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The International Journal of Clinical and Experimental Hypnosis 
1984, Vol.  XXXII, No. 2, 102-117
DIFFICULTIES DIAGNOSING THE
MULTIPLE PERSONALITY SYNDROME IN  A
DEATH PENALTY CASE
RALPH B. ALLISON
Morro Bay, California

Abstract: The problems involved in diagnosing the multiple
personality syndrome in a rape-murder suspect are illustrated by
the case of Kenneth Bianchi and the Hillside Stranglings. 
Hypnotic investigations of his amnesia revealed "Steve," who
admitted guilt for the rape-murders.  "Billy" later emerged,
claiming responsibility for thefts and forgeries.  Attempts to
evaluate Kenneth Bianchi with methods used in therapy yielded an
original opinion that he was a multiple personality and legally
insane.   Later events showed the diagnosis to be in error.  A
new diagnosis was made of atypical dissociative disorder due to
the effects of the examining methods themselves.  Warning is
given that it may be impossible to determine the correct
diagnosis of a dissociating defendant in a death penalty case.

The diagnosis of the multiple personality syndrome is difficult
enough in the case of clinical patients, with their extensive
use of denial, repression, and dissociation.  The difficulty is
greatly compounded when the individual under consideration is
charged with first degree murder and is facing the death
penalty.  Because of the rarity of the occurrence of the
multiple personality syndrome in the general population,
guidelines for diagnosis are based on samples of limited size
(Allison, 1978; Coons, 1980).   When faced with the question,
the forensic psychiatrist has to view these guidelines in the
context of the legal situation, with its many differences from
the clinical setting (Allison, 1981).  All these difficulties
existed in the case of 27-year-old Kenneth Bianchi and the
Hillside Strangler case (Schwarz, 1981).

THE CRIMINAL CASES

In the fall and winter of 1977-78, the nude bodies of 10 women
were found on various hillsides of Los Angeles County.  All bad
been raped and then strangled.  Extensive police investigation
failed to identify the killer or killers.

On January 11, 1979, 22-year-old Karen Mandic and 27-year-old
Dianne Wilder were raped and then strangled in a vacant house in
Bellingham, Washington.  Their clothed bodies were found in the
Mandic car several hours after their friends notified police,
since they had not reported to work on time.  Immediate police
investigation revealed physical evidence

Manuscript submitted August 11, 1982; final revision received
November  29,  1982. 
which led to the arrest, the following day, of Bianchi as the
sole suspect.   The Los Angeles Hillside Strangler Task Force
was notified, and their detectives interviewed Bianchi, who had
lived in the Los Angeles area when the 10 killings occurred in
1977-78.  After their interrogation of him, the detectives did
not consider him a likely suspect.

When first questioned by his defense attorney, Dean Brett,
Bianchi claimed to have been driving his car some distance from
the crime scene when the victims were killed.  When confronted
with facts which made his alibi impossible to believe, he then
claimed be had fabricated the story to fill in the gap in his
memory for the time span in question.  Brett called in the first
forensic psychiatrist, Donald T. Lunde, M.D., from the Stanford
School of Law.  Lunde reported that Bianchi gave a history of
repeated spells of amnesia since childhood and recommended
calling in someone experienced in the use of forensic hypnosis. 
John G. Watkins, Ph.D., Professor of Psychology at the
University of Montana, was called in by Brett.  During Watkins's
hypnotic interview, what appeared to be an alter-personality,
"Steve," appeared, claiming responsibility for the 2 local
killings and involvement in 9 of the 10 Los Angeles deaths.

On March 30, 1979, the defense entered a plea of not guilty by
reason of insanity, based on the possibility that Bianchi
suffered from the multiple personality syndrome at the time of
the offenses.  Along with Charles W. Moffett, M.D., a Bellingham
psychiatrist, the present author was appointed by the Court to
examine the defendant, with specific instructions to determine
whether or not he suffered from the multiple personality
syndrome.  Subsequently, the prosecution appointed Martin I
Orne, M.D., Ph.D., Professor of Psychiatry at the University of
Pennsylvania and Saul J. Faerstein, M.D., of the University of'
Southern California Institute of Psychiatry and the Law, Los
Angeles.

EVALUATION STRATEGY

Since I had identified my first multiple personality syndrome
patient in 1972 (Allison, 1974), I had seen 48 other individuals
who appeared to have the multiple personality syndrome, 40
females and 8 males.  My forensic experience included court
appearances in seven cases (involving five males and two
females).  The crimes involved were bank robbery, forgery (see
Ashby, 1979), embezzlement, theft, assault, drunken driving (see
Hawksworth & Schwarz, 1977), and arson.  The arsonist was later
convicted of two murders, but the multiple personality syndrome
diagnosis was not offered as a defense in those trials (Allison
& Schwarz, 1980, pp. 159-182).  Thus, the Bianchi case was to be
the first one I was involved with where the charge was murder,
the maximum penalty death, and the only possible defense legal
insanity based on a diagnosis of the multiple personality
syndrome.

