David Van Nuys:Welcome to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC covering topics in mental health, wellness, and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show we'll be talking about dissociative disorders with Dr. John Kihlstrom. John F. Kihlstrom, Ph.D. is a Cal Berkeley professor, researcher and world-renowned expert on dissociative disorders. He earned his bachelor's degree in psychology from Colgate University where he was introduced to hypnosis research by William Edmonston. He continued his studies at the University of Pennsylvania, working with Dr. Martin Orne, Frederick Evans, and Emily Carota Orne. He received his Ph.D. in psychology, with a concentration in personality and experimental psychopathology in 1975, and completed a clinical psychology internship at Temple University Health Science Center. He has been a faculty member at Harvard University, the University of Wisconsin, the University of Arizona, and Yale University. He is now professor in the Department of Psychology at the University of California, Berkeley, where he is also a member of the Institute for Cognitive and Brain Sciences and the Institute for Personality and Social Research. He currently directs the undergraduate Cognitive Science program at Berkeley. Dr. Kihlstrom is perhaps best known for his hypnosis research, for which he has received many awards
And now, here's the interview.
David: Dr. John Kihlstrom, welcome to Wise Counsel.
John Kihlstrom: Well, thank you very much.
David: We're going to be talking about dissociative disorders today and maybe also a bit about hypnosis. Perhaps we can get started by having you recap a bit about your educational background and how you came to research these areas.
John Kihlstrom: Well, I got interested in the dissociative disorders through my interest in hypnosis, which I became interested in almost by accident as an undergraduate; but I became fascinated enough by the phenomenon of hypnosis that I went on to focus on it in graduate school at the University of Pennsylvania, where I worked with the late Martin Orne, who's was a very noted authority on hypnosis.
David: Yes, and I certainly recognize his name because I did my doctoral work in the area of hypnosis and I used the hypnotic susceptibility inventory that, I believe, he worked on.
John Kihlstrom: Yes, and actually a lot of that work was done by his wife, Emily Carota Orne, who adapted another hypnotic susceptibility scale initially devised by Ernest Hilgard and André Weitzenhoffer at Stanford. So it turns out that not everybody experiences hypnosis the same way, as you know, and these investigators -- first Hilgard and Weitzenhoffer and then Emily Orne and her collaborator Ron Shor -- devised a set of procedures modeled on the intelligence test, in fact, that measure people's ability to respond to hypnotic suggestions.
David: What a small world it is because actually I also had the occasion to meet Ron Shor, who you just mentioned, while I spent two years on exchange at the University of New Hampshire, so I got to know him a bit. But enough about me, as they say. Just to bring our listeners up to speed, let me jump start our conversation by noting that dissociative disorders refers to a grouping in DSM IV, the diagnostic manual of the American Psychiatrist Association. And the term refers primarily to four conditions of impaired memory and/or identity; the four being: dissociative identity disorder, or what used to be called multiple personalities; dissociative fugue, amnesia, and depersonalization. I think the phenomena associated with this grouping has captured the public imagination perhaps more than any other grouping. Why do you think that is?
John Kihlstrom: Well, I think that the dissociative disorders are of particular interest because they raise fundamental questions about the nature of self and identity. In the dissociative disorders people forget who they are or they think they're somebody else, or they forget the important things that they may have done in the past; and these kinds of things are so critical to our sense of who we are, that when we see somebody lose them, that's very interesting to us. I also think, although the dissociative disorders are serious forms of mental illness, there's a sense in which they're very romantic disorders for just this reason, because they have to do with the loss of self, the loss of identity and all of that.
David: Yes, in fact, speaking of the romanticism, when I took a course in abnormal behavior back in grad school, I was told that the multiple personality was so rare that I would probably never encounter a case in clinical practice, yet I now know therapists who claim to have whole practices full of multiples and I've had students in my university classes confess that they have multiples in an almost bragging sort of way. And then I discovered there are online communities of multiples. So what's going on here?
John Kihlstrom: Well, it's possible that there has been a genuine in increase in the diagnosis of dissociative disorders. This is a very controversial area and many of us, including me, think that for one reason or another the dissociative disorders, while genuine, have been over-diagnosed; that is, diagnosed more frequently than is actually necessary.
