Dissociative Identity Disorder: Case of Sizemore

1. Dissociative Identity Disorder

1.1. What is dissociative identity disorder?

Dissociative Identity Disorders (DID) are mental illnesses that normally involve smoothly memory, consciousness or awareness, deterioration or deterioration of identity and mental functions.

People with DID develop one or more alternative personality, working with or without awareness of the person’s normal personality. Persons with IDD have two or more different and distinct personalities known as alternative personalities as well as their usual ‘core’ personality. (The number of these different identities can be 2 or more than 100). Some characters are specific to some situations. At any time, only one of these personalities applies.

A person with DID may or may not be aware of other personality situations or memories of the time when the core was dominant. Alternative identities can change in a very short time, one can suppress the other. Stress or anything reminding a trauma (psychosocial stress) can be a trigger for the emergence of altering at any time.

People with DID also often experience memory problems. They may have a hard time recalling personal information, learned knowledge, or important parts of their childhood.People living with this disease have serious gaps in their memories of personal history, people, places and events. Different identities can remember different events.

Although everyone with dissociative identity disorder is unique, they often share certain features with others with DID, and this is especially true in terms of structuring different parts of personality. Patient with dissociative identity disorder; identity, memory and consciousness is difficult to collect in a single personality.Each character that the patient impersonates has his own story, personal image and identity. All of these features are very different from the primary identity of the person.

Also dissociative identity disorder (DID) was formerly called multiple personality disorder.

1.2. What causes dissociative identity disorder?

This disease is thought to be a coping mechanism when the person differentiates himself from a very severe, traumatic or painful condition or experience in order to assimilate him with his fully conscious self. Dissociation can serve as a defense mechanism against the physical and emotional pain of a traumatic or stressful experience. By dissociating painful memories from everyday thought processes, a person can use dissociation to maintain a relatively healthy level of functioning, as though the trauma had not occurred.

People of any age, ethnicity, gender, and social background can develop DID, but the most significant risk factor is physical, emotional, or sexual abuse during childhood. Experts also draw attention to hereditary features of the disease. Many studies have shown that the prevalence of the same disease in the biological relatives of people with dissociative identity disorder is higher than in other people. In addition, the more the disease is seen, the more difficult it becomes to diagnose. It might also be linked to accidents, natural disasters, and war. An important early loss, such as the loss of a parent or prolonged periods of isolation due to illness, may be a factor in developing DID. The reason for the dissociative identity disorder, which manifests itself in individuals who are traumas at the time when consciousness is newly formed or not at the time of childhood, may manifest itself in a different way in every individual.

1.3. What are the symptoms of dissociative identity disorder?

DID is commonly accompanied by other symptoms such as headaches, hallucinations(Visual or auditory hallucinations may occur in people with dissociative identity disorder), suicide attempts, and self-injurious behavior, as well as by other dissociative symptoms such as amnesia and depersonalization.. People with dissociative identity disorder have symptoms such as depression, anxiety, passivity, addiction or guilt. The problem of behavior of these people in their childhood or the focus on school is often seen. Mood swings, anxiety, eating and sleeping disturbances, problems with functioning sexuality, substance abuse, amnesia, aggressive behavior may be another symptom. The another symptom may be suicide risk.

Most of the time patients do not know about other personalities. Therefore, the short- term memory losses, the person can not remember where and why he came to the place, sudden changes of emotion can give a tail of dissociative identity disorder. The time between first symptoms and diagnosis is usually 6–7 years. Some symptoms begin in childhood for at least some people who are diagnosed with DID during adulthood. It is not clear, though, that the early symptoms included the presence of alters. However, for correct diagnosis and treatment, psychological support should be obtained and discussed with a specialist name.

1.4. How the detection of dissociative identity disorder?

Both adults and children are diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

A physician will also ask the child or caregiver about his symptoms and will usually refer them to a mental health professional., DID usually begins in childhood, but is rarely diagnosed until adulthood. It is more severe and broader than other dissociative disorders, and the improvement may be less complete. Women are more common than men. There are often other diagnoses, including post-traumatic stress disorder, major depressive disorder and somatic symptom disorders (Rodewald et al., 2011).

For the diagnosis of DID, a person may:

Demonstrate two or more personalities that disrupt one’s identity, behavior, awareness, memory, perception, cognition, or senses. In addition to personal information and daily events, there are gaps in the memory of past traumatic events.

You have symptoms that cause serious problems in work and social settings.

Experience unacceptable disturbances as part of accepted cultural or religious practices. For example, you cannot disclose symptoms while acting as fictional friends or role-playing in children.

Therapists who are most likely to be diagnosed with DID tend to use hypnosis, encourage clients to overcome their unusual experience of abuse, or name different changes. Few clinicians contribute to most of the DID diagnosis for a period of time.

Tests used for diagnosis include the dissociative disorder interview program and the Rorschach Inkblot method.

However, advocates of post-traumatic model suggest that people with DID may be referred to specialist clinicians in the treatment of this condition (Gleaves, 1995).

