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A Call for a New Legal Understanding of Multiple Personality Disorder

Multiple Personality Disorder is thought to be caused by child abuse so severe that it causes the mind to fragment into person-like “alters” with distinct personalities, memories, abilities and sense of morality, according to law professor Elyn Saks. She is pictured here in front of a dressing room mirror that multiplies her image, providing a visual example of a person with MPD.

Photo by Irene Fertik

CRIMINALS WITH Multiple Personality Disorder (MPD) – or so-called split personality – have killed, raped and dealt drugs. One even turned on his own therapist.

But when they enter the U.S. legal system, “multiples” often become victims themselves, according to a USC researcher.

“Courts are in disarray about how to handle MPD,” said Elyn Saks, a law professor and the author of a new book on MPD and the law. “Consequently, multiples are being convicted of crimes for which they should not be held responsible.”

In Jekyll on Trial: Multiple Personality Disorder and Criminal Law (New York University Press), Saks blames an increasingly frequent miscarriage of justice on legal tests for insanity that predate the American Psychiatric Association’s first recognition of MPD in 1980.

“Instead of looking at the question of MPD afresh, courts often try to speak a language that was not formulated with MPD in mind,” writes Saks, an expert in mental health law who teaches at the Law School and School of Medicine.

TRADITIONALLY, the insanity defense has held that an accused criminal may be held responsible for his actions only if he knew what he was doing and he knew his actions were wrong, Saks said. The test fails MPD defendants because most multiples have at least one person-like “alter” who willfully carries out the crime. However, one or more other alters frequently were either oblivious to these actions or were powerless to control them.

Take the case of a 39-year-old woman who was arrested for drug dealing after police found 67 bags of heroin and $13,000 in her Boston-area apartment. Abandoned as a girl by her mother and later abused when they were reunited, Norma Roman developed a violent, street-smart, tough-talking personality named Vicky after a suicide attempt in her early teens. Alice, a take-charge personality, also surfaced at times. Norma, meanwhile, remained suicidal and depressed, checking in and out of mental hospitals and blacking out memory of vast periods of time, according to her therapist of 10 years.

Norma told police that she knew she had not dealt drugs. During Norma Roman’s trial, “Vicky” took the stand, admitting having dealt the drugs, but said she did so without Norma or “Alice’s” knowledge, “because if Norma and Alice find them, they would flush them down the toilet.”

Despite this and more evidence that at least two of Roman’s seven personalities had not participated in the crime, Roman was convicted and sentenced to seven years in prison. The conviction was upheld on appeal after the testimony of a psychiatrist, who did not address the question of whether Norma – or the alters – knew that they were dealing drugs. The expert witness said that Roman should have been able to conform to the law because she knew her actions were wrong.

“There is a tendency for expert (witnesses) simply to conclude that a multiple could know or not know the nature or wrongfulness of her act, and for courts then to repeat these conclusions in rote fashion,” Saks writes. “A theory of insanity should come from the law, not from an expert.”

The inequity of the situation has even struck the victims of some multiples. In a 1994 case, a therapist pleaded for leniency after the client she was treating for MPD tied her up and sexually molested her. In an emotional appeal before a Washington court, the therapist explained that Tyrone, William Greene’s small-child alter, was re-enacting an abuse scene with his mother. Greene’s 18 other alters were unaware of Tyrone’s actions – or if they knew about them, they were unable to stop him. But the jury convicted Greene, a previously convicted sex offender, and gave him a life sentence under a “three-strikes” law.

“The multiple is no more capable of responsible acts than any other criminally insane person, but he still is being held culpable,” Saks said.

MPD is thought to be an adaptive mechanism caused by child abuse so severe that the mind fragments, creating other, person-like dimensions to cope with the pain. So distinct are these entities that they answer to different names, display different abilities and behave as though they were different ages. Sometimes, alters even display physical differences. One alter displayed no allergic reaction to citrus, while his other alters broke out in hives.

