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About Dr. Allison



Ralph B. Allison, M.D.

P.O.Box 6546

Los Osos, CA 93412-6546

Phone & Fax 805/528-7599


Running Head: "Alter-Personalities v. Imaginary Playmates"

Submitted to

The American Journal of Forensic Psychiatry

July 1997


The differentiation of Alter-Personalities from indwelling
Imaginary Playmates is essential when evaluating a defendant
whose offense may have been committed by a Mental Entity other
than his Original Personality. Two examples of defendants who
exhibited dangerous Imaginary Playmates are presented.
Explanation is given as to how dissociation is a function of the
Essence (Intellectual Self), while imagination is a function of
the Original Personality (Emotional Self). Creation of
Alter-Personalities is considered involuntary for forensic
purposes, but creation of Imaginary Playmates is considered
voluntary. Treatment is needed for integration of
Alter-Personalities, but the defendant can destroy Imaginary
Playmates by an act of will. Key Words: Playmate, Imagination,
Alter-Personality, Multiple Personality, Dissociation


In forensic psychiatry, a major issue which often needs to be
addressed is whether an illegal act was "voluntary" or
"involuntary." The law commonly considers a voluntary act which
violates a criminal statute to be worthy of punishment, but the
same act done involuntarily might not warrant punishment, and
the perpetrator might be referred for treatment of the
underlying mental illness. When the misbehaving party appears to
be a Mental Entity (ME) which only intermittently controls the
defendant's body, then the psychiatric examiner must determine
whether or not that ME was created voluntarily or involuntarily.
The thesis proposed here is that a ME which is a bona fide
dissociated Alter-Personality is created involuntarily, but a ME
can also be an Imaginary 

Playmates residing inside the body, and these are created


As long as man has been on this globe, the shamans, philosophers
and other wise individuals have known that each of us humans is
composed of body, mind, and spirit. I acknowledge the great
importance of the "body" part, the brain, but here I put it
aside to focus on the other two aspects, the mind and spirit.
While working with dissociators for the past 25 years, I have
learned that both the mind and the spirit are composed of the
same "substance," intelligent energy or consciousness, but each
has a different role to play in human life on earth. In healthy
persons, they are psychic partners bonded together for a common
goal. The "mind" is the Original Personality and is usually in
charge of the physical body, while the "spirit" is perceived by
the Original Personality as that "still small voice within." But
the bond can be broken under certain circumstances, allowing the
"spirit" to control the body. This breaking of the bond between
the two is one variety of dissociation.     

My clinical experience has been with highly hypnotizable
patients who were severely traumatized before the age of seven
and showed evidence of dissociation known as Multiple
Personality Disorder (MPD). In these patients, the first
dissociation was between the "mind" and the "spirit," but I used
other terms to describe these MEs. In these patients I called
the "mind" the Original Personality or the Emotional Self. I
called the "spirit" the Inner Self Helper (ISH) (1) prior to
personality integration, and the Essence or Intellectual Self
after integration (2). During the period of personality
disintegration, the Essence takes on the role of ISH so as to
maintain enough order to keep the patient alive.      

In these patients with MPD, the Original Personality hides
inside the mind to escape further life-threatening abuse. The
ISH uses dissociation to create appropriate Alter-Personalities
(Alters) to run the body until a therapist can be found who will
return the Original Personality to control of the body. This is
all done for the sake of survival of the whole person, but
without any participation by the Original Personality, which is
still an infant or small child. This is one variety of
pathological dissociation, one which often goes on for decades. 

A shorter lasting type of pathological dissociation would
commonly be called a fugue state in a highly hypnotizable
person. During a serious emotional upset after age seven the
Essence  dissociates from the Original Personality so as to be
able to run the body itself. It also may cause temporary amnesia
to the Original Personality. This condition lasts from minutes
to days, during which the Essence runs the body while the
Original Personality takes a rest. When the crisis has been
handled properly, the Essence allows the Original Personality to
regain control of the body and then may provide memories of what
happened when the Original Personality is able to handle them.  