If symptoms are present, a complete medical history and physical examination will be performed. Although there are no laboratory tests to diagnose dissociative disorders, various diagnostic tests such as blood tests or imaging (X-rays, CT scans or MRI) can be used to rule out the physical diseases or side effects of drugs.When a person is diagnosed correctly, treatment is an integral part of learning to live with DID.

2. Chris Costner Sizemore

2.1. Who is Chris Costner Sizemore (About her personality)?

Chris Sizemore has been the subject of books and movies with his interesting life story and has gained an important place in the history of psychology.

Christine “Chris” Costner Sizemore was born on April 4, 1927 and died on July 24, 2016. She was an American woman who, in the 1950s, was diagnosed with multiple personality disorder, now known as dissociative identity disorder.

When she was only two years old she had witnessed several tragic events. Within a period of three months, she saw her mother’s terrible injury in a kitchen accident, she witnessed a man severed in three by machinery at her father’s workplace, she saw a drowned man pulled from a ditch and baby cousin’s funeral affected her badly (Bernstein, 2016).

According to Sizemore, these traumatic events only triggered the evidencing of selves which were already present:

“Despite authorities’ claims to the contrary, my former alters were not fragments of my birth personality. They were entities, whole in their own rights, who coexisted with my birth personality before I was born. They were not me, but they remain intrinsically related to what it means to be me (Sizemore, 1989).”

Her teachers and some family members did not believe in her behavior, so they thought she was playing or lying. They thought she’d get herself into trouble because she couldn’t remember what she did. For example one of her personality would sit in class for a lesson, and another would arrive the next day for a test, not having been there for the lecture (Bernstein, 2016).

2.2. What is her story with DID?

Sizemore appeared to a psychiatrist when she experienced severe headaches, frequent fainting, and behavioral changes. She also heard voice about his husband. Later, psychiatrists Corbett Thigpen and Hervey Cleckley began to therapy with her and at first they thought she was suffering from a lot of stress. As they continued the treatment, they realized that Chris Sizemore had turned into a completely different person. When Sizemore was normally a dignified person, his new personality was even more aggressive, more talkative. Psychiatrists called this provocative personality “Eva Black” and the dominant but silent personality as “Eva White”. The personality who tried to choke Sizemore’s two-year-old daughter and leading her to seek for help was Eva Black (Thigpen, 1957).

While Eva White enjoyed reading, Eva Black enjoyed going to the cinema and nightclub. While the therapy was underway, psychiatrists noticed that Jane had emerged as a third personality. Jane was more capable. According to psychiatrists, the treatment worked, but it was not all over, and Chris had to fight harder. After the therapies, Jane died and replaced her with new personalities. Eva Black and Eva White disappeared with Jane. This three old personality was replaced by three new ones. As time went by, each triple personality was wiped and replaced by a new three personality. Therapists thought she had more than twenty personality and all personalities had different characters, ages, and physical health (Thigpen, 1957).

Chris Sizemore’s some personalities:

There was the Strawberry Lady, who was 21 and ate strawberries to the exclusion of all else. The Banana Split Girl was a temperamental child who would only consume that dessert. There was the Purple Lady, an arthritic 58-year-old who wore white wigs and purple dresses. The Virgin wore no makeup and could not stand to be touched by her husband. The Spoon Lady collected spoons. The Blind Lady could not see. There was the Retrace Lady who never liked to take the same route twice (Bernstein, 2016).

“Accepting the fact that it was all right to be myself and I didn’t need these personalities to function, that there would be some people who dislike me and that that’s okey.” She added in an interview with Sizemore in 1993.

A few years later, she said “The personalities were in a kind of Greek arena. They all joined hands and then walked behind a screen and then everything disappeared. They have never come back.”

In 1957, the story of Sizemore was published as a book by her psychiatrists Corbett Thigpen and Hervey Cleckley. The book’s name was “Three Faces of Eve”. In the same year, a movie with the same name was filmed. In 2003 “Identity” and in 2016 “Split” that movies were inspired by Sizemore’s story.

After a while, Chris wanted to tell his own story, and in 1977 wrote his first book “I’m Eve” and in 1989 his second book “A Mind of My Own”.

3. Conclusion

3.1. Why we did choose case of Chris Sizemore?

Chris Cortner Sizemore has been the subject of even cinema and literature with interesting life story, one of the most interesting cases in the psychology history. The reason why we consider this case which is both suprising and frightening, leave in impression in psychology literature and even community. In this research report; the case of Eve White was examined extensively, symptoms and etiology of dissociative identity disorder (DID) were adressed.

Dissociative identity disorder also known as multiple personality disorder, it is a psychological disorder characterized by the person have at least two personalities (alters) different from each other and has transitions between these personalities. Each alter have own name, age, story, behavior patterns, attitudes, relationships and memories. While an identity shows many respectable, admirable features, it is possible that the other identity can exhibit characteristics that are perverse, sadistic, capable of all kinds of evil (Carlson & Putnam, 2016). The average number of alters usually ranges between 2–10. However, depending on the severity of the trauma, more than 100 alter personality may ocur (Boysen & VanBergen, 2014).