The first case of so-called multiple personality disorder was diagnosed in the late 18th century, the case of Mary Reynolds; and of course there were some famous cases in the late 19th century and early 20th century leading up to the famous Three Faces of Eve case, which became an Oscar winning movie starring Joanne Woodward. In all that time, more than 150 years, fewer than 50 cases had been published, and then in the 1970s and 80s, as you say, some therapists were announcing that they had dozens, hundreds, of cases themselves. And that kind of rapid, dramatic increase in a diagnosis is pretty much unprecedented in psychiatry, leading some people to think that maybe some of these cases were mistakenly diagnosed and really are something else.
I think it's interesting to note that Thigpen & Cleckley, the psychiatrists who worked with the Eve case, had many cases referred to them after that and they said that they never really saw another genuine case of multiple personality disorder; so if Thigpen & Cleckley never saw another genuine case, that suggests just how rare it is.
In addition, when the psychiatrists began to refine their procedures for psychiatric diagnosis, they devised a set of structured clinical interviews that are a terrific advance in making diagnosis reliable. And they considered the dissociative disorders so rare they didn't even include them in the procedure. So there's something going on there, and I wouldn't want to prejudge any particular case, but it seems very likely that the dissociative disorders have been over diagnosed by enthusiastic clinicians and, for that matter, enthusiastic patients.
David: I had planned to ask you the frequency of dissociative identity disorder in the general population and whether statistics vary by country, but it sounds like the incidence is really too low to even address that issue.
John Kihlstrom: Well, some of us think it is very low, but then again, as you point out, there are these clinicians -- including some very prominent clinicians -- who claim to know of hundreds of cases. So this is one of those epidemiological controversies about whether increased incidence is real or not; it's just going to be with us for a while, I think.
David: Now also, I have the impression that you're a researcher and not a therapist, is that right?
John Kihlstrom: Yes, I have clinical training but I've never -- not since my internship -- have I actually practiced as a therapist. But I retain an interest in clinical practice and especially in the continuing movement to put clinical practice on an ever firmer scientific base.
David: Okay, well that's good background for us to have and I'm glad to hear that you have that exposure to clinical training and so on, because I know you've done a lot of research in this area and sometimes there's a gap between research and clinical practice, and people might tend to discount some of your findings if they say, oh, well, this guy really doesn't understand the clinical setting. But it sounds like you've had enough training to have some empathy, sympathy and understanding for that setting.
John Kihlstrom: For that matter, I've had all the formal training that any clinical psychologist has had.
David: Okay, good. Now the traditional understanding of multiple personality or dissociative identity disorder has used psychoanalytic ideas such as repression and early childhood trauma, particularly sexual abuse. How do these ideas, these psychoanalytic ideas relating to repression, hold up in the research that you've done?
John Kihlstrom: Well, as far as research goes, they haven't held up particularly well at all. It's very easy, I think, for people to think that some terrible trauma must have triggered this dissociation, this change in identity, or this loss of memory. But in fact, in the well diagnosed cases leading up to Eve, there's not that much trauma in the histories of these individuals, and in the later literature the diagnosis of trauma -- and especially the repression of trauma -- is not always done as rigorously as we would like.
What you see very often is an assumption that somebody with a dissociative disorder must have had some trauma in his or her background; typically something like childhood sexual abuse. But the independent corroboration of that kind of trauma is very hard to come by; and, in fact, well done so-called prospective studies of trauma victims show that amnesia doesn't play a major role in their symptomatology. In fact, there's no evidence for any kind of psychological process like repression or dissociation instigated by trauma causing somebody to be amnesic for a traumatic event. That evidence just isn't there, surprisingly.
David: Let me have you explain what you mean by prospective because that's kind of important in the work that you've been doing.
John Kihlstrom: Yeah, there are two kinds of study at issue here. In retrospective studies, we take people who are already diagnosed with something like post traumatic stress disorder or dissociative disorder and then we look backwards into their histories to see if we can find evidence for trauma. In a prospective study, we take people who we know have been exposed to trauma and we look forward, we follow them to see whether they develop any particular form of mental illness.