After serious consideration of my options, I decided that the
only way I could determine if the multiple personality syndrome
diagnosis was correct was to match Bianchi's performance against
that of multiple personality syndrome patients I had known best
(i.e., those who had been in long-term therapy with me).  This
meant asking Bianchi to act like a patient, even though he would
not actually be in the patient role with me. I knew of no other
way to secure his cooperation in doing the mental maneuvers I
needed him to perform so that I could compare him with my
patient sample.  The areas to be compared were family and
psychiatric history, performance on several hypnotic procedures,
and certain psychological tests.

I knew there was a risk in approaching Bianchi in the forensic
setting as a pseudo-patient, when I was not under contract to be
his therapist, but I saw no other way to accomplish the task for
which I had been appointed.   Prior to my first visit to
Bellingham, I asked Brett to tell Bianchi to have ready some
questions he wanted answered regarding a specific period of his
childhood, in order to give me a logical reason to use hypnotic
age regression, my main therapeutic modality for multiple
personality syndrome.  Also, the Minnesota Multiphasic
Personality Inventory (MMPI; Dahlstrom & Welsh, 1960) had
already been given to Bianchi on April 9, 1979. I asked John
Johnson, a psychiatric social worker assisting Brett, to give
Bianchi a California Psychological Inventory (CPI; Gough, 1964)
before my arrival. Further CPls were completed in June, 1979 by
Bianchi and his two "alter-personalities."2 

The clinical examination was carried out in two separate visits,
one in April and one in June of 1979, each lasting 1.5 days.3 
After the April visit, Bianchi was seen again by Watkins for
further hypnosis and Rorschach testing.  Bianchi was also seen
by Orne, Faerstein, and Moffett before my second visit.

                         THE APRIL, 1979 INTERVIEWS
Structure

The first several hours were devoted to obtaining a detailed
history and listening to the reactions Bianchi expressed to the
interview with Lunde.   Lunde had noted the discrepancy between
Bianchi's view of his mother as a saint and the documented
history of her maternal psychopathology.   While discussing his
feelings about her, Bianchi willingly played the patient role,
thus cooperating in my plan.  He also admitted to a history of
senseless lying to his wife, but claimed that he would do his
best to give us the true facts as he knew them, with so much at
stake.  Per my prior

2These tests were computer scored by Behaviordyne, Inc. of Palo
Alto, CA.

3A transcript of the videotaped clinical examination which took
place in April and May of 1979 has been deposited with the
National Auxiliary Publications Service (NAPS).  For 255 pages,
order Document No. 04181 from NAPS % Microfiche Publications, P.
0. Box  3513, Grand Central Station, New York, NY 10163.  Remit
in advance in U S. funds only, $78.25 for photocopies or $4.00
for microfiche, and make checks payable to Microfiche
Publications -NAPS.  Outside the United States and Canada, add
postage of  $28. 00 for photocopies, $1.50 for microfiche
postage.instructions to Brett, he asked to know what important events
had happened at age 8 when he had lived on Villa Street in
Rochester, New York.   I then explained the use of ideomotor
signals to help answer his question.

The second session of the day began with ideomotor signals under
hypnosis, which indicated that the ages of 9 and 13 were
significantly related to the current problems.  Regression to
age 9 was accomplished, then progression to age 13.  With
progression to age 27, the criminal entity "Steve," emerged.  I
then called on Ken to replace "Steve." Dehypnotizing Ken did not
seem necessary.  Next, I used ideomotor signals to determine if
there were any other entities besides Ken and "Steve" and
received a negative answer.  Then I suggested that Bianchi might
have a dream that night which would help him learn to cope with
"Steve." (I did this because Watkins had already suggested that
Ken would have increasing awareness of "Steve" but not what he
was to do with that awareness.) I suggested that he use "the
highest elements of helping power inside [his] mind," in an
attempt to activate an Inner Self Helper, which has been of
great help to the victims of the multiple personality syndrome
(Peters & Schwarz, 1978).  The following morning, he reported a
dream of being with a twin brother, "Sticks," at one age, then
with him again at an older age, when the twin was called "Steve
Walker." Next, I asked Bianchi to conduct a dialogue with
"Steve" as if he were talking to him on the telephone.  This he
did, speaking only as Ken but never as "Steve."

Results

1.	Regression to age 9. Bianchi remained in a trance-like state,
talking in the present tense.  He did not behave as a conscious
9-year-old boy, in a state of revivification, as many multiple
personality syndrome patients do. He reported his best friend to
be Billy Thompson, the boy next door. Only when I asked if he
ever hid inside his head did he mention talking there to "Steve
Walker, my second best buddy." This reportedly occurred while he
was hiding under his bed to escape his mother's wrath when she
was very angry with his father for gambling too much.

