to stay married to Don.  Before that,
her ambivalence on the subject of the marriage, as expressed by
Betsy's constant attempts to find ways to leave Don and return
to the drug pushers she had met in the State Hospital, kept her
from really trying to improve their marital relationship.  Once
she made up her mind to get well, she started using the various
opportunities she had previously ignored.

The other necessary ingredient for cure was her complete
acceptance of the fact that she had several personalities.  Once
she found herself sitting beside those two unwashed hitchhikers,
whom she would never have picked up, she really knew, deep down,
that Betsy was real and that she would have to get control over
her.  Since Betsy took care of all the management of anger. and
also had all the fun, I had to point out repeatedly her need to
express appropriate anger and to go out to have mature female
fun, so that Betsy would have nothing to do. Indeed, with any
efforts of  hers in these directions, Betsy lost her energy.
After a while, all Betsy had energy for was to sit on the beach
and drink a can of beer, a far cry from her previous wild
behavior. This management by alter-personalities of certain
drives is well described by Ludwig and his co-workers (Ludwig.
et al., 1972).

Once she started the Internal Dialogue with Beth, she started
remembering all the past history she had so carefully walled
off, especially those guilt-producing things that Betsy had
done.  Beth carefully timed the revelations so that they came as
Elizabeth could handle them.  I helped once, when she noted that
when she wore two of three sets of earrings, she became very
irritable with Don. Wearing the third set of earrings, she was
quite civil with him.  I asked her to bring the first two sets
of earrings to the office.  I had her hold one set in her left
palm and close her fingers over it.  I asked, "What feeling
comes to you now?" She answered, "Disgust." I said, "Now take
yourself back to a time when you felt this same type of
disgust." She then visualized herself, as Betsy, back at the
State Hospital, being gang-raped by the attendants.  The
earrings had been given to her as a gift by one of the
attendants in payment of her sexual favors.  Once the walls
started tumbling down around such memories, she recalled more
and more, filling in the many gaps in her recollection of the
past, and accepting the behavior of Betsy as hers, but not
having to feel guilty about it.

Elizabeth, Don, and their two children moved to their home state
nine months after I first met them, when Don got an excellent
job. She has kept in touch with me by phone and letter in the
ten months since they left.  Back among her old friends she had
no more dissociations, saw no doctors for any reason, and
weathered a number of crises involving her family members.  Her
parents filed for divorce, her husband was hospitalized for
medical problems, and her younger brother was arrested on drug
charges.  Elizabeth and Beth are indeed only two parts of the
same personality, as planned, and Betsy is apparently no more.

My final evidence of the effectiveness of the therapy in this
patient is this poem which she sent me five months after leaving
this area.

I was lost inside myself.
Crying out, yet no one heard.
I couldn't see but I knew somehow,
I was there - somewhere.

My eyes were open - I knew.
Nothing was there to see.
No shapes -  No light - was I in Hell?
Dear God - Am I?

We met - you didn't know.
You let me see.
Dear Doctor, I'll not forget,
You gave me life - you gave me
		Me!

Discussion

Just who or what really was Beth, and why did the Internal
Dialogue between Elizabeth and Beth seem to be so critical in
her healing of the splits in her personality? Was she just
another dissociated personality, or something quite different?
She had no neurotic conflicts, she was always polite and
gracious, she always knew what to do in every situation, and she
knew God.

Experience with five subsequent patients with multiple
personalities, all of whom had an equivalent to Beth, and all of
whom found that they could get well only by listening to their
Beth, has convinced me that this is the manifestation of a
higher part of the personality which is a derivative of the
Soul, a part called the Inner Self, the Real Self. or simply the
Self.

Now putting aside temporarily the question of just what is the
Self, why should it be so important for a person with multiple
personalities to communicate freely with such an entity.  The
best explanation I have found is in a science fiction novel, The
Mind Parasites, by Colin Wilson, (Wilson, 1967).

"But what causes a physical cancer?. . . It springs from the
same root as the 'split personality.' Man is a continent, but
his conscious mind is no larger than a back-garden.  This means
that man consists almost entirely of unrealized potentialities..
. . The 'average man  . . . prefers the security of the
back-garden.

"Now a 'split personality' occurs when some of these unrealized
potentialities take their revenge. . . .

"Cancer is also caused by the 'unrealized potentialities' taking
their revenge.  The earliest cancer research workers noticed
that it is a disease of  frustration and old age. . . .

"Both cancer and split personality become impossible as soon as
man learns to descend into his inner being, for it becomes
impossible for these pockets of frustration to build up."

Since I am no expert on the subject of cancer, I do not know if
there is data on the psychological state of cancer patients to
support this quotation.  But, if you can stretch the comparison
aways, the disease of multiple personalities could be considered
cancer of the personality, since the unconscious seems to be
multiplying in the same uncontrollable fashion as do the cancer
cells, with the creation of coexisting memory systems, belief
systems, etc., all poorly connected with one another.  Only when
all personalities decide to subordinate themselves to the
direction and authority of the Beth-personality, can order come
out of chaos, and healing proceed.  I have shown this quotation
to several subsequent patients with multiple personalities, and
they all agree that it is quite accurate in describing one force
which must be reversed if they are ever to get well.

