THE SINGULAR CASE OF BCA
During his long career as a specialist in the treatment of nervous
and mental diseases, Doctor Morton Prince, the celebrated Boston
psychopathologist, has been called upon to deal with many puzzling human
riddles, and to solve mysteries which, in their way, have been quite as
complicated and baffling as any that ever taxed the ingenuity of that
most ingenious of story-book detectives, Mr. Sherlock Holmes. In fact,
some of the problems laid before the New England specialist surpass even
the most astonishing of the adventures of Sherlock Holmes, thus proving
once more that truth is stranger than fiction. This particularly applies
to the BCA affair.
In the beginning, however, there was nothing in the BCA affair to
suggest to Doctor Prince that it had features which would test to
the utmost his psychopathological skill. It opened in a prosaic,
matter-of-fact way, with the arrival at his office of a young woman who
wished to be treated for what she described as a "nervous breakdown."
The story she told was a sad one, but he had heard many quite like it
before, and it did not impress him as involving anything out of the
ordinary.
"My trouble," she said, in describing the evolution of her malady,
"began when my husband was attacked with an incurable disease. For four
years my life was altogether given up to caring for him, striving to
make him as comfortable as possible, and endeavoring to conceal from him
my grief and anxiety. You can imagine the strain put upon me all that
time. Finally he died, under circumstances that caused me a great shock.
"Within less than a week after his death, I lost twenty pounds in
weight. For nearly three months I ate scarcely anything, and did not
average more than three or four hours' sleep out of the twenty-four. I
was depressed, overwhelmed; felt that I had lost all that made life
worth living; and, in short, wished to die. I became highly nervous,
tired easily, and suffered almost constantly from headaches.
"This went on for many months. Then there came a period of temporary
recovery. Strangely enough, it followed an occurrence that brought to me
suddenly a realization that my position in life was entirely changed,
that I was quite alone, desolate, and helpless. For a few minutes these
ideas flashed through my mind, and then all seemed changed. I no longer
minded what, a moment before, had caused me so much distress; and, what
is more, I immediately began to improve in health, until I was able to
mingle with my friends, take long walks, go driving, and really enjoy
life as I had formerly done. Alas, there soon was a relapse, and now I
am feeling worse than ever."
Listening to her recital, and examining carefully her mental and
physical condition, Doctor Prince felt justified in assuring her that
there was nothing seriously the matter, and that he would ere long
have her on the highway to health. In fact, he regarded her case
as one presenting "the ordinary picture of so-called neurasthenia,
characterized by persistent fatigue and the usual somatic symptoms, and
by moral doubts and scruples"; and planned a course of treatment which
he expected would speedily result in a cure. It was, to describe it
briefly, treatment by hypnotic suggestion--a method often employed by
psychopathologists in handling cases of neurasthenia, for they have
discovered that it is perfectly feasible to "suggest away" the fatigue,
insomnia, and other symptoms connected with this widespread and
distressing malady.
The use of hypnotism in the present instance, though, was attended by
consequences vastly different from any Doctor Prince had anticipated,
since it revealed to him that his patient was, in reality, suffering
from something infinitely more serious than ordinary neurasthenia, and
infinitely more difficult to overcome. Put into the hypnotic state, her
ills, to Doctor Prince's amazement, disappeared as though by a miracle.
Her whole expression was altered. She looked, and declared that
she felt, entirely well. It was hard to believe that this radiant,
vigorous, brightly smiling woman was the one who had entered his office
so short a time before, a typical nervous wreck, her features haggard
and careworn, her eyes dull and heavy, her hands trembling. And, most
astonishing of all, the hypnotized patient herself insisted that, in a
very literal sense, she was not the same person.
The tone, the language, the manner--all were changed. Struck with
sudden apprehension, Doctor Prince quickly brought her out of hypnosis.
Immediately there was another transformation, and she was neurasthenic
once more, without the slightest remnant of the strength, independence,
and self-assertiveness she had just been displaying. Nor, although she
was sharply questioned, could she remember anything she had said while
hypnotized; still, this proved nothing, for it is seldom that what goes
on during hypnosis is recalled in the waking state.