Dissociative identity disorder, like other dissociative disorders, is intended to cope with the trauma experienced. For the diagnosis of this rare disease, people should have experienced trauma (“Dissociative Identity Disorder (Multiple Identity Disorder)”, 2016).

In addition to, people with multiple personality disorder can experience short-term memory losses, cannot remember where they came from and sudden changes in emotion. Actions and findings such as depression, self-mutilation, recurrent suicide attempts, imagination, headaches, and unstable behaviors are often seen in multiple personality disorders. Post traumatic stress disorder, substance use and addiction, depressive disorder and borderline personality disorder are comorbid with DID (Steinberg, 1994).

Research shows that the majority of patients diagnosed with multiple personality disorder are women. Among the reasons for this; women are exposed to more sexual assaults, men tend to hide their exploitation and assaults due to their gender roles (Cintron & Salloum et.al, 2017). In the posttraumatic model, many psychologists and psychiatrists agree that severe and horrible harassment in childhood, plays a role in dissociative identity disorder. The child in helplessness and weakness is gradually becoming someone else through a process similar to self-hypnosis to cope with this emotion. The sociocognitive model argues that the individuals

who are open to reconsider are unconscious in the society by legitimizing and reinforcing many suggestions, and they adopt and implement more than one identity role (Itkowitz & Chefetz et.al, 2015).

The case of Eve White is famous with book The Three Faces of Eve as well as a movie, provided a highly detailed report of DID in 1957. Chris Costner Sizemore became the century’s first worldwide publicized case. In Mrs. Sizemore’s case, the dissociation in her mind began when she was as young as 2, after she had witnessed a series of terrible incidents, including her mother being bloodily injured in a kitchen accident, the funeral of an infant, the dragging of a corpse from a ditch and a man being cut in half by a saw at a lumber mill (Costner, 1989).

The woman, who has experienced severe faint headaches, frequent fainting and behavioral changes that cannot even open her eyes, seems a doctor and an interesting situation arises in the treatment process. Her psychiatrists realize that Chris Sizemore turns into a completely different person. Chris Sizemore is transforming into a completely different person from time to time. When she’s a normally dignified person, this new personality is more aggressive, more talkative, more active. This alternative personality is called “Eve Black” and his silent personality is “Eve White”.The distinction between these alters is too much, and the dark side of his personality, “Eve Black,” tries to suffocate his two-year-old daughter (Weber, 2016).

Sizemore, who was diagnosed with dissociative personality disorder and according to she said later, these personalities were not the result of disintegration in her mind after traumatic events. These alternative personalities were in her mind before she was born. “They’re not me, but they’re all coming together and they are making me. They all have different truths, different characteristics.” she told (“Chris Sizemore, Multiple Personality Disorder Patient — Obituary”, 2016)

3.2. Case Study Method

Case studies are in-depth investigations of a single person, group, event or community. The case study method often involves simply observing what happens to, or reconstructing ‘the case history’ of a single participant or group of individuals (such as a school class or a specific social group). They are usually used in clinical situations or when laboratory research is not possible or is not practical.

3.2.1. Strengths of Case Studies

Case studies ensure detailed and rich qualitative information therefore it provides insight for further research. One of the biggest advantages of a case study is that it allows researchers to investigate things that are often impossible to reproduce in a laboratory. At the same time, permitting investigation of otherwise impractical (or unethical) situations (Diamond and Sigmundson, 1997).

3.2.2. Limitations of Case Studies

One of the main limitation is that the data collected cannot necessarily be generalised to the wider population. This leads to data being collected over longitudinal case studies not always being relevant or particularly useful.

Some case studies are not scientific. Freud used case studies for many of his theories or studies. Such examples are that of Anna O and Little Hans. Both of these are not scientific nor are they able to be generalised. This can be attributed to them being case studies, but also Freudian theory in general.

Case studies are generally on one person, but there also tends to only be one experimenter collecting the data. This can lead to bias in data collection, which can influence results more than in different designs.

It is also very difficult to draw a definite cause/effect from case studies (Freud, 1977).

References

Bernstein, A. (2016). Chris Sizemore, whose many personalities were the real ‘Three Faces of Eve,’ dies at 89. The Washington Post. July 29, 2016. https://www.washingtonpost.com/national/health-science/chris-sizemore-whose- multiple-personality-disorder-was-filmed-as-the-three-faces-of-eve-dies-at- 89/2016/07/29/3ed468e2–55b4–11e6-bbf5- 957ad17b4385_story.html?utm_term=.08a83da5fce3

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Sizemore, C. (1989). A Mind of My Own: The Woman Who Was Known as “Eve” Tells the Story of Her Triumph Over Multiple Personality Disorder. NY: William Morrow & Company. Steinberg, M. Interviewers’ guide to the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). Arlington, VA: American Psychiatric Publishing, 1994.

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