The Minds of Billy Milligan

Nonfiction | Biography | Adult | Published in 1981

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Summary

Background

Chapter Summaries & Analyses

Preface-Book 1, Chapter 2

Book 1, Chapters 3-6

Book 2, Chapters 7-13

Book 2, Chapters 14-19

Book 3-Afterword

Key Figures

Themes

Index of Terms

Important Quotes

Essay Topics

Tools

Beta

Discussion Questions

Index of Terms

Alters

An alter is a “dissociated self state” (“Alters in Dissociative Identity Disorder.” Dissociative Identity Disorder Research). The book refers to Milligan’s alters as “personalities” or the “people inside.” In DID, each alter has its own, unique sense of self and can display different behavioral characteristics, values, feelings, skills, and abilities. Each alter may even have a specific age, gender, sexuality, and ethnicity that differs from the “host” self and from the other alters. Thus, in Milligan’s case, Arthur was English, Ragen was Yugoslavian, and their speech was accordingly accented, although Milligan himself was American; similarly, April, Adalana, and Christene were all feminine alters; and Tommy exhibited incredible skill with electronics and escape mechanisms, which the other alters and Billy himself did not. Alters may or may not be aware of and communicate with each other; thus, Arthur and Ragen were aware of and communicated with some but not all the other alters. An individual experiencing DID may or may not be aware of the presence of alters; Milligan was initially unaware of his alters. All the alters within an individual are known collectively as a system.

Dissociation

In the context pf psychology and psychiatric illness, dissociation refers to disconnection among an individual’s thoughts, memories, feelings, actions, and sense of self (Drescher, Jack. “What Are Dissociative Disorders?” American Psychiatric Association, 2022). Dissociation by itself is not an abnormal or clinical phenomenon; the experiences of daydreaming or losing oneself in a book can be considered mild dissociation. However, when the disconnect between one’s immediate surroundings intensifies to the point that it causes memory loss and, in turn, significant distress, as in Milligan’s case, dissociation becomes a clinical symptom. Dissociation can occur in response to traumatic experiences, wherein the individual is unable to tolerate an extremely difficult experience and thus dissociates from it. The Diagnostic and Statistical Manual of Mental Disorders lists various other dissociative disorders in addition to DID. Milligan was diagnosed with DID, which then (in the 1970s) was known as “multiple personality disorder.”

Fusion

The process of integrating, or fusing, the different alters in an individual experiencing DID is fusion. Fusion is integral to the individual’s healing because it enables improved and easy communication among the alters as well as a consistent sense of self, presence, and being grounded within one’s body. This allows for dissociative amnesia, i.e., memory loss as a function of dissociation, to recede. In a state of fusion, the individual can access the memories and abilities of the different alters even in their absence (Reuben, Katherine. “Integrating Dissociated Parts.” Dissociative Identity Disorder Research, 2021). In Milligan’s case, the Teacher exemplified fusion, as he presented with total recall of Milligan’s life, including the existence and actions of the “undesirables,” which neither Billy nor Arthur was able to do. Furthermore, over time, the Teacher exhibited some of the skills and feelings of the other alters even when they were not present, such as Tommy’s ability to pick locks.

Neurosis and Psychosis

The terms neurosis and psychosis are associated with mental disorders and indicate the type of illness. Neurosis is associated with illnesses that cause a “sense of distress and deficit in functioning” (“Neurosis.” Encyclopædia Britannica), i.e., mental disorders related to anxiety or mood. By definition, all mental disorders negatively affect an individual’s functioning in different aspects of life, from work to relationships to daily functioning. However, despite this impairment, neuroses are not characterized by a break from reality, as in psychosis. This is the defining characteristic of psychosis: a “disturbed sense of reality and a disorganization of personality” (“Psychosis.” Encyclopedia Britannica). This loss of connection to reality occurs through symptoms like hallucinations and delusions, and is typically associated with mental disorders like schizophrenia, which is classified as a psychotic illness. However, some neurotic illnesses can present with symptoms of psychosis. For instance, bipolar disorder, a mood disorder characterized by alternating states of depression and mania, can cause delusions and hallucinations.

Before “multiple personality disorder” became a part of the third edition of the DSM in 1980, symptoms associated with the illness were classified as “hysterical neurosis, dissociative type.” When Milligan stood trial in 1978, work had begun on the third edition of the DSM; hence, the term “multiple personality disorder” existed, but the illness was still classified as neurosis. The fifth edition of the DSM, classified DID as a separate category of dissociative disorders (“Highlights of Changes from DSM-IV-TR to DSM-5.” American Psychiatric Association, 2013).