2.	Regression to age 13.  This time Bianchi told of arguing by
neighbors and between his parents, sneaking out to visit school
buddies, and "Stevie" trying to talk him into running away from
home.  Only after I asked about the biggest problem that year
did he mention his father's sudden death at work.  No mention
was made of any new personality being created thereby, as I had
expected.

3.	Appearance of "Steve." "Steve" was seen in full bloom, out of
trance. He was very crude and nasty, using the word "fuck" in
every sentence.   He lunged at Johnson, who was operating the
video camera behind my right shoulder.  He talked about Ken in
the third person, constantly putting him down.  He freely
admitted to strangling the two local victims cause I hate
fuckin' cunts." He committed the crime, he said, to get Ken out
of the way, so that he could control the body full-time.  He
further admitted to killing four of the Hillside Strangler
victims and watching his cousin, Angelo Buono, kill the other
five victims.  He denied there were any others like him inside
Ken.  When I called for Ken and put my hand in front of his
forehead, "Steve" slumped into his chair and was replaced by a
very tired Ken.

4.	"Telephone" conversation with "Steve." Ken talked to "Steve"
about childhood friends in Rochester, a psychological clinic
evaluation done at age 9, and the two local killings.  Ken
appeared to know "Steve," accept his existence, and know that
"Steve," who considered himself above the law, had committed the
murders.  Ken, in contrast, considered himself a law-abiding
citizen who knew it was wrong to kill.

                      THE JUNE, 1979 INTERVIEWS

Goals

Since April, 1979, Bianchi had been hypnotized by Watkins and
was seen by Orne.  Information from Los Angeles indicated
Bianchi had secured fake diplomas as a psychologist, using the
name "Thomas Steven Walker," but giving a mailing address of "%
Mrs. K. Bianchi." He had rented a psychologist's office in the
evenings and had passed out professional cards at the title
company where he worked.  Numerous items found in Bianchi's
apartment in Bellingham were found to have been stolen from a
store where he had worked as a security guard.  None of this
could have been explained by the existence of "Steve," the
killer.

The videotape of Orne's "hypnotic" session with Bianchi showed
Orne telling "Steve" that he, Orne, could not believe "Steve"
had been interested in working in a title company.  Orne asked
"Steve" if he were aware of another part within him that Ken did
not know about.  Following "Steve's" denial, "Steve" was
replaced by a crying 9-year-old "Ken," who was followed by a
14-year-old "Billy." who admitted responsibility for the false
diplomas, the psychologist role-playing, and the various thefts.
When Orne asked if there was a higher level source of
information present, Bianchi nodded in the, affirmative, but he
refused to talk to Orne in that mode.

Therefore, my goals in the second trip to Bellingham were to
interview "Billy" and to talk to that higher source of
knowledge.  I had a long list of questions for both of them.

Structure

The first several hours were spent trying to get Bianchi's
cooperation in these tasks, as lie claimed he had amnesia for
all the material he had produced during the various hypnotic
sessions, and he was tired of seeing those sessions first
reported in the newspaper.  He appeared quite depressed and
claimed to have tried to hang himself after his interview with
Faerstein.

The second period was spent getting handwriting samples and
questioning the Inner Self Helper, the higher source of
knowledge.  Many answers were quickly and clearly provided by
"Ken's friend," as this entity called itself.  I then asked Ken
to enter into a dialogue with "Billy," which he could not do.  I
called out "Billy," secured his handwriting samples, and then
asked him to initiate a dialogue with Ken.  I could hear both
voices this time.  Ken then carried on a dialogue with "Steve."
Finally, "Billy" came out to take the CPI.

During the third period, Bianchi made pictures of the faces of
"Billy" and "Steve," using the Identi-Kit, under the supervision
of Detective Fred Nolte.  Then I called out "Steve" and
persuaded him to take the CPI.   The test booklet was left with
Johnson so Ken could take that test again, also.

Results

To reach "Ken's friend," I had to appeal to that part of Ken's
mind that had refused to talk to Orne.  He initially talked in
the first person and then switched to the third person in
referring to Ken.  After one question of his own, Ken asked me
to give the questions.  He told of "Steve's" beginning, of his
killing, and pimping in Los Angeles.  "Billy" was defined as "a
source of secrets, of denial of facing up to the facts," having
been created when Ken went daily to his father's casket prior to
burial.  "Billy" and Ken were co-conscious, while Ken was
amnesic for all "Steve" did. "Billy" was the thief and pretended
to be a psychologist as a new way to meet people. "Steve's"
emotions were "anger, hate, and violence, while 'Billy's' were
non-violent, such as deceit."

