Dissociation: The celebrity metaphor of the 1980s
The creation of a new category of dissociative disorders in DSM-III (1980) resurrected “dissociation” as a double-duty metaphor for both a causal (defense) mechanism and a descriptive term for the splitting apart of consciousness, complexes within memory systems, and the subjective sense of a unitary self. Disoriented by the loss of a formal Freudian paradigm and the newly energized discourse of biological psychiatry, psychoanalytic clinicians found asylum among the dissociative disorders and their presumed reactive, trauma-induced origins. Within a few short years multiple personality disorder (MPD) would emerge as the most frequently diagnosed entity in this group and would be the subject of several large clinical studies that seemed to validate its existence. The research of 3 psychiatrists in particular caught the profession’s attention: Richard P. Kluft of the Institute of the Pennsylvania Hospital in Philadelphia; Frank W. Putnam of the National Institute of Mental Health; and Bennett G. Braun of Chicago’s Rush Medical College.
These 3 men were then asked by Robert Spitzer to be new members of the Advisory Committee for Dissociative Disorders for the forthcoming DSM-III-R, which finally appeared in 1987. Other new members were psychiatrists Philip M. Coons and Marlene Steinberg and social worker Janet B. W. Williams. Spitzer was the only holdover from DSM-III.
The DSM-III-R revisions for the dissociative disorders were extensive. The sequence of the disorders in the chapter was changed, with MPD placed first because it “is in many ways both the paradigm and the most pervasive expression of the spectrum of dissociative phenomenology.”4(p40) Severe physical, sexual, and emotional abuse in childhood were its predisposing factors. Described as “apparently extremely rare” in DSM-III, in the years 1984 to 1987 large numbers of cases were reported in the literature by Kluft (200 cases), Putnam (100), Coons (20), and Braun and co-authors (355).4(p40)
In order to further study the epidemic which they did so much to create, in 1983 they founded the International Society for the Study of Multiple Personality and Dissociation (ISSMP&D). By 1990 there were approximately 2000 members. The ISSMP&D’s annual conferences were carnivals of workshops by and for many varieties of mental health professionals. The first, in December 1983, drew more than 300 participants. Beginning in 1986 some taught tales of cults and childhood Satanic ritual abuse.5 In March 1988, the first issue of the peer-reviewed journal Dissociation appeared, with Kluft as the chief editor, Braun as associate editor, and 2 additional assistant editors.
Psychiatry battles the devil
The DSM-III-R Advisory Committee on Dissociative Disorders was conscious of the historical implications of the MPD diagnosis, noting that MPD “and its attenuated forms are, historically, the secularized descendants of the Judeo-Christian possession syndrome.”4(p44) In other words, they knew they were expanding the jurisdictional boundary of “scientific” psychiatry and colonizing the supernatural. Treatment rationally follows from diagnosis. Psychiatrists soon claimed for themselves superior therapeutic expertise for techniques that had formerly been the province of magico-religious practitioners (exorcists).6-8 What they did not anticipate was that the blurring of this boundary would backfire, pulling many of them off into the rip tide of Satanic panic.
Bennett Braun was the first and most fervent DSM-III-R Advisory Committee member to join the crusade against Satan. His public expression of interest in cults and MPD dates at least to 1986. But at an ISSMP&D conference in Chicago in 1988, Braun presented a workshop in which he directly linked the MPD epidemic to the abuse committed against children by devil-worshipping cults. He argued that these Satanic cults were everywhere in the US, internationally organized with a structure similar to communist cells, with local regional, district, national, and international councils.9(p395-396),14(p46-47,232-233) Braun also argued that Satanic cults were transgenerational family traditions that had been going on in secret for at least 2000 years.
At that same conference, Sally Hill, a social worker in private practice in Chicago, and Jean Goodwin, a psychiatrist and professor of medicine at the Medical College of Wisconsin in Milwaukee, presented a paper that attempted to validate Braun’s claims by citing historical accounts of allegations of “the Satanic black mass” and other obscene cult behaviors going back to at least A.D. 100. Reproducing these accounts without regard to context, these clinicians read them as fundamentally true reports of actual events. Professional historians who specialize in those eras tend to interpret such material as a discourse of propaganda aimed at undesirable minority groups, whether real or imagined.
A few months later, in March 1989, this conference paper was published in Kluft and Braun’s journal, Dissociation.10 It quickly became a citation success in the SRA literature as evidence in favor of the historical continuity of Satanic cults and their rituals.9(p393),19 (p177) The message to the public and the mental health professions was clear: elite members of the American psychiatric profession seemed to be sanctioning the SRA moral panic. Satanic cults were probably real, had probably been around for almost 2 millennia, and were abusing children and creating the MPD epidemic.
As for the other members of the DSM-III-R Advisory Committee and the leadership of the ISSMP&D, there was only one response: public silence.