But, comparing her latest declarations with her prior account of the
course her malady had run, Doctor Prince could not help asking himself
whether she might not actually be a victim of what is technically
designated "total dissociation of personality," whether the second
emotional shock of which she had spoken, acting on a system already
disorganized by the severe and prolonged strain imposed upon her by her
husband's illness, might not have resulted in a psychical upheaval so
catastrophic as to involve the disintegration of her ego, or "self," and
the creation of a secondary self markedly differing from her original
personality.
In such an event, the period of temporary recovery would, indeed,
represent a period when the secondary self had obtained at least partial
control of the patient's organism; and it was quite conceivable that
there might come a time when, momentarily, at any rate, the secondary
self would become wholly dominant. In that case, the young woman's
plight would be appalling, for she would be in ignorance of all she said
and did while in the secondary state. This was precisely what occurred.
Only a few days after she had first visited him, she came into Doctor
Prince's office in a greatly excited condition.
"Doctor," she cried, "the strangest, the most inexplicable thing has
happened to me! This morning, after breakfast, I went up-stairs,
intending to lie down for a time, as I felt so utterly exhausted. I
think I fell asleep, but am not sure. I do know, though, that two hours
afterward I found myself standing in the post-office, about to mail to
you a letter which I am certain I did not write, but which is plainly in
my handwriting. It is such a queer letter, too, for it speaks of matters
of which I know nothing, and even refers to me as though I were somebody
else, and somebody else were I. What does this mean? What does it mean?"
And, in a day or so, she had an even stranger story to relate.
"Yesterday afternoon," she said, "I went for a walk, not because I
wanted to, but because you had told me that I ought to take some
exercise. I returned home about four o'clock, and went straight to my
room. I remember nothing of what then happened until, in the evening,
I suddenly became aware that I was at a gay dinner party, drinking
wine--which is contrary to my principles--and, what was far worse,
smoking a cigarette. Never in my life had I done such a thing, and my
humiliation at the discovery was deep and keen.
"I assure you, on my honor, that I have not the least recollection of
accepting an invitation to dine out, of dressing for dinner, or of
leaving the house to attend the party. Everything is a blank to me from
the moment I went to my room, in the afternoon, until I came to my
senses, several hours afterward, to find a lively group about me, a
wineglass at my plate, and a half-smoked cigarette in my fingers. Tell
me, Doctor Prince, am I going insane?"
The physician hastened to reassure her, but nevertheless he felt
seriously alarmed. It was evident that she was in a thoroughly
dissociated condition, and that she had become, so to speak, a
battleground on which was to be fought out the weirdest and most uncanny
of conflicts--a duel between two separate selves for absolute supremacy
in the use of the organs of her body.
Further, it soon developed that the advantage would lie with the
secondary self--which Doctor Prince called her B self--because, although
her ordinary, or A self, suffered from amnesia, or loss of memory,
regarding her actions when in the B state, the B self had a memory
extending over both states. The mental agony growing out of this
recurring forgetfulness on A's part may readily be imagined. As the
patient herself has since expressed it, in an autobiographical account
written at Doctor Prince's request:[44]
[44] This autobiographical account was first published in the
_Journal of Abnormal Psychology_. Afterwards it was brought
out in book form by Richard G. Badger, the Boston publisher,
under the title, "My Life as a Dissociated Personality," and
with an introduction by Doctor Prince. It is an account well
worth reading by all students of psychology.
"The amnesia made life very difficult; indeed, except for the help you
gave me, I think it would have been impossible, and that I should have
gone truly mad. How can I describe or give any clear idea of what it is
to wake suddenly, as it were, and not to know the day of the week, the
time of the day, or why one is in a given position? I would come to
myself as A, perhaps on the street, with no idea of where I had been,
or where I was going; fortunate if I found myself alone, for if I
was carrying on a conversation I knew nothing of what it had been;
fortunate, indeed, in that case, if I did not contradict something
I had said, for, as B, my attitude toward all things was quite the
opposite of that taken by A."
Picture to yourself, my reader, how you would feel if, for a few hours
almost every day, and sometimes for whole days at a stretch, you became
virtually nonexistent, yet were made to realize, from what your friends
told you, that a something or a somebody had taken possession of your
organism, and was veritably acting in your place, and in a way utterly
unlike your natural self. This was the state of affairs with Doctor
Prince's luckless patient. In moods, tastes, points of view, habits of
thought, and controlling ideas, her secondary personality was the very
reverse of that which had been dominant when she first sought medical
advice.
