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The American Journal of Forensic Psychiatry, Vol. 111, No. 4,
1982-83, pg. 181-192

THE MULTIPLE PERSONALITY
DEFENDANT IN COURT
Ralph B. Allison, M.D.

Ralph B. Allison, M.D. has continued the excellent work done in
the field of exploring multiple personalities.  From my point of
view as a forensic psychiatrist, multiple personality theory
permits the therapist to apply a "technique" with which to
"legitimize" response, - an exploratory probe to allow the
patient to use himself as a participant observer and calmly talk
about another self that has committed acts considered
inappropriate by society.  The "multiple personality subject can
be opened up, calmed and encouraged to talk more easily about
himself (rather than made to feel shame and guilt, - which would
distort the interview results).  Acceptance of the existence of
a second, third... personality momentarily affords the patient a
way of shifting responsibility to another self or selves and
hence legitimizing otherwise intolerable acts. Treating in
another manner a psychiatrist might fail completely to evoke
meaningful responses from a forensic patient.  There would seem
to be many more areas of 'multiple personality' theory still to
be explored.  In my mind, there is little question, however,
that Dr. Allison holds many of the important keys to this
important storehouse of information.

Leonard R. Friedman, M.D., J D.
Boston, Massachusetts

ABSTRACT

	When a forensic psychiatrist determines that a defendant may
have multiple personalities, a complex diagnostic workup faces
both the psychiatrist and the defense attorney.  A case report
is presented in which the defendant was found guilty and sane
under the ALI rule, in a case of assault and robbery, even after
all three of his personalities testified in court. 
Recommendations are given regarding proper workup, recording of
interviews, use of historical data, use of sodium amobarbital or
hypnotic interviews and pleading mental incompetency to stand
trial

	As the result of heightened interest in dissociative states,
hypnosis, and altered states of consciousness during the last
several decades, forensic psychiatrists have had to develop
better ways of dealing with defendants who claim amnesia for
their offenses.  With the adoption of the American Law Institute
(ALI) definition of legal insanity in many jurisdictions, a
clause has been added under which acts performed in a
dissociated state can now be included.  The "second leg" of the
ALI Rule adds the inability to conform one's conduct to the
requirements of the law to the McNaghten Rule definition of
insanity.

	The questions now facing the forensic psychiatrist are: 

	1.   Did the defendant perform the illegal act in mind state A
(his usual waking state), or mind state B (an altered state of
consciousness but not sleep)?

	2.   If in B, what is the relationship between the self (or
personality) in mind state A and the self in mind state B?

	3.   Is there an amnesic barrier between mind states A and B?
If so, is the barrier total in both directions or is there
one-way amnesia only? (is A unaware of B's activity, but B aware
of A's activity?)

	4.   What degree of control, if any, can the self, in mind
state A, exert over the actions of the self in mind state B, and
vice versa?

	5.   What are the stimuli which bring a the change from mind
state A and B to A? Are strong emotions adequate, sedative
drugs or alcohol also required?

	All these questions must be explored in evaluation of a
defendant who has exhibited dissociative behavior during
criminal activity.  The most extreme and dramatic examples of
changing mind states is the condition known as multiple
personality.  In forensic psychiatry, this condition occupies a
very unstable and uncertain status in relationship to the
insanity plea(l).  Many psychiatrists have a hard believing this
condition exists in their patients and, therefore, they find it
even harder to believe it could be the correct diagnosis in a
criminal defendant where much secondary gain is involved.  Coons
has written an excellent paper on the differential diagnosis of
this condition(2), and anyone faced with this question should
study his paper carefully A recent paper published in The
American Journal of Forensic Psychiatry (3) presents guidelines
for establishing the diagnosis in criminal defendants.  In that
paper many questions were raised, but left unanswered, about
what one does in regard to attorneys and court procedures if
multiple personality is believed to exist in a defendant.  This
paper is meant to try to answer some of those questions.

