Multiple personality disorder — now known in modern psychological lingo as dissociative identity disorder (DID) in the DSM-IV — is a fairly uncommon mental health concern. But it remains an intriguing one because of its nature: The presence of two or more distinct identities or personality states. Each of these identities or personality states has its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self, and take alternating control of the person’s behavior.

Sybil is one of the most popularly known individuals who had multiple personality disorder, largely because of a book published in the 1970s that detailed her experience and that of her psychiatrist in trying to help treat her.

Now Debbie Nathan, writing in her new book, Sybil Exposed, suggests that the core diagnosis for Sybil — of multiple personality disorder — was made up by the patient to keep in the good graces of her psychiatrist.

NPR has the story, and describes how Shirley Mason — Sybil’s real name — came to have multiple personality disorder:

Shirley Mason, the real Sybil, grew up in the Midwest in a strict Seventh-day Adventist family. As a young woman she was emotionally unstable, and she decided to seek psychiatric help. Mason became unusually attached to her psychiatrist, Dr. Connie Wilbur, and she knew that Wilbur had a special interest in multiple personality disorder.

“Shirley feels after a short time, that she is not really getting the attention she needs from Dr. Wilbur,” Nathan explains. “One day, she walks into Dr. Wilbur’s office and she says, ‘I’m not Shirley. I’m Peggy.’ … And she says this in a childish voice. … Shirley started acting like she had a lot of people inside her.”

So the implication by the book’s author, Debbie Nathan, is that ‘Sybil’ made up her diagnosis in order to keep the attention of her psychiatrist, Dr. Wilbur, and to gain the emotional rewards from such attention. Shirley Mason wouldn’t be the first patient to ever want increased attention from their therapist.

An interesting hypothesis. But is it true?

Nathan suggests a letter Shirley Mason wrote in 1958 to her psychiatrist (2 years after first being diagnosed with this then unheard-of condition) reveals the truth:

At one point, Mason tried to set things straight. She wrote a letter to Wilbur admitting that she had been lying: “I do not really have any multiple personalities,” she wrote. “I do not even have a ‘double.’ … I am all of them. I have been lying in my pretense of them.”

Wilbur dismissed the letter as Mason’s attempt to avoid going deeper in her therapy. By now, says Nathan, Wilbur was too heavily invested in her patient to let her go.

But this is a truth already pretty well-known and accepted in the profession. According to Reiber and his colleagues (2002), only 40 percent of psychology professors didn’t know that Sybil’s case may have been a case of malingering (or “faking it”). Herbert Spiegel, who also occasionally saw Shirley Mason as a surrogate therapist at the time, also said as much in a 1997 interview (Borch-Jacobsen, 1997). Rieber (1999) published a journal article on the issue, and then wrote a book describing the case more in-depth in 2006 (Lynn & Deming, 2010).

We may never know the “real” truth, as Shirley Mason died in 1998.

The case remains an intriguing and interesting story in the history of psychiatry. Rather than a classic example of multiple personality disorder, Sybil may instead serve better as an example of the power of co-dependence and transference in the therapeutic relationship.

Just as importantly, the malingering or faking of a single patient decades ago should in no way denigrate or de-value the experience of people who have dissociative identity disorder today. Dissociative identity disorder — the modern term for multiple personality disorder — is a recognized and valid psychiatric diagnosis. And while it indeed may have been a diagnosis that was abused in the past, I hazard to guess that few clinicians do so today.

Read the full story: Real ‘Sybil’ Admits Multiple Personalities Were Fake or listen to the podcast.