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Friday, May 25, 2012

Walter Franklin Prince - The Doris Case of Multiple Personality


The Doris Case of Multiple Personality
 - Walter Franklin Prince -
The article below was taken from "An Outline of Abnormal Psychology" (1929, A. S. Barnes & Co.) edited by Gardner Murphy. With Dr Prince's consent, Murphy made some minor alterations to the original text published in the Proceedings of the American Society for Psychical Research, vol. ix.

          AS AN easy introduction to the Doris Case I will ask the reader to put himself in my place in the late fall of 1910, when I still supposed that it was one of hysteria only. You are talking with a somewhat stolid looking young woman with apprehensive manner and nervous laugh (Sick Doris) when suddenly you note what seems to be an odd change of mood. (Sick Doris sinks into the depths, and Margaret "comes out"). Though not startling in its abruptness and antithesis (the personalities are on their guard, more or less, to preserve their secret) yet she now has an air of restrained mischievousness, her demeanor is in some indefinable way more childish, her laugh is freer and her remarks often naive. Presently the stolid look comes back but with a difference, there is a tendency to chuckle, the signs of nervousness are increased, and in the eyes is a peculiar fixity of regard (Sick Doris has returned, but Margaret is now more intently watching underneath, and is amused, disturbing the consciousness of Sick Doris). Later you begin to talk about books or pictures, and suddenly note that the girl is no longer stolid or childishly gay but is following what is said with lips parted in a happy smile and face fairly luminous with interest (Real Doris has taken Sick Doris's place), and you congratulate yourself upon the choice of a subject which has evoked such an intelligent appreciation. At another time the transition from reserve and stolidity to the rollicking and humorous "mood" is more pronounced (Margaret is somewhat off her guard, and is acting more according to her real nature). Gradually you begin to note oddities and contradictions. You expect her to partake of a dish for which she expressed an evidenced fondness yesterday, and she cannot be induced to touch it, but declares that it is not agreeable to her. At the very next meal she devours a quantity of it (Sick Doris did not know that Margaret had said she liked the article of food and had eaten it, and Margaret, while aware of Sick Doris's refusal and remark, was herself too fond of her favorite dishes to decline them on account of the risk of discovery). Often she repeats a story within a few hours of the first relation, and seems confused when reminded of the fact that she told it before, saying, "Oh, I forgot that I told you that - I thought it was some one else." Not infrequently she contradicts a statement lately made by her, or expresses an opinion at variance with one previously uttered. Sometimes at a "change of mood" there seems to be a hitch in her part of the conversation, she seems for a few moments to be talking somewhat at random. You have not noticed that the moods succeed each other in a certain order when followed by this momentary conversational obscuration. On the whole, she impresses you as being a very mercurial young lady of unsettled mental habits and not uniformly veracious character.

Similar impressions prevail among her acquaintances and even her relatives. Intuitively, as seems to be the rule in these cases, she has felt that she is different from other people, and the group of her personalities has guarded the secret, all except the primary one more or less masking their peculiarities, in proportion as the demeanor of persons with whom she is in company gives token that caution is necessary. Paradoxically, she is in least danger of discovery by those who have known her all her life. They are wholly ignorant of the literature of abnormal psychology, and have been so familiar with her oddities that nothing about her can now surprise them. It is the new acquaintance, known to be well-read and noted to be observant, of whom the group of personalities stands in awe, and with whom they take the most pains, not uniformly maintained - nor always successful, to dissemble their individual differences.

