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Forensic Aspects of Dissociative Identity Disorder

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This ground-breaking book examines the role of crime in the lives of people with Dissociative Identity Disorder, formerly known as Multiple Personality Disorder, a condition which appears to be caused by prolonged trauma in infancy and childhood. This trauma may be linked with crimes committed against them, crimes they have witnessed, and crimes they have committed under duress. This collection of essays by a range of distinguished international contributors explores the complex legal, ethical, moral, and clinical questions which face psychotherapists and other professionals working with people suffering from Dissociative Identity Disorder. Contributors to this book are drawn from a wide range of professions including psychotherapy, psychoanalysis, counselling, psychology, medicine, law, police, and social work.

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CHAPTER ONE: Satanist ritual abuse and the problem of credibility

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Joan Coleman

“All that is necessary for the triumph of evil is that good men do nothing.”

Edmund Burke, Reflections on the Revolution in France, 1790

Do some satanists really commit crimes and abuse children? Many people believe not. My own hard-earned professional experience tells me otherwise. This chapter is an account of my own journey: a journey from relative ignorance prior to 1980, through growing awareness of the extent of child sexual abuse, through my bizarre, frightening introduction to satanist ritual abuse, to my eventual belief that satanist crime does, indeed, occur. And I would like to think that mine is a reflective, rather than reflexive, belief (van der Hart &Nijenhuis, 1999)—that is, belief that stems from reflecting on the evidence, rather than blind acceptance of what initially seems highly improbable.

Ritual abuse evoked considerable interest in Britain between 1987 and 1994. The subject was taken up by many professionals, mainly psychologists, counsellors, and social workers; numerous children thought to be at risk were taken into care. In 1989, some of us who had encountered it formed an organization called RAINS (Ritual Abuse Information Network &Support), with the aim of sharing information and supporting each other.

 

CHAPTER TWO: Unsolved: investigating allegations of ritual abuse

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An interview with Chris Healey

C an you tell us about your first experience as a police officer investigating an allegation of ritual abuse?

It was about 17 years ago. The carer of a young woman wrote to the police with a complaint saying that a crime the young woman had reported had not been investigated. My senior officer, who was the Head of the Criminal Investigation Department (CID), asked me to follow it up.

I went to meet the young woman, who was 24 years old, and interviewed her and her carer. I had two meetings with the young woman and took a lengthy statement from her. She told me that when she was 16 she came to the area and was homeless. She was picked up by two men who gained her confidence, gave her a room, and later sexually assaulted her, then introduced her to ritual abuse. She was able to name some of the people involved in the abuse. I checked the names she gave me, and these people did exist. One of them was a doctor and another was a senior policeman. I was rather doubtful that the latter would be involved in such practices, but this was what she told me.

 

CHAPTER THREE: The Extreme Abuse Surveys: preliminary findings regarding dissociative identity disorder

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Thorsten Becker, Wanda Karriker, Bettina Overkamp, &Carol Rutz

Where are the data?

Experts and sceptics in the field of dissociative disorders have, for at least 25 years, been asking the question: where are the data?1 The preliminary results of three international online surveys (offered in English and German) are starting to show quantitative, as well as qualitative, data regarding the accounts of survivors of extreme abuse. Many of the survey participants had developed dissociative identity disorder when they were children, as a defence against the horrors of these crimes.

Ideologically motivated crimes

In his work as a case consultant with law-enforcement agencies in Europe, co-author Becker has coined and uses the term ideologically motivated crimes (IMC) to describe crimes that are committed in the name of and justified by a transcendent religious belief system (e.g. Aum Shin Rikyo: Lifton, 2000) or an immanent Weltanschauung (e.g. Nazi-ideology group). In the former, the physical presence of leaders and perpetrators is supported and/or enforced by gods or deities who are non-terrestrial beings and therefore can be perceived as omnipresent, especially by young children. This is a serious threat and may continue as a stressor to them even when they become adults. In the latter, a group's leadership exists in the temporal world, and rewards for suffering or committing criminal activities happen in their earthly lives.

 

CHAPTER FOUR: The protectors of the secrets

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“Aahbee”

I am a female survivor of childhood neglect, trauma, and abuse, now in middle age. I have dissociative identity disorder and am on a therapy-based journey of recovery. In sharing from my own experience, I am aiming to avoid graphic details but, instead, to reflect on the impact of various deprivations, traumatic occurrences, and abuses on the development of a number of distinct parts to my persona.