And it's these retrospective studies that typically generate the evidence to sustain the claim that trauma is an instigator of dissociative disorder. And the problem with that is the traumas that are identified are usually very hard to confirm independently; they're mostly based on self report. And also, to be honest, the criteria for a traumatic event are very, very loose. Virtually anything can be called a trauma, in part because trauma's always diagnosed from the point of view of the trauma victim.
But in fact, people who are exposed to traumatic stress of various kinds, their typical problem is that they remember the trauma all too well; that to keep unwanted, intrusive memory is a key symptom of post traumatic stress disorder. So it's kind of hard to understand how it is that trauma could actually instigate these kinds of amnesias; we don't see them in people with verified trauma, we just don't see it. So a dissociative disorder comes from somewhere, but it doesn't necessarily reflect something that's happened to somebody who's been traumatized.
David: Yes, I was struck by -- in reading through some of your papers -- you report that there's been a failure to correlate memory loss with victims of trauma such as war veterans, survivors of floods, fires, earthquakes. And what about rape?
John Kihlstrom: Well, again, there's a lot of amnesia in cases of rape, but then again, a lot of that takes place under conditions of violence or alcohol intoxication or whatever. This is not to blame rape victims; it's just a simple fact of the kinds of circumstances that these things occur in. And when you've got violence, physical trauma; when you've got alcohol intoxication, for example; when you've got someone being attacked out of nowhere, it's very likely that they won't remember very much of the incident. But it's not because of repression or dissociation, it's because of normal memory processes.
David: Well, what's your personal stance on the Freudian idea of the unconscious?
John Kihlstrom: Well, the Freudian idea of the unconscious is not something I'm particularly fond of. Freud was right about the unconscious in the sense that there is such a thing as an unconscious mind and our behavior can be affected by unconscious mental processes. But the particular psychoanalytic or Freudian view of the unconscious is one that we don't really have much evidence for in the laboratory. The Freudian view is of the repression of primitive sexual and aggressive impulses, and of symptoms as reflecting the kind of eruption of this repressed material into behavior; and that's not a process that we find any evidence for in the laboratory. We do find lots of evidence of unconscious processing in the laboratory; it just doesn't look like what Freud was talking about.
David: What about his idea of parapraxes, in other words the mistakes of everyday life like a slip of the tongue, a slip of the pen, if you will. You know, sometimes I'll catch myself singing a song unconsciously -- humming or something in the course of my day -- and then I say, "What the heck am I humming?" And then I realize that the words, which I haven't even been singing, actually comment very importantly on some issue that was important for me at the time, that I wasn't "consciously" thinking about.
John Kihlstrom: Well, again, that's the kind of thing that happens quite a bit, but as you say, you were conscious of it at one point and you made the connection later on. This is the kind of thing that happens a lot in creative problem solving; people will think about a problem consciously and not be able to solve it, and then put it aside for a while and then all of a sudden a solution will pop into consciousness. That kind of thing there's pretty good evidence for, but again, none of that has to do with repression or infantile sexuality or any of the stuff that Freud was talking about and that colored his own view of the unconscious. I guess the point there is that there is unconscious processing, there are unconscious percepts, there's something to the phenomenon of so-called subliminal perception; but none of that provides any evidence for Freud's specific psychoanalytic formulations about the unconscious.
David: Okay, now going back to what you said about rape and in the context of violence and so on there can be memory issues, the whole area of recovered memories of sexual abuse in the context of psychotherapy has been very controversial. Can you take us through an overview of the evidence, both pro and con?
John Kihlstrom: Well, yeah. In the first place, there's a view that when people are traumatized -- whether it's child sexual abuse or rape or whatever -- they can defend themselves against this trauma by repressing or dissociating their memories of the trauma, and that works for a little while. And then some therapists have the view that in order to get past the trauma and really deal with the trauma, that the person has to recover these memories, bring them into consciousness so that they can be worked on consciously in the therapeutic hour.