When Margaret followed Sick Doris or Real Doris, she came with the knowledge of all the sensory impressions and thoughts of the previous state. The same was true when Sick Doris supplanted Real Doris. But it was otherwise when the alternations occurred in the reverse order. If Real Doris came directly after a Sick Doris or Margaret period, or if Sick Doris followed Margaret, the present personality was utterly ignorant of what had previously taken place. Whatever had been done, said, heard or thought by her predecessor was to her absolutely unknown except as she could make shrewd inferences from her situation at the moment she "came out." Of course, when the transition was in the order that did not break the mnemonic chain, a conversation, for example, could be carried on across the barrier with perfect case. But what was the personality to do that came on deck by a sequence that involved amnesia, and found herself engaged in a conversation of whose nature she had no idea whatever? She would do what is always done in cases of this kind, "fish," pretend that she did not hear the last remark of her fellow-interlocutor, appear to have her attention attracted by an object of enough interest to cause her to begin to talk about that, and by various other devices to mark time until with shrewdness developed by practice she was able to get her bearings.
A SKETCH OF THE PERSONALITIES
Margaret
Margaret was mentally and emotionally a child of not more than ten years, with some extraordinarily naive notions not usually carried beyond the age of five or six. Her facial expression was strikingly childlike, her voice in speech or laughter that of a young tomboy, her point of view, mental habits and tastes in every way juvenile. When alone with friends who knew her secret so that she acted as she felt, her speech and whole demeanor were such that one almost forgot that the bodily size did not comport with all else which so consistently constituted the make-up of a child. She was mischievous, roguish, witty, a consummate mimic. ingratiating, winsome and altogether lovable, as a rule. She delighted to sit cross-legged on the floor and show her dolls and the trumpery contents of "her drawer" to grave doctors and other professionals who had been initiated, and by her delightful drollery would send them into gales of irresistible laughter. She alone of the group was slangy, and mispronounced or misspelled many a word which offered no difficulties to Real Doris, Sleeping Margaret, or even Sick Doris. Although she had direct access to all the thoughts of the primary personality, many of these thoughts were as incomprehensible to her as is the political and scientific conversation which a normal child may daily hear but let pass idly by. She devoutly believed in fairies, and was amazed that I had not learned that doctors find babies on river-banks and take them to expectant mothers in their satchels. She fibbed and romanced for the fun of it, but could not avoid a betraying twinkle of the eye while doing so. It was a mystery to her why Real Doris and Sick Doris cared for church or Bible-study. It was not that she was opposed to religion, she simply could not comprehend it - it was all "dumm stuff" to her. She was demonstrative and affectionate, the antithesis of Sick Doris in this respect. She possessed a form of visual hyperaesthesia which enabled her to make her way with ease about an almost completely strange room so dark that I could not have moved three steps without getting into difficulties. Her auditory hyperaesthesia was still more extraordinary, as many incidents will show. She could hear at thirty-one feet the ticking of a watch which was audible to the ordinary person less than five feet away. One is almost tempted to say that she could hear the grass grow.
Sick Doris
Sick Doris was characterized by woodenness of expression, her face. probably from relaxation of the muscles, was broader and more flabby than that of Margaret in particular, her eye was dull, lacking in the glee and mischief of Margaret's and the wide-open intelligence of Real Doris's. Her glances were apt to be somewhat furtive, while both Real Doris and Margaret always looked you directly in the face. Her voice had a quality hard to define, lacking the soft, womanly modulations of Real Doris's voice, and the infinite variety of tone-color in that of Margaret; it was somewhat monotonous and metallic. In manner she was reserved, half independent-half deprecatory, and nervous. Having no capacity for affection, she was nevertheless capable of a dog-like friendship, which never manifested itself by caresses, but only by a disposition to seek the society of its object, to perform tasks for her and to make her presents. Thus, for many months during which both she and Margaret were endeavoring to avoid meeting me for fear that I would discover their secret, and were even resolving to stay away altogether, she was yet brought back to sit and talk with Mrs. Prince, as by a hypnotic spell. She was a slave to her narrow conceptions of duty. Her chief joy was to make and present gifts to her friends, and she did this to an extent which exasperated Margaret, and which the calm judgment of Real Doris would not have approved. She was religiously inclined without Real Doris's well defined reasons for being so, while Margaret was frankly pagan. Her sense of humor was not keen. A joke about a man who had a wooden leg which sprouted under the stimulus of a powerful liniment would only puzzle her - and she would wonder how it could be. Nor would Margaret see the humor of it, since to her childish fancy almost anything was possible. Real Doris and Sleeping Margaret, on the other hand, would compass the grotesqueness of the conceit in a moment and laugh heartily. While she never, learned certain elementary manual operations which were easy even to Margaret, such as the proper way to set the hands of a clock, in other directions her manual skill was the greatest found in the circle of the group. Embroidery, for instance, Margaret could do in rather clumsy fashion, while Real Doris had some degree of skill, but Sick Doris's work was exquisite. Not only did she embroider with artistic dexterity, but this and some other species of work she was capable of performing at phenomenal speed with no impairment of quality; though it must be added that in such cases she enlisted, by some obscure process of compulsion, the cooperation of Margaret, and consequently brought upon herself revengeful reprisals. Suggestible to a degree, she was also subject to that narrowing of the field of attention which results in so-called fixed ideas.
Sleeping Margaret
Sleeping Margaret, whose title is a misnomer, in that she was neither Margaret asleep nor in any respect like Margaret, was the especial riddle of the case. From appearances one would say that she always slept, since she practically never talked except when the eyes were closed, but she professed never to sleep, and in fact was never known to wander in her speech or to oscillate in the clearness of her understanding. We have seen that Real Doris, Sick Doris, and Margaret each part of the time reigned supraliminally, and each part of the time became subliminal, the latter two consciously so. But it is hard to fix Sleeping Margaret's status, whether it was ever strictly supraliminal or strictly subliminal. When Margaret was "out," to use a quasi-technical term employed by the personalities, meaning supraliminal, Real Doris and Sick Doris were "in," that is subliminal. Likewise when Sick Doris or Real Doris was out, the remaining two members of the trio sunk into the interior depths. But, up to a late stage, Sleeping Margaret talked only when Margaret was out, though asleep. There was no question that Margaret was supraliminally there and sleeping in her curious fashion, for though mysteriously inhibited from hearing Sleeping Margaret talking with the same lips, she often made remarks in her own very different tones, sometimes cutting a sentence or even word of Sleeping Margaret's in half, and performed her characteristic acts unconscious that she was interfering with another. The expressions of the two flitted across the face in turn, or were sometimes momentarily blended, and many illustrations will be given of the two consciousnesses acting at the same time, now in unison, but more frequently at cross-purposes. Sleeping Margaret seemed to be as truly "out" as was Margaret sleeping, and yet is it possible for two mental complexes to be operative not only at the same time but at the same psychical level? Sleeping Margaret herself would say, "I am never out or in; I am always here." It was held that subliminal Margaret was nearly always conscious, ranging through three degrees of awareness, from intense to obscure. Sleeping Margaret professed to be always conscious, somewhere, without distinctions of degree. Even as Margaret disclaimed proprietorship over parts of the body, Sleeping Margaret uniformly disclaimed ownership of any part of it, yet she had limited and intermittent control, during the sleep of Margaret, or at a later stage of Real Doris, of the facial muscles, the instrumentalities of speech, and of the limbs. She went so far as to sit up at times, but never to walk or stand, giving the reason, however, that this would endanger waking and frightening the personality sleeping. She would often smile sedately or even break out into laughter, especially at some odd speech or antic, interpolated by Margaret. Mentally, she seemed the maturest of all, in fact impressed me as if she were a woman of forty. She was my chief coadjutor in the cure, though Margaret was also generally anxious to help, studied the progress of Real Doris, and gave valuable information. But Sleeping Margaret studied the interior situation unremittingly, watched the result of my experiments and reported thereon, suggested measures which often proved of great importance, and made predictions as to the development of the case which were nearly, not quite, always justified by the event.
Sleeping Real Doris
Sleeping Real Doris is the name which Margaret very properly applied to a somnambulic personality which was created at the age of eighteen, in consequence of a fall and injury to the head and back. She would make her appearance only now and then after Real Doris had fallen asleep, and it is doubtful if she ever rose fully above the threshold or Real Doris ever sank completely below it during her manifestations, though the latter was not conscious of her or any more aware of her existence than of the existence of Sleeping Margaret. She was like the fog which exhales from a lake and hangs over its surface. It is doubtful if she had self-consciousness. Yet she had her peculiar facial expression when she was reacting to external stimuli, one of quizzical puzzlement; her characteristic harsh, croaking tones, on the rare occasions in which her utterances were not those of an automatic transmitter; and repeated tests showed that she had memories which were not those of Real Doris or Sick Doris, but were exclusively her own.
SKETCH OF THE HISTORY OF THE CASE

