Tuesday, November 8, 2011

Scandalous Book Review: Sybil Exposed by Debbie Nathan

• Title: Sybil Exposed

• Author: Debbie Nathan
• Pub. Date: October 2011
• Publisher: Free Press
• Format: Hardcover, 320pp

I remember watching the TV mini-series Sybil as a pre-teen and being riveted. The story of Sybil Dorsett, a young, shy graduate student who suffered such traumatic abuse by her mother, that her psyche shattered into 16 distinct personalities, was Must-See TV. Sally Field, who played the title role, won an Emmy Award for her work, and totally changed her career around, proving that she could handle serious drama as well as light comedy. But it was the story of Sybil and the idea of multiple personalities that really got me. I was fascinated by the idea that someone could suffer such trauma that the only way they could deal with it was by splinting into different personalities. I eagerly watched The Three Faces of Eve, based on one of the earliest known cases of multiple personality disorder. But Eve only had 3 personalities while Sybil had 16. Later on, the TV soap opera One Life to Live featured a mother and a daughter who both suffered from what has become known as Dissociative Identity Disorder. I even bought the book that the miniseries was based on to read more. The story terrified and fascinated me. I’m one those people who reads about a disease and then thinks that she has it. Not that I thought that I had DID, but I’ve often felt that I have more than one person inside of me. Little did I know that the entire story was based on a lie.

Picking up a copy of Debbie Nathan’s new book Sybil Exposed, I felt the same way that I did when I found out that Go Ask Alice wasn’t the real diary of a teenage drug addict who died tragically. I felt cheated, that book scared the crap out of me so much, that I vowed then and there that I would never do drugs. Finding out that the story was just a novel somehow cheapened it a little. But Sybil Exposed is a powerful story of how three women managed to pull the wool over not just a nation of readers but also over the whole psychiatric establishment.

What is interesting about Nathan’s book is that neither Dr. Connie Wilbur, the psychiatrist who treated Shirley Mason (Sybil) nor Shirley nor Flora Schreiber who wrote the book planned on deceiving anyone. Shirley just wanted to please the doctor who she had developed an unhealthy attachment to, Dr. Wilbur wanted the respect of the medical establishment that she felt that she had been denied during her years practicing, and Flora Schreiber was eager to move beyond writing fluff pieces for the women’s magazines. Nathan’s book Sybil Exposed examines how the whole thing went down. It’s a sad and cautionary tale about how the trust between a patient and a doctor can be abused, and how overwhelming ambition can warp one’s sense of right and wrong.

Shirley Mason was a young woman who grew up a member of the 7th day Adventist Church in a small town in Minnesota. Shirley was an only child, born when her parents were in the 40’s. Her mother, Mattie, had great difficulty carrying a pregnancy to full term so Shirley was doubly precious. . Imaginative and creative, Shirley devised various ways of hiding the stories that she wrote from her mother who was not only over protective but a bit neurotic. Shirley would cut up letters and words from magazines, like the word magnets that they sell today, and use them to create her stories. As a child, Shirley felt torn between her desire to paint and write and the teachings of her church which discouraged such activities, placing her already in conflict. She also suffered throughout her childhood from various ailments. Doctors diagnosed anemia, and after a few treatments, she would feel better but then she would go into a decline. The condition continued throughout her high school and early college years. It was in Omaha that Shirley met Dr. Connie Wilbur who was one of her first therapists.

It’s a testament to Nathan’s judicious reporting that Wilbur manages to come across as both a caring psychoanalyst as well as an ambitious monster. Wilbur had an overwhelming sense of her own importance. Her father, who was a noted chemist, had told her that she wasn’t smart enough to go to medical school, so she had to prove him wrong. She’d tried and failed to invent a cure for athlete’s foot. She became a psychiatrist at the time that there were very few women not only in medical school but in psychiatry. From the beginning, she was willing to try experimental techniques, including electro-shock therapy. For her the ends truly justified the means, although she genuinely wanted to help people.