There even were pronounced physical differences. Whenever she was in the
A state, she was extremely neurasthenic, being afflicted now by one, now
by another, of the multifarious functional disturbances that accompany
neurasthenia, and being exhausted by the slightest effort. A walk of a
few hundred yards would be almost enough to prostrate her.
In the B state, on the contrary, she did not know the meaning of the
word "pain," and was seemingly incapable of feeling fatigue. She
would walk for miles without experiencing the slightest distress, was
constantly on the go, and appeared to be in every way an exceptionally
robust, healthy woman. Thus, physically, she was--as B--a decided
improvement over herself as A. But with respect to psychical differences
it was altogether another matter.
In the A state, she was kind, considerate of others, self-sacrificing,
animated by a keen sense of, and devotion to, duty; profoundly stirred
by any tale of sorrow or suffering, and most conscientious--if anything,
overconscientious, being tortured at times in an extraordinary degree by
moral doubts. In the B state, she was selfish, thoughtless, and cold;
one might almost say devoid of human feeling. Here is the way she
herself has put it:
"As B, I felt no emotion, except that of pleasure, using the word
pleasure as meaning a 'good time'--social gayety, driving, motoring,
walking, boating, etc.; but my enjoyment of these things was very keen.
As B, I was always the gayest of the company, but for people I cared
nothing. The little acts of affection which we all perform in daily home
life I never thought of. The habit of shaking hands with one's friends,
kissing or embracing those nearer and dearer, had no meaning to me.
Ordinarily, I think, when one shakes hands with a friend, one feels the
individuality of the person, more or less, and the clasp of hands means
something; but, as B, it meant no more to me than clasping a piece of
wood, and the acts of shaking hands, embracing, or kissing were all
alike--it made no difference to me which I did--one meant just as much
as the other. This lack of feeling applied only to people, for I loved
the outside world; the trees, the water, the sky, and the wind seemed to
be a very part of myself. But the emotions by which as A I was torn to
shreds, as B I did not feel at all."
In still further contrast, this most remarkable young woman, when in the
B state, was giddy, irresponsible, and frivolous. In the A state, she
was most serious-minded and intellectual, being fond of reading such
excellent literature as the works of Shakespeare, Hugo, Ibsen, Tolstoi,
and Maeterlinck. All this, B found very tiresome, and cared only for the
lightest kind of fiction, when she read at all.
In matters of dress and social pleasures, A and B were also
diametrically opposed. A believed that she ought to wear black; B, who
seems never to have given a thought to the dead husband, detested black,
and, on the other hand, had a really abnormal liking for white. So that,
as the two selves alternated in control, the strange spectacle was
presented of the same woman at one moment arrayed in deep mourning, at
another dressed in some light, bright gown.
To cap the climax, B took a malicious pleasure in tormenting her other
self in many ways. She made engagements which she knew that, as A, she
would not like to keep; she cultivated friendships with people with
whom, as A, she had little desire to associate; she was wastefully
extravagant, freely spending on useless articles money which, as A,
she had been carefully hoarding against a rainy day; she indulged in
innumerable petty, but annoying, practical jokes at A's expense.
For example: A would often wake in the morning to find on her pillow or
dressing-table notes advising her jeeringly to "cheer up," to "weep
no more," and not to "bother Doctor Prince so much." These notes she
herself had written during the night, having changed to the B state
while she slept, awakened as B, risen, and penned the notes, and then
returned to bed, to fall asleep once more, and, in the morning, awake as
A, with no memory of what she had done since retiring.
The flood of notes continuing, she began to destroy them unread, hoping
that this would discourage B's malicious activity. It only made matters
worse, for B now began to affix the notes to the center of her mirror,
pasting above them inscriptions warning her to be sure to read them, and
declaring that they contained--as they sometimes did--information of
importance to her.
But the best idea of the topsyturvy, kaleidoscopic, almost incredible
life led by this woman with a double existence may be given by quoting
a few extracts from a diary kept jointly by the two personalities, at
Doctor Prince's suggestion. Unique as a record of human experiences, it
had a distinctly practical value, for it enabled A to keep track of what
she had been doing while B was in control. B, of course, had no need of
it for this purpose, since, as was said, she did not suffer from loss
of memory, like A. The extracts quoted are not always in chronological
order; but, for the present purpose, that is unimportant:
"I am here again to-night, B, I am. I may as well tell all I have done,
I suppose. For one thing, I had a facial massage--there is no need of
being a mass of wrinkles. I know A doesn't care how she looks, but I do.