A week after Bianchi had been infected with gonorrhea by his
wife, who claimed to have been raped while on vacation, "Steve"
had killed the first of the Los Angeles victims, a prostitute. 
Bianchi's feeling of being betrayed was considered by Brett and
Johnson to be a logical motive for this first murder.  But
"Ken's friend" denied the psychological connection, explaining
that the physical weakness resulting from the infection had left
Ken defenseless against "Steve's" coming out.

"Billy" appeared to be a shy, quiet, 14-year-old boy, who now
wanted to cooperate with Ken in dealing with "Steve." He took
the CPI quickly calmly and cooperatively

When "Steve" and Ken spoke together this time, I could hear both
voices while they talked of "Steve's" plan to send the coat and
scarf of one of the local victims to cousin Buono.  Bianchi
reported that talking to "Steve" left him with a chill at the
end of his spine, but he was comfortable talking with "Billy."

While making the Identi-Kit pictures, Bianchi repeatedly closed
his eyes and appeared to visualize each face inside his head,
carefully correcting the features to his satisfaction.  Neither
picture looked at all like Bianchi, and both matched the
personality characteristics seen on interview.

When "Steve" returned to take the CPI, he was initially quite
resistant, but he finally gave in, expending much energy in foot
shuffling and pencil jabbing.

PSYCHOLOGICAL TEST RESULTS

The Behaviordyne computer reports a series of diagnoses in the
order of preference.  Both the MMPI and CPI scales can be run
off using the CPI answer sheets.

1.	MMPI taken by Ken on April 9, 1979.  Preferred diagnosis;
psychoneurosis, hysteria, dissociation reaction, consisting of
sudden episodes of unaccustomed behavior, related to hysterical
acting out, possibly with true amnesia.

2.	CPI taken by Ken in April, 1979.  Preferred diagnosis:
personality with risk of a drinking problem.  Second diagnosis:
personality trait disorder, dissociating (hysterical)
personality with sociopathic and passive aggressive features,
emotional instability, and unpredictable (hysterical) acting out
of unconscious impulses.

3.	CPI taken by Ken in June, 1979.  Preferred diagnosis:
personality pattern disorder, paranoid personality, with
passive hostile behavior.

4.	CPI taken by "Billy" in June, 1979.  Preferred diagnosis:
personality trait disorder,  dissociating [hysterical]
personality.

5.	CPI taken by "Steve" in June, 1979.  Preferred diagnosis:
psychosis, schizophrenia, paranoid type, with aggressive hostile
behavior.

FORENSIC CONCLUSIONS

Following my April evaluation of Bianchi, I had reported to the
Court that Bianchi suffered from the multiple personality
syndrome, was legally insane at the time of the offenses, and
because of the amnesia for the time period of the offenses, was
unable to stand trial.  After my June evaluation, I concluded
that he was now able to stand trial, but my other opinions
remained the same.  I submitted 124 pages of reports detailing
the data which supported the diagnosis of multiple personality
syndrome.  Space limitations prevent me from repeating any more
of that material here.  He was also believed to be insane by
Lunde, Moffett, and Watkins.  Both Faerstein and Orne considered
him sane.  With this split opinion, Bianchi agreed to a plea
bargain in which lie would plead guilty to 2 counts of first
degree murder in Washington and to 5 counts of first degree
murder in California in exchange for his testimony against
Buono.  On October 18, 1979, Bianchi was sentenced to 2
consecutive life terms in Washington.   On October 22, 1979, he
was sentenced to 6 concurrent life terms in California.  Buono
had been arrested on October 19, 1979 and is currently on trial
for 10 counts of first degree murder.  Bianchi has been the
primary prosecution witness against him, but his stories keep
changing, and no one can tell what version he is going to relate
the next time he testifies.

THE AFTERMATH

Letters from Jail

Seven letters were sent to me by Bianchi, from the Los Angeles
County Jail, between October 14, 1979 and December 4, 1979. 
These letters were all from Ken, but in them he referred to
"Steve" and "Billy" as himself in different states of mind.  I
had hoped, in responding to his first letter, that he would
clear up some of the still unanswered questions about the
Washington crimes.  In a letter dated November 10, 1979, he laid
the blame on a man he named only as Greg, whom he knew had died
in all accident after Bianchi's arrest.  He claimed that he and
Greg had invited the two victims to the house for a blind date. 
He claimed that, as "Billy," he had gone to the store, and, when
he returned, Greg was in the process of hanging the two women. 
There was indeed a man named Greg who lived in the area at the
time of the crime, but police investigation proved he could not
have been at the crime scene with Bianchi the day of the
killings.