Nonpathological dissociation in highly hypnotizable persons led
to the discovery of the Hidden Observer by Hilgard (3) at
Stanford University. Grade V hypnotizable students were found to
be able to reveal a ME which was aware of what the person had
been hypnotized to be unable to perceive. I believe this Hidden
Observer is the same as what I called the ISH, Essence or
Intellectual Self, but it was found in nontraumatized
individuals under hypnosis. Hypnosis is one method of inducing
artificial dissociation in susceptible subjects.      

I now know that dissociation is a method used by the Essence for
the purpose of assuring the survival of the individual. It acts
without the consent or knowledge of the Original Personality.
Since the Original Personality is considered the social person,
such behavior is involuntary from the point of view of the
Original Personality of criminal defendants.      

Fortunately for our criminal justice system, it would be
extremely unusual for any Essence to design an Alter which
deliberately performs a felonious act, such as killing another
person, since such acts are not conducive to personal survival.
Therefore, I became suspicious that MPD was not the correct
diagnosis in felony cases where the evidence indicated a ME
other than the defendant's Original Personality committed the
violent crime. The many differences between dissociating 
individuals I had seen for treatment and those examined after
arrest for violent felonies were presented in a paper titled
"Maybe Multiples in Courts and Corrections" (4). At the time, I
did not know what might be the origin of MEs responsible for
these serious felonies.       The answer became clear to me when
I examined the murder defendant described in Case No. 1. During
his preliminary hearing, his sister described how both she and
her brother created Imaginary Playmates after their father shot
and paralyzed their mother in front of them. I met his murderous
Imaginary Playmate during my interview. After he tried to
strangle me, I had him moved to a secure interview room. There
the defendant talked to me over the phone as the quiet placid
boy, while his murderous Imaginary Playmates talked to him from
the wall beside him. Now I realized that many examiners were
confusing Imaginary Playmates inside a defendant's body with
dissociated Alters.     

To confirm this hypothesis, I interviewed a  woman who had
integrated 70 Alters 13 years before (2). During the last month
of my therapy with her, she manifested a number of MEs who had
not required psychotherapy to disappear, as had the Alters I
knew well. She admitted to me then that, at the time, she, the
Original Personality, was panicked because I planned to move out
of the area, and she had deliberately imagined into existence a
number of hostile MEs to entice me to stay. They used her body
to insult and physically attack me in the office. After I left
town, she got rid of all of these Imaginary Playmates during a
nine day stay in a state hospital. What she had willed into
existence she willed out of existence. She described how she
could easily move them from inside her to outside her body by an
act of will. 


With this new insight, I reviewed many articles on Imaginary
Playmates in the psychiatric and psychoanalytic literature. What
I discovered was an almost universal lack of interest by the
writers on whether or not these MEs could exist within the
bodies of their creators. They usually assumed that Imaginary
Playmates existed only outside the body of the child who created

One exception was Bach (5) who reported on "Robin: An Imaginary
Alter Ego". He wrote that, after her grandmother's death when
she was 4 , "she invented a double named Robin. Robin was
permitted to wander in the woods and fields adjoining the house
and to experience all the adventures that were forbidden to
Margaret. When engaged in these adventures, the little girl
became Robin; that is, she deliberately assumed an alter ego
that completely replaced her self. Late in the evening, when the
father would return to the gloomy household bringing fascinating
stories of the world outside, Margaret would dress up in her
best clothes and become Robin. Then she would tell her father of
her own imaginary adventures in a ritual which they shared for
many years."     

Another exception was a paper by Fotheringham and Thompson (6)
who described four individuals with Down's Syndrome. Three had
external Imaginary Playmates and one was thought to have MPD,
the only time MPD had ever been reported in someone with Down's
Syndrome. But the only difference between the first three and
the one with "MPD" is that the latter patient's two MEs resided
inside the body of that person. His "alter-personalities"
appeared in his early 20's without any history of abuse but
apparently handled his anger at his roommates. One ME may have
been modeled after the lead actress in the TV show, "The Bionic
Woman." All one needs do to call the MEs in the fourth case
Imaginary Playmates is to accept the premise that a ME can exist
inside the creator's body, as well as outside.     