And again, the problem is that the assumption is that people can repress or dissociate these kinds of traumatic memories, and that assumption's questionable. And then there's a further assumption that various kinds of techniques can enable people to become conscious of something that they've repressed and since the concept of repression to begin with is questionable, the idea that you can recover repressed memories has also got to be questioned.
Then there's the third problem which is that these so-called recovered memories are very, very difficult to confirm independently so that you rarely know, in the final analysis, whether the memory that's ostensibly been recovered is an accurate representation of an event that actually occurred. What happens so often is that to the therapists and the patients the story makes sense to them, and the story makes sense to them because we have this kind of clinical folklore or urban legend that trauma causes repression to begin with; and that because the story makes sense, that's used as the basis for therapy. But we don't know if the story is true or not, and we're rarely in that kind of position.
And this is actually part of the legacy of Freud's own work with psychoanalysis because for Freud, the truth of whatever the patient recovered, whatever the patient produced during the psychoanalysis, wasn't to be found in historical fact; the truth was to be found in whether the story made sense and whether the story explained the symptom. But we have a lot of explanations for things that make sense that aren't necessarily true -- how the leopard got his spots is one -- and it's not clear that these kinds of stories are any truer than those. And that's in part because there's an assumption that the stories are true, but not very much interest in collecting the kind of evidence that would tell us whether it was true or not.
David: You've also done a lot of research on hypnosis. What about the role of hypnosis in retrieving repressed memories? I gather that this, too, is very controversial
John Kihlstrom: Well, it's very controversial for some people, but for those of us who have worked on this problem in the laboratory, there's no controversy there. Hypnosis just isn't particularly effective in recovering memories. A bout of hypnosis is no more effective in recovering memories than just trying again. And, again, there are these myths about the power of hypnosis that are quite interesting, but they're mostly myths. Hypnosis doesn't make you a better person; it doesn't make you smarter; it doesn't make you see better; it doesn't make you remember better.
Even something like hypnotic age regression -- which is a very dramatic phenomenon when you look at it -- it's not at all clear that the subject is actually recovering forgotten memories from childhood, or behaving the way he or she would have as a child. In fact, Martin Orne, my own teacher, did a pioneering study of hypnotic age regression as far back as the early 1950s, in which he took college students and age regressed them in the laboratory and then had them do things like draw and paint and make up poems and all of that. And then he went to the students' parents, who actually collected these things the way our parents do, and compared the products of the age regressed college students to things that they actually produced when they were children, and there was just no similarity between them.
David: Oh, that's fascinating.
John Kihlstrom: In hypnotic age regression you can get a very convincing portrayal of a child, but what you get is the adult's imagination about what he or she was like as a child, rather than a revisitation or recovery of what that childhood experience was actually like.
David: And I gather that hypnotic age regression -- or not age regression so much, but the recovery of memory -- isn't allowed in court. In a 2003 review, you write, and I quote: "Because the risk of distortion vastly outweighs the chances of obtaining any useful information, forensic investigators and clinical practitioners should avoid hypnosis as a technique for enhancing recollection."
John Kihlstrom: Right. Again, the courts have been pretty savvy about this. They understand first, that hypnosis hasn't been shown to have any special power to recover memories but, more important, that hypnosis is an inherently suggestive technique, and that it's entirely possible for somebody to remember something in hypnosis that is factually inaccurate, but precisely because they're remembering it in hypnosis -- surrounded by all the mythology about hypnosis --to believe that the event actually occurred as they remembered it. So in legal terms, you've actually contaminated the witness's memory there. They don't have an independent recollection any more; they'd have a recollection that has been contaminated by hypnotic suggestion. And in the courts -- in American courts, anyway -- all people can testify to are their independent recollections; they can't say, "Well, she told me this." And hypnosis is legally very much like that; it's not quite hearsay, but it's almost hearsay. And so hypnotically elicited memories are not admissible in courts in most of the United States -- that's true in California -- and, in fact, there are some jurisdictions where, I believe, a witness who's been hypnotized at all in connection with a case can't testify about anything about that case because of concerns about the contamination of the individual's memory.
