Contemporary Interest in Multiple Personality Disorder and Child Abuse in the Netherlands

Interest in multiple personality disorder (MPD) as well as sexual child abuse is rapidly growing in the Netherlands, perhaps more so than in otherEuropean countries. Clinical, theoretical, and research developments in these respects are outlined, and it is mentioned that patients stating that they have been victims of satanic cult abuse are also encountered in the Netherlands. The need fin-more international cooperation is expressed. THE INTEREST IN THE NETHERLANDS IN MULTIPLE PERSONALITY DISORDER AND CHILD ABUSE In many parts of the world outside North America, multiple personality disorder is still regarded as either extinct, an extremely rare mental disorder, or an exclusively North American disease (cf. Fahy, 1988). Until recently, the Netherlands was no exception. Our brief review of the current history of MPD in the Netherlands indicates that changes are occurring in this regard. The interest of this review is probably not that these developments are unique but rather that they closely resemble those which have already taken place in many parts of the U.S. and Canada. As in the Netherlands, too, more clinicians especially those who are treating incest victims are making the diagnosis of MPD, it becomes clear that MPD is not an exclusively North American disease at all. Clinical Developments After one of us (Onno van der Hart) saw his first MPD patient in 1980, and we subsequently saw more, the extremely difficult nature of the treatment of MPD made us look for outside help. Our Institute already had a strong tradition of inviting distinguished foreign colleagues to present workshops and seminars on divergent topics. Therefore, it seemed both material and obvious to invite to the Netherlands established international authorities in the field. Thus, since 1984 Bennett G. Braun, M.D., Richard P. Kluft, M.D, and Roberta Sachs, Ph.D., have conducted workshops for interested Dutch colleagues and ourselves, seen our patients with us, and supported us in many other ways. One of the results of this continuous training was that we started to see many more MPD patients. Some of them were discovered among our own patients, often those with whom we had not been very successful before, to say the least. Other participants of the workshops, too, started to see MPD patients and made their own pioneering efforts to treat them accordingly. One side effect was that quite a number of colleagues got word of our interest in the diagnosis and treatment of MPD patients and subsequently confided to us that they were treating an MPD patient. They had not shared this fact before with other colleagues, because resistance against the diagnosis of MPD is still strong in Dutch psychiatry. A literature review in the Dutch journal of Psychiatry in 1985 (Megens, 1985) showed the usual ambivalence towards the existence of MPD. On the one hand, he showed fascination for this subject but, on the other hand, he himself had not diagnosed and treated MPD patients and was, therefore, unable to properly evaluate unfounded claims such as made by Leavitt (1947) and Kampman (1976) that multiple personalities can be created by hypnotic suggestion. Today an increasing number of colleagues are pioneering in the treatment of MPD patients. We are aware of 60 cases currently being treated in the Netherlands. Mutual help is provided through "live" consultations with therapists, assessment of one another's patients, and through supervision. An increasing number of workshops and seminars is being held on the diagnosis and treatment of MPD. Based on the work of Braun, Kluft and Sachs, and our own clinical experiences, we published a stage model for the treatment of MPD patients (Boon & van der Hart, 1989). Theoretical Developments Interested Dutch clinicians are, of course, following the North American literature on the subject. A "doctoral scriptie" (the Dutch equivalent of M. A. Thesis) gave a review of the literature and a description of the author's treatment of a MPD patient (Hof, 1985). Some of our own contributions to the Dutch literature have been aimed at reanimating Pierre Janet's old dissociation theory, which we try to integrate with recent findings in the (mainly contemporary North American) literature and our own clinical practice. As interest in psychological trauma and its sequelae is growing in the Netherlands, the importance of Janet ' s clinical ob34 DISSOCIATION, vnl. Ill. No. 1: March 1990