AS PsychologyAS PsychologyThe Core The Core studiesstudies

Individual Differences approach& Psychodynamic perspective

The Three Faces of EveThe Three Faces of EveA case studyMultiple personality disorderThigpen & Cleckley (1954)

The Three Faces of EveThe Three Faces of EveThis is a case study and a record of a therapeutic

process

The Three Faces of EveThe Three Faces of EveWho were Thigpen & Cleckley?

• They were psychiatrists (medically qualified)• Their paper was published in the Journal of

abnormal & social psychology (1954)

The Three Faces of EveThe Three Faces of EveWho was Eve?• A 25 year old woman who was referred because

of her severe & blinding headaches and spells of amnesia

• Thigpen & Cleckley tested her with Psychometric tests, projective tests

The Three Faces of EveThe Three Faces of EveIn the initial interviews (Eve White)Eve complained of (symptoms)• Blinding Headaches• Blackouts• Marital Problems• Personal problems

The Three Faces of EveThe Three Faces of EveWhat was Eve White like?• IQ score 110• Memory - excellent• Repressive personality• Conservative, shy, dutiful• Loving wife and mother

The Three Faces of EveThe Three Faces of EveThen What Happened?

Eve WhiteEve showed amnesia for a recent trip and washypnotised in order to restore her memory

The Three Faces of EveThe Three Faces of EveThen What Happened?

• First sign of something odd!A letter arrived which was written in two kinds of handwriting!

The Three The Three Faces Faces of Eveof Eve

The letter is objective evidence

The Three Faces of EveThe Three Faces of EveWhat did Eve say about the letter?

She denied writing it, though she did say she hadbegun a letter which she had not finished

The Three Faces of EveThe Three Faces of EveWhat happened then?• Eve became distressed and asked “whether

hearing voices in her head meant she was insane”

• she said that she had heard a voice in her head speaking to her

The Three Faces of EveThe Three Faces of EveThis was a critical interviewSeveral times she put her hands to her head as if in pain

and then...

The Three Faces of EveThe Three Faces of EveThe Transformation!

Eve White changed and became Eve Black!

1st ‘alter-ego?

The Three Faces of EveThe Three Faces of EveThe Transformation!The therapist notedA quick reckless smile…”hi

doc”Eve White now displayed a

childishly daredevil air, an erotic glance, even her sitting posture changed

Eve White became Eve Black

The Three Faces of EveThe Three Faces of EveWhat was Eve Black like?• IQ score 104• Memory - poor• Regressive personality• Childish, extrovert, mischievous• Denied being a wife & mother

The Three Faces of EveThe Three Faces of Eve• The therapy lasted 14 months and 100 hours of

interviews

• Eve Black would sometimes ‘appear’ but could only be called out under hypnosis

The Three Faces of EveThe Three Faces of Eve• Eve White was not aware of Eve Black• Eve Black was aware of Eve White

• Eve Black had existed since childhood• Eve Black - “would emerge, would behave badly

and then retreat and let Eve White take the blame…(parents verified incidents)

The Three Faces of EveThe Three Faces of EveHow T & C described Eve Black• “childish, irresponsible & shallow• “seeking pleasure & excitement• “denied marriage to EW’s husband (whom she

despised)• “denied relationship with EW’s daughter

The Three Faces of EveThe Three Faces of EveDid her family not notice anything odd?

When they observed EB they put her harshness &aggression down to ‘occasional temper tantrums ina normally gentle woman

How did the therapists How did the therapists measure the variables of measure the variables of

personality?personality?

Personality tests (psychometric tests)Rorschach ink blot testsEW = repressive (Freud)EB = regressive (Freud)Electroencephalograms (EEG) to record brain

activity)

How did the therapists How did the therapists measure the variables of measure the variables of

personality?personality?

Rorschach ink blot test = a projective test

Discussion:

• What do you see?

• Is what you see a projection of your unconscious mind?

• Is this a quantitative or qualitative measure?

• How valid is this measure?

How did the therapists How did the therapists measure the variables of measure the variables of

personality?personality?

Thematic Apperception Test = a projective test

Write a storyline for the pic:

• What has been happening?

• What is happening?

• What will happen?

Is your story a projection of your unconscious fears/desires?

How valid is this measure?