Then I re-read the autobiography of my male patients with MPD,
Henry Hawksworth (7). He described how he first created two
Imaginary Playmates before he dissociated his Essence from his
Original Personality at age four. Then his Essence created two
Alters to run his body.          "Soon, like other lonely
children, I began countering the emotional strain of not having
real friends by inventing imaginary playmates who lived only in
my head. The first of these, unfortunately, was Johnny. I would
spend hours alone carrying on conversations with him. Shortly
after my second birthday I was given a Charlie McCarthy doll and
I pretended that Johnny lived inside it. I would hold the doll
on my knee and make the mouth move whenever Johnny was supposed
to be talking. . . .     

"I began blaming Johnny whenever my father became mad at me. . .
. Johnny was the one who was bad and should be punished. . . .  

"When I was three I created a new playmate. This was Peter; he
formed in my mind shortly after I received a book about Peter
Pan for my third birthday. The story, of course, is about a boy
filled with nothing but goodness. He loves nature and can talk
with flowers. He is 100 years old, yet he never grows up. He is
tender and gentle yet remains all boy. He is able to express
emotions I, too, had always felt, but which I had had to hide
because they hadn't fit my father's concept of masculinity."
(pg. 23-24)     

The next year, when he feared death at his father's hands, his
Essence, Jerry, dissociated from his Original Personality,
Henry, who went into hiding in his mind for the next 40 years.
Dana, an Alter, was made by his Essence to run his body, along
with Johnny and Peter. Later, Phil, another Alter, was created
by his Essence. When he was 43 years old, Henry came back in
charge of the body, after he destroyed both Imaginary Playmates,
and both Alters integrated into the original Henry. So here we
had a man who showed both Alters and Imaginary Playmates,
indicating the difficulties in making the proper diagnosis.  


Fred, a 24 year old black man and member of a local CRIPS street
gang, was seen in jail while on charges of murdering a cab
driver. He and his brother had robbed the cab driver, and then
his brother took the victim's bank card to an ATM to get more
money. While alone with the driver, Fred shot him to death with
several bullets. Prior to leaving, his brother had tried to
persuade him not to kill the man.     

Fred had been in continuous trouble since entering school and
had been incarcerated numerous times. He was on parole from the
youth authority. Prior to trial, a psychologist who had never
handled a forensic case before diagnosed him as having MPD.
Other forensic examiners disagreed with that diagnosis, but he
was been found incompetent to stand trial and was sent to the
state forensic hospital. There, Fred was diagnosed as
malingering MPD and found to be competent to stand trial. In the
hospital, he repeatedly assaulted staff members and was in
seclusion most of the time. On return to county jail, he
repeated assaulted correctional officers and was kept in chains
whenever out of his cell. I was called in by his attorney just
prior to his trial because she wanted me to advise on a
placement in state prison for treatment of his MPD after his
anticipated conviction.     

During his preliminary hearing, his older sister had testified
that they were both present when their divorced father came to
their house and shot several bullets into their mother in front
of all the children. The father was sentenced to prison for
attempted murder. The mother was thereafter confined to a
wheelchair. In her bitterness, she repeatedly told Fred he would
grow up to be just like his father. Fred was seven years old
when his mother was shot.     

The sister testified to personality changes in Fred after his
father's shooting his mother. He started talking to himself, and
"he wouldn't be Fred." She reported talking to "Mr. Mann" or
"Chuck" instead. "Mr. Mann" was perfect, always dressed just
right and very concerned about how to act properly around girls
on the bus to school. "Chuck" was a bully who kept getting Fred
into trouble.      