The Compton Case

On September 6, 1980, an envelope was delivered to my home,
postmarked "Seattle, Washington," but with a return address of
"LAPD, Homicide." Inside I found a brassiere and an unlabeled
cassette tape.  On the tape was the voice of a young man
claiming to have framed Bianchi for the murders in Washington,
in return for money.  Nothing on the tape told me who he was or
where I could contact him.  The package was turned over to the
local police, who contacted the Bellingham Police Department. 
Two similar tapes were delivered in Bellingham, one to a
clergyman and one to the Whatcom County Sheriff's Department. 
The latter tape had been hand delivered, and the messenger was
able to provide a description of the woman who had given it to
him at the Seattle airport.  On September 29, 1980, the same
woman lured a Bellingham woman into a motel room and tried to
strangle her.  The victim escaped and 24-year-old Veronica Lynn
Compton was arrested for attempted murder.  She was identified
as a scriptwriter from Los Angeles County, a frequent visitor to
Bianchi, and the owner of several other tapes on which were
recorded threats against my daughters.  In March, 1981, she was
convicted of attempted murder in the first degree and sentenced
to 5 years to life in prison.

Other New Information

With the list of boyhood friends supplied by Bianchi, detectives
searched Rochester to find anyone who could remember his having
complaints of lapses of memory or who had observed sudden
personality changes in him.  No one could be found to
corroborate that history which he had given.  When his wife was
interviewed on television, she denied having noticed any
personality changes she could now attribute to the existence of
"Steve." None of the psychiatric staff at the Los Angeles County
Jail reported meeting either "Steve" or "Billy."

Only in 1980 did the use of the Rorschach for specifically
diagnosing multiple personality syndrome come to my attention
(Wagner & Heise, 1974).  When Wagner independently reviewed the
Rorschach protocols of Ken and "Steve," he concluded,

My considered opinion is that this is not a multiple
personality....    Ken is what I would call ... a paranoid with
a psychopathic overlay...    Such cases are quite dangerous and,
as might he expected, tend to he diagnosed as psychopathic or
paranoid . . . Ken is exclusively self centered and preoccupied
with his own ideas.  He is a compulsive ruminator with a marked
incapacity to derive pleasure from interpersonal relationships.
He is intimidated by women because of a love-hate relationship
with his mother and, under conditions of lowered consciousness
(e.g., fatigue, alcohol), is capable of a revenge type of
rape-murder. Normally, because, he can't share his thoughts with
anyone, he seems quite dull to the casual observer. 
Qualitatively, it is interesting to note that he makes frequent
references to his childhood.  This often occurs with people who
find themselves in threatening circumstances from which they
feel they cannot escape.   I believe that "Steve" represents
Ken's escape hatch (a last desperate measure).

Steve's Rorschach does reveal hostility and sexual preoccupation
but there is a perverse, deliberate aspect about it which smacks
of psychopathic intent.  The refusal to respond and desire not
to "play' is psychopathic, not schizophrenic . . . . What is
frightening about Ken is that his murders were probably
committed without much affect and with a certain detachment.

Structurally, the basic inconsistency is that . . . the two
Rorschachs are cognitively similar.  From my experience,
alter-personalities are contained within (and break off from)
the major or first personality.  This is not the case with
Bianchi. Ken and Steve appear to be mirror images - one "good"
and the other "bad," like Dr. Jekyll and Mr. Hyde.  This type of
patterning is viable from a literary but not a psychological
point of view.

Later, in 1981, 1 started working full-time in a state prison
after spending 3 years working in a county jail part-time.  In
the prison, I began hearing the tales of convicted felons who
claimed to have fabricated stories prior to trial so as to
create insanity defenses.  Having failed at that goal, they were
now finding those histories of "mental illness" haunting them
when they sought paroles from the Board of Prison Terms.  I also
met rapists who explained to me some of the mental aberrations
they had undergone during their crime sprees, when they acted as
law-abiding citizens by day and rapists at night, being, to a
great degree, unaware of the two lives they were leading until
they were apprehended and confronted with the evidence.  These
seemed to be honest reports of some type of a dissociative
process which only occurred during a limited span of time.

THE BUONO TRIAL

In October, 1981, 1 was called to testify in Los Angeles in the
preliminary hearing for Angelo Buono.  The main issue of debate
was whether or not Bianchi had ever been "really hypnotized,"
since a positive judicial decision on that question would cast
doubt on the reliability of his testimony.  That issue was
easily settled in my mind with the concept that there is no way
to prove any person is in a state of hypnosis, since there is no
universally accepted standard of behavior or objectively
measurable physiological process which is accepted as being
indicative of a hypnotic state of mind.