The Q's spent the evening here, and I smoked a cigarette. Now, A, don't
go and tell Doctor Prince; you don't have to tell him everything--you do
it, though. I _must_ have a little fun."
"I have struggled through another day. B has told what she did. How
_can_ I bear it? How explain? I am so humiliated, so ashamed. Why should
I do things which so mortify my pride? Quite ill all day. I am, as
usual, paying for B's 'fun.' It is not to be borne."
"A terrible day--one of the worst for a long time. I _cannot_ live this
way; it is not to be expected. I am so confused. I have lost so much
time now that I can't seem to catch up. What is the end to be? What will
become of me?"
"A was used up, and had to stay in bed all the morning, but I came about
one o'clock, and Mrs. X asked me to motor down to Z. Had a gorgeous
ride, and got home at seven, nearly famished, for A had eaten nothing
all day--she lives on coffee and somnos--nice combination!--steak and
French fried for mine, please."
"Good gracious! How we fly around! A has been ill all the day, could not
sleep last night. I hope he [Doctor Prince] won't send for us, for he
will put a quietus on me, and, as things are now, I am gaining on A. Had
a gay evening--no discussions of religion or psychology, no dissecting
of hearts and souls while I am in the flesh."
"I wonder if A is really dead--for good and all? It seems like it. The
thought rather frightens me some way, as if I had lost my balance wheel.
She wants to die, she really does, for she thinks it to herself all the
time. I wish I were myself alone, and neither A nor B; I cannot bear to
hear A groan, she cannot bear my glee."
"Such a day! A got away from me for a little while, and tried to write
a letter to Doctor Prince. It was a funny-looking letter, for I kept
saying to her: 'You cannot write, you cannot move your hand,' but she
had enough will power to write some, and direct it. The effort used her
up, however, and I came, and the letter was not mailed."
"I am too much bewildered to write. I have succeeded in writing Doctor
Prince. If I can only mail it! Oh, but I am tired! Such an awful
struggle!"
"Another queer thing happened to-day. I have not been to the cemetery
for a long time, so started to go there. I had gone only a little way
when I began to feel that I could not go on. I do not mean that I did
not wish to, but that I could not easily move my feet in that direction.
It was as if some physical force was restraining me, or like walking
against a heavy wind. I kept on, however, and finally reached the
entrance; but farther I found it impossible to go. I was _held_--could
not move my feet one inch in that direction. I set my will, and said to
myself: 'I _will_ go, I _can_ go, and I will!' But I could not do it.
I began to feel very tired--exhausted--and turned back. As soon as I
turned away, I had no trouble in walking, but I was very tired."
These last paragraphs refer to a phase of the case which was, from
the standpoint both of the patient and Doctor Prince, one of its most
serious and mysterious features. Although B, try as she might--and she
undoubtedly tried hard enough--could not permanently oust the A self,
and had to be content with manifesting as an alternating personality,
it was none the less the fact that, even when A was uppermost, B was
able to exercise, from some subconscious region, a certain amount of
influence, often impelling A to do things contrary to her inclinations.
The consequence was that A suffered fearfully from what seemed to be
aboulia, or paralysis of will, somewhat similar to that experienced by
Doctor Pierre Janet's patient, Marcelle, described in the preceding
chapter. The cemetery episode was only one of many incidents, when,
overpowered by some force she could not understand, and which was
actually the superior will of B, she was unable to carry out projects
she wished to execute, or was made to perform acts not at all to her
liking.
The diary is full of allusions to this subconscious mastery of A by
B. Scores of times, B influenced her to read some particular book
she--B--wished to read, or to go out for a walk when she--A--wished to
remain at home. Naturally A began to consider herself changeable and
weak-minded.
"One day," B writes, "it was raining and she did not want to go out, but
I felt that I could not stay in the house another minute. So I willed
that she should go to walk, and she changed her clothes and went out.