THE MOST VULNERABLE of these alters enter psychic “pockets” of amnesia, where they are unaware of the experiences – or actions – of other alters. “The blackouts are protective devices,” Saks said. The host personality – or the personality who answers to the multiple’s real name – is no less vulnerable to such blackouts. From this constellation of personalities, a stronger alter tends to emerge as the “protector,” and it is not unusual for this alter to display some of the same aggression as the abuser who originally caused the multiple to fragment.

Despite Dr. Jekyll and Mr. Hyde, Psycho and other fictional portrayals of multiples as criminals, most people with MPD are not criminals, Saks stressed. However, the number of criminal cases involving multiples is on the rise, probably because MPD diagnoses have increased since the APA recognition. Still, MPD remains extremely rare, affecting from one in 100 to one in 10,000 people, according to wide-ranging estimates.

For Jekyll on Trial, Saks pored over more than 100 legal cases and 500 journal articles about MPD. A therapist in training, she also reviewed nearly 100 hours of videotaped interviews with multiples and personally interviewed more than 75 MPD outpatients at a local hospital.

She concluded that courts should use a similar – but slightly stricter – standard for culpability for alters as for accomplices in a crime.

“When you look at legal and philosophical literature, you find that alters share the same, main attributes of individuals, with the exception of a separate body,” Saks said. “If one accepts that it is not permissible to punish one person or person-like entity for the crimes of another, it shouldn’t matter whether the ‘guilty person’ is an alter or an independent person.”

Under Saks’ theory, multiples with alters who did not participate in a crime could be exonerated. Unlike regular accomplices, however, the alters also would have to demonstrate that they were powerless to stop the crime.

“This is the Norman Bates scenario,” she said, referring to the Psycho motel operator whose host personality is oblivious to his alter, a mother figure and ruthless killer.

In the case of the Boston-area drug dealer, Norma Roman should have been found not guilty by reason of insanity because two of her seven alters were not aware of the crime and would surely have stopped it if they had known about it, Saks said. The same situation holds in Greene’s case. In fact, Saks said, it’s not clear that Tyrone – the sexually abused, little-kid alter – even knew that his actions were wrong.

But exoneration would not be possible under a scenario similar to that of Dr. Jekyll, the Robert Louis Stevenson character who knows that he becomes the murdering Mr. Hyde when he drinks a certain potion.

“Any alter who knows of the crime has an obligation to stop the crime if he can, and any alter who tries to absent himself precisely so as to avoid this obligation remains subject to its dictates for that very reason,” Saks said.

In a case that illustrates culpability under Saks’ test, a New Jersey jury acted appropriately by convicting a multiple of kidnapping and murder, she said. In the 1988 case, Marie Moore revealed two personalities: a host personality with her own name and a vicious alter named Billy Joel. Billy Joel confessed to holding hostage and terrorizing a group of children and coercing one of the children into killing another. Meanwhile, Marie was found to have covered up for Billy as the police closed in on the crime.

“This was clearly a disturbed person who may have deserved to be exonerated, but not on the basis of MPD,” Saks said. “Both alters conspired in the crime.”

UNDER HER PROPOSED test, few multiples would be found criminally responsible, Saks conceded. Still, she stressed, a multiple found not guilty by reason of insanity need not pose a threat to public safety.

“Getting away with the crime is something of an overstatement because the person would lose his liberty – he would be committed to a mental hospital until he is no longer ill or dangerous,” she said. “That is no trivial sanction.”

If ever established as precedent, Saks’ “theory of non-responsibility” also would result in the appeal and possible overturn of a number of MPD convictions. But she believes the alternative is worse.

“In these days of victims’ rights, it is tempting to overlook the rights of a criminal, even a mentally ill one,” she said. “But as a society we have decided that it’s better let a guilty person go free than to convict an innocent person. It’s a matter of compounding injustice.”

A Call for a New Legal Understanding of Multiple Personality Disorder

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