The long, hard re-integration of multiple-personality patient

August 11, 1991|By Gerri Kobren

THE FLOCK. Joan Frances Casey with Lynn Wilson. Knopf.

303 pages. $22.95. In early March 1981, a young woman presented herself in thoffice of a clinical social worker in a mental health center at a university in Chicago. A graduate student, newly divorced and ambivalent about her lover, the patient said at first that she was feeling desperate, then that she was merely stressed.

But in subsequent sessions, Joan Casey (or Jo, as she sometimes wanted to be called) confessed that she had been fighting an urge to jump from a window, and that she had been losing time -- that is, she would be doing something, and then find herself somewhere else, doing something else, with no idea what had happened in between.

In a few weeks the social worker, pseudonymously named Lynn Wilson, had determined that Ms. Casey -- also a pseudonym -- had "Multiple Personality Disorder," a fragmentation of the ego into a number of separate selves. The cause, in most cases, is childhood abuse so horrific the youngster must create alter egos to absorb the punishment.

Originally known as "dissociation" of the personality, MPD burst upon the public consciousness with the publication of "The Three Faces of Eve" in 1957. Since then, it's appeared with increasing frequency -- in the book "Sybil," which came out after "Eve"; in Eve's later discovery that she really had more faces than three; and in recent court cases of the true and the TV type.

But its incidence remains in dispute. Some experts put it right up there with depression and anxiety disorders, while others say it's rare, and suggest the apparent increase in cases is fueled by a fad for finding it.

In any case, it did not join the official list of mental illnesses in the "Diagnostic and Statistical Manual" of the American Psychiatric Association until 1980, and Lynn Wilson would have been going pretty far out on a limb when she decided, a year later, that Joan Casey was a multiple. But diagnosis was followed by demonstration. Sociable Renee emerged immediately, and then 5-year-old Missy, head-banging Josie and smart-alecky Rusty, Isis the lesbian and Kendra the rescuer, and a whole flock of others.

As Ms. Wilson encourages, accepts, cuddles and prods, they begin to tell their stories. Missy remembers that her erratic mother stepped on her hand when she was 6 months old. A year and a half into therapy, Renee recalls being born when Jo was seduced by one of her high school teachers. At the two-year mark, Josie relives the rape by her father; she likes to bang her head as a substitute for that other pain.

Did it all really happen? Ms. Wilson believed it, even before any of the personalities revealed it. Ms. Wilson also had turned the patient into her emotional child, as she and her own schoolteacher husband attempted to heal her by reparenting the personalities. But that leads to a question: Could the flock have remembered what it thought the therapist/parents wanted to hear?

The narrator through most of this is Renee; toward the end, it becomes the re-integrated Joan Frances. Ms. Wilson's voice is interspersed with Ms. Casey's, and presented as her clinical notes and diary. It is probably not: Ms. Casey tells us that she proposed to write the book from her own journal, from tapes of her therapy sessions and from memos the Wilsons jotted on napkins and navigational charts. They both died in a boating accident before the book was published.

"No life has a happily ever after," Ms. Casey writes, referring to her own. After six years with the Wilsons, she had become a single entity, but still was an unhappy person, insecure and prone to abusive relationships. Living at a distance from her mentors, she began therapy with a psychiatrist, who encouraged her to write about her life as a multiple. It was good advice. This is a dazzling juggling act, and the inevitable doubts somehow add to the intensity of the reading experience.

Ms. Kobren is a writer for the To Your Health section of The Sun.

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