Prologue

The phenomenon of multiple personality disorder (MPD) recently has come upon us like Halley's comet. Absent or hidden for scores of years, it now burns brightly in the diagnostic sky. We are discovering it anew, and with it have come challenges to our conceptualization of psychopathology and the treatment process. Interestingly, not everyone sees it. Even those that do often describe it differently. This secondary phenomenon, the split between MPD experts and skeptics, also deserves our attention and study.

This issue of Inquiry evolved out of a symposium titled, “Viewpoints on Multiple Personality Disorder,” which was held as the 25th Annual Scientific Day program of the Sheppard and Enoch Pratt Hospital on April 21, 1990. An in-depth presentation of a case of MPD by Dr. Kathleen Lyon was followed by a discussion of the case by four experienced clinicians, each with a different viewpoint. The discussion that developed was spirited and stimulating. The case and the discussions by Drs. Putnam, Roth, Ross, and Kluft constitute the main body of this monograph.

One of the problems that became apparent during the symposium was that this was a particularly complicated case. The patient was more than usually difficult and complex, Dr. Lyon was relatively new to the treatment of MPD, the hospital course was prolonged, members of the treatment milieu were seriously split as to their views of MPD, and Dr. Lyon had to transfer the case owing to reality factors outside the scope of therapeutic considerations. In