INFAMOUS CASES

	Whereas the psychiatric and popular literature on multiple
personality has featured women such as Miss Beauchamp(4), Eve
(5-7) and Sybil (8), the legal cases have usually involved men. 
William S. Milligan of Columbus, Ohio, manifested 10
personalities and was charged with rape performed by the female
Lesbian one of them (9).  He was found not guilty by reason of
insanity and is now hospitalized in Dayton, Ohio.  Kenneth
Bianchi, who manifested two alter-personalities (one a lust
murderer and the other an adolescent psychologist) pleaded to
two murders in Bellingham, Washington, and five murders in Los
Angeles, California.  He is now doing prison time in Los
Angeles(10).  Paul Miskimen was found not guilty by reason of
insanity for the murder of his wife in Sacramento,
California(l1).  All psychiatrists involved in that case agreed
that the murder was committed by his alter-personality while in
a co-conscious state, and that Paul had no capacity to stop the
killing.  This is the first case known where the act of an
after-personality led to a successful insanity defense in the
case of murder. (He is currently in Napa State Hospital.)

	Esther Minor is the sole female defendant to be reported in the
literature(12).  She was found not guilty of forgery in a San
Bernardino, California court because her alter-personality,
Raynell Potts, admitted writing the bad checks.  The insanity
issue was not an issue in this case.

	In 1977, five of my own cases were briefly reported in a
newsletter(13).  Since that publication is not generally
available now, the case summaries are repeated here.

" 1) Nineteen-year old man, arrested for arson, found guilty and
sent to prison.  On release, he and his family filed a civil law
suit in which he tried to prove incompetency to file earlier. 
He showed an alter-personality that set fires and had periods of
amnesia.  The Judge concluded that he was competent after my
testimony.  Later he killed two people and is on death row with
first and second degree convictions.  Multiplicity was never
raised an issue In these trials.  For further details, see
chapter 7, Minds in Many Pieces (14).

"2.     Thirty-three year old woman had been convicted
previously of felony bad checks.

Alter-personalities became apparent in treatment, while on
probation.  So she could offer input in probation planning, I
arranged a conference with the judge, the patient and me, during
which a helper personality came out and discussed the situation.
 At a court date later, when an attorney disputed the diagnosis
as unproven, the Judge could say, "I saw it.  I believe it.  The
question is settled." (For her view, see her autobiography (15).)

"3) Fifty-year old man robbed a bank here and in Reno.  A
psychiatrist in Reno recognized multiplicity, treated him for
one year, fused him and returned to Federal Court.  At trial,
videotapes of the personalities were shown.  Verdict was not
guilty by reason of insanity.  He returned here for trial and
Judge found him not guilty by reason of insanity.

"4) Forty-two year old man I treated to fusion.  Before fusion,
his bad personality had been arrested for drunk driving and
refusal to take alcohol test.  In trial after fusion, I age
regressed him six months and brought out two pleasant
alter-personalities who told about the bad one.  The Judge was
convinced and found him not guilty because of no physical proof
of intoxication.  The man still lost his license since he didn't
want to fight it out in court near home. (see his autobiography
(16).

"5) Forty-one year old man with 20-year history of writing bad
checks was charged with embezzlement of $17,500 from employer. 
In treatment elsewhere, therapist found an alter-personality who
took the money.  When I saw him in consultation, I got rid of
the bad one and we later went to trial.   Testimony before jury
was all verbal.  Even though he had paid all the money back, he
was found guilty.   His attorney felt the jury was not convinced
that he had been multiple, in spite of a very convincing history
of repeated blackouts with stupid illegal behavior.

CASE REPORT

	This previously unreported case is presented to illustrate, in
some detail, the problems and pitfalls that can occur in
presenting a defendant with multiple personalities to a court of
law in a non-capital felony case.  This case was complicated by
the fact that I had to play two roles with the defendant.  My
position included treating any prisoners in jail needing
psychiatric help, of which he was one.  Since I was the only
psychiatrist with good rapport with him, I was court appointed
to assist his defense attorney in preparing the defense. 
Another important factor was that the defense attorney was new
to law practice and this was his first insanity case.

	Anthony J. was a 20-year old single black man who was first
seen by me in the local county jail during the weekly
psychiatric sick call.  He was suicidally depressed and terribly
perplexed over how he had gotten into so much trouble. 
Originally from New England, he had been in much legal trouble
there, ever since he had been taken from the custody of his
mother, a prostitute, and placed with a white family.