But the night before I was due in court, I reviewed all the
transcripts of my sessions with Bianchi, as well as the events
mentioned above.  I

Wagner, E., personal communication, February, 1980.
discovered that, in making the original diagnosis of multiple
personality syndrome, I had inadvertently ignored certain items
which, at the time, did not fit into a neat pattern.  This was
not an unusual situation for me in working clinically with
multiple personality syndrome patients, as many times bits of
data emerged which could not, at that time, be understood in the
total context.  Further digging into the repressed material
usually clarified the problem and allowed me to fit that piece
of data into the total picture.  This was why I maintained
contact with Bianchi by mail in the first place.  The facts
which I now looked at with more attention, however, fitted a
dissociative disorder, but not what I knew to be the multiple
personality syndrome.

In court, I testified that I had come to a new conclusion
regarding Bianchi's psychiatric diagnosis.  I now believe that,
although he had to have been extremely disturbed to have
committed the lust-murders at all, he did not have multiple
personality syndrome at the time he committed the crimes.  My
new view was that all of the pathological elements we had seen
as "Steve" and "Billy" had existed in Bianchi's mind for years,
but had not "crystallized" into the forms we saw until he was
first hypnotized by Watkins (for "Steve") and Orne (for "Billy")
(I knew that Watkins had testified that be believed Bianchi was
in hypnosis when he first found "Steve" and that Orne had
testified that Bianchi had never been really hypnotized by any
of the examiners, including himself.  While viewing the
videotapes of Bianchi with Orne, I believed that Orne did have
Bianchi in a hypnotic trance, which gave Bianchi a chance to
show his psychopathology in a most dramatic fashion via "Steve'
and "Billy.") I was quite willing to take responsibility for
bringing out "Ken's friend." The Assistant Attorney General
carrying out the cross-examination later told me that Bianchi
said to her, "It was the best way I could think of at the time
to explain to the doctors how my mind was working then." Once
the trial was over, Bianchi no longer needed to explain his
motives to the psychiatrists, so neither "Steve" nor "Billy"
were necessary for him to bring forth.  Ken apparently felt he
had the capacity to deal with the problems in Los Angeles County
completely on his own.

Before I list the factors in this particular case which caused me to
change my original diagnosis, I must emphasize that there is no
typical patient with multiple personality syndrome against which
to match any future patient.  To assume that the presence of
the exact opposite of these listed characteristics would
guarantee the diagnosis of multiple personality syndrome is
faulty logic.  Diagnosis from any list of necessary findings, as
is implied by DSM-III (American Psychiatric Association, 1980)
leads one into the pigeonhole myth (Dirckx, 1977, pl. 111-1 12).
Human beings are much too complicated to view in that fashion,
and more complex methods, such as factor analysis, may be more
realistic.  But the average clinician has to use the "list of
criteria" method to start with, and these points are only
guidelines to help those who may come across such individuals in
their own local courtrooms.

1.	Personality characteristics of Ken.  Ken, as himself, seemed
to be able to express a full range of emotional feelings.  He
was not unable to experience anger, resentment, fear, sexual
pleasure, and other such feelings that multiple personality
syndrome patients learn, from their families, are forbidden and
thus require expression through their alter-personalities.  That
is one reason for creating an alter-personality, to express the
forbidden thought and emotion.

2.	Regression to age 9. Bianchi did not mention "Steve" as an
imaginary playmate until I brought up the idea of hiding inside
his own head.  In retrospect, it would have been better not to
have brought up that concept and to have left Bianchi to his own
devices.  Unfortunately, any question and tone of voice used
gives some message as to the acceptable answer.   Bianchi had a
very strong need to please authority figures, of which we
psychiatrists were the latest version.  Multiple personality
syndrome patients in therapy can and do ignore what I want to
bear and do want to tell their story in age regression.  They
hint at subjects they are ashamed to mention and just need
encouragement to continue, with assurance that they will not be
punished for telling the truth.

3.	Origin of the villainous "Steve. "Bianchi reported no new or
different physical or mental trauma the day he claimed he first
heard "Steve" talking to him, while hiding under his bed.  A
dissociative process in multiple personality syndrome usually
occurs when trauma of a life-threatening nature occurs, is too
stressful for the child to handle in any physical fashion, and
mental mechanisms must be used instead.  Had his mother set his
clothes on fire or chased him with a hatchet in her hand, the
story would have been more convincing.

4.	The boy next door.  Bianchi's first choice as a best friend
was a living boy, a fact which ruled out the need for an
imaginary playmate.  Multiple personality syndrome sufferers
were very lonely children and usually felt there was no one
--child or adult-- to whom they could turn in times of crisis.

5.	School.  Both Ken and "Steve" disliked going to school.  If
"Steve" really existed in those days, he should have had a
different attitude than that of Ken, not necessarily the
opposite.  Ken could have liked going to school and "Steve"
could have just ignored the whole scene, since it held no
interest for him.  If there had been a hostile teacher who
whipped the boys, "Steve" would have been the one who threw ink
on her when her back was turned, and then allowed Ken to take
the punishment.

