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A twenty-five-year-old married woman suffered from repeated attacks of amnesia. Precipitating factors were anxiety over a thyroidectomy and the commitment of her father to the state hospital because he had threatened to cut his children's throats.
The case first was diagnosed as hysterical amnesia with conversion symptoms. Psychotherapy was combined with hypnosis during amnesic attacks which yielded repressed and suppressed incestuous material concerning her father and brother. The patient reacted with suicidal threats and developed two distinctly different, alternating personalities: the primary one characterized by severe depression and the secondary by destructive and assaultive behavior with visual and auditory hallucinations about her brother. Incidental investigation into her history showed earlier traces of dissociation.
Progressive manifestations of schizophrenia indicated insulin therapy. After fifty-nine treatments and forty-five comas some improvement was noticeable and the dissociation disappeared, but the patient showed no insight and had again forgotten much of her history.