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Paula

Multiple-Personality Disorder
Dorothy King & Marina Leiman
38 years old

Divorced (two children)

Lives in a rural community

Taking courses at university

Part-time job (secretarial position on campus)


Referral
Referred to Dr. Harpin by her professor

Threat of killing Headaches,


other people dizziness,
breathing
problems
Possible alcohol Memory problems
abuse
Erratic behavior
Suicidal threats Mood vacillation (seemed high in
class)
and self harming
Mrs Mr
Stewart Stewart

Cal Paula Roger


53 y 38 y

Daughter Son
15 y 18 y
Mother Father
- Outspoken and dominant woman - Shy, withdrawn, unaffectionate
- Strict disciplinarian man
- Physical punishment - Ignored Paula until 5 years old
- She interfered in Paulas life - Forced incestuous
relationship upon her
Cal - He behaves as if she doesnt
- 15 years older than Paula exist
- Rescuer, but married another
woman Roger
- Interested in Paulas sexual favors - He was in the Air Force
- Paula has mixed feelings about - Got divorced for Paula
him - Married Paula after their first
child
- Dont have contact anymore
5
years
15 Traumatic
Sexual abuse by 16
years rape
Meets Cal
her father years
18
years
20
1st child
years
22
years 2nd child
Married Roger
38
years
Follow-up
48
years
Protective
Sherry 30 years and
promiscuous

Angry
Janet 15 years
adolescent

Guilty and
Caroline 5 years
scared

In love with
Heather 23 years
Cal
Case Conceptualization
Predisposing Persisting Factors
Factors Personal
Contextual: Reinforcement of problem
Authoritarian parenting style behavior
Sexually abusive father Contextual
Abusive mother Relationship with Cal
Attachment problems Family doesnt recognize problem
Mothers external locus of control
Personal:
Overly-internalized locus of Continued poor relationship with
father
control
Precipitating Protecting Factors
Factors
Personal
Interactions with Cal High academic achievement
Acceptance of help
Stressful situations at
Contextual
University and work
Good relationship with Dr.
Harpin
Arguments with mother University professor who
and children referred her cares about her
Treatment plan
1. Hypnosis
(to explore gaps in Paulas memory).

2. Recall and exploration of previous traumatic


experiences.

3. Talking to Paulas multiple personalities.

4. Making Paula read Sybil.

5. Watching and discussing videotapes of Paulas


different personalities.
2. Facilitate the
1. Discourage further
integration of
fragmentation of Paulas information across the
divisions of conscious
conscious experience
experience
Results
1. More disruptive incidents.

2. More severe suicidal gestures


(involuntary hospitalization).
Follow-up
Dr. Harpin avoided
Ended relationship Alters started to
speaking to alters
with Cal disappear

Paula became Many sessions


more aware of with daughter
Sherry
Critical review
Strengths Limitations

Strong working Treatment research in


relationship. DID is well behind.

Improvement of Paulas Treatment developed by


relationship with her trial and error.
children.
Really long treatment
(although DID patients respond well to extensive
psychological treatment*).
* (Brand et al., 2009; Maldonado, Butler, & Spiegel, 2002).
1. Earlier Family To achieve a favourable
Intervention social environment

2. Relaxation
As a coping strategy
techniques

3. Self-Instructional
To get more self-control
Training