	During his first county jail incarceration at age 18, he had
tried to kill himself and was hospitalized in a psychiatric ward
for several weeks.  Once he was jailed in New York City under
the name of John Grace.   He had total amnesia for that arrest
and booking and had been told he was quite hostile and
uncooperative during the booking procedure.  Finally, he was
sent by the Court to a residential treatment center in Maine,
from which he ran away, hitchhiking to California.  He found his
way to a central valley city where he worked at various jobs. 
He had amnesia for most of his trip to California, as well as
for many blocks of time back East.

	After a year in California, he agreed to drive a friend to
southern California.  Both were high on LSD.   His car down on
the freeway and they hailed a passing motorist.  They tried to
get a ride into town, but the motorist, noting their drugged
states, refused.  Anthony then grabbed the car keys from the
motorist.   The motorist snatched his key back, drove to the
next town and reported the incident.  Police arrested Anthony
and his friend on charges of forcible theft of the car keys. 
Anthony took full responsibility for the crime, even though he
had blacked out when the motorist refused to give him the keys. 
He was sentenced to 5 years in state prison.

	While awaiting sentencing, his auto license number was run
through the police computer.  Thus it was discovered he was
wanted in our county, which neighbors his county of residence. 
The charge was theft and assault involving the wife of the
assistant county health officer.  His car had been parked
outside the victim's home when the incident occurred, and
neighbors had reported the license number to the police.   Our
detective visited him in jail, where he gave a full confession
of the crime, which was tape-recorded.   After being sentenced
to prison, he was transferred to our county jail to face these
charges, and it was then I first met him.

	A few days later at his arraignment, while listening to the
district attorney describe his criminal deeds, he felt he would
be locked away for life.  He blacked out and, the next thing he
knew, he found himself running out of the river on the other
side of town facing the drawn guns of several deputies.  He had
tricked a deputy at the courthouse into letting him get to an
unlocked door and then he took off running, trying to look like
one of the local joggers.

	I had already left word at the public defender's office that
Anthony had serious problems but gave them no details.  Since
the public defender had witnessed the escape from the courtroom,
another attorney was appointed to defend Anthony.  I was
appointed to be the psychiatric consultant to the attorney.  For
the next 5 months we tried to unravel the mysteries and prepare
ourselves for trial.

	Since there was no doubt about his escaping from court, I used
that incident to determine if an alter-personality existed.  I
asked him to recreate his feelings as he sat in the courtroom
that day.  As he did this, I asked him to let whatever took
control of his body then, take control now.  After a few minutes
of facial twitching, his eyes opened, and he greeted me as if he
had never seen me before, using very crude street language.  He
identified himself as John Grace and claimed to know nothing
about any Anthony.  He admitted to planning and executing the
escape.  At first he denied responsibility for the assault and
robbery, but in a subsequent interview he admitted to that
offense.  He and his girlfriend had been going door to door
pretending to raise money for a fictitious black charity.  What
they were really trying to do was to find the most racially
prejudiced person on the block.  The doctor's wife's comments
seemed to him just like the welfare worker who had taken him
away from his mother.  This was enough for him to push his way
into her house, knock her down and take her wedding rings from
her.  The assault was meant as a degradation of her as a
representative of all the white people who had put him down when
he was living back East.

	I tried to persuade the defendant's attorney to plead him
incompetent to stand trial, so he could be sent to a state
hospital for treatment.  Anthony had amnesia for the criminal
acts, was quite depressed, and John told the truth only when it
pleased him.  He denied confessing to the detective while in the
other jail.  The attorney disagreed with me, saying, "I get
along with him fine.  I can get all the history I need.  He can
change personalities in my office with me alone, and I can't see
why he can't stand trial."

	I later learned that what had happened was that the attorney
had met a third personality, Alexander, a rescuer.  He supplied
the attorney with all the information Anthony and John did not
have.  Alexander had given the confession in his attempt to get
the matter straightened out.  I was usually talking with John or
Anthony, and the attorney usually conferred with Alexander.

	During the five months prior to trial, Anthony came to know and
accept the other two personalities.  His memory of many of the
past events improved as I fed back to him what I learned and as
he felt less frightened to know the truth.  We made videotapes
while the different personalities were out.  Anthony was taught
how to talk to John in internal dialog method (17).

