Sybil

The film Sybil is one of the powerful portrayals of Dissociative Identity Disorder (DID), which was filmed based on a young woman’s true story. The young women, Sybil who went through a terribly traumatic childhood went to develop a total of 16 personalities, and each of her personalities adopt different life history, self-image, name, voice and movement style. The film Sybil has reminded me a recent film called Split (2016) that features a man with diagnosed 23 distinct personalities. Many movies nowadays love to exaggerate the symptoms of mental illness for dramatic effects, and the film Split is one of those portrays a highly stigmatizing, inaccurate version of DID. However, in my opinion, the film Sybil has rather provided a more accurate portrayal of DID, and the symptoms portrayed by Sybil match with the criteria stated in DSM-V.

According to DSM-V, the criteria for DID includes having two or more distinct identities, and the inability to recall personal information, everyday or traumatic events. Moreover, the person must experience distress caused by disorder or have trouble functioning in major life areas. It is also important to note that the disturbance is neither attributable to the direct effect of a substance, nor a part of cultural or religious practices. Apparently, Sybil meet the criterion for DID, and the film presents a fairly accurate portrayal of the diagnosis of DID. The alter identities of Sybil differ in striking ways involving gender, age, languages spoken, emotional state, knowledge and ability. For examples, the alter Peggy is a nine-year-old girl who hold Sybil’s traumatic fears, and another alter Vicki is a twelve-year-old girl who speaks French and knows about the presence of other personalities. We can find that the behaviour (e.g. dating, playing piano, drawing) inhibited in the host identity, Sybil, are freely displayed by the alter identities. The alter identities are there to protect and take action when Sybil herself cannot, for example, the alter Vanessa falls in love with Richard but Sybil herself is afraid of approaching and dating the man.

The switches can occur quickly or slowly, when switches occur in people with DID, it is often accompanied with a gap in memories for things that have happened (Butcher, Mineka, & Hooley, 2013). Like Sybil, people with DID may suffer from blackouts and find that there is a period of time that they cannot remember. However, the amnesia episodes may not consistent across all the identities, wherein some identities may be more conscious of certain alters than other identities (Butcher et al., 2013). DID can be seen as a failure to integrate various aspects of a person’s identity, consciousness and memory (Spiegel, 2006).

DID is often resulted from repeated or long-term childhood trauma. Like Sybil, often the person with DID have experienced child abuse, and the person might deal with extreme physical or sexual abuse by displaying other identities and hiding those unpleasant memories. Posttraumatic theory can be used to explained the development of DID (Gleaves, 1996; Maldonado & Spiegel, 2007; Ross, 1997,1999). According to posttraumatic theory, DID develops from the child’s attempt to deal with an overwhelming sense of hopelessness and powerlessness that caused by repeated traumatic abuse (Butcher et al., 2013). The development of certain alters are to protect the person from traumatic memories, because by escaping into a fantasy, it may help the person to alleviate the pain and distress caused by the abuse. However, not all the children who undergo traumatic events are prone to dissociate or escape into a fantasy. The development of DID might also need to view from the perspective of diathetic-stress model (Butcher et al., 2013), which states that the disorder occurs when the combination of the predisposition and the stress exceeds the individual threshold. That is, people like Sybil may have a diathesis for developing DID when severe abuse occurs.

An important treatment goal for DID is to integrate the separate identities into one primary identity that is able to cope with the stressors. The treatment for DID also focuses on undercovering and working through the past trauma and other stressor that lead to the disorder. The treatment may involve the use of hypnosis, which helps patients to recover the hidden past traumatic memories as well as reestablish the connection between the separate identities. In the film, Dr. Wilber uses hypnosis to help Sybil to recover her repressed childhood memories of physical and sexual abuse by her mother, as well as to help her to integrate her separate identities into one. At the end of the film, Sybil meets with her other identities and embrace them in the hypnotic state, this could mean that she has accepted her other identities. However, there is a risk that people are suggestible under hypnosis, which may in turn affect the accuracy of the recovered memories. There are many times Dr. Wilbur hypnotizes Sybil and asks leading questions that lead her to explain on her childhood memories of abuse. It arises a question about the validity and accuracy of recovered memories because human memory is malleable and people are prone to have false memories of an event that never happened (Butcher et al., 2013). Thus, there is a danger that the therapist may induce the false memories of abuse that never happened. In the movie, at least Dr. Wilbur confirm the validity of Sybil's recovered memories, such as physical and sexual abuse by her mother and the green kitchen she always mentions, by checking her medical record and visiting her old house. 

Moreover, Dr. Wilbur spends very much of her time with Sybil to accompany her and to take care of her. The issue of multiple relationship might need to be taken into consideration because there are several times Dr. Wilbur meets her client Sybil outside of the counseling session. Multiple relationship should be avoided if two relationships indicate conflict of interest and impair the psychologist’s ability to maintain objectivity (Sawyer & Prescott, 2011). However, there seem to be no exploitation or loss of objectivity found in this case. On the other hand, Stockman (1990) argued that avoiding personal encounter with clients and refusing to attend any personal event can lead to breach of trust and impair the therapeutic relationship, which consequently harm the clients. Furthermore, Sybil is at risk for suicide, thus there is a need for Dr. Wilber to be with her and protect her from hurting herself. To sum it up, a successful treatment for DID requires good therapeutic skills and commitment from both therapist and patient.