David: Interesting. Now somewhat paradoxically, while hypnosis can't be used to recover memories, I gather that it can be used to enhance forgetting. You say in one or your articles, and again I quote: "Post hypnotic amnesia may serve as a laboratory model of the functional amnesia associated with hysteria and dissociation, such as psychogenic or dissociative amnesia fugue and multiple personality disorder." So what have we learned from the laboratory about post hypnotic amnesia?
John Kihlstrom: Well one thing we learn from the laboratory -- work in my lab and in other labs -- that in the first place, hypnotic amnesia is a genuine phenomenon of memory, and it does look like the kind of amnesias that we see in the dissociative disorders with the big exception that, of course, there's no question of trauma in the hypnotic case. And one reason for doubting that trauma plays a role in dissociative amnesia is that we can get the same kind of amnesia in the laboratory with hypnotic suggestion without any kind of trauma at all.
But one of the other interesting things we found is that the effects of the hypnotic suggestion are somewhat limited in that post hypnotic amnesia affects what we call explicit memory, or conscious recollection, but leaves intact implicit memory or unconscious influences of the memory on the subject's subsequent behavior. And that's something we see in the dissociative disorders as well. For example, in the case of the Three Faces of Eve, Eve White may not remember consciously anything that she did when she was Eve Black; still, those Eve Black experiences can filter through, as it were, and influence Eve White's behavior unconsciously. And we see that in lots of different kinds of amnesia, not just in hypnotic amnesia but also in various kinds of organic amnesias like the amnesic syndrome, the patient H.M, for example.
David: The patient H.M.?
John Kihlstrom: Yeah, there's a patient -- he just died -- a very famous neurological patient, H.M., who had a radical surgery on the temporal lobes in an attempt to relieve intractable epilepsy. And in fact, the operation worked; H.M. didn't suffer from these kinds of seizures anymore, but the surgeons unknowingly at the time destroyed a part of the brain that we now know is critical for laying down consciously accessible memories, a part of the brain called the hippocampus. And H.M. -- his surgery was about 1952-1953, he just died late last year -- for all that subsequent time, he had essentially no conscious recollection of anything he had done, yet if you tested him carefully, you could show that he did retain some memories of these experiences, and if you tested him in the right way, you could see those memories come out. It's just that he didn't consciously know he had them.
David: That's interesting. So what about the treatment of people suffering from, I still want to say multiple personality because it seems so much more descriptive than DID.
John Kihlstrom: It is really. I'm sorry that we lost that term in the diagnostic system. There are so many really good terms like -- well even neurosis is gone from the diagnostic system now. But multiple personality disorder really does capture it in a way that's very nice. As far as treatment is concerned though, one thing we know is that the treatment is very, very difficult. And for that reason, I think, there are not that many systematic outcome studies of the treatment of multiple personality disorder. Frankly, if as some of us suspect, a lot of cases of dissociative disorders have been misdiagnosed, that is, that they're really cases of some other form of mental illness, it's not surprising that treating somebody as a multiple personality who's not a multiple personality doesn't go very well.
David: They could be bipolar for example.
John Kihlstrom: Well, they could be bipolar, they could have schizoaffective disorder, they could have borderline personality disorder; or, more dramatically, every one of us in the ordinary course of everyday living, becomes a kind of different person in various different kinds of contexts. I don't know about you, but I'm a different person when I'm with my wife than I am with my students; I'm a different person with my sister than I am with my mother, and so on and so forth. We're all like that and that kind of situational flexibility in personality can sometimes be mistaken, I think, for multiple personality disorder. And again, that's not something that you treat; in fact, that kind of flexibility is something that we celebrate. Somebody who's only one kind of person forever, that's a person that may not be too flexible.
David: Okay, well, we've been speaking about multiple personality and that's a term that everybody is familiar with. A term that people are less familiar with is fugue. Tell us about fugue.