Dissociation is a survival strategy that enables one to tolerate the intolerable and survive the catastrophic. In a dysfunctional and traumatic home environment, an outward appearance of normality must be maintained in order to avoid aggravating the abuser. Imagine a lake, the quiet surface representing daily life and consciousness. When overwhelmingly painful traumas occur, threatening to disturb the surface, dissociation separates and contains the memories and emotions, as if in a bubble or balloon, which is then weighted down out of sight on the bed of the lake, far away from consciousness. Daily life goes on, the secrets of both the abuser and the abused protected.

 

CHAPTER FIVE: Am I safe yet?

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Sue Cross, with “Louise” (and her alters)

“We were not the normal bag: an affable, funny teenager and then with the next breath we could have pinned you to the wall. We became hard, we fought, we were cocky, vulnerable, easy-going, funny, affable, dangerous, known to be bordering on evil, very bright, very thick, whatever we needed to be, and there was one thing we agreed on—we had to stay alive.”

HJ

Life became so unbearable at home that when I was about 16 I ran away and lived on the streets. It was like being freed: no rules or regulations, no bedtime, no going to school, and I could do what I wanted when I wanted. There was a naivety about me. I never thought of the consequences. I wasn't innocent, but it was all a game, not serious, just fun and exciting, and I don't think I deliberately did anything to hurt anybody.

Sometimes it was confusing. I'd be asleep, and the next thing I was being woken up by a policeman and taken to hospital because they said I'd taken an overdose. Once I got put in a children's home.

 

CHAPTER SIX: Dissociative identity disorder and criminal responsibility

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James Farmer, Warwick Middleton, &John Devereux

The seemingly bizarre symptoms of dissociative identity disorder (formerly known as multiple personality disorder [MPD]) have long fascinated and polarized psychiatrists, psychologists, philosophers, and lawyers. Constructions offered in the courts range from that of one person with a fundamentally disintegrated psychic structure and prone to flashbacks and hallucinations in multiple sensory modalities, through to that of a person with a number of personalities or person-like states of consciousness inhabiting the same body (Saks, 2001). Philosophers ponder such questions as whether a DID sufferer possesses a continuing sense of personal identity and consciousness and can perform actions as a true agent (Sinnott-Armstrong &Behnke, 2001). Lawyers and judges, who rely on expert witnesses (particularly psychiatrists) to give evidence in courts on DID, face particular challenges in cases dealing with the criminal responsibility of DID sufferers. As a result, the judgments show contradiction and inconsistency in their reasoning, further adding to the confusion faced in future cases [State of Washington v Wheaton (1993)].

 

CHAPTER SEVEN: When murder moves inside

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Valerie Sinason

The police were in a quandary. On the one hand, the woman's detailed descriptions had correctly pinpointed where the body had been found and the marks that would be found on it. A 28-year-old graduate, part-time language teacher and part-time housewife, Mrs Carly Lawrence (not her real name), was sharp and articulate. The details had not been in the press, and there was no way she could have guessed it without prior knowledge. On the other hand, some details were completely wrong. Her descriptions of clothes and weather did not tally in any way with what was known. She could not describe the alleged murderers. Also, her concepts of time and place and how long it took to get from one particular house in a built-up city to the rural scene of the crime were woefully inadequate. The police are, on the whole, not geared up to psychological complexities. Time and place are pivotal pieces of information for police but often the least relevant, or the least held in mind, for the witness or the victim.

 

CHAPTER EIGHT: When the imaginary becomes the real: reflections of a bemused psychoanalyst

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Phil Mollon

Some years ago, I had been working in psychotherapy with a woman artist, Natasha, for a couple of years or so. Her paintings displayed vivid abstract images of violent intrusions, explosions of red engulfed by a menacing black. From the beginning, she had presented narratives of sexual and other forms of abuse by her father, a senior manager in public services. He had, according to her account, behaved during her childhood—and even now that she was adult—in extremely controlling ways, telling her repeatedly that everything in the house, including her, belonged to him and that therefore he could do as he chose with his “property”. She appeared to have a confused perception of her father, perceiving him at one moment as a monstrous perpetrator of crimes against her, and at other times believing that he was the only one who loved her. These conflict-laden perspectives were also at times expressed in the transference. For example, she once tearfully exclaimed that I obviously did not care about her because I did not abuse her.

