Memory expert Elizabeth Loftus, Ph.D., warns that psychiatrist
MarleneSteinberg, M.D., in her new book Stranger in the Mirror, is trying
to breathe new life into a form of therapy that once destroyed thousands
of lives. Dr. Steinberg responds.
When you look into a mirror, who looks back? If you sometimes have
the eerie feeling that you don't really know who that is in the looking
glass, then you may be one of the 30 million Americans who suffer from
Dissociative Identity Disorder (DID). Such is the extraordinary claim of
psychiatrist Marlene Steinberg.
Steinberg, with the help of writer Maxine Schnall, makes her case
in Stranger in the Mirror: Dissociation: The Secret Epidemic of Our Time
(Cliff Street Books, 2000). In it, she states that DID is due to
traumatic experiences, typically childhood sexual abuse. According to the
theory, the traumatic experiences are too horrendous to contemplate, so
the victim forces them into a dark corner of psychic inner space, where
they nevertheless chafe the unknowing ego, eventually splitting it into
fragments that later manifest themselves as alternate personalities. This
is one reason why when a DID victim looks in the mirror, she may see a
stranger staring back.
Steinberg thinks this is what happened to many of her patients. She
goes into detail about three in particular, including Nancy, who
supposedly experienced abuse by her father, mother and grandfather. When
discussing this abuse, she would abruptly switch personalities, from the
mother of teenagers that her friends and family knew, to an anguished
8-year-old child. When in "child mode," Nancy would slip into
grade-school speech, saying "skeered" and "veery," for example, as in,
"I'm veery skeered."
Then there was Jean, the 40-year-old mother of two pursuing a
college degree. Jean didn't buy the DID diagnosis at first: "When I tell
Jean that I have diagnosed her with DID," Steinberg writes, "she becomes
defensive." Jean apparently insisted that she came to therapy because of
panic attacks, anxiety and poor school performance; couldn't they just
deal with those problems?
Apparently not. Once the diagnosis of DID is made, therapy must
focus on dredging up those repressed memories of abuse; there is no time
to waste talking about anxiety or how to improve a "D-" in American
History. Important, long-buried memories must be brought to light.
Steinberg claims a high success rate for which, unfortunately, she
provides no documentation. In evaluating her claim, consider how she
defines success. In the manuscript version of her book, she writes, "I
consider achieving functional cooperation among a person's alternate
personalities a successful outcome of therapy... " In other words, if
you and your 37 selves are all getting along with one another, Steinberg
will pronounce you cured!
To make a diagnosis of DID, Steinberg uses a test she developed
called the Steinberg Clinical Interview for DSM-IV Dissociative
Disorders, (SCID-D, for short). She modestly characterizes the test as a
"breakthrough diagnostic tool," but offers no scientific evidence for its
validity. Nevertheless, her confidence in the instrument knows no bounds:
If the test says you have DID, then you have DID.
Steinberg's faith in her "breakthrough" tool may have prompted her
to include in her book a series of questionnaires, adapted from the
SCID-D, that readers can use to determine whether they, too, are in need
of treatment for dissociative disorder. I sat down one day and took these
tests. To my dismay, I found that I had amnesia and suffered from "mild
identify confusion."
Identity confusion? I thought I was a college professor, a
researcher in the field of memory, sister to two wonderful brothers, aunt
to adorable nieces and nephews. While I admit I occasionally wonder what
I want to do next in life, this hardly seems to qualify as identity
confusion.
The test includes items such as, "I have a critical commentary in
my head about things I do," and, "Who I am can change from day to day." I
had the choice of checking these and similar items "never, .... once or
twice," "sometimes," "many times," or "almost all the time." It seems
likely that most people would admit to having these experiences now and
then, but it turns out that the only way you can avoid a diagnosis of
identify confusion is to check "never" to all the items. Steinberg admits
that mild or short-lived episodes of dissociative feelings are normal,
but her test makes it hard for people to escape a diagnosis.
It doesn't take a crystal ball to foresee thousands of people
finding themselves described in the pages of Steinberg's book and having
their fears confirmed by its tests. Nor will it be very surprising if
many of these people go to therapists who, wittingly or unwittingly,
implant memories of childhood cruelty that never happened. No doubt some
innocent people (especially parents, grandparents and siblings) will be
accused of the "remembered" abuse, and some may be sued or prosecuted.
Some may even go to prison.
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Memory,
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