Now back to the question of just who is that "Inner Being," who,
in this case is the origin of Beth.  Realizing that every
psychological theorist, theologian, philosopher and mystic will
have his own definition, I shall present the view of the
theosophical school as one definition.  As presented by Winner
(Winner, 1970), "There is One Life in all beings . . . even in
the farthest galaxy of fiery suns that we can imagine.  And yet
this is not a mere pantheism, or concept of a divine life in
Nature, because beyond all the manifestations of the universe,
which are pervaded by one fragment,' THAT still remains.

Yet. when we investigate the writings of the mystics. . . . we
find them speaking of some experience by which the individual
feels himself  'one with the One.' This Divine Self, . . . is
felt to have a fundamental identity with man's own inner being.

The self of man is part of the great Self, and is felt to be
essentially identical with it and, potentially at least, equally
infinite. . . .

"There is a general belief, held by the mystics of all ages,
that there is a supreme Self with which the individual aspires
to realize his unity, which is immanent in all the manifested
universe of matter and yet which transcends it.  "

So far, I have focused on the patient and what caused her to
bring forth her Inner Self.  But what is required in the
psychotherapist for the Beth-personality to emerge? Here again,
I call upon the accumulated experience of dealing with the
equivalent of this personality in a group of six patients.  Most
had seen a long list of therapists who were quite unaware of
what was going on.  First, they had to have complete trust in
their therapist.  These patient share an exquisitely sensitive
receptive mechanism to the feelings and qualities of other
people, therapists included.  If they feel the therapist is
incompetent, is not truly interested in their welfare or is not
completely trustworthy, they will not let the Beth personality
come out.  She is very selective to whom she talks, and will not
waste her time if she isn't going to be taken seriously. 
Secondly, the therapist must call for Beth to come out.  She
will not come unbidden, except in emergencies, and at these
times, the Beth-personality makes the patient place a phone call
to the therapist.  Then the therapist must realize that he has
to call out another part of the personality while on the line,
and listen carefully, as she will start pouring out all the
hidden facts he needs to know about this patient.  She wants to
work in conjunction with him and she is a most knowledgeable
co-therapist.  Thirdly, the therapist must be in good contact
with his own Inner Self, since his Inner Self is in constant
communication with the patient's Inner Self.  Stoller describes
his discussions with his patient about her "Charlie," who is the
same as Beth, in my opinion, and his description of how he and
his inner voice are one is very clearly an excellent description
of the mature qualities needed for a psychotherapist of such a
patient (Stoller, 1973).

To be truly in touch with one's Inner Self is the key to mental
and spiritual health.  Patients with multiple personalities
provide a striking example of persons who have lost touch with
that part of them which is creative, non-neurotic, problem
solving, and everything else which is needed to survive and grow
in the world as it is.  Whenever a therapist can bring this
communication about, the patient can put his or her own healing
forces to work, and that is the most any therapist can ask of
himself.

REFERENCES

ALEXANDER.  V. K. A case study of multiple personality.  Journal
of Abnormal and Social Psychology. 1956. 52, 272-76.
BOWERS, M. D. & BRECHER, S. The emergence of multiple
personalities in the course of hypnotic investigation.  Journal
of Clinical and Experimental Hypnosis. 1955, 3, 188-199.
BREUER.  J. & FREUD.  S. On the Psychical mechanism of
hysterical phenomena (1893). International Journal of
Psycho-Analysis, 1956, 37, 13.
LANCASTER.  E. The final face of Eve.  New York: McGraw-Hill,
1958.
LUDWIG.  A. M., et al.  The objective study of a multiple
personality.  Archives of General Psychiatry, 1972,  26, 298-310.
McKEE, J. B. & WITTKOWER, E. D. A case of double personality
with death of the imaginary partner.  Canadian Psychiatric
Association Journal, 1962, 7, 134-139.
MORTON, J. H. & THOMA, E. A case of multiple personality. 
American Journal of Clinical Hypnosis, 1964, 6, 216-225.
PRINCE.  M. The dissociation of a personality.  London: Longmans
Green. 1913.
PRINCE, M. Journal of Abnormal and Social Psychology, 1906, 1,
170-187.  As quoted in Taylor, W. S. & Martin, M. F. Multiple
personality.  Journal of Abnormal and Social Psychology, 1944,
39, 281-300.
SCHREIBER, F. R. Sybil.  Chicago: Henry Regnery, 1973.
SMITH.  J. J. & SAGER, E. B. Multiple personality. Journal of
Medical Society of New Jersey, 1971, 68, 717-719.
STOLLER.  R. Splitting: A case of female  masculinity.   New
York: Pentangle. 1973.
SUTTLIFFE, J. P. & JONES, J. Personality identity, multiple
person