6.	 Buddies. Bianchi reported many neighborhood friends in his
later school years.  With so many friends, be would not have
needed to keep "Steve" around.  In addition, "Steve's" obnoxious
behavior would have driven away those children who tried to
befriend Ken, keeping him in a lonely state of mind.

7.	Regression to age 13.  The error here was that Bianchi first
mentioned fights of neighbors and between his parents, but
nothing new.  If that was when "Billy" was created, at his
father's death, he should have mentioned the death first.  Only
when I asked about the main difficulty that year did he bring
up the subject of his father dying. 

8.	Creation of "Billy." "Ken's friend" reported that "Billy"
wits created during repeated visits to his father's casket at
the funeral home.  An alter-personality would have been more
likely to have been created when news of his father's death was
first brought by the messenger from work.  It was reported by
the family that Ken did go into hysterics when told the tragic
news.

9.	The murder victims.  None of the victims had any emotional
tie to Bianchi.  They were not threats to him in any way.  They
were only the objects of the transference of his hatred for his
mother, a common reason for lust-murder (Macdonald, 1971, pp.
132-139).  Defendants with multiple personality syndrome, whom I
have met since the Bianchi case, each killed a spouse or a
parent-figure when their anger towards that individual
overwhelmed their repressive abilities.

10. 	Fatigue after hypnosis.  Fatigue after only switching
personalities is not common with multiple personality syndrome
patients, since each alter-personality has its own source of
energy and it does not need to draw energy from the primary
personality or each other.  After age regression, fatigue is
common, since much energy is expended in the lifting of
repression in psychotherapy.

11. 	Internal dialogue.  The first time he had internal
dialogue, Bianchi followed my suggestion too literally and
talked to "Steve" as if on a telephone.  No multiple personality
syndrome patient has ever done that in front of me, even when
given the same instructions.  Also, Ken claimed to have amnesia
for all he said in the internal dialogue, while multiple
personality syndrome patients usually have full recollection of
both sides of the dialogue.  The purpose of the exercise is to
bring that repressed material to consciousness.  This is one
procedure I would now avoid in a forensic case, since there is a
clear standard of the "proper" response and few defendants are
ready to become aware of unconscious material during the trial
phase of their incarceration.  After conviction, they are much
more likely to be willing to look at their faults and try to
correct them.

12. 	Ideomotor signals.  Bianchi's fingers answered "No" to the
questions about the presence of entities other than "Steve"
being present.  This was a lie, if "Billy" had been present in
the first interview.  But it was a truthful answer, if "Billy"
did not crystallize until Orne challenged "Steve" as being an
inadequate explanation for the role-playing as a psychologist. 
It is quite logical to believe that Bianchi then had to produce
"Billy" to satisfy Orne's objections.

Then there is the question of the basic reliability of ideomotor
signals for telling the "unconscious truth." These signals may
be very useful in therapy where the social consequences are
minimal, but that procedure certainly does not have the sanction
of research and judicial decision as a lie detection process. 
Until the procedure has passed such tests of reliability and
validity, it is not acceptable in a court of  law and must be
reserved for therapeutic and research purposes only.

13.	 Dehypnotizing. Bianchi did not seem to need dehypnotizing
after the age regression and first appearance to me of "Steve."
He was so alert that I did not think any procedure was
necessary.  Was he really hypnotized or not? In another case,
when I forgot to dehypnotize a multiple personality syndrome
patient who resisted and broke out of her age regression
session, she reported being very uncomfortable the next day
until she realized she was still in trance and dehypnotized
herself

14.	 Blaming Greg for the murders.  Multiple personality
syndrome patients who have been arrested for crimes know, at
some level, that they are guilty of some wrongdoing, but they
are not sure what it is they did.   They usually take their
punishment, since they feel that they deserve it; they do not
blame another individual.

15.	The Compton case.  Again we see an attempt to lay blame
elsewhere.  At first, I was perplexed as to why Bianchi should
have chosen to send that package to me, instead of to anyone
else involved in the case.   Gerald Chaleff, Buono's attorney,
because of his knowledge of Bianchi's current state of mind,
identified this as a hostile act towards me.  I tend to agree,
since Bianchi had expected that I would be involved in his
psychotherapy in the California prison system and may have seen
me as a rescuing father-figure.  When he found himself locked in
the Los Angeles County jail for an indefinite period of time, he
may have felt betrayed by me and used Compton to strike back. 
Ex-patients with multiple personality syndrome have generally
been appreciative of my recognition of the reasons for their
distress and have remained friendly towards me, even if they did
not agree with me at the time of first contact.

