Thigpen And Cleckley Case Study Method

Theaim of this case study was to provide an account of the treatment of a 25-year-old woman who was referred to Thigpen and Cleckley because of 'severe and blinding headaches'.

The psychiatrists used a case study method.  This consisted of interviews with the patient and her family, hypnosis, observation, EEG tests and a number of psychometric and projective tests including, memory tests, ink blot tests and intelligence tests.

The patient (referred to as Eve White in the study) had been referred for therapy to one of the authors because of ‘severe and blinding headaches’. At the first interview she also complained of ‘‘blackouts’’ following her headaches

However they were puzzled that Eve White had no memory of a recent trip. The therapists used hypnosis and the amnesia was cleared.

Several days after a visit to the therapists, a letter from Eve White appeared at the therapists’ office.  The letter concerned her therapy and was written in her usual handwriting, but at the bottom of the page there was a paragraph that looked like a child had written it.

On her next visit Eve White denied sending the letter, though she recalled having begun one, which she never finished and thought she had destroyed. During the interview, Eve White who was normally very self-controlled became distressed and asked whether hearing an occasional imaginary voice made her insane.

She reported that she had on several occasions over the last few months briefly heard a voice addressing her. During this conversation Eve White, as if in pain suddenly put both hands to her head. After a tense moment of silence her hands dropped, and the therapist observed a ‘quick, reckless smile’ and in a bright voice she said: ‘Hi there, Doc’!

To the therapist it seemed that the usually conventional and retiring Eve White had changed into a carefree person.  She also seemed to have a very different physical presence in terms of manner, gestures, and eye movements.  When asked her name she immediately replied that she was Eve Black.  

The therapist noted that this new person ‘had a childish daredevil air, an erotically mischievous glance, a face marvellously free from the habitual signs of care, seriousness and underlying distress’. The voice and language structure were also very different, and to the therapist it appeared to be an entirely different woman.

Over the next 14 months, during a series of interviews totalling approximately 100 hours, extensive material was obtained about the behaviour and experience of Eve White and Eve Black.

The therapists believed that Eve Black had enjoyed an independent life since Eve’s early childhood and when she was ‘out’ Eve White was not aware of what was happening.  In contrast, when Eve Black was not out she was aware of what was happening.

According to the therapists, Eve Black’s behaviour was ‘characterised by irresponsibility and a shallowly hedonistic desire for excitement and pleasure’.    She succeeded in concealing her identity not only from Eve White, but also from her parents and husband. Eve Black denied marriage to the man, who she despised, and denied any relationship to Eve White’s daughter except that of an unconcerned bystander.  To her husband, daughter and parents her unpleasant behaviour, harshness and occasional acts of violence were explained in terms of ‘unaccountable fits of temper in a woman who was habitually gentle and considerate’.

Both personalities were given a series of psychometric (i.e. IQ and memory tests) and projective tests (i.e. Rorschach and drawings of human figures) by an independent expert with the following results:

IQ test results:  Eve White obtained an IQ of 110 and Eve Black 104.  

Memory Test results: Eve White had a superior memory function than Eve Black

Rorschach test (ink blot test) and drawings of human figures results:  The profile of Eve Black was far healthier than Eve White.  Eve Black though was regressive whilst Eve White was repressive showing obsessive-compulsive traits, rigidity and an inability to deal with her hostility.

As Eve White became aware of Eve Black’s existence through the therapy, she became able to prevent her ‘getting out’ on occasions, and so negotiation was necessary for Eve Black to get more time ‘out’.   After eight months of treatment Eve White seemed to be making progress.  Her ‘blackouts’ had ceased and she was working well at her job (as a telephone operator) and ‘was reaching some acceptable solution to her marital problems’.

However as the treatment progressed, Eve White’s headaches returned and so did the ‘blackouts’. Eve Black denied all responsibility and said that she also experienced lack of awareness during these ‘blackouts’. Eve White’s general state of mind was deteriorating and confinement was considered. It became easier for the therapist to call up whichever personality he wanted to examine, and childhood experiences were investigated under hypnosis. During one such episode, Eve White appeared to relax into a sleepy state. ‘After two minutes, her eyes opened, blankly staring about the room trying to orient herself.  When her eyes finally met those of the therapist, slowly, with an unknown husky voice and immeasurable poise, she said, ‘Who are you?’  

The therapists believed that another personality had emerged who called herself Jane. The other personality, they argued, was more responsible than Eve Black and more confident and interesting than Eve White.

After Jane appeared the three personalities were given electroencephalogram tests (EEG).  It was possible to make a clear distinction between the readings of Eve Black and the other two personalities.  Although it was not possible make a clear distinction between Eve White and Jane’s EEG.  

