Multiple personality disorder

Multiple personality disorder becomes the defining clinical diagnosis in William Stanley Milligan’s story, but it does not settle every question raised by his condition. The book follows a shift from an early diagnosis of acute schizophrenia to later clinical and legal recognition of multiple personality, while showing how that recognition affected criminal proceedings, hospital placement, and the possibility of treatment. Diagnosis, present ability to participate in court, responsibility for past acts, and decisions about confinement remain connected but distinct issues.

Early Assessment and the Question of Identity

In January 1978, while Milligan was in Franklin County Jail, the public defenders’ office released funds for a psychological evaluation. On January 8 and 13, clinical psychologist Dr. Willis C. Driscoll administered a battery of tests. Milligan’s measured IQ was 68, a result Driscoll qualified by noting that depression had lowered the score. He diagnosed acute schizophrenia and described a profound disruption in Milligan’s sense of identity and in his ability to distinguish himself from his surroundings. The assessment also recorded reported voices and a belief that both harmful and helpful people entered his body. Driscoll concluded that Milligan could not then assist in his own defense and urged hospital examination and possible treatment.

That report brought the clinical question directly into court. On January 19, Judy Stevenson and Gary Schweickart presented it to Judge Jay C. Flowers as evidence that Milligan could not assist with his defense. Flowers ordered an examination by the forensic psychiatry unit at Southwest Community Mental Health Center. The defense feared that the unit, which it regarded as generally aligned with the prosecution, might use information from its interview against Milligan. After disagreement over confidentiality, the parties reached a compromise: prosecutors could question Milligan about potentially incriminating statements to the court-appointed clinicians only if he testified in his own defense. The defense accepted the examination on those terms. At this stage, the immediate legal issue was Milligan’s present capacity to participate in proceedings, not whether a particular diagnosis automatically determined his responsibility for earlier acts.

From Clinical Opinion to a Legal Finding

During Milligan’s later trial, Judge Flowers distinguished the evidentiary questions surrounding individual charges from the medical evidence concerning insanity. The court dismissed the first rape count because corroborating evidence was lacking and the alleged conduct did not show a similar modus operandi. For counts two through ten, however, the medical evidence was stipulated. The doctors agreed that Milligan had been mentally ill when the offenses occurred, could not distinguish right from wrong, and could not refrain from the acts. With no contrary evidence, Flowers found him not guilty by reason of insanity on those counts. The ruling was a legal conclusion based on his condition at the time of the offenses; it was not simply a restatement of Driscoll’s earlier opinion about his ability to assist counsel.

A later proceeding concerning assaults at roadside rest stops and the Gray Drug Store robbery made the diagnostic disagreement explicit. Four psychiatrists and psychologist Dorothy Turner submitted depositions stating that there was reasonable medical certainty that Milligan had been a mentally ill multiple personality when the offenses were committed in December 1974 and January 1975. They also considered it probable that he had been unable at the time to assist his attorney. The prosecutor called Dr. Harold T. Brown, who had treated Milligan at fifteen and sent him to Columbus State Hospital for three months. Brown said he would now revise his earlier diagnosis of hysterical neurosis with passive-aggressive features to dissociative disorder with possible multiple personality. Yet he questioned whether Milligan had multiple personalities because, in Brown’s view, Milligan appeared to know about his acts, whereas separate personalities were not expected to know one another’s actions. The dispute shows that the diagnosis was argued through competing interpretations of memory and awareness, not accepted as a self-explanatory label.

Recognition, Treatment, and Institutional Control

The book also presents diagnosis as something clinicians sought to observe in a treatment setting. When Milligan arrived early at Harding Hospital on March 16, Judy Stevenson and Dorothy Turner accompanied him to Wakefield Cottage, a locked unit for patients requiring constant observation and personal attention. Turner wanted staff to see the multiple-personality syndrome directly and suggested that Arthur come forward to meet those who would work with Milligan. The scene makes clinical recognition an interpersonal process: the treatment team was being asked to encounter the reported identities rather than rely only on a written description. Later, Dr. David Caul told Milligan that after the insanity verdict he was not regarded by the hospital as a criminal, and framed recovery as work toward bringing himself together.

Recognition did not guarantee a stable or consistent treatment environment. After publicity and conflict over Milligan’s care, staff at the Admissions and Intensive Treatment ward demanded changes and greater authority over day-to-day management. Social worker Donna Hudnell drew up a contract restricting visitors, phone calls, access to sharp or glass objects, spending, painting materials, and contact with other patients. Privileges could be restored in stages after two weeks of compliance. These rules show how a clinical identity could coexist with close institutional regulation: treatment was presented as the aim, while access to ordinary choices remained conditional.

In October 1979, after a confrontation near Ward 5, Milligan was transferred to Lima State Hospital for the Criminally Insane. At a subsequent hearing, speaking as the Teacher, he argued that treatment depended on wanting help and trusting the people providing it. He said he did not trust the Lima clinicians because they did not believe in his illness, and feared that he would be treated for a different condition. The court did not resolve that medical disagreement at the hearing, but left open review of whether Lima was the appropriate placement. His objection therefore concerned more than the name of a diagnosis: it concerned whether the institution accepted the condition for which he sought treatment.

Diagnosis, Risk, and the Continuing Search for Treatment

On December 10, 1979, Judge David R. Kinworthy’s findings formally diagnosed Milligan’s condition as multiple personality. The court described a substantial disorder affecting thought, mood, perception, orientation, and memory, with serious impairment of judgment, behavior, and reality recognition. It found him subject to hospitalization because of risks to himself and others and concluded that he required a maximum-security facility. At the same time, the order specifically required treatment consistent with the multiple-personality diagnosis. The ruling joined confinement and clinical recognition in one legal document: the diagnosis supported the treatment direction even as the court ordered a restrictive setting.

After a delay in the dispute over placement, state officials moved Milligan to Dayton Forensic Center on November 19, 1980. He read, wrote, and sketched, but was not permitted to paint. He hoped a 180-day hearing would lead to a return to Athens, where Dr. Caul could treat him, fuse the personalities, and restore the Teacher. The book records deterioration during this period: Milligan sometimes said he did not know who he was; during partial fusion he had no name; and Ragen had lost the ability to speak English. Communication among the personalities diminished. A daily log, suggested as a way for whoever was on the spot to leave messages, helped for a time before entries became less frequent.

Treatment aimed at fusion resumed through Dr. Judyth Box, who used intensive methods that had previously succeeded at Athens Mental Health Center. She worked with David, Ragen, Arthur, Allen, and Kevin before reaching the Teacher. The sequence gives the diagnosis a narrative consequence beyond courtroom classification: treatment sought communication and integration among identities, while transfers and institutional disagreement repeatedly interrupted that work. Multiple personality disorder thus functions both as a medical description and as the disputed basis on which Milligan’s capacity, care, liberty, and prospects for integration were negotiated.