The sister reported that she also made her own Imaginary
Playmate, named "Akasha Richardson," at this time. With "Akasha"
inside her, she could be bolder and more assertive at school.
"Akasha" also sat next to her at home so she could talk to her.
"Akasha" stayed with her until she got pregnant at age 17. She
reported that another sister also had "other people."     

My interview began in an office with Fred in wrist and ankle
chains. He was hostile, yelling and swearing abruptly, and I
quizzed him about the duties of the officers of the court. (At
the hospital, he had shown full ability to understand court
procedures.) He claimed ignorance of the duties of anyone in a
courtroom. When I calmly challenged his claim of ignorance, he
rose from his chair and came towards me, aiming his wrist chains
at my neck. I immediately verbally terminated the interview and
headed for the door to get a correctional officer.      

I resumed the interview in a bail bondsman's room, by phone
through Plexiglas. This time I interviewed a much calmer, more
juvenile, cooperative young man who also had several delusions,
including the belief that he was going to leave the jail for
another state after his trial. He calmly give me all the history
I asked for during the next 90 minutes. After reviewing all the
reports, I had a list of 19 names that were reported to be his
"Alters," including "Mr. Mann" and "Chuck." Fred reported that
"Chuck" considered himself white, but "Amrak" hated white people
and wanted to hurt them. "Madam" and "Chuck" protected him.
There was no clear pattern of beneficial purposes as I had come
to expect in noncriminal patients with MPD. He was able to tell
me some characteristic of each name but "Mr. Mann."     

During this part of the interview, he claimed several of his
"friends" were in the room with him in different locations,
talking to him as voices, but none of them seemed particularly
helpful. None took over his body to introduce themselves to me.
Fred repeatedly closed his eyes and lost concentration with me,
but never talked as another person during that time.     

I agreed to a diagnosis of schizoaffective disorder, but not
MPD. It was clear to me that, at the age of seven, he had felt
guilty because he was not able to protect his mother from his
angry father, so he created a series of Imaginary Playmates to
contain and manage his conflicting feelings. "Mr. Mann" had to
be perfect, to help keep him alive in that family. "Chuck" and
the other antisocial MEs were made by identification with his
father and fueled by his intense anger at the man. This
"identification with the aggressor" led him to kill the cab
driver in the same way his father had tried to kill his mother.
He had no insanity defense, since he had voluntarily chosen to
make all these MEs, and I believed he could destroy them
whenever he chose to do so. I did not recommend any treatment
program in prison, since he had to learn not to assault
therapists first. When he found the existence of the MEs to be
more trouble than benefit, he could get rid of them all by


Ted was a 34 year old white male electrician who was evaluated
for his defense attorney to determine if he had MPD. He had been
arrested by the Sheriff's Bomb Squad after his therapist, a
Marriage, Family, and Child Counselor (MFCC), called police at
Ted's girlfriend's request. Two days earlier, the MFCC had
hypnotized him for two hours, dredging up memories of Ted being
sexually abused in childhood by his mother and older sister. Ted
could not get these memories out of his mind. He purchased
material with which to make a bomb so he could blow up the
memories in his head. He drew a picture of a pipe bomb, and then
read his Bible. He decided he would not go to heaven, so he gave
up the idea. He remained in a very agitated state for the next
two days, causing  his girlfriend to call the MFCC. Ted told
police he would never use the items to hurt anyone else and
claimed he had worked with bombs as a US Navy Seal. He talked
irrationally in the police car. He was charged with intention to
make a destructive device. The MFCC told his attorney that Ted
had MPD.     

At the time, he was on probation for burglarizing his mother's
earthquake damaged home and was awaiting trial on a DUI charge
after he angrily left an Alcoholics Anonymous meeting and
crashed his motorcyle.     

Besides interviewing him in jail, I interviewed his two most
recent girlfriends, secured local psychiatric and medical
records, secured past VA hospital records, and administered two
tests. I first gave him the DES (Dissociative Experiences
Scale)(8) then the DDIS (Dissociative Disorders Interview
Schedule) (9).     Ted claimed his mother liked to dress him in
female clothing as a boy and fondled him sexually. He claims he
had sexual intercourse with his older sister into his teens.  