 

CHAPTER NINE: Some clinical implications of believing or not believing the patient

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Graeme Galton

Do you think I'm making all this up?” asks David, a man in his forties with dissociative identity disorder who has just described to me a shocking and nauseating experience of sadistic sexual abuse that he experienced as a child.

It is my experience that people with DID are likely to describe having experienced severe and ongoing emotional, physical, and sexual abuse from an early age, and it will be extremely important to them that we believe their account. They may also describe committing such abuse themselves. It is possible that these accounts will not be presented until several years of psychotherapy have established sufficient trust that the therapist will take them seriously. The memories of these experiences may be divided between different personalities, with amnesic barriers keeping certain memories from the awareness of other personalities. This means that a memory of an experience may be held by a particular personality and may not be available to a patient's other personalities, leaving those personalities with no knowledge of the experience, or several personalities may remember an experience but the main personality may know nothing of the event. One of the difficulties that can face us as psychotherapists when a patient describes traumatic experiences of emotional, physical, and sexual abuse is the challenge of believing the reality of what the patient is saying, especially if the memories have not been held continuously in the patient's conscious memory. This chapter explores some of the clinical implications of a psychotherapist either believing or not believing a DID patient's memories of extreme abuse and the effect that the therapist's response may have on the patient.

 

CHAPTER TEN: Infanticidal attachment: the link between dissociative identity disorder and crime

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Adah Sachs

The DSM-IV-TR (APA, 2000) states that individuals with dissociative identity disorder (DID) frequently report having experienced severe physical and sexual abuse, especially during childhood.1 Many authors have attempted to explain this link between abuse and dissociation. Schore (1994, 2003), Davies and Frawley (1994), van der Kolk, McFarlane, and Weisa-eth (1996), Wilkinson (2006), and others have written extensively on the neurobiological process that leads from extreme trauma to dissociation, as a bodily “shutting-down” response. Ross (2000) describes a deliberate creation of DID through government-sponsored mind-control programs. Van der Hart, Nijenhuis, and Steele (2006) coin and describe structural dissociation as the result of chronic, especially (but not only) early, traumatization. Liotti (1999), Southgate (1996), Sinason (2002), and others have written about the link between trauma and dissociation from an attachment perspective, focusing on disorganized attachment as the almost inevitable sequel of severe relational trauma.

 

CHAPTER ELEVEN: Letter from a general practitioner

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Alison Anderson

Adah Sachs and Graeme Galton
Consultant Psychotherapists
Clinic for Dissociative Studies
London

Dear Adah and Graeme,

I would appreciate the opportunity to share my thoughts about some clinical issues regarding the treatment of the patient that we share, who has dissociative identity disorder.

Perhaps it would be helpful if I gave you some of the background. I had been Katie's GP for several years and had known her as a quite regular attender—an unhappy woman of about 40, with recurrent depression and intermittent contact with the Community Mental Health Team. There had been a few attempted overdoses in the past, and a suggestion of some sort of personality disorder, never finalized. She was on several different medications, some for depression, some for chronic pain, and one day as I was asking Katie how she was, she said, in a rather different voice, “Actually, it's Kielly.”

And so I entered into the confusing world of DID. At times it feels like a Hitchcock story rather than an actual medical condition, and, for the GP, the almost constant underlying feeling is that you are joining and possibly increasing your patient's delusion, rather than helping and treating a very difficult psychological condition. This is largely because DID is barely mentioned in medical school, and I have never read an article on it in the usual GP journals. Most GPs, when confronted with such a diagnosis, have very little recourse to informed colleagues, and very few have even heard about it, let alone understand the condition.

 

CHAPTER TWELVE: Corroboration in the body tissues

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John Silverstone

Before training in osteopathy, I obtained a degree in physiology, then trained and worked for 12 years in general nursing. I have been a qualified osteopath for 22 years, and in my work as an osteopath I have treated 10 patients with dissociative identity disorder. All my patients with DID reported injuries of various kinds that were inflicted by others. Some of these were physical injuries, including many childhood injuries, such as being picked up and thrown across a room, having their head banged against a wall, or being held by one arm and swung against a wall. Other injuries were current and were the result of ongoing abuse. These injuries included being hit hard over the vertex of the head with a heavy object, leaving a tissue memory of impaction of the upper cervical spine into its articulation close to the anterior margin of the foramen magnum, and being kicked in the lower posterior rib cage with resulting haematuria and hospitalization due to puncture of the kidney by fractured eleventh and twelfth ribs and crush fractures of the vertebral bodies at the thoraco-lumbar junction, necessitating hospitalization and fitting of a spinal brace. One patient reported being kept in extreme confinement locked in a cage, unable to stand up straight, or lie down, or stretch their limbs to full length. At some point in their treatment, all these patients reported sexual abuse.