Having been able to work with the three personalities for several months the therapists concluded that if Jane could take possession of the personalities the patient would regain full health and find her way to a happy life.  Jane had awareness of both Eves’ thoughts and behaviour but did not have complete access to their memories prior to her appearance.  Jane had learnt to take over many of Eve White’s tasks at home and work to help Eve White and showed compassion to Eve White’s daughter.  However, although the therapists could work with Jane to determine whether Eve Black had been lying, Jane had not found a way to displace Eve Black, or to communicate through her.

A case of multiple personality - Thigpen, C.H. and Cleckley, H. (1954)

Multiple personality disorder (MPD) is a strange condition in many ways. One of the rarest and most controversial of all psychological diagnoses, it is at the same time one of the most famous and widely known to the general public. This is despite the fact that, for many researchers, the condition does not actually exist at all! Of all the supposed cases to have been reported, by far the most famous was that of Christine Sizemore, or 'Eve'.
The original article can be read here.

The Holah site has a summary and evaluation of the study here. Then...

Test your knowledge:

Alternative study - Thigpen and Cleckley as an observational study

Thigpen and Cleckley conducted interviews and tests with Eve/Jane. Another way to investigate her multiple personalities might have been to do an observational study.

1. Describe the observational study as a research method in Psychology. (5)


2. How could they have performed a study with similar aims, but as an observational study?

Write a description of the study, including the who, what, where and how. (10)

3. What would the advantages and disadvantages of such an experiment be, compared to the original?

Evaluate this new study in methodological and ethical terms. (10)

Big Issue - snapshot vs longitudinal data

A longitudinal study is one carried out over a period of weeks months or even years, to allow researchers to see a change in behaviour over time. In contrast, a snapshot study will take place over a few hours or maybe days.

DID and ethnocentric bias?

Dissociative Identity Disorder is diagnosed far more frequently in America than in the rest of the world...
  • Are Americans naturally more at risk of developing the disease?
OR...
  • Are American therapists more likely to diagnose it. This would be a clear case of ethnocentric bias in the diagnosis of DID.

Snapshot

  • Quicker, easier and cheaper to carry out.
  • Allows larger samples to be used more easily.
  • Can't demonstrate changes in behaviour, as it only takes a snapshot

Longitudinal

  • Can demonstrate change over time, so useful for developmental psychology studies.
  • Costly and time-consuming
  • May lead to attrition, where participants drop out of the study over time.

"Psychometric" vs "psychological" tests...

Thigpen and Cleckley used a number of different tests on Eve. Some of the tests were psychometric and some were not:

Psychometric tests are ones that try to make a quantitative measurement of a psychological property. In this study the psychometric tests used are the IQ tests and the memory tests.

Other tests that were not psychometric include the Roschach tests and the drawing tests.

A common exam question might ask you about the tests performed by Thigpen and Cleckley, but it might ask specifically about either 'psychometric' or 'psychological' tests. For psychological tests you could mention any tests performed, but psychometric tests are more specific. Make sure you know which are which.

E.g." Describe the results of one psychometric test performed by Thigpen and Cleckley" (2)
"Thigpen and Cleckley conducted a number of psychological tests on Eve. Describe two of them." (4)

... and projective tests?

Projective tests are designed to give an insight into a person's personality, often through them interpreting ambiguous images. See here for details of the ten projective inkblot (Rorschach) test images that Thigpen and Cleckley used.

Making links across the syllabus

Thigpen and Cleckley's interpretations and treatments of Eve were both very influenced by Freud's psychodynamic approach. Look back through the study and identify as many places as you can where Freud's theories are used. Of course this was also a case study, another similarity.

Exam hint: If they are using Freud's theories then this means that many of the evaluations of Frued's study will also be applicable to Thigpen and Cleckley's study. Two for the price of one! Make a list of these shared evaluation issues.

Are there any other links to other studies we've covered? Thigpen and Cleckley used an EEG on Eve, the same technique that Dement and Kleitman used (though with a very different research aim).

Assignment 1 - Practice paper 2 questions

Thigpen and Cleckley (multiple personality disorder) investigated Eve through hours of therapy and testing to find out more about her symptoms and help to treat her disorder.

 (a) What is meant by a psychometric test? [2]

(b) Describe the results of the psychometric tests used in Thigpen and Cleckley’s study. [3]

(c) Compare and contrast the psychometric testing approach as used by Thigpen and Cleckley with one other way of gathering data. [10]

(d) Discuss the extent to which individual and situational explanations of Eve’s behaviour are supported by Thigpen and Cleckley’s findings.(10)

Submit your answers through the form on the home page.

Revision

Watch the video and then fill in the summary sheet in as much detail as you can from memory.
study_description_blank.docx
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Extension

Here is a great report into the controversy over DID. In fact, very few DID cases seem to show entirely distinct 'personalities' as Thigpen and Cleckley found. Instead, they may simply have a few different 'modes' - different ways of being themselves. 

Do you think that 'extreme' DID cases like Christine Sizemore's actually exist?

This website would certainly say so. It is a site for 'survivors' of the condition and it contains a lot of interesting material, especially in the 'frequently asked questions' section.

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