	Records were secured regarding his schooling, medical and
psychiatric treatment and his behavior in the therapeutic center
in Maine.  This data was shared with both Anthony and John. 
Frequently, there were reports of him arguing and fighting with
teachers.  Anthony denied ever fighting with teachers, but
admitted to blackouts after a mild argument.  John readily
admitted to taking over at that point and engaging in fisticuffs
which led to Anthony being punished, but not knowing why.  In
contrast, Anthony remembered the psychiatrist who treated him
after his suicide attempt in jail, but John had no memory of
having talked to that particular psychiatrist at all.  On the
other hand, Anthony was very unclear as to the reason for his
suicide attempt, while John very clearly reported that it was a
time during which he felt completely rejected by his family
because none of them would bail him out of jail.

	Anthony completed the California Psychological Inventory (CPI),
which was computer-interpreted by Behaviordyne, Inc.  Their
program is unique, in that the CPI, which has many questions in
common with the Minnesota Multiphasic Personality Inventory
(MMPI), reports MMPI scales as well as CPI scales from the CPI
answer sheet.  It showed a hysteria score of 66.5
(normal=48-52).  In my experience, all those patients who scored
higher than 55 eventually proved to have multiple personalities.
 The readout indicated that "he has built his way of life around
the defense mechanism of dissociation, repression, denial and
conversion... By focusing on one bodily sensation or another, he
gives himself conversion symptoms ... He may also have
dissociative reactions, spells of mood or behavior differing
from his usual self. . . He is hysterical in character... he
makes himself unaware of those impulses of his that would
distress him if he were aware of them.  He is naively unaware of
his sexual, hostile, and dependent motives even while he's
putting them into action."

Diagnoses in order of preference were:

"295.3 Psychosis, schizophrenia, paranoid type, with
dissociating (hysterical) features.

300.1	Psychoneurosis, hysteria, conversion reaction with
pseudo-neurological symptoms such as pains. There is some
possibility that dissociative reaction may also be present.

300.1 Psychoneurosis, hysteria, manifested by conversion
reaction. anxiety reaction. or dissociative reaction, in a
dissociating (hysterical personality.)"

	I was unable to get Anthony's cooperation in getting John to
take the CPI.  Because Anthony claimed his IQ had been found to
very high in school, he was given the Slosson Intelligence Test
with a resulting IQ of 90.  No other tests were given mainly due
to his reluctance to cooperate in any kind of formal testing
procedure.

	In regard to the mention of conversion symptoms on the CPI, it
should be noted that Anthony regularly reported for medical sick
call with aches and pains, none of which had any organic
causation.

	Since the defense attorney decided plead him not guilty and not
guilty by reason of insanity, two court-appointed psychiatrists
came to see him in jail.  The defense attorney did not talk to
them about the case or show them the videotapes.  They just came
to the jail, talked to the prisoner and wrote their reports. 
During both interviews, Anthony gave his history and then John
broke in later, introduced himself and tried explain how he
(John) was the tough guy while Anthony was a weakling and a
sissy.   One examiner accepted that Anthony had at least two
personalities and was legally insane by the ALI rule.  The other
examiner wrote a report that was more of a diatribe against
Anthony than a psychiatric report and basically recommended
locking him up forever.  He stated that Anthony was not at all
typical of multiple personality patients he had know. (He had
seen 2 cases 15 years before, both white middle-aged females.)

	At the time of the trial, the attorney waived a jury trial and
only the Judge heard the case.  Anthony took the stand testified
that he didn't remember committing the crimes charged.  Then, at
his attorney's request, he closed his yes, and John Grace came
out to testify how he committed the crimes, throwing snide,
nasty comments at the Judge and district attorney along the way.
 Then John would give way to Alexander, who would calmly and
patiently explain why John did the things he did and how John
kept it all secret from Anthony.