The irony of this whole story is that after she finished her initial treatment with Dr. Wilbur, Shirley was fine for several years, until she moved to New York and started treatment with Dr. Wilbur again. Nathan concludes that Shirley was suffering from pernicious anemia, and that if she had been diagnosed properly, she probably would never have gone back into therapy with Dr. Wilbur. Another doctor who briefly treated Shirley when Dr. Wilbur was out of town, thought that Shirley was a hysteric who was highly suggestible under the influence of hypnosis.

The relationship between Doctor and patient was clearly co-dependent or countertransference. Wilbur, who was unable to have children, needed to be needed by her patients, and Shirley liked the attention that she received from Dr. Wilbur. From the beginning, Dr. Wilbur crossed professional lines which should have gotten her thrown out of the AMA if it had been known; she took Shirley on trips, gave her money, and made house calls to treat her. Later on when Shirley went back into therapy with Dr. Wilbur, she helped pay her rent, found her jobs and allowed her to rack up thousands of dollars’ worth of therapy. Why? Because at some point, Dr. Wilbur decided that Shirley suffered from multiple personality disorder, and she became determined that Shirley’s case would establish her at the forefront of American psychology. She pumped Shirley almost daily with Pentothal which Shirley quickly became addicted to, along with a whole host of other psychotropic drugs including Demerol, Benzedrine; Daprisal, Seconal, Equanil, Edrisal, Dexamyl, Thorazine, and Serpatilin, a combination of Ritalin and a tranquilizer, and Phenobarbital. Shirley was like a walking pharmacy. It’s a wonder that she could remember her name.

Nathan includes snippets of the therapy sessions (which were taped) which clearly indicated that Wilbur was leading Shirley along the path that she wanted her to go. Wilbur was relentless, increasing the dosages of Pentothal until Shirley came up with increasingly bizarre stories about her mother including lesbian orgies and repeated brutal rapes with various instruments. The more outrageous the story, the more Wilbur was happy. Shirley, to her credit, attempted to tell Dr. Wilbur at one point that she was making the whole alternate personalities/abuse stories up, but Wilbur made it clear that she would not only stop treating Shirley, but end the friendship. By this time, the only friend Shirley had was Dr. Wilbur. The involvement of Flora Schreiber, the journalist who like Dr. Wilbur, never felt that she’d gotten the recognition that she deserved completed the trio. The book’s success had a different effect on the 3 women. For Dr. Wilbur, MPD or DID was finally accepted as a genuine diagnosis, but Flora Schreiber began to resent having to share not just the money but also the spotlight with Dr. Wilbur. And poor Shirley, after spending several years after her ‘integration’ happily teaching art at a small college, the book’s publication turned her eventually into a total recluse, as soon as someone realized who she was.

If you have any doubts about psychiatry or psychoanalysis, this book will just reinforce your feelings about the profession. On the other hand, it just goes to show easy the doctor/patient relationship can be abused, if one is not careful. Nathan doesn’t indict psychiatry but she goes to show how repressed memories and DID had gotten a little out of hand over the past thirty years. Nathan gives a brief overview of how psychiatry and psychoanalysis evolved in this country, moving away from Freud’s theories, as well as the different treatment one gets if one has the money versus if one is poor. She also examines why Sybil became such a phenomenon, coming out as it did when the women’s movement was really taking off in this country. Nathan believes that MPD “became a kind of language” for women to explain their roles as wife, mother, friend, boss, employee etc. She also makes the valid point, that women historically had been the guinea pigs for any new kind of psychiatric treatment, particularly in the 19th century when so many women were diagnosed as hysterics.
Sybil Exposed is  thoroughly and meticulously researched. Nathan was able to listen to the tapes of Shirley’s sessions with Dr. Wilbur, as well as Flora Schreiber’s papers which are housed at John Jay College in New York. Unfortunately, after Dr. Wilbur’s death, a large number of her papers were destroyed. It’s amazing that this book wasn’t written before now. Even now the book is still controversial, with many people still believing that the story of Sybil couldn’t possibly have been made up, along with those who doubted the veracity of the story from the beginning. The book made me grateful that I found a therapist who was sympathetic to my needs and didn’t have a hidden agenda. I felt pity for Shirley, anger towards Dr. Wilbur, and frustration that Flora Schreiber didn't walk away when she had the chance.

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