John Kihlstrom: Well, one way to think about fugue is that it's kind of a less dramatic form of multiple personality disorder. In fugue the person loses his or her identity and may pick up another identity, but a primary characteristic of fugue -- in addition to this loss of identity -- is physical relocation. So the classic example is of a soldier on the front lines who's traumatized by war and wanders away from his post and is discovered years later as a baker in some French village or something. He's not got no awareness of who he has been. These are very rare cases, too, but you do read about them in the newspaper once in awhile. I think you see about one case a year where somebody will turn up in some town and they're asked for one reason or another to identify themselves, and they discover they don't know who they are. And their pictures will be shown in the news and then eventually they're typically identified by family members who have seen the news shot. Again, these are very, very rare but they do occur from time to time. But because they're so rare and because they're typically resolved relatively quickly these days, there isn't that much systematic experimental study of them.
David: Well, again I have to ask; you know the popular conception when this happens -- whether it's fugue or an example of amnesia -- is that there's some underlying trauma; that the person, let's say in the extreme, committed a murder or saw a murder and so they blanked out and they find themselves in another location with another identity, or they don't know who they are. Is there any evidence to support that? You know, why does it happen if not from a trauma?
John Kihlstrom: Well, that's the $64,000 question: why does it happen if there's not trauma? It makes sense to us that something like this that's so dramatic would be instigated by trauma, but again, when you look into the backgrounds of these individuals you don't often see trauma, or it's not typical, or whatever the trauma is it's the kind of thing most people don't respond to with something as dramatic as fugue. The most famous case of fugue is the case of Ansel Bourne, which was described by Williams James himself in the 19th century, and there's no evidence of trauma in that case. And that's more typical, I think, than anything else.
David: Or if not trauma -- getting back to Freud's idea of repression and motivated forgetting -- how about just something difficult in the situation, a bad marriage or something else that would provide motivation for wanting to escape?
John Kihlstrom: Well, again, you could imagine that that's the case, but one man's trauma is another person's bad marriage. Again, I don't want to second guess anybody's experience, but there are lots of bad marriages, unfortunately, and there are lots of difficult marriages and there are very few fugue cases. So the connection, the causal connection between even that kind of trauma and fugue is just not there. Something else is going on; we don't have a good sense of what it is. The trauma theory is one that's historically made sense to us, again, I think because of some of the romance that surrounds these forms of mental illness, but the actual evidence for trauma just isn't there.
David: Okay, now I gather there's a distinction between fugue and amnesia. I recently saw an old Hitchcock movie and I can't remember the title, but I think Cary Grant was suffering from amnesia.
John Kihlstrom: Spellbound. That's a famous depiction.
David: Yeah, and what triggered his amnesia?
John Kihlstrom: Well, of course this was a movie.
David: Yes, but in the story what triggered it?
John Kihlstrom: If you have listeners who have not seen Spellbound, I wouldn't imagine giving it away.
David: Good point.
John Kihlstrom: I will say, though, there is a trauma that seems to have instigated Cary Grant's amnesia and fugue, but I wouldn't go farther than that; your listeners would have my head if I did. But I will point out, since we're talking about movies, again this is real fodder for various kinds of romance movies. Random Harvest, which was an academy award winning film from the 1930s, based on a novel by James Hilton, who wrote Lost Horizons, the Shangri La book. That is a classic film depiction of fugue. Just like I talked before, there's a soldier who's traumatized in war, who loses his identity and picks up another identity, and it's a very, very interesting portrayal of this kind of thing. But how often trauma results in fugue and how often fugue results from real trauma like that, those are very, very difficult questions and we really just don't have the evidence one way or another.
David: What's the difference between fugue and amnesia?
John Kihlstrom: Well, you can think about these things as being on a continuum. In so-called dissociative amnesia, what the person forgets is a circumscribed period of his or her life. That's very similar to what we see in, say, post-hypnotic amnesia, where what the subject forgets is what he or she did or experienced while he or she was hypnotized; so dissociative amnesia affects what we call episodic memories or autobiographical memories, memories for your personal experiences, personal activities.