He had his first "nervous breakdown" at age 10 when his dog was
killed by a car. In his depression, he carried the dog around in
a box until his family persuaded him to bury it.     

After high school, he had honorable service in the US Navy as a
firefighter on board ship. He led a crew in fighting a shipboard
fire which killed some of his crewmates, but he suffered no
permanent emotional harm.      

He was a heavy alcohol drinker since age 10, and became addicted
to cocaine at age 22. He then spent three months in a VA
hospital drug abuse program. He had his second "nervous
breakdown" at 29 when he found his fiancee in bed with a black
man. He wanted to kill both of them. He returned to a VA
hospital for three months. Psychological testing (Minnesota
Multiphasic Personality Inventory & Mellon Clinical Multiaxial
Inventory) led to diagnoses of Polysubstance Abuse, Organic
Affective Disorder, and Mixed Personality Disorder with
antisocial and borderline features. He was also considered a
transvestite due to a history of crossdressing. He showed no
personality switches during these hospitalizations.     

During the two years he had been in this county, he had made
three suicide attempts, each leading to hospitalization. He was
thought to have Bipolar Disorder and was on various medications
by various doctors. Both girlfriends saw three MEs, two female
and one male. They alternated in taking over his body after long
drinking followed by depression. The male ME threatened to cut
the first girlfriend's throat with a knife when she tried to
throw him out of her home. Ted thought they split up on good
terms, having no memory of this misbehavior.     

Between Ted and his two girlfriends, I developed a composite
description of four ME's, two male and two female. He showed me
none during interviews, as he was sober and on medication in
jail. "Tammy" was a seven, 10, or 12 year old "little homemaker"
whom he made up at age six to help out in the kitchen. She was
made when no one was doing any cooking at home. If he wanted
eggs, she would know how to cook them. While "Tammy" was in
control, he wore female clothing.     

"Tamara" was a 17 or 42 year old "crazy older woman" which he
made up at age seven as "my alter-ego, another part of me." She
is what he thought his mother wanted him to be when he grew up.
She was described by one girlfriend as sophisticated, angry,
mean, and like his mother. She had no beneficial purpose and
wanted to kill people. She was all emotion. When "Tamara" was
out, he would dress up with a wig, female clothing and high

"Rick" was a male ME which the girlfriends knew as the "macho"
one. "He is the one I want to be. He grows up alongside of me,
likes hunting, fishing, dancing, mountain climbing, motorcyle
racing." "Rick" thought he had been in the US Navy Seals. He
also thought he was on a mission to Russia on orders from
President Reagan to kill certain officers. He acted out this
fantasy in front of the second girlfriend, acting as if he
commanded a squad of assassins which included "Tony" and
"Cornfed." "Rick" was the one who put the knife to the first
girlfriend's throat.     

"Eric," described only by Ted, was a 25 year old male who told
Ted to die and go to heaven. Eric made him think of killing
himself. "Eric has only one face, which I see inside. He is my
frustration, anger, makes me cut myself, hurt myself, burn
myself on the legs so others don't see it. The only bad one is

On the DES, a screening test for dissociative tendencies, Ted
had a score of 37.8 and endorsed 20 of the 28 questions. This
was not high enough to qualify him as a dissociator, being well
below the level found with PTSD. The DDIS, a structured
interview, gave the most reliable diagnoses as Substance Abuse,
Major Depression (recurrent), Borderline Personality Disorder,
and Psychogenic Amnesia. (One characteristic of Borderline
Personality Disorder is "identity disturbance: markedly and
persistently unstable self-image or sense of self.")     My
conclusion was that Ted did not have MPD or any other
dissociative disorder. He had a Borderline Personality Disorder
and the Mental Entities he had shown when intoxicated were made
by his emotional imagination. He plea bargained for a four year
sentence to state prison. 