 

CHAPTER THIRTEEN: Opening Pandora's box

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Sue Cook

In Greek mythology there is a famous tale about a woman, Pandora, who was entrusted with a special box and the safe keeping of its contents by the god Zeus. She had no idea that inside was every imaginable evil and sorrow that could afflict mankind. She was simply told never to open the lid. She forgot about this box for many years, until one day, coming across it, innocent curiosity overcame her and she lifted the lid, releasing its deadly contents throughout the world. When she realized what was happening, she slammed the lid shut, trapping at the bottom of the box the very thing that could save mankind from endless torment and despair. The world remained an extremely bleak place until one day Pandora chanced to revisit the box again, and, lifting the lid a second time, the box's remaining occupant—hope—flew out in the form of a dove, thus making life in the world worthwhile and bearable even in the face of horror and tragedy.

For adults living with dissociative identity disorder, lifting the lid of their box (also something that in their minds is “not allowed”) and uncovering and releasing a host of horrors can be equally devastating. As with Pandora's box, hope is often the last—but the saving—grace to emerge. Once these horrors and their effects have surfaced, they can never be pushed back inside—and, indeed, one would not want them to remain hidden, as they need to be worked with and resolved. Even with hope this is an incredibly difficult and bewildering process, not only for the individual with DID but also for the therapist, support workers, friends, and family who accompany the sufferer on his or her courageous journey to recovery.

 

CHAPTER FOURTEEN: From social conditioning to mind control

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Valerie Sinason

“Man does not have the right to develop his own mind. This kind of liberal orientation has great appeal. We must electrically control the brain. Some day armies and generals will be controlled by electric stimulation of the brain.”

Jose Delgado, Congressional Record, No. 262E, Vol. 118,1974

“Ordinary people, simply doing their jobs, and without any particular hostility on their part, can become agents in a terrible destructive process. Moreover, even when the destructive effects of their work become patently clear, and they are asked to carry out actions incompatible with fundamental standards of morality, relatively few people have the resources needed to resist authority.”

Stanley Milgram (1974)

The year was 1992. The former military American man was lying on the London hospital bed in a state of terror. He did not know why he had flown to England when he had no friends or family here, but he knew he had to kill someone. After an unbearable period in which he had become aware of the charged meaning of a word, “delta”, which meant something extremely dangerous to him, he had gone to his local GP. The GP had anxiously referred him to a psychiatrist. The psychiatrist had been sympathetic but thought the man was a paranoid schizophrenic and sectioned him.

 

CHAPTER FIFTEEN: Mind control: simple to complex

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Ellen P. Lacter

Organizations with a wide range of political and criminal agendas have historically relied on coercive interrogation and brainwashing of various types to force submission and information from enemies and victims, and to indoctrinate and increase cooperation in members and captors. In modern times, these techniques are used by political, military, and espionage organizations, race and ethnic hate-groups, criminal groups (e.g. child pornographers and sex rings, and international traffickers of women, children, guns, and drugs), and exploitative and destructive cults with spiritual, political, and/or financial agendas. Methods of thought reform used by such groups include intimidation, deception, shaming, social isolation, religious indoctrination, threats against victims or their loved ones, torture, torture of co-captives, and brainwashing through social influence, regimentation of activities, or deprivation of basic needs, such as sleep or food (Hassan, 2000).

Mental health and law-enforcement professionals working with severe trauma are increasingly seeing victims of torture administered with the purpose of installation of more covert mind control—that is, mind control that was installed in a deeply dissociated (without conscious awareness) state and that controls the person from these unconscious, dissociated states of mind (Boyd, 1991; Coleman, 1994; Hersha, Hersha, Griffis, &Schwarz, 2001; Katchen &Sakheim, 1992; Keith, 1997; Marks, 1979; Neswald &Gould, 1993; Neswald, Gould, &Graham-Costain, 1991; Noblitt &Perskin, 2000; Oksana, 2001; Ross, 2000; Rutz, 2001; Ryder &Noland, 1992; Scheflin &Opton, 1978; M. Smith, 1993; Weinstein, 1990). The evidence of the existence of covert mind control has begun to surface in the legal arena as well (e.g. Orlikow v. U.S., 682 F.S. 77 [D.D.C. 1988]).

 

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