	As expected, the Judge found him guilty on all counts.  He also
found him sane at the time of the offenses.  The defense
attorney believed the Judge felt that Anthony did not qualify
under the second leg of the ALI rule, because he showed control
of the ability to change personalities on the stand.  The
attorney believed the Judge felt that, if Anthony could control
which personality was testifying, then he should have been able
to control which personality was assaulting the doctor's wife. 
The fallacy of this line of reasoning was that we had spent 5
months teaching him that control, both for his safety in jail,
where John Grace antagonized jailers and other prisoners alike,
and so he could demonstrate his mental illness in court.  What
the Judge may have failed to realize was that, at the time of
the offenses, Anthony did not know of the existence of the other
two personalities, that they came out in response to certain
emotions in Anthony, and that Anthony had no control over when
they might come out.

	When Anthony was sent to prison, he was assigned to the
psychiatric treatment center.  The Director of Research was
asked to look into his case and he assigned him an individual
psychotherapist while he participated in one of the group
treatment programs.  John Grace continued to act out, mainly
against white female supervisory personnel.  Anthony did come to
accept John's anger as his own and, after about a year in
prison, came to believe that John and Alexander no longer
existed.  He has improved in his self respect and he now takes
full responsibility for his actions.  He now has the ability to
set goals for himself, one being marriage and the other further
education.

DISCUSSION OF THE CASE

	This case illustrated pitfalls of having a multiple personality
defendant testify prior to his fusion.  To substantiate the
diagnosis I had to use various confronting techniques which are
used in initial phases of psychotherapy to enable any such
patient to become aware of his alter-personalities.  The
attorney needed all the facts he could get from Alexander, the
observing personality, and these facts were then relayed to
Anthony, thus blurring self-imposed boundaries between them.  In
jail, Anthony frequently would black out when John came out to
pick fights with certain deputies he disliked.  Afterwards,
Anthony would ask me to find out what had happened and why.  So
I would interview John and report my findings back to Anthony. 
All of this was designed to give Anthony more control over his
angry behavior so as to preserve the health and safety of the
deputies and the other prisoners.  Yet this increased control,
which came about gradually, worked against his legal interests
in court.  If the Judge had only had him testify when he was first incarcerated, he would have realized that
Anthony was not able to control John at all.   Anthony did not
even consciously know John existed, but defense mechanisms of
denial, dissociation and repression kept John's hostile energy
high, and periodically John had to let off steam.  When he did,
someone got hurt.

	The failure of the defense to share with the two
court-appointed psychiatrists all the data about his past school
and psychiatric history, and the videotapes of Anthony switching
personalities, definitely set the stage for a "battle of the
experts." The dissenting psychiatrist in this case may not have
agreed with my interpretations of the data but he would have had
to explain his reasons under cross-examination.

	Fortunately, in this case, the adverse examiner showed such
extreme bias against the defendant that neither the Judge nor
the district attorney appeared to pay much attention to his
opinions.

	The final item to be noted is that, since so few offenders who
have this problem are likely to be found legally insane, some
adequate treatment must be found in prison.  This disorder does
not disappear with the passage of time alone, and further
criminal acting out can be guaranteed if the prisoner is not
confronted with the psychological reality and aided in changing
the psychodynamic forces within him.

GUIDELINES FOR EVALUATION OF THE MULTIPLE PERSONALITY SUBJECT
AND PREPARING THE DEFENDANT FOR COURT

	In the prior paper(3), I posed a number of questions which
always arise when the diagnosis of multiple personality is,
entertained by the defense attorney and any examining
psychiatrist.  I will try to deal with these questions here,
drawing on experience with all such defendants I have examined.

1.   THE WORKUP: As much psychological and neurological
evaluation should be done as one would do for a private patient
with the same history.  Psychometric testing by a competent
psychologist will add important facts and also will add another
expert witness to buttress the defense, should he agree with the
diagnosis.  If it is possible to administer identical tests to
contrasting personalities, this adds to the validity of the
diagnosis.  When a psychologist is not readily available, my
preferred objective test is a CPI, through the Behaviordyne
computer.  The MMPI would work as well on that computer program
since it is mainly the hysteria scale one would look at.

	The Rorschach test should be done and read according to
Wagner's criteria for multiple personality(18).   Wagner's
criteria for interpreting the Rorschach test needs more
validation, but so far it seems to be accurate in both sexes in
the small number of multiple personality clients who have taken
it.  If the Rorschach is given to both the original personality
and to the offending alter-personalities, there will be found to
be major differences as well as major similarities.