As treatment As treatment progressedprogressed

• EW headaches recurred & got worse• Blackouts increased• Both EW & EW denied awareness in these

blackouts• EW state of mind deteriorated (confinement was

considered)Then what happened?

Another personality Another personality appears!appears!

A Third Personality • Called herself Jane• Jane had full awareness of EW and EB • Neither EW nor EB were aware of Jane

What did Thigpen & What did Thigpen & Cleckley do?Cleckley do?

• All three personalities were tested by electroencephalogram

• Clear differences were recorded• Therapy continued to treat all three women in

the one body

The decision of The decision of

Thigpen & CleckleyThigpen & CleckleyJane seemed to be the person most likely to bring a solution to the troubled mind

She was increasingly dominant over the other personalities

The moral dilemma The moral dilemma (ethics) (ethics)

They noted the moral problem

The problem of killing one or more of the personalities

Other explanations?Other explanations?• Was the woman a very good actress (were T & C

conned?)• Was the woman psychotic (schizophrenic?)• Could the hypnotism have caused the multiple

personality effect?

What did T & C What did T & C conclude?conclude?

• They did wonder whether they had become so involved that they ‘lost their sense of judgement and over dramatised the case’

• They remain convinced that they witnessed a case of multiple personalityNote: A film was made!

Another strange caseAnother strange caseThe multiple personalities of

Sybil(see Schreiber 1973)

Extract from Film ~ Sybil

3 faces of Eve

Back to the question?Back to the question?What do we mean by personality?• Is personality a stable trait?• What do we mean by

o not like himself/herself o s/he’s a changed persono acting out of character

The Three faces of Eve The Three faces of Eve - postscript- postscript

• In 1975 a woman came forward and said she was Eve White

• said she had experienced many other personalities both before therapy and since (22 in all)

• that the fragmentation of her personality had been to protect herself from ‘unbearable experiences’

Ethical problemsEthical problems• Killing one/more of the personalities - who should

decide this?• Making a film for profit - who benefits & what

about patient confidentiality?• During the treatment Eve White got worse. ‘Who’

gives informed consent for the treatment procedures ?

Ethical problemsEthical problems• Which personality do you think T & C approved of

most?

• Might there be a culture & gender bias issue here? Were their judgements biased by the ‘social norms’ of the 1950s

Questions you should Questions you should be able to answerbe able to answer

• What were the similarities & differences between Eve White and Eve Black?

• What is the main difference between multiple personality disorder & schizophrenia?

• What problems with the case study method does this study highlight?

• What factor(s) may have influenced their diagnosis?

Multiple Personality Multiple Personality DisorderDisorder

• Frequency distribution• 14 cases between 1944 - 1969• 50 cases in the 1970s ! (6 by Sybil’s therapist)• even more in the 1980s (an epidemic)• the rise & fall correlates with the

impact of Freud’s psychoanalytic theory

• Mostly in the USA

Research into DIDResearch into DID• Research is ambiguous.  • 2011 place the prevalence of DID at about 1-3% of the general population • But studies that these guidelines refer to show that prevalence of DID ranges

from 0.4% (Akyüz et al, 1999) to 14% (Sar et al, 2007) • studies of all dissociative disorders range from 1.7% (Akyüz et al, 1991) to

40.8% (Ross et al, 2002).  • So which is right – less than 2% or over 40%?  • And how on earth can anyone be certain of the accuracy of these results? • A review of prevalence studies shows that DID is found in 0.4% to 7.5% of

psychiatric inpatients (Sar, 2011).  • Rates for outpatients – so people accessing mental health services but on an

appointment basis – range from 2% to 6% for DID.  • And finally, community studies – so research based on people with no

involvement with mental health services, ie ‘Joe Bloggs’ – show the prevalence of DID  ranging between 0.4% and 3.1%.  .

• To put that in perspective, prevalence rates for schizophrenia generally sit around the 0.55-1% range of the general population (Goldner et al, 2002).

• So arguably more people have DID than schizophrenia and yet there is more rigorous research, appropriate treatment services, charity support and government investment for schizophrenia than for people with DID

Further reading…Further reading…• See blog for

Discussion points.docx

T&C Evaluation Sheet.doc

Homework ~ To complete all evaluation material for T and CWatch the videos on the blog for next session