In fugue, the memory disorder is more far reaching because it covers the person's identity as well as his or her fund of memories. In fugue the person doesn't just forget some things that he or she did, he forgets everything; and he not only forgets everything that he did, but he forgets who he is. That's the classic picture of fugue. Now sometimes in fugue, the person forgets who he is and picks up another identity; that's a subclass of fugue. But if that happens, the person goes from identity A to identity B, lives in identity B for a while and then snaps back to identity A.
In multiple personality, or so-called dissociative identity disorder, what the person does is to alternate between and among two, three, maybe even more different identities, each of which has associated with it a bundle of episodic memories or personal experiences. So these things run a continuum. Dissociative amnesia affects a circumscribed bundle of episodic memories; fugue a massive loss of autobiographical memory accompanied by a loss of identity; and in multiple personality disorder or dissociative identity disorder, what you have is a person who shifts back and forth between different identities and their associated autobiographical memories.
David: Okay, and I guess somewhere on that continuum we have the fourth category from the DSM IV, which is depersonalization; and I think most of us have experienced that to some degree or another. For example I can remember as a kid being sent to the principal's office and sort of almost feeling like this can't be happening to me, I'm sort of out of my body, I'm numb, I'm up on the ceiling somewhere.
John Kihlstrom: Right, well, this is something that you often see actually in cases of stress. There was a famous study by Dr. David Spiegel of Stanford University and his associate, Professor Etzel Cardeña after the Loma Prieta earthquake here in Northern California around 1989. And they found that people who had lived in the Bay Area at the time of Loma Prieta actually experienced many of the symptoms of depersonalization, but that's fairly common.
When depersonalization becomes a disorder is when the feelings of unreality go chronic and the person doesn't really snap out of them, again, for awhile. Again, we have two different forms of this: in depersonalization disorder the person experiences him or herself as changed or unreal or somehow different. There's a companion disorder called de-realization, not depersonalization but de-realization, where the person experiences the outside world as being somehow changed or different. But depersonalization, I think, is the more common of the two disorders. But, as you say, it's very common in times of stress.
David: I noticed on your website that you've done quite a bit of work as an expert witness. Are you able to talk about any of those cases?
John Kihlstrom: Well, most of those cases have been cases where hypnosis was used in an attempt to recover memory, and mostly because there's no evidence that hypnosis can recover memory, I was typically testifying as an expert witness for the defense. Usually the prosecutor or the police were attempting to introduce hypnotically recovered memories into evidence.
One of the cases was a case where a woman was claiming that she had been sexually abused as a child by her pediatrician, and there was some other case work there, but mostly it's the use of a hypnotized witness in a court case that got me going as an expert witness. And in those cases -- and I don't have to talk about any particular case -- in those cases very often the testimony of the hypnotized eye-witness was the only evidence in the case. And the courts don't like that at all.
In one case that I worked on, the witness had been hypnotized and remembered under hypnosis seeing identifying marks, a tattoo, on the accused person. But the conditions under which she saw these things, or said she saw these things, was such that she couldn't possibly have seen what she saw even if they were there. The lighting was just very bad. And here's a case where by use of hypnotic suggestion, people can believe they had experiences that they didn't really have. They can remember things that probably didn't happen that way, but they don't know the difference any more and so you get this problem of contamination of an eye-witness.
David: Okay, well, you've been very generous with your time and so, Dr. John F. Kihlstrom, thanks so much for being our guest today on Wise Counsel.
John Kihlstrom: Well, you're very welcome, thanks for having me.
David: I hope you found this interview with Dr. John Kihlstrom as interesting and informative as I did. It's clear to me that I'm going to need to revise a number of my long-held beliefs about the role of trauma in these dissociative disorders, as well as any lingering impressions about the power of hypnosis to recover lost memories. Perhaps you're finding some of your own cherished notions challenged by this interview as well. Dr. Kihlstrom has a number of fascinating papers on his website at UC Berkeley. They cover such topics as trauma and memory, dissociation, and hypnosis and memory. The URLs are too long to give over the air, I'm sure you can find them by conducting a Google search or by going to the links that we'll provide in our show notes.
You've been listening to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC.
If you like Wise Counsel, you might also like ShrinkRapRadio, my other interview podcast series, which is available online at www.shrinkraprado.com. Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.