	In the Bianchi case, the two sets of Rorschach test results
were sent for blind interpretation to two different
psychologists, each a renowned expert.  In the first instance,
the two protocols were sent with no mention that one man took
them in two different states of mind, just with two separate
names at the top of the page.  They were read as having been
done by two separate individuals, one quite mentally normal and
one a violent sex sadist.  The other expert was told that two
protocols were done by one man at two different sittings.  That
expert reported that, whereas they looked superficially
different, there were many subtle similarities which showed the 
same persona took both tests, but one time he was in an angry
mood.  There is no way I know of for an interpreter who gets two
protocols for blind analysis to avoid getting one message or
another.  If two protocols are received with no explanation, one
will assume two people took it.  If the transmittal letter
states one person took it, then that fact will be a part of the
interpreter's bias.  Fortunately, Wagner's method of
interpreting the Rorschach of the primary personality avoids
this problem.

	It would also be wise to get an electroencephalogram and CT
scans of the brain on these defendants.  If either is abnormal,
then a neurological consultation should be secured to rule out
temporal lobe or psychomotor seizures (now called complex
partial seizures) (19) or a brain tumor.

2.   RECORDING OF PSYCHIATRIC INTERVIEWS: As soon as anyone
dealing with a client has a suspicion that a dissociative
disorder may be involved in the criminal act, all diagnostic
interviews should be audiotaped and videotape recorded.  In a
capital case, this should be an absolute rule.  In cases of
non-violent felonies, audio tapes may be sufficient if made with
a lapel microphone so that each voice is clearly heard.  The
audiotapes must be transcribed, so that everyone can have access
to the data.  Each examiner should view all prior videotapes
before seeing the defendant so s/he will know what has happened
to the defendant as a result of prior examinations.  Each
examiner has a tremendous impact on these defendants, and the
defendant is different after each interview.  The next examiner
needs to know what has happened to bring about this difference
in the defendant.

3.   HISTORICAL DATA COLLECTION: Records from schools, social
service agencies, hospitals, doctors and mental health centers
can be very valuable in bringing to light behavior which could
either support or weaken a presumptive diagnosis of multiple
personality.  An ability to discuss details of events not
connected with the offense would mitigate against the diagnosis.
 However, many patients with this disorder complain that they
cannot remember many years of childhood.  Asking them to explain
more about what is reported in written records can show if there
is amnesia for episodes where secondary gain is non-existent. 
Much collateral information out family dynamics may have been
recorded and this would aid the examiner in understanding what
kind of a life the defendant has really led.

4.   SODIUM AMOBARBITAL OR HYPNOTIC INTERVIEWS: These methods
can be used to discover what the defendant did at the time of
the offense for which he claims amnesia.  From the legal point
of view, there is the right to privacy of one's unconscious
mind, which hypnosis or sodium amobarbital would violate. in a
case where the physical evidence is not strong enough to convict
the defendant on its own merits, the defense attorney may advise
leaving the situation as it stands to avoid the defendant being
put in the position of testifying against himself.  But if the
evidence leaves little doubt that the defendant did the act
charged, then the greater benefit will be from finding out how
the defendant's mind worked at the time of the offense.  If the
uncovering interview is done by a psychiatrist secured by the
defense attorney, then all information revealed is covered by
the attorney-client confidentiality privilege and can be kept
secret from the prosecution.  This is not so in the case of a
court -appointed examiner, who will be reporting to the court
and to both attorneys.  The court-appointed psychiatrist does
not have the right to invade the patient's subconscious mind
unless the defendant has voluntarily given up that right, with
the agreement of his attorney.

	Usually a defendant is amnesic of whatever he said or did in a
trance.  The defendant should view the videotapes as soon as he
is emotionally able to do so.  Only then can a defendant become
competent to stand trial, knowing what evidence he has provided
during the trance state.  Before going to trial, the defendant
should get over the shock of seeing a nasty, foul-mouthed
personality take over his body and admit committing the crimes
which the defendant believes he would never do.