The First Dissociating Shock, and the Rise of the Two Secondary Personalities
When about three years old, her father in a fit of anger dashed her to the floor. It was in the midst of the previous quarrel, according to her statement, that Sleeping Margaret came into being. It was a few moments after the act of violence, according to both Sleeping Margaret and Margaret, that the existence of the latter began. Consistently, the account of the incident by Margaret (who had no insight into the mind of Sleeping Margaret) lacked the earlier details mentioned by Sleeping Margaret. Margaret often related that the first thing she ever did was to make the crying Real Doris play with her fingers and toes. Furthermore, she asserted, she used to make the child Real Doris "see things that weren't there," cause her to hear "choo-choo," ask her what her name was, etc. Later - and this Real Doris well remembers - the two would have long conversations together, Margaret's replies being made aloud (at times), and with the same lips, but without Real Doris's volition or slightest previous knowledge of what would be said. Margaret early asserted her own rights to certain property and demanded deference to various personal tastes. One early lesson remembered by Real Doris was that of letting Margaret's ball alone. She was impelled by a will not hers to pick up the ball with her left hand and to transfer it to her right hand, then the left hand plowed scratches in her cheeks and eyelids until they bled. From the time that she was four until she was about eight, her face was seldom entirely free from scratches, because she could not learn to keep her hands away from Margaret's property. When the lesson had been pretty thoroughly mastered the scratching mostly ceased, to be renewed only when Real Doris became rash again.

When Real Doris began to go to school at the age of six, she at first had a hard time, for incessantly there emerged in her consciousness the clamors of Margaret unused to such monotony, "Come on! Let's go out!" It was difficult for Real Doris to study, and often Margaret coming would cut some ridiculous caper, and set the room in a giggle. Sometimes, in hot weather, Margaret would come and dash from the room without permission, later imperturbably returning, her head and perhaps her garments dripping with water. As Margaret came to realize that Real Doris could not be blamed for going to school her complaints ceased, but not her outbreaks and her astonishing speeches. In spite of all drawbacks, Real Doris secured high marks in her studies, but not for conduct - that was quite impossible. Ofttimes she came to consciousness to find herself being chided for misbehavior of which she knew nothing. Margaret came out regularly to practice writing and to conjugate, since she liked these exercises, but seldom for any other recitations, except to help out Real Doris in case of emergency. And so the days of school-life wore on, until, in spite of all drawbacks, Doris was ready for High School at fourteen, the youngest but one in a class of fifty two. But here Margaret put her foot down, and declared, "No more school!" She would not even permit Real Doris to go and fetch her diploma, fearing that this would be the threshold to, the attainment of the desire to enter the High School.

Invariably it was Real Doris who started upstairs for bed. Invariably Margaret came at the head of the stairs, and invariably Real Doris knew no more until she found herself downstairs in the morning. But in the meantime what things had happened! When very young she slept with others, but caused them such annoyance that finally she was relegated to some quilts on the floor by a window. Margaret spent a longer or shorter time each night in playing, as evidenced by what Real Doris would find in the morning. She would also, until the period when she so far fell behind Real Doris in mentality that she was incompetent to do so, write out the school exercises for the next day. She likewise would write notes to Real Doris to read, advising, reproaching, commanding her, according to need. Perhaps two years before the schooling was over Margaret ceased to help in the exercises, because they had become too advanced for her. She had reached the limit of her intellectual expansion, while that of Real Doris went on. Margaret was then of the mentality of an average girl of ten, and such I found her ten years later.
Second Dissociating Shock and Addition of Sick Doris to the Group of Personalities
At about six in the afternoon of May 5, 1906, Mrs. -, who had appeared perfectly well in the morning when Real Doris left to go to work, lay down, suddenly ill. The stricken woman died at two in the morning. Real Doris, overcome with grief, and undergoing a raging headache, nevertheless managed to maintain her individuality until she had performed the last offices in her power for her dead idol, whereupon Margaret took her place. Almost immediately thereafter a terrible pain shot through the left cerebral hemisphere, Margaret vanished, and a new personality, afterwards to be known as "Sick Doris," came into the drama.
Sick Doris and "Infant" Personality
She came without memory of any event whatever, of any face, any object, or the use of any object. She did not remember a single word, either to speak it or to understand its meaning when she heard it spoken. She instinctively moved her limbs, walked and handled objects with her fingers, but she did not know how to eat, and when she imitatively drank coffee it simply ran down her throat, for she did not know how to swallow. She did not understand how to undress herself, or that she should undress or that the dress was a thing separate from herself. All affection was gone, and all grief; not a tremor remained of the mental agony of a few moments before. She was as one horn with an adult body, and a maturely-inquiring mind, but with absolutely no memory and absolutely no knowledge.