Confusion is understandable in this area of forensic psychiatry.
To ferret out the truth takes a great deal of time and
information from multiple sources. I have not even touched on
the issue of those who dissociate after the age of seven, as
they demonstrate a completely different clinical picture.
Malingering has not been mentioned, but is extremely important
in any forensic evaluation. Here I have chosen to focus only on
the differences between imagination and dissociation, two quite
different mental processes.      

Dissociation is a process used by the Essence for the purpose of
creating useful Alters which can substitute to operate the body
for an absent Original Personality. Alters are designed for
survival of the total organism. If the first dissociation of the
Essence from the Original Personality is before age seven, the
Original Personality may not be available to run the body for
decades. Alters are created for specific purposes, using
characteristics that the Original Personality would have taken
on if it had stayed in charge. When an Alter becomes obsolete,
it must be replaced by a newly created one. Since very few
people are highly hypnotizable enough to be able to create
Alters, MPD is a real but rare condition. As far as the Original
Personality is concerned, the creation of the Alters is
involuntary. With proper psychotherapy, Alters can eventually be
"layered onto" the Original Personality during psychological
integration. The Original Personality cannot do this by itself. 

Imagination is a process used by the Original Personality for
the purpose of creating MEs for a wide variety of purposes.
There are no limits to human imagination, so MEs can be created
in any size, shape, age, sex, or physical form. They may live
inside or outside their creator's body. They are fueled by raw
human emotions and are not designed for survival purposes. They
may have limited and changing characteristics, as they can be
constantly redesigned by the imagination of the Original
Personality, as needs and desires change. Since all but the
demented can imagine, Imaginary Playmates are ubiquitous
throughout mankind. Since they are chosen to be made by the
Original Personality, the creation of Imaginary Playmates is
voluntary. The Original Personality can destroy any and all
Imaginary Playmates, once the person makes up their mind to do
so. All that is needed is the will to get rid of them and take
responsibility for what they have been doing in the person's


A forensic psychiatrist who evaluates a defendant whose body
apparently committed the criminal act while under the influence
of a ME instead of the Original Personality needs to determine
if imagination or dissociation was used to create that ME.
Dissociation requires high hypnotizability and a life
threatening trauma, and produces an Alter which is designed by
the Essence to prolong that person's life. Persons with bona
fide Alters are rare, and Alters are unlikely to have any
interest in felonious misbehavior against strangers. From the
point of view of the Original Personality, they are created

However, MEs created by the imagination of the Original
Personality are fueled by raw emotion and are not created with
any inner control mechanisms in place. They can exist wherever
their creator wants them to be and can do whatever their creator
wants them to do. As they can be manufactured by almost any
human, they are much more likely to be present in individuals
who commit violent crimes. From the point of the Original
Personality, they are created voluntarily.                      


1. Allison RB & Schwarz T: Minds in Many Pieces: New York,
Rawson/Wade, 1980

2. Allison RB: Memories of an essence, 1996 (unpublished

3. Hilgard ER: Divided Consciousness: Multiple Controls in Human
Thought and Action. New York, John Wiley & Sons, 1977

4. Allison RB:  Maybe multiples in courts and corrections. Paper
presented at the American Academy of Psychiatry and the Law,
Ottawa, Ontario, Canada, October 15, 1987.

5. Bach S: Notes on some imaginary companions. Psychoanalytic
Study of the Child 1971; 26: 159-171

6. Fotheringham JB & Thompson F: Case Report of a Person with
Down's Syndrome and Multiple Personality Disorder. Canadian
Journal of Psychiatry 1994; 39:2:116-119

7. Hawksworth H & Schwarz T: The Five of Me: The Autobiography
of a Multiple Personality: Chicago, Henry Regnery Company, 1977

8. Bernstein EM & Putnam FW:  Development, Reliability, and
Validity of a Dissociative Scale. Journal of Nervous and Mental
Disease 1986; 174: 727-735

9. Ross CA: Multiple Personality Disorder: Diagnosis, Clinical
Features and Treatment. New York, John Wiley & Sons, 1989 


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