16. 	Bianchi's lying.  Bianchi admitted to being a chronic liar,
as Ken, even regarding facts which were unimportant.  Multiple
personality syndrome patients, because of their many amnesic
spells, learn to pay careful attention to what happens when they
are in charge.  They pride themselves on their excellent memory
of those events of which they are aware.  The charges of lying
come about because of their refusal to admit to misdeeds which
have been done by an angry alter-personality.

17.	No witnesses to personality changes.  None of his family
members or friends admitted witnessing personality changes, and
jail staff witnessed none, even when they had reason to look for
them.  Multiple personality syndrome patients in hospitals or
prisons do show different personalities to different staff
members, depending on their feelings about each staff member. 
Thus, the patients tend to polarize the staff into camps of
believers and nonbelievers in multiplicity.  None of this
happened with Bianchi in either jail.  Now, I would say that if
the institutional staff is not split on the question of the
diagnosis of multiple personality syndrome, and very strongly
so, the patient most likely has some other mental disorder.

CONCLUSIONS

The first principle to remember is that the human mind can do
anything.  The only limits are those we put on it, with our own
narrow view of what is possible.  A man under the threat of
death, who has never before been a defendant in any criminal
action, is not bound by any rules of conduct involving honesty
decency or fair play.  The only rule is to save his own skin; if
he has to use mental gymnastics, so be it.  Consciously, he may
believe he is telling only the truth; unconsciously, he must act
in whatever manner he believes will prolong his life.  That is
why the unconscious mental mechanisms of defense exist in the
first place.

The second principle is that it is extremely difficult--if not
impossible--to be sure that a defendant who has not been in
psychotherapy for the disorder really has the multiple
personality syndrome, since we have no firm criteria against
which to measure him.  Clinical patients have such different
situations and motives and show such variations in behavior,
mood, and thinking patterns that there is no typical multiple
personality syndrome patient.  That is why there can be only
general guidelines for determining who is and who is not
disturbed in this particular fashion.  A clear understanding of
the psychodynamics underlying the disorder seems to be the best
protection against error.

A third principle is that it may be impossible to determine the
state of mind of a defendant claiming amnesia at the time of the
crime, with his unverified statements being the only available
historical evidence of mental status.  Bianchi's story supported
an insanity plea, but no other evidence could be uncovered to
support the idea that he had at diagnosable dissociative
disorder while in Rochester, Los Angeles, or Bellingham.  He
clearly had a longstanding personality disorder, but, without
documented psychiatric observation or witnesses to provide
evidence of any mental disease, defect, or disorder, I have no
other data supporting any dissociative disorder diagnosis during
those years of his criminal activity.  My support of his
insanity plea was based on the assumption that the dissociative
disorder shown to the forensic examiners had existed prior to
his arrest and was causally related to the commission of the
crimes.  Since that assumption no longer seems warranted, my
forensic opinion now is that there is insufficient evidence to
support an opinion that he was legally insane at the time of the
crimes.  His urges to rape and kill most likely arose from
repressed unconscious conflicts, as is true in many crimes of
violence, but that concept does not justify an excuse from legal
sanctions in our courts today.  Because the determination of his
mental state during the crimes was hampered by his habitual
tendency to lie, the truth may remain a mystery for many years. 
My prison experience indicates that such an individual defends
against insight until faced with parole board hearings when his
clear understanding of those unconscious motivations is required
before release from prison can be considered.

My diagnoses of Kenneth Bianchi, as of the time of the forensic
examinations, are as follows:

Axis I 300.15 Atypical Dissociative Disorder (see DSM-III, p.
260), occurring under stress of intensive and extensive
psychiatric evaluations, while under threat of the death
penalty, and limited in duration to the period of time between
arrest for murder and sentencing.

Axis II 301.89 Mixed Personality Disorder (see DSM-III, pp.
329330), with antisocial, paranoid, and histrionic features.

I do not believe Bianchi was deliberately and consciously faking
the multiple personality syndrome clinical picture.  He
possessed the drives to lie, steal, rape, and kill in his
unconscious mind since childhood.   Certain triggering
situations caused the resultant criminal behavior to occur.  He
may well have chosen to forget a large portion of his criminal
behavior over the years to be able to live his version of a
normal life at work and at home.  But his amnesias were not due
to the sudden control of his body by alter-personalities which
had been created by psychosexual traumas occurring at the ages
of 9 and 13.  He found his targets for his negative transference
feelings in those women he identified as the streetwalking
prostitutes of Los Angeles, even while he was employing other
young women as prostitutes himself. Then, for some still
unknown reason, he raped and killed two completely innocent
women in Bellingham.  I believe that he also unconsciously set
himself up to be caught in Bellingham so that he could be
stopped forever.  Fortunately, the Bellingham Police Department,
in their thoroughly professional manner, cooperated in his plan.

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