She found herself sitting on the edge of the bed looking at two similar shapes. She did not wonder how she herself came there or regard herself at all, - her first mental experience was a languid curiosity as to why one of the similar shapes moved while the other was quiet. In fact movement and immobility first seized her attention, and her main problem for the first two days was why similar things did not always behave in similar fashion. She did not inquire why chairs did not move about of themselves for no chair did. But every figure of the shape of those prostrate ones of the first evening moved except one consequently that one, the corpse, fascinated her, and she sought occasions to experiment upon it to see if she could make it move. During the first days she wondered why some were doing a thing to her incomprehensible (weeping) and others were not doing the same, why one figure only was horizontal and yet in motion (the sick Sister) while the rest, with the exception of the motionless one were in different and changing attitudes. Differences of any kind were the first objects of her mental inquiry which she had no words to express, and particularly differences in respect to movement.
The Education and Development of Sick Doris
She comprehended the most primitive type of language first, that of gesture. And here a swift process of inference, experiment and verification entered. For example, when in the morning she entered a room where her sisters were drinking coffee, they handed her a cup. She saw the cup approaching, saw that they held similar objects, inferred that she was, to take it, and since after she did so nothing else happened concluded that she had done what was expected of her. She quickly learned to interpret expressions, and involuntary nods and shakes of the head in the midst of remarks which were unintelligible to her. She observed that following the issuance of sounds from the mouth of one person another would often be stirred to activity, and inferred that the sounds must have been intended for such effect. Some experiments by way of imitating the sounds were made, for instance she yapped out in the same tones a phrase uttered by sick Trixie, but the results were disconcerting, and she vaguely felt that the experiment was not successful.

On the third evening Margaret began to take a hand, as subliminal teacher. When the lips began to utter a series of sounds Sick Doris knew that she was not responsible, and when the hands began to do things and the fingers to point, she felt that it was not her work. Nor was there any especial surprise, for during the two previous days Margaret had occasionally made the lips speak or the hands perform an act in case of emergency. Margaret made but little headway in her new vocation as pedagogue at first, since Sick Doris knew no language. But she soon hit upon the scientific way. "All the way I could get her to understand," said Margaret long afterward, "was by doing things. She would say things over after me and do what I did." And as soon as Margaret by the double process of pointing and pronouncing the name of an object, performing an act and naming it, built up in the mind of Sick Doris a small vocabulary, the process of education became rapid. It generally is, in such cases, scores of times faster than is the education of an infant. Night after night Margaret continued to labor, a stern and contemptuous preceptor. In a week's time Sick Doris was fairly competent to get along, though she had many difficulties yet to meet. Nor did she ever become physically complete or symmetrical, since to the end she was lacking on the side of the affections, though morbidly the slave of duty and lacking in humor, in conceptions of the abstract, and other respects.
The Four Personalities
Real Doris from the night following the mother's death had no conscious existence for two months. The mentally crippled Sick Doris mechanically continued what Margaret instructed her to do, and Margaret knew of nothing but to continue what Real Doris had been doing. So the old routine, working away during the day, house-keeping mornings and evenings, went on. Real Doris, when she began to come again, put in very brief appearances, usually of not more than five minutes. There was a subsequent period of three months during which she did not "come out" once, and the sum of all her appearances for five years could not have equaled three days. Fortunately, all the secondary personalities were favorably inclined to her, and tried by every means to increase the number and length of her emergences.

Overwork, together with the baleful influences of the home, chiefly militated against the primary personality. Margaret knew that something must be done, and dinned it into the mind of Sick Doris that she must earn more money, by working at night. Sick Doris learned the lesson all too well. As Margaret afterwards ruefully expressed it, "She began to work like fury, and - and then she made me work!" By a process of abstraction, Sick Doris, particularly while sewing, could gradually enchain the will and entire consciousness of Margaret, so that both consciousnesses cooperated, intent upon the task. Everything but the needle and stitches faded away, the eyes never wandered from the work, color fled from the countenance, the fingers flew with magic speed, and hours passed before the spell was broken. An instance will later be given of the definitely proved execution of an elaborate piece of embroidery in less than a quarter of the time that the most conservative judges estimated as necessary. In this instance the abnormal work went on more than twelve hours at a time absolutely without rest except such as was furnished by seizures of catalepsy, when the needle paused midway in the air, the body immobile and the eyes fixed, for ten minutes or more, whereon the arrested movement was completed and the task went on, Sick Doris not being aware that she had paused more than a second. When the task was ended Margaret would come out and dance a wild dance of joy.

Thus nearly all the life was divided between Sick Doris and Margaret. The former was on the whole the dominant character for five years, though Margaret often got the upper hand and asserted herself as temporary tyrant. Real Doris made her little pathetic appearances, for five or ten minutes at a time, sometimes for several consecutive days, oftener at longer intervals. Sleeping Margaret still talked when Margaret was asleep, the latter still under the illusion that she was listening to her own voice. Still that profounder consciousness carried on her guarding function, and brought a psychic force to bear, mainly upon Margaret, in cases of danger or other urgent need.
The Third Dissociating Shock and the Advent of the Sleeping Real Doris
Toward the latter part of September, 1907, Margaret, startled as she was going up a flight of steps, fell, striking the head violently against an earthen crock. I will leave it to the physiologist to say if a group of neurons was thrown out of functional alignment by the shock; certainly, as Margaret afterwards expressed it, "A little crack was made in Real Doris." The following night began the interesting verbal performances which in later days were shown to belong to a true though incompletely developed personality, Sleeping Real Doris. Thereafter, whenever in the dead of night Real Doris would float briefly to the surface, she would be followed by this fifth and last member of the group. According to Sleeping Margaret, a second fall about a year after the first, seemed to strengthen Sleeping Real Doris, particularly making her voice stronger.
Discovery of Margaret
The first extended observation of a long series of somnambulic alternations was entered upon, and I noted, now the spiteful voice uttering threats, with hands endeavoring to injure the body, now the wary, harassed expression and half-awakened murmurs, now the ecstatic smile, hands reaching out and tender pleading, "Mother, don't leave me," and now the kaleidoscopic and correspondent changes of voice, facial expression and manner as one side of conversations apparently dating from childhood to that very day were rehearsed, and now the shrinking form and pathetic appeals, "Daddy, don't hit me." Impressed that the somnambulic phenomena were worth noting down and studying, on that very day I began the daily record which continued with hardly a break for three years and four months. Speedily it was discovered that in a certain state the sleeper could hear me and fluently converse. On Jan. 20th, somnambulic references to "that Doris" first suggested the suspicion that a secondary personality might be speaking, and the evening was not ended before the suspicion became a certainty.

