The Osiris Complex: Case Studies in Multiple Personality Disorder

Sarah Robertson is associate editor of the Canadian Book Review Annual.

This lucidly written and involving book emphasizes the need for the
medical community to become more proficient in the diagnosis and
treatment of multiple personality disorder (MPD). Ross argues that MPD,
a dissociative disorder stemming from childhood sexual abuse, is the
“key diagnosis” in an impending paradigm shift in psychopathology,
from a psychoanalytical/biomedical-reductionist model to a general
trauma model. “The case studies in The Osiris Complex,” he writes,
“illustrate the clinical roots of this paradigm transformation.”
Instead of citing references within the case studies, the author
provides a brief description of the literature in his introduction.

Nineteen of the book’s 26 case studies are case studies of MPD; the
remaining seven are case studies related to MPD. The latter, generally
falling under the heading dissociative disorders not otherwise
specified, are less structured than MPD cases, and therefore harder to
treat. Each case in this book allows for discussion of MPD in
conjunction with a variety of phenomena, including prostitution, the
paranormal, transsexualism, homelessness, electro-convulsive therapy,
depression, schizophrenia, exorcism, and sexual crimes. While Ross
generally accepts the trauma in each of these patients as a real event,
the case of “Pam” (a woman who exhibited a mind-boggling 335
personality states) demonstrates that “very detailed, congruent
memories can be completely fabricated.”

In the book’s most provocative chapter, Ross uses Diane Wood
Middlebrook’s biography of Anne Sexton to argue that the poet had MPD,
not the biologically based mental illness diagnosed by her therapist.
According to Ross, the suppression of Sexton’s MPD in favor of a
biomedical model of mental illness absolved the poet’s therapist (and
others in her life) from responsibility in her suicide.

Ross is refreshingly candid about the errors he made in these MPD
therapies, many of which, for various reasons, were terminated well
before integration was achieved. His agnosticism vis-а-vis the
paranormal will distress medical reductionists, despite its many
practical applications. In rare cases, Ross argues, exorcism
(“aligning strategically with the patient’s belief system”) could
be a viable form of coercive mental-health intervention.

Although written primarily for a mental-health audience, these case
studies, like Oliver Sacks’s explorations of neurological wonders,
will fascinate laypersons with an interest in MPD in particular and
dissociative disorders in general.