She thought: 'What nonsense this is to go out in this rain! I wish I
knew what I wanted to do five minutes at a time.' She would think: 'I
guess I will go to walk.' And then she would think: 'No, I don't want to
go out in all this rain.' Then, in a few minutes: 'I believe I _will_
go to walk,' etc. And finally she went, more for peace of mind than
anything else."
Frequently, moreover, the subconscious willing to affect A's conduct,
resulted in completely effacing A, and allowing B to reëmerge
spontaneously, in full control.
Thus, there was a dinner party which B was anxious to attend, but while
A was dressing she--A--decided she would not go, and started across
the room to telephone and say she would not be present. At once B
subconsciously began to think: "I want to go," "You must go." And poor
A first became very much confused, then faded away entirely, with the
result that the telephone message was not sent, and B was free to
attend the party, and enjoy another of the "good times" that meant so
much to her.
Where A suffered most of all by reason of this subtle power of B to
influence her actions, lay in the difficulty she had in communicating
with Doctor Prince, and in going to him for treatment. B well knew that
her career would come to an end the moment Doctor Prince succeeded in
reassociating his patient's disintegrated personality, and she fought
desperately to preserve her existence, repeatedly preventing A, as
mentioned in the extracts quoted from the diary, from telephoning to
Doctor Prince, writing to him, or visiting him; all of which greatly
increased A's confusion, misery, and unhappiness.
But, as it chanced, although Doctor Prince was earnestly desirous of
effectually and forever suppressing B, he was not at all desirous of
doing this for A's sake; and was, in fact, as anxious to get rid of A
as he was to get rid of B.
For, to inject a new complication into this most complicated affair, he
had by this time discovered that A had no more right to consideration
than B, since A no more than B represented the patient's normal
personality. His searching study of the case--the duel between A and
B lasted a year or more--had convinced him that there had been not a
single, but a double, dissociation of personality; and that the normal
self, in consequence first of the shock occasioned by the husband's
illness and death, and afterward of the shock that brought the B
personality to the fore, had been violently relegated to some obscure
department of the patient's subconsciousness, where, however, it
assuredly was existent, and where it was an intensely interested, if
helpless, spectator of the struggle being waged for control by the two
usurping selves.
To recall this lost self, which he designated as C, was Doctor Prince's
paramount object; and, after many months of weary and futile effort, he
ultimately succeeded. One day, after he had plunged his patient into
deep hypnosis, he saw that she had undergone a striking change.
Physically she seemed much as in the B state, though not so boisterously
vigorous; mentally she was like A, thoughtful and intellectual, but
happily devoid of the vacillation and morbid overconscientiousness that
had made A's life a misery to herself, and most difficult to all who
came in contact with her.
Questioned, she showed that in this new state she possessed a complete
memory for both the A and the B states, and was closer to normal than
either. In Doctor Prince's mind, no doubt remained--he had found C,
the missing self, the self which, after nearly two years of exile, had
promise of coming once more into its own.
It had yet to be reëstablished in sovereignty--no easy task, as the
event proved. Not many hours after its first emergence, B once more put
in an appearance, wrathful, vehement, and defiant, angrily challenging
Doctor Prince to suppress it if he could. Then came A, and soon a
momentary return of C, quickly put to flight, however, by the still
powerful will of B. In short, the conflict now became triangular, with
B and C active opponents, and A a participant because she could not
help herself.
The invaluable diary affords a clear view of the chaos that prevailed,
and of the increasing effectiveness of Doctor Prince's vigorous
reënforcement, by hypnotic suggestion, of the claims of C. We find,
for instance, B lamenting, after several days' banishment:
"Well, once more I am permitted to write in this diary. After we got
home, C went to pieces. I never saw such a lot! And then poor old A
came again, in anguish, wringing of hands, finally tears. Then, thank
goodness, I came myself! I _cannot_ see why Doctor Prince would rather
have that _emotional_, _hysterical_ set than to have _me_! It passes
comprehension. I know _everything_, _always_, and they know only a few
things for a few minutes."
The note of woe and panic sounded here was amply justified. Little by
little, A and B became less in evidence, until at length they were heard
from no more, and C--the normal self--was left dominant, with a complete
restoration to physical as well as mental health.
But, the reader may well ask, what does all this mean? Can there really
be more than one self, one personality, in human beings? If so, what
are we? What is the true nature of man? These are questions that cannot
be avoided, and in my next and closing chapter I will make some attempt
to answer them.