Yet it was evident that the discovered personality (at first denominated X) did not intend to betray herself. Occasionally she would stop with puzzled expression to inquire, "Did you know that Doris?" but as the conviction dawned upon her that at least a part of the secret was known she grew more and more frank. Moreover, it appeared that X asleep did not embrace the whole consciousness of X awake, since the former was plainly unable to recognize in her interlocutor the Dr. Prince whom the latter knew so well, and constantly spoke of the latter as a third person. Taking unwise advantage of this fact, I soon began, when X asleep threatened to hurt Doris, to tell her that Dr. Prince would punish her if she did so. This was all the more successful as a terrifying measure in that at that time Margaret awake stood in awe of me and "came out" as little as possible when I was present. Margaret asleep soon, began to address her interlocutor as "He."

On Jan. 22 Margaret asleep told me that Doris called her by the name Bridget, and that she disliked the name. Feeling the need of some name for her I suggested several names, and at the mention of Margaret she accepted it with delight. Henceforth "X" was known as Margaret.
THE FOLLOWING IS AN EXTRACT FROM THE DETAILED CHRONOLOGICAL RECORD
Jan. 22, Sunday: This morning Doris reported that when she was asleep last night she tore at her side and made it bleed, and scratched her arms.

In the afternoon Margaret came over. She asserted that while asleep when Doris was "away" she, Margaret, could go to Dr. Prince and put her hand on his and he could not move his hand. "(Anything else?(1)) Yes. I could put my hand in front of his eves and he would think he was going blind. (Well, you do that, and let Doris's hip alone) here she scowled. "(Tease Dr. Prince. You would like to tease him?). Yes" - delightedly. "(Well, you may do that. Give him a jolt.) Don't his books tell him anything about that? (No, I guess not. But you must let Doris's hip alone.). No!"

(1) Parentheses indicate Dr. Prince's replies.

In the evening she came in looking very jaded and miserable, and was evidently suffering. She said little, but it is nearly certain that Margaret had been punishing her for coming to the rectory in the afternoon in spite of the subliminal urgings to stay away, and that she dared not tell what she had gone through for fear of further torments. Presently she lay down and went to sleep. Margaret came, and clutched savagely at the left hip, and scratched the neck. I remonstrated in vain, and held her hands only to see them snatched away and the vicious movements repeated. Stern commands to desist had no effect but to increase the manifestations. Attempting suggestion I began to say impressively ("I am going to take away your power. You are growing weaker. You are losing your strength"). The struggles became weaker. Finally I said ("Your strength is gone. You are powerless"). All striving ceased, the face changed, and she (Sick Doris) awoke. She now appeared extremely languid and spoke with difficulty. Her vital forces seemed to be ebbing away, and she gradually passed into a condition. which made Mrs. Prince and me think, not for the first time, that she was dying. Her pulse descended to 54, and became feeble. She seemed only half conscious, but occasionally looked wonderingly at the two who were sitting by her, affected by their impression that she was near her end. At length she murmured, "Am I dying? (I think so.) Don't you want me to go?" She smiled peacefully, as though glad both to go and to know that she was to be missed. She looked singularly unlike her afternoon self, the very shape of her face altered - it seemed thinner, as though she had passed through a period of sickness since. Under the spell of considerable emotion I was looking into her eyes, and presently her gaze fixed upon mine, and with parted lips she continued to look, not rigidly, but dreamily and peacefully while we waited for the end which we thought so near. After some time it suddenly struck me that her gaze and features were unnaturally fixed. I stooped to examine her.
Sleeping Margaret Takes Command
Just then a voice issued from her lips, though no other feature moved: "You must get her out of this. She is in danger." It was as startling as lightning from the blue sky. Of course, I thought, it must be Margaret speaking, but there was a calm authority in her tone which was new. I shook the girl gently, her face did not change. "Shake her harder," the voice went on. "Hurry! Hurry!" It was evident that Doris was in a profound state of hypnosis, and I began vigorous measures to bring her out, with the result that her eyes rolled and her limbs moved. Shaking her and shouting in her ear brought her to a sitting position. "Walk her! Walk her!" said the voice. At first there was difficulty in carrying out this order, she stumbled and tended every moment to collapse upon the carpet. Directions occasionally continued to issue from the lips, directions which I supposed to be uttered by Margaret, suddenly most singularly endowed with wisdom and calmness, directions which I never thought of disregarding, they were delivered with such authority and characterized by such good sense. Finally we heard, "She is coming to herself now; she will be all right soon." No more directions were given, and almost at once the face showed more animation and intelligence. But it was soon evident that Margaret and Doris (Sick Doris) were rapidly alternating. Facial expression, tones, utterances, all showed this, though for a time the utterances were only responsive to queries. At one moment to the question ("What is your name?") the answer would be given, "Doris," the next "Margaret"; now to the question ("How old are you?") the reply would be made, "Twenty-one," again, in other tones, would be heard, "Eighteen." The alternations averaged perhaps twice a minute for half or three-quarters of an hour, their duration getting longer as time went on. Her feet were first freed from the hypnotic spell, by the process of "walking her," but the use of her hands and arms remained for some time inhibited, probably because the suggestions of losing strength had been mainly employed against Margaret's malevolent exercise of them. Counter-suggestion at first had no effect. ("Raise your right hand.") She looked down at the hand, hanging limply at her side, and made an effort to obey, but failed. ("Raise it. You can do it.") She looked at it again, smiled, and said, "I can raise it. (Certainly you can. Why don't you?) I don't feel like it." After repeated suggestions, the arm went up, and she exclaimed, as if proud of the achievement, "See, I can do it." Her muscular powers were restored as by installments. Later Margaret became vicious again, and grasped the throat with both hands. Finally she fell into a state of lethargic slumber, and remained inert and speechless until nearly morning. At about five she (Sick Doris) woke, and crept feebly home to get her father's breakfast. Neither she nor Margaret ever evinced any recollection of the details of the hypnotic incident.