5.   PLEADING MENTAL INCOMPETENCY TO STAND TRIAL: Amnesia for
the offense alone is usually not sufficient grounds for being
found incompetent to stand trial (20).  So long as the defendant
is otherwise able to behave appropriately in court, permanent
amnesia would not preclude him going to trial.  Temporary
amnesia, especially of a histrionic type, as in a fugue state or
multiple personality, would be grounds for postponing the trial
until an attempt has been made to help the defendant regain
memory of the events surrounding the offense.  This should be
done in a therapeutic environment.  If a judicial finding of
incompetency is needed to gain such a postponement, then that
should be sought.   However, there may be cases in which it
would be to the defendant's legal disadvantage to regain memory
of the offense.  If there is inconclusive physical evidence that
he was responsible for committing the illegal act, and only he
could provide further clues to strengthen the case against him,
then his lawyer may advise that he keep his amnesia intact and
hope the prosecution will fail to prove its case against him. 
However, on the general principle that it is better for any
individual to know what he is doing at all times, defendants
should be given the opportunity to regain whatever memory is
possible and to discover why they have amnesic spells.  This, of
course, presumes that there is a place where such psychiatric
help is really available.  Competent one-to-one therapy would be
needed to safely lift the lid of repression that causes
histrionic amnesia.  This must be available or the delay in
getting to trial is just a waste of time.

CONCLUSION

	Defendants who have amnesia for their crimes may have committed
the illegal acts while the body was under the control of a
dissociated, previously created, alter-personality.  When the
history indicates repeated episodes of unusual behavior during
amnesic periods, a diagnosis of multiple personality should be
entertained.  Further workup is recommended, with school and
medical records being secured.   Psychological and neurological
testing should be done.  If the physical evidence shows clearly
that the defendant did commit the acts charged, then the defense
attorney has the option of arranging for trance induction either
by hypnosis or sodium amobarbital.  All such sessions should be
audiotaped and videotaped so all future examiners, as well as
the prosecutor, judge and jury can become fully aware of what
actually happened in the trance state. The defendant must be
shown the tapes before they are shown in open court so he can
emotionally react to them in a safe setting.  In most cases, the
defendant should not testify in court prior to personality
integration since there is no way of knowing which personality
will testify when, and confusion can be guaranteed.  If the
judge and jury are convinced that the defendant did have
alter-personalities, and that an alter-personality did the act
charged, and that the patient has fused all of these
personalities into one non-dangerous self, then there is a fair
to good chance that the defendant will be found not guilty by
reason of insanity.  He will then be allowed to continue in the
treatment that has already proved successful.  In this way both
the client and society will have benefited.

Editor's note: Since the writing of this article, a California
Supreme Court decision was rendered -- The People v. Donald Lee
Shirley.  Briefly, the decision was that the testimony of a
witness who has undergone hypnosis for the purpose of restoring
his memory of the events in issue is inadmissible as to all
matters relating to those events, from the time of hypnotic
session forward. (March, 82)

An additional memorandum we recently received from Dr. Martin
Reiser, Director, Behavioral Science Services, Los Angeles
Police Department states: "The per se decision against
hypnotically aided testimony by the California Supreme Court
will have a chilling effect on the use of investigative hypnosis
by police in major crime cases.  They will likely use it only in
dead end cases with nothing to lose.  The ruling is being
appealed by the District Attorney's Association and we are also
exploring legislative remedies.  " (April 5, 82)

