Her name is Alice, at least that is the name I’m using in this blog. I have known her since 1966. She was 16. I didn’t know much about multiple personalities at that time nor was I sure I wanted to know more. I was a skeptic.

First Contact With Alice

Alice was referred for therapy by her school counselor, a former grad student of mine. He told me that Alice had conduct and behavioral problems including truancy, lying and sexual promiscuity. Her teachers reported that Alice would frequently forget her assignments and act as if the assignment was never given.           

The Hallucination

After her high school graduation, she attended the University and would occasionally stop by my office. I tried to get her to go to the counseling center but she refused.

One evening I had a call for help from the Methodist student center. They said Alice was having hallucinations. When I got there Alice was staring at her reflection in the window in a highly anxious state saying, “Who is that?”

I needed to get her in touch with the moment so I stood beside her so she could see both of our reflections.  I asked her if she knew who I was and if she remembered seeing me in my office that day. She said yes and told me why she had stopped to see me.   

Soon her anxiety settled down and I took her back to the women’s dorm (there were no coeducational dorms in the 1960s). I didn’t know it at the time but this was the beginning of a relationship that has extended to this day.


Dissociation is thought to be a coping mechanism where the person literally dissociates herself from a situation or experience that is too violent, traumatic or painful to assimilate with her conscious self.  It is believed that dissociation is a defense against severe childhood trauma. Some argue dissociation does not happen, however, my experience with Alice suggests to me that Dissociative Identity Disorder clearly exists.


One evening during therapy I decided we should talk about trust and risk. Alice told me, “It’s very difficult for me to trust anyone.”  I asked, “What would need to happen for you to trust?”

She pondered and answered, “I think I would need to change but I don’t know how. I’m afraid.”

I told Alice, “Some people learn to trust by sharing a secret. I believe, Alice, that risk is the most important four-letter word in our vocabulary.  If you do not risk sharing what is inside, everything just gets packed up tight and becomes too heavy to carry around.”

As the therapy session progressed Alice decided to tell me her story about a time when she was approximately 4-years old. This was a story of severe physical and sexual abuse during her early childhood. The setting was the back room of the small grocery store that her father owned. It was early in the evening after the store closed.

Alice went into frightening detail of how her father sexually abused her on a rug covering the cement floor. Her memory of the pain and suffering at her father’s hands brought back the experience in three-dimensional relief. I caught a glimpse of why people create multiple identities to cope with trauma, especially when it occurs at a young age. 

This severe childhood trauma created a mental split or “dissociation” as a defense against the trauma. An alter emerged named Patrice.


Much of Alice’s sexual experience occurred when she was dissociating.  One time she tearfully told me, “I woke up and there was $50 on my dresser. I don’t remember being with anybody." She found it difficult to reconcile these sexual encounters with her Christian beliefs.  

We later discovered that the alter who emerged and engaged in numerous promiscuous behaviors was Alina who probably had origins during her first seven or eight years. Alice’s father left when Alice was about 7, however, I know that she was sexually abused by other men into her 30s. 


Alice had a clearly identified “host” personality whose name was Monica.  Monica would frequently “come up” to talk to me. As the host personality, her job was to keep track of all the other personalities. The alters distinguished themselves from each other by age, sex or race. Each had his or her own postures, gestures, and distinct ways of talking.

For example, I had a phone call from a person who sounded very much like Alice, but I wasn’t sure.  I asked, “Who is this?” “This is Jackie and I don’t know how I got here. I think I’m in the East Side Shopping Center parking lot.”  I made sure she got safely home.

Among the 40 alters there were three who would “come out” but usually for a specific reason, like the parking lot incident.   


I finished my doctoral program in 1963.  It included very little information about multiple personality disorders. Between 1968 in 1980 the term for Dissociative Identity Disorder was “hysterical neurosis, dissociative type.” Most of us referred to the disorder as Multiple Personality Disorder.

When I first began therapy with Alice I fought the notion of multiples but I read everything I could about multiple personalities. Most of the helpful education, however, came from Alice.

The number of reported cases sharply increased in the late 1970s and throughout the 1980s. The first scholarly monograph on the topic appeared in 1986. Dissociative Identity Disorder was called Multiple Personality Disorder until 1994.  The name was changed to reflect a fragmentation or a splintering of identity rather than the growth of separate identities. The point I am making is, Alice was not diagnosed with a dissociative problem until well into the 1970s.

What was it like for Alice?

Alice reported 40 personalities. The average is about 13 to 15. As stated, her father was sexually and physically abusive and her mother pretended that the abuse did not exist. The more I worked with Alice, the more I understood how insufficient her childhood nurturing had been. I became aware of the family’s dysfunction and that one of the ways Alice dealt with it was to dissociate. My treatment goal was to help Alice work through underlying issues that I believed caused her Dissociative Identity Disorder.

Research indicates that as many as 99 percent of individuals who develop dissociative disorders have histories of recurring, overpowering, and often life-threatening disturbances at a sensitive developmental stage of childhood (usually before the age of nine.)

Now, Alice is near retirement. She believes that her alters have existed for a reason. She has never believed that there was a need for her alters to integrate. She saw no need for them to lose their identities.  She believes that her Dissociative Identity Disorder has made her strong.



Spanos, N. P. (1994). Multiple identity enactments and multiple personality disorder: A sociocognitive perspective. Psychological Bulletin, 116, 143–165. doi:10.1037/0033-2909.116.1.143

Cherry, Alexandria, Multiple Personality Disorder: Fact or Fiction? A paper to the Rochester Institute of Technology


Dr. Knittel is a professor emeritus at the University of Nebraska at Kearney where for 30 years he taught classes in counseling theories, counseling methods, group counseling, practicum, and psychodrama. In addition to his current book, One Hand Clapping  (2015).  He wrote Counseling and Drama: Psychodrama A' Deux in (2009) which was translated into Mandarin and published in Taiwan in 2013.

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