Jan. 23: Doris came over in the evening, and went to sleep at a little past eight. For over an hour she went through the movements of massage, rubbing her arms and neck, and making soft touches along the hip. (Comment by Sleeping Margaret, "Margaret treating Sick Doris.") Doris woke with bad pains. In her eyes was the old expression of staring wonder, surprised sadness. "Why did you call me? (I did not, I have not spoken for five minutes.) You must have called me. (No; don't you believe me?) Yes, but some one called me." Again she slept, and again awoke, declaring she had been called. This occurred repeatedly. Earlier in the evening she said, "I never asked God but for one thing, and He doesn't give it to me. (What was that?) That I might go." Now I asked ("Have you ever prayed against the voices?") Instantly her body seemed to be racked by violent twinges of pain. She answered, "No. (Remember that Jesus helped people who had troubles. Perhaps if you pray the voices will leave.)" The wincing and writhing renewed during my words, and directly her eyes closed, her face underwent that strange transformation, and a sharp voice cried, "What made you tell Doris to pray? I don't want her to pray. (Why don't you want her to? Do you dread prayer?) Yes. (Can prayer weaken you?) Yes." Here I uttered a prayer aloud. At once the life went out of her hands, and they sank upon her breast. The head rolled over to one side, and her lips parted in quiet slumber. (Comment by Sleeping Margaret, "Margaret went away.") After a while I noticed that her neck and arms were stiff, rubbed them, and they relaxed. Twenty minutes of perfect quiet on her part passed, and then I directed her to wake peacefully. In about a minute her eyes quietly opened, and more swiftly than I had ever before seen, her lips wreathed in a sweet and tender smile. (Comment by Sleeping Margaret, "That was Real Doris. I remember that she came for just a moment, before Sick Doris spoke. That was the first time you saw Real Doris after you commenced to care for the case.") I ascertained that she (Sick Doris now) had little pain, and felt cheerful and refreshed.
HERE THE ABRIDGED STORY OF THE CASE RESUMES
This incident determined the permanent exclusion of hypnosis in the after-conduct of the case.

Not suspecting that the Doris whom I knew was not the primary personality, I told her facts about Margaret which she knew much better than I did, and started a series of efforts to strengthen her on her side while attempts were being made to subdue Margaret on the other.
Sick Doris Cut Loose from Various Entanglements
The normal person may best conceive how a hysteric can both powerlessly cherish and act out a delusion and yet in a manner be conscious it is a delusion, by remembering how, in certain dreams, one both believes that it is real and has a haunting suspicion that it is not. It is certain that Sick Doris attempted to contrive so that Mrs. Prince should see the hip that was supposed to be eaten with tuberculosis, and yet the strange fantasy went on; likewise she insisted in putting in my care the books supposed to contain some of her marvelous pictures, so loosely tied with a twine string that it makes convincing her after-statement that she meant that I should examine and find them blank, and yet the waking dream automatically proceeded. Discovery of the fabrications shattered their power over her, and the most of the pains accompanying the tuberculosis delusion, so severe that she jerked, and sweat came out on her forehead even in her sleep, vanished immediately.
Revelation of Real Doris
The supreme proof of the winning of Margaret's confidence came on the 28th when she disclosed the central secret. "You never saw the real Doris, but very little when it was all Doris," she said impressively, and went to sleep, adding, "I will wake Doris so that she will be all Doris for a little while!" And she did so, though I did not fully comprehend that the clear-eyed girl looking wonderingly about her was the primary personality, and as such quite another than Sick Doris.
Revolution in Environment and Resulting Rapid Movement
On the 2nd of March I wrung from the father a reluctant and entirely heartless consent for his daughter to live for a while with the family which she was destined never to leave. That night Sick Doris appeared at the rectory in a pitiful condition, and a night of mingled lamentation and fright followed. But the effects wore off quickly. The very next day Real Doris came for a few moments, surprised and overjoyed to find herself transplanted. The next day Sick Doris and Margaret ceased to converse. Margaret would seek to talk with Sick Doris in the old ways, but Sick Doris no longer responded. Some tie between them had snapped, and Sick Doris, as Margaret often complained, could no longer hear her. On the 5th it was found that the fading memories of Sick Doris were beginning to emerge in the consciousness of Real Doris and within two days these were coming in such a flood as almost to overwhelm her. Usually she recovered the termination of an incident first, and it often caught her gasping with surprise and perplexity as it stood out isolated and unexplained. The whole incident developed by no regular process, but in a general direction backward. The memory of Sick Doris's acts came before that of her reasons for the acts, and the originally accompanying feelings often never showed up at all. States of extreme abstraction and emotion were never recovered. Sick Doris's delusions came to light slowly and imperfectly. It was months before the process of the absorption of memories was completed, during which the disappearance of the corresponding memories from the consciousness of Sick Doris was nearly contemporaneous. Much came back during sleep in the form of dreams, and the process of assimilation was smoother in that case.