REFERENCES

1.	Pollack S: ALI Insanity in the Insanity Plea.  Los Angeles,
University of Southern California, 1980, p. 58
2.	Coons PM: Multiple Personality: Diagnostic Considerations.  J
Clin Psychiatry 41 :330- 336, 1980
3.	Allison RB: Multiple Personality and Criminal Behavior.  Am J
Forensic Psychiatry: Vol 2, Issue 1, 1981
4.	Prince M: The Dissociation of a Personality.  London,
Longmans Green, 1913
5.	Thigpen CH and Cleckley HM: The Three Faces of Eve.  New
York, McGraw-Hill, 1957
6.	Lancaster E: The Final Face of Eve.  New York, McGraw-Hill,
1958
7.	Sizemore CC and Pittillo ES: I'm Eve.  Garden City, New York,
Doubleday, 1977
8.	Schreiber FR: Sybil, Chicago, Regnery, 1973
9.	Multiple Personalities: Looks at the 10 Faces of an Ohio
Rapist.  People Weekly, Jan 8, 1979, p. 46
10. Farrell B: Stalking the Hillside Strangler.  New West,
March 10, 1980, pp. 19-32
11. Wilson W: Planner found legally insane in wife's
strangulation slaying.  Sacramento Bee, April 18, 1980, p. 1
and 24
12.	Ashby A: Esther Minor: Multiple Personalities in Court. 
Forum 6: 3-30,1 979
13.	Allison RB: The Multiple In Court.  Memos on Multiplicity 1:
8-9, 1977
14.	Allison RB and Schwarz T: Minds in Many Pieces.  New York,
Rawson-Wade, 1980, pp. 		161-179
15.	Peters C and Schwarz T: Tell Me Who I am Before I Die.  New
York, Rawson-Wade, 1978
16.	Hawksworth H and Schwarz T: The Five of Me.  Chicago,
Regnery, 1977
17.	Allison RB: A New Treatment Approach for Multiple
Personalities.  Am J Clin Hypn 		17:15-32, 1974
18.	Wagner EE and Heise MR: A Comparison of Rorschach Records of
Three Multiple 	Personalities.  J Pers Assess 38:308-331, 1974
19. Massey EW and Riley TL: Pseudoseizures: Recognition and
Treatment.  Psychosomatics 2 1:	987-997, 1980
20. McGarry AL: Psycholegal Examinations and Reports, in Modem
Legal Medicine, Psychiatry 	and Forensic Science.  Edited by
Curran WJ, McGarry AL, Petty CS.  Philadelphia, FA 		Davis,
1980, p. 759

Ralph B. Allison, M.D. is a noted expert and writer on Multiple
Personality disorders.  He is staff psychiatrist at the
California Men's Colony, Son Luis Obispo, California.

COMMENTARY ON DR.  ALLISON'S ARTICLE

	After reading this very nicely written clinical paper by Ralph
Allison, M.D., regarding his experiences with Multiple
Personality, and how to handle this most unique problem, I
really feel like a general practitioner.  In an agrarian area
without even a hospital.  I must say that I am very envious of
Dr. Allison's position and all that goes with it, including his
access to time, money and facility.

	I have to compare this to Texas where we have one hospital for
the entire state for the housing and treatment of the criminally
insane.  I have never known the very competent staff at this
hospital to take more than one month to evaluate someone that we
have evaluated here and found incompetent to stand trial, then
sent to the hospital.  Our private or state institutions cannot,
unless they are deceived, admit a person with a mental illness
if they are charged with an offense.

	Over a period of several years that I have been in forensic
psychiatry, I have seen several very unusual and rare insanity
defenses in Texas and surrounding states, but up to this point,
to my knowledge, we have not had one of Multiple Personality. 
It goes without saying, however, that this is possible in the
future, but with our limited facilities at present, it is
doubtful.

	Several things intrigue me about this defense.  First is the
one concerning incompetency to stand trial; which personality
does one examine for competency? and does one examine all as
they appear? and, if so, which one was used? The second thing
that comes to mind is the Constitutional Rights that an
individual has.  Would each one of the "personalities" have to
waive their rights or would one be sufficient? We already have
such a backlog of cases pending appeal in our various courts due
to "rights" of the individual, that I personally feel it could
take years for the Courts to issue a ruling of opinion on these
issues.

	Over the years, I have seen a couple of cases of, what I
considered to be, multiple personality, and I have been involved
in the treatment program.  However, these individuals had not
been charged with a crime, thus they were able to be committed
to a private facility for long term intensive therapy.  Unless
the laws and facilities change appreciably here in Texas, I
cannot see that it would be feasible, both from an economical
and practical standpoint, for us to be able to diagnose and
consequently treat a criminal with multiple personality.

	Thank you very much for asking me to comment on this very
interesting and well written article.

E. Clay Griffith, M.D. Dallas, Texas

Note:	Dr. Griffith is a psychiatrist who has appeared as an
expert witness in more than 3, 000 criminal and civil cases.  He
will be present at our February symposium in Santa Barbara and
serve as Chairman of the "Criminal Low and Psychiatry" section.








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