We mentioned Sybil, a best-selling book in the early 1970s, which, in subsequent years, unintentionally increased the amount of interest in a place called Castlewood Treatment Center. The Castlewood experience was later (very recently!) described by journalist Rachel Corbett as “The Therapy That Can Break You.” Corbett’s meticulous and thorough history provides a full picture of how the situation developed into a program that, however innovative and well-intentioned, did not turn out to be the epitome of childhood obesity prevention or treatment.
The methodology called Internal Family Systems, or IFS, started out hopefully, but was unable to provide the needed answers for many… and that is putting it mildly. On the other end of the spectrum, the psychological model either has been or could reasonably be characterized as weird, bizarre, contested, revolutionary, misinterpreted, harmful, and/or dangerous.
The ideas developed, held, and disseminated by founder Richard C. Schwartz had always encountered a certain amount of resistance, as unconventional ideas will tend to do. His theory was developed in the 1980s, when the public had not only been exposed to Sybil but also influenced by many similar publications that jumped on the sensationalist “multiple personalities” bandwagon. The literate world had experienced a couple of decades of ever-increasing interest in theories, which, in turn, contributed to a perfect storm in the realm of public willingness to consider unfamiliar and previously unacceptable ideas.
The backstory
Before Schwartz came along, there was a condition known as dissociative identity disorder, which meant that the patient’s body was inhabited by more than one complete personality. Since medical conditions were given Latin names, another self was called an “alter ego.” In literature, one of the fictional works that popularized the notion was Strange Case of Dr. Jekyll and Mr. Hyde by Robert Louis Stevenson, which emphasized the idea that the polarity between dual personalities must necessarily be “good versus evil.”
In the course of learning about dissociative identity disorder, psychiatry found that there might even be more than one alternative personality, along with the original and the first alter. There might be several multiples, who may or may not be aware of each other. They might battle for dominance, and could, at the very least, find many different ways to complicate and damage the life that the body they cohabited was trying to establish as an individual.
Not surprisingly, this condition was viewed as a sickness, or at the very least, an undesirable and potentially damaging condition. Alters might be discovered or uncovered through hypnosis, and the therapeutic approach taken by psychiatry was to attempt to knit the two, three, or more personalities into one entity that would function in harmony with itself.
The controversy
Critics maintain that there is no scientific basis for a belief that the condition, abbreviated as DID, even exists. On the other hand, brain scans (of which there are five distinct types: MRI, CT, PET, SPECT, and fMRI) had been used to prove quite a number of medical theories up until that point, so it is interesting to see what a typical scientific report says about dissociative identity disorder.
For instance, one publication described a meta-study that encompassed 13 studies on patients with dissociative identity disorder, depersonalization disorder, dissociative amnesia, and similar conditions, and what their various brain scans showed. Naturally and understandably, researchers always wish there were more hardcore studies to base conclusions on, but there is what some professionals consider pretty solid evidence to suggest “the existence of particular brain activation patterns in patients belonging to this diagnostic category.”
The Conclusions section of this particular paper goes into more detail about particular disorders, but the overall picture is this:
Prefrontal dysfunction is frequently reported in dissociative disorders. Functional changes in other cortical and subcortical areas can be correlated with these diagnoses. Further studies are needed to clarify the neurofunctional correlations of each dissociative disorder in affected patients, in order to identify better tailored treatments.
(To be continued…)
Your responses and feedback are welcome!
Source: “The Therapy That Can Break You,” TheCut.com, 10/30/25
Source: “Functional Neuroimaging in Dissociative Disorders: A Systematic Review,” NIH.gov, 08/29/22
Image by World Obesity Image Bank
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