On the 6th Real Doris emerged for by far the longest time since her mother's death. Soon thereafter it was not unusual for her to sum up several waking hours in a day. At first she was satisfied with what she got, and ecstatically pronounced it "like heaven," but the more her gains the more voraciously ambitious she grew to maintain herself, and the more she deplored "losing time." And this, of course, was as it should be. On the 9th, also, she was the one to sleep a considerable part of the night, which she had not done since she was three years old, and the very next night she reigned supreme and alone, and this became the rule, subject to many exceptions. Now the "Wake quietly, wake happily, wake in a minute" formula was transferred to her and began to be the process for bringing her by night or by day. A characteristic happy smile on the sleeping countenance was the sign that she was near, and I ultimately learned to wait until it beamed brightly before using the formula, otherwise it might not, be successful. It was found that she should be seen soundly asleep in her own personality, before leaving her, otherwise she failed to remain, but Sick Doris and Margaret spent the night between them. One day, while alone, Margaret struck the keys of the piano, and Real Doris came, and sang, for the first time for five years. On the 21st Real Doris was actually "out" more than ten hours awake. But she had been present but three minutes the preceding night. Even sleeping in her own personality meant increased expenditure of energy.

But from the 5th to the 10th Sick Doris was not seen, and Margaret thought that she was defunct. When she reappeared she was minus some of her memories. Again she was gone for six days, but on the 16th took up her old course of daily alternations. As Sleeping Margaret afterwards said, she had to come - the burden of the changes was too great for Real Doris and Margaret to divide between them.
The Declining Sick Doris
By the 16th of March, the bodily anaesthesias of Sick Doris had greatly deepened. With the ebbing of her memory her manner changed, becoming more cold and abstracted. She was allowed to help about the house, but sewing of all kinds was denied her, since its tendency to bring on catalepsy was observed. But sewing was a part of her, and no measure more powerfully operated to push her toward the brink of extinction than this. By the 27th taste and smell were practically annihilated.

On March 31st, Sick Doris accompanied Mrs. Prince and myself to a church in another part of the city. This was her last journey, so rapid was her declension after the change of environment, and the adoption of restrictive measures.
Margaret Also Declining, but More Slowly
On the 21st of March, Margaret declared that she could no longer voluntarily bring Real Doris, but must first sleep in order to hasten the coming of the latter. On the 24th, it was recorded that she was beginning to have intervals of not being conscious of Real Doris's thoughts when the latter was supraliminal and awake. That is, she was "away and sleeping." This was new in reference to Real Doris, though Margaret had previously at times been in that subliminal condition when Sick Doris was on deck.
The Battle with Sick Doris and her Retreat
The memories of Sick Doris ebbed daily. On the 6th of April she had no recollection of the rooms in the old home or the way thither; by the 8th she seldom remembered anything of the previous day, two days later she did not know who I was and began to call me "Mister." With the fading of memory she daily grew more childish and apathetic. She began to make pathetic appeals while being banished, saying, "I never did anything to you, Mister," and even to attempt touching cajolery, patting my cheek and declaring, "We don't want to go home. We like this place. We like you, Mister." By the 20th she had only a few fixed ideas, all in relation to her old home, her housework there, and buying provisions for dinner. On the 21st she had forgotten how to read and even her own name.
Infant Sick Doris
From the 6th of May it was observed that the visual angle of Sick Doris was narrowing, and directly afterwards her visual field began to shorten. By the middle of the month she could see but 14 inches away. My voice won only the response, "Noise! Noise!" as her eyes wandered about bewildered. She could not walk, stand or sit, and when raised from the couch her head fell with a snap and hung whichever way gravity carried it, while all movements of her hands were automatic. If her hand crossed her line of vision she asked "Waz zat?" as she did when any other foreign object intruded. Thus she continued until her end, the only essential alteration being that she came less and less frequently.

First on June 18th, I was witness of another singular phenomenon, that of Sleeping Margaret's "jolting" Margaret. That is, when Margaret asleep was refractory Sleeping Margaret would sometimes cause her to experience the hallucination of receiving a blow on the forehead. Margaret always thought that I was responsible, and would shrink from me in fright.
The Vicissitudes of Margaret
Careful engineering was gradually ameliorating Margaret's disposition. Yet occasionally she continued to have what were known as "tantrums." On June 2nd she experienced one so serious that she began to tear her clothing and, unable to wreak vengeance on Sick Doris, to threaten Real Doris for the first time. Once she addressed infant Sick Doris mournfully, "Gee! It's no use to scratch you. If I did scratch you all you'd say is, 'Waz zat?'" Following a tantrum no memory of it survived.

When asleep, the most fleeting touch of her hypersensitive fingers sufficed to tell her what my facial expression was and elicited chuckles or cries of dismay to correspond. More extraordinary, if not inexplicable, while asleep she had only to touch my lips with her fingers to know what I said, even though I only shaped the words rapidly, without conscious emission of the slightest breath. This power continued to her final exit, and she never showed consciousness while awake of having exercised it.

The policy henceforth pursued was to keep Margaret asleep so much of her time as was possible, and to narrow the range of her activities and pleasures all that could be done and preserve her good-nature.

Margaret still, in general, resolutely insisted on her property rights, and if Real Doris rashly laid hand on one of her dolls, opened the drawer in which the most of her knick-knacks were kept, or tossed away some supposedly worthless article like an empty "perfoonery" bottle which Margaret valued, she would be "stirred up" and come out with protestations and even threats.
Sleeping Margaret "Yanks In" Margaret
On Oct 8th, while Real Doris was in church, Margaret came out and was about to shout, according to her custom at home, "Oh, you papo!" when Sleeping Margaret made a great effort and sent her into the subliminal depths, forcing the return of Real Doris. When Margaret was next seen in the house, her eyes were bulging with excitement as she declared, "There is another Sick Doris. There must be, for I was yanked in just as I used to yank in Sick Doris. You can't fool this chicken; there's some one else." Again on Nov. 12th, in a similar emergency, Sleeping Margaret "pulled Margaret in," as the former termed it, but declared that it required so much expenditure of energy that she did not want to repeat the feat, and that I must keep Real Doris away from the church until the danger was over. The drain of force on both occasions was shown by the subsequent fatigue of Real Doris and by an increased number of alternations.
Margaret Becomes Mentally Less than Six Years Old and Reaches Blindness
With the exception of one month, to be noted in a separate section, Margaret's retreat continued throughout this period of a year and four months. Her recession to earlier mental childhood was manifest. By September, 1912, such expressions as "I've been bitteded by a bug" were frequent, and such pronunciations as "hankchet" for handkerchief, "breket" for breakfast, and "leamun" for liniment, appeared. In November a German accent began to emerge, "vot" for what, "vell" for well, and a curious pronunciation of dog like "doch," with the true German guttural sound. This had peculiar interest from the fact that in her sixth year the girl picked up some traces of accent from frequenting, out of her love of horses, a nearby stable where German hostIers were employed. She had not previously acquired it from her father, since she fled from his approach, and she laid it aside soon after entering school in her seventh year. I once heard her utter the Teutonic expression, "Did you make the light out?"

Even the memories of early years were now departing. In September it was found that the name F- was foreign to her, the next month she remembered neither her father nor her beloved mother, nor Ella, nor scarcely a person or thing connected with her former life. The general dulling of her comprehension, of course, kept pace with the loss of her memories. Margaret's general interest in life diminished in proportion. Her anaesthesia and failing vision were isolating her from the present world and her amnesia from the past. Vision, which had narrowed as we have seen, began also to shorten. As with other changes, this did not trouble her spirits, more than John Robinson is troubled because he cannot fly.

By September, 1913, she had become anxious to do whatever Real Doris desired she should do. If Real Doris wished that "Phase A" would not throw things about the floor, Margaret would at once begin to be religiously careful, declaring with all earnestness, "Margaret don't want to make the Real Doris trouble. Margaret don't want the Real Doris to think that Margaret's sloppy." But it must be a spontaneous wish on the part of Real Doris, one suggested to her by another as suitable for her to put in operation would not do.

Since Sick Doris had left a testamentary document, Margaret thought it proper that she should make her will also. After several experimental drafts, she at last wrote it out in gigantic characters, leaving grave and reverend doctors as well as the mother and papo, her dolls, child books and odd little knick-knacks. Several codicils were added, but these were dictated when Margaret was past writing. After her decease my duties as administrator of the estate were faithfully carried out. According to the provisions of the will, a number of articles are being preserved for presentation to "another Margaret," if I ever should find a person with one.

Of course, Real Doris's individual progress was keeping pace with Margaret's declension. Bridging the morning chasm, she often was staying in control for 22 or even, more than 24 hours at a stretch.
From Margaret's Blindness to her Death
As already stated, Margaret remained blind until the close of her career. But about Nov. 30th, 1913, a phenomenon related to the eyes began which curiously illustrated the physical effects of a relaxation of psychical control. So long as Real Doris was on deck, she could read or sew in a bright light with perfect impunity. But within a minute after Margaret came, exactly the same location in respect to artificial light would cause her eyes to sting and water, and soon two slender streams of water would be flowing down her cheeks. She did not know what the matter was, but placing a screen between her and the light relieved the difficulty, and this precaution was henceforth taken. Any oversight was attended by the same result, and the more as the months went on. A doctor was called in, Dec. 20th, to see Doris's eyes, which were badly inflamed, and he diagnosed the difficulty as due to eye-strain. Real Doris had done nothing to strain her eyes, and increased care in regard to Margaret soon brought relief. By January, Margaret was sometimes blundering and injuring herself while pursuing a familiar route through the rooms, but this was due to failing mental alertness. In the meantime her ability to detect my facial expressions remained intact, and continued to do so. Sometimes I would make a face, and instantly she would cry, "Don't make snoots at your Margaret when your Margaret can't see."
Real Doris
The very day that Margaret became blind Real Doris, ignorant of that fact, reported with surprise that she could see more clearly and farther than ever before in her life. After a number of resolves and futile attempts Real Doris first succeeded in maintaining herself through a day and succeeding night. After two repetitions of this feat, another advance upon the enemy was made by staying from the evening of Feb. 22nd to that of the 25th, a period of 70 h. 50 m. She was still failing to bridge the evening gap in a majority of cases when, beginning with 11 p.m. of April 8th, she accomplished the mighty achievement of 8 days, lacking 55 minutes.

On April 19th, owing to Margaret's departure, Real Doris, after 22 years of exchanging personalities, again stood on the firm ground of mental integrity, and since then has had not one moment's interruption of a clear and continuous consciousness.

Real Doris has continued to improve in physical health and mental tone. The physiologist would pronounce her bodily condition excellent, and the psychologist, uninformed about Sleeping Margaret, would observe no indications of mental abnormality. It could occur to neither that less than five years ago she was the subject of a condition strange and deplorable in the extreme, the climax of nineteen years of psychical dissociation(2).

(2) I made the acquaintance of "Doris" in 1923. I should agree entirely with Dr. Prince as to the absence of any sort of indication of abnormality. - Gardner Murphy.

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