CHROI\lC CG\IMS OF ALIEN ABDCCTION A~1) SOME OTHER TRAU\,gS AS SELF- VICTnnZATIO:\ SY~DROMES Jim Schnahel Jim Schnabel is a science writer with an interest in dissocia- tive phenomena. For reprints writeJim Schnabel, 6000 Kennedy Drive, Chevy Chase, MD 20815, (301) 907-2662. ABSTRACT This paper discusses the case ofan alleged alien abduction victim who claimed a wide range of dissociation-related and traumatic experiences, with a heavy thematic emphasis upon sexual abuse, extending back to a traumatic non-abuse incident in childhood, for which she apparently was never amnesic. Certain aspects ofher his- tory seem consistent with dissociative disorders, organic mental dis- orders, andMunchausen 's syndrome. This caseand thealien abduc- tion syndromeas wellas someorallnarratives associated with multiple personality disorder and "Satanic ritual abuse, "do not derive exclu- sively from severe exogenous trauma and may be viewed more use- ful~ as manifestations of manipulative self-victimization syn- dromes. INTRODUCTION In recentyears, numerous individuals have claimed that they have been, and periodicallyare, abducted and subjected to medical examination and manipulation by extraterres- trials. The phenomenologyof the syndrome is complex, and has appeared to evolve continuouslysince abduction accounts first began to appear widely in print in the mid 1960s. It cur- rentlyinvolves claims offrequentamnesicfugues; unexplained scars; sudden memories (in adulthood) ofchildhood abduc- tion; mysteriously-originating and mysteriously-disappearing pregnancies; mysteriously-originating and mysteriously-dis- appearing neurological and reproductive monitoring devices or "implants"; sudden awakening, paralysis, and a sense of presence in the early morning hours; poltergeist phenom- ena and other mysterious electrical disturbances; eating dis-. orders and food allei:gies; and an anxiety syndrome which has been termed "post-abduction syndrome" by some abduc- tion researchers (Fuller, 1966; Keel, 1975; Hopkins, 1981; Evans, 1984; Hopkins, 1987; Strieber, 1987; Bullard, 1987; Jacobs, 1992; Schnabel, 1994). The view of prominent abduction researchers in the U.S. is that this phenomenology indicates a covert alien pro- gram in which, among other things, human sperm and ova are collected for the creation of human-alien hybrids (Hopkins, 1987;Jacobs, 1992). However, otherobservers (Evans, 1984; Ganaway, 1989~ Noll, 1989; Powers, 1991) have noted that the phenomenology of the syndrome bears a strong similarity to the experiences claimed by individuals who are prone to dissociation. Even Ring (1992) ,who does not contend that the etiology ofabduc- tions is necessarily mundane, has noted from his own sur- veys that abductees tend to report a history of (mundane) childhood abuse or trauma, and tend to score highly on measures of dissociative experiences. The following is a report of a woman who has claimed frequent abductions and manipulations by aliens; frequent rapes, abuse, and harassmentbygovernment agents and other men; and frequent mysterious ailments which have result- ed in inconclusive but expensive and intrusive hospital tests. Her experiences are discussed in the context of a number ofdissociative and other syndromes, including Miinchausen's syndrome, and a framework for understanding the connections between these syndromes is proposed. CASE REPORT "Annette" (a pseudonym) is a woman in her late twen- ties, intelligent, with a university degree, and quite person- able, although apparently prone to depression and despair as a result of her experiences. Her story was told to this researcherwith the understanding that it mightbe discussed in a book being written about the history of UFO-abduction research (Schnabel, 1994). This story - which I must emphasize is largely unverified - is as follows: Annette's mother developed measles when pregnant with her, and Annette was born with severe ear problems, a heart murmur, and a cleft palate which subsequently was reconstructed surgically. During her first year, she experi- enced two minor convulsive seizures, but none thereafter. When Annette was eight years old, a man in the neighbor- hood began to harass her family, and Annette's father bought and loaded a gun for protection. Annette's father was killed, in Annette's presence, when he attempted to unload the gun and it discharged accidentally. Annette's mother then hastened her from the room, and Annette was not allowed to attend the funeral. Within a few months ofthe incident, Annette was abrupt- lytold by her mother that itwas time to attend summercamp. She was taken into the backyard ofthe house, where a coarse- featured young man of about 16 took her hand and some- how conveyed her to a remote cabin where he repeatedly raped her over a period of three days. The man's name was 51 .b-- -----l _ CHRO~IC CLlli\IS OF ALIEN ABDUCTION -- -- -- "Luke n (a pseudonym). He told Annette thal in fact she had killed her father and that from now on, no one but he would truly befriend her or fully undersland her. When Annette returned from "camp," her mother said, "Oh, look at you, you've been sitting on some poison ivy! vVhat were you doing sitting on poison ivy without your underpants on?" Annette had had imaginary playmates and a vivid imag- ination, but she knew the difference between such fantasies and the reality of Luke, who continued periodically to visit her. Usually he lOok on a malevolent aspect, taunting her ("You're going to like this") andsexually and physically abus- ing her, al th ough on occasion, he seemed reasonably placid. He once allowed Annette to pull hair from his chest to ver- ify that he was reaL Luke also claimed to be a member of Annette's family, and although he was never specific about this claim, Annette's mother appeared to recognize him. 'When at age nine Annette drew his picture in school and afterwards presented it to her mother, her mother burned the picture and told her never again to draw or to discuss the person whom Annette had depicted. As a teenager, one of Annette's brothers once under- went a strange experience, changing his voice and person- ality briefly when confronted at home with the news of a grandparent's dealh. He reported afterwards that he had seemed to float out of his body across the room, from which vanlage point he had observed his altered self. Annette also had an uncle who was widely known to be a psychic. Annette's oddexperiencesseemed to be far more numer- ous than those ofanyofherrelatives. She hadfrequent episodes of somnambulism. She had out-of-body experiences while in bed at night, and experienced occasional periods ofamne- sia, even in daytime, often awakening in a strange place, cov- ered with scars and bruises. In one incident, which alarmed her family, she disappeared while snowmobiling in freezing weather and was discovered hours later, lying in the snow beside her snowmobile, with her scarf folded neatly next to her. Oddly, she was neither hypothermic nor injured in any other way. On other occasions when she suffered minor, prosaic injuries, she noted that she had a remarkable insen- sitivity to pain. Annette also noted that machinery would sometimes malfunction around her. Electric wristwatches - even with new batteries - frequently ran slow or Slopped altogether. Occasionally the telephone would ring but when she would pick it up, she would hear an ordinary dial tone, as if no one had called. 'When Annette became sexually active, she noticed that her "first time" hadn't been at all painful. She mentioned it casuaJly to her mother and her mother responded thatAnnette, when only a year old, had broken her hymen by sitting on a funnel; she had bled for a day or two and then she had been brought to the hospital. Annette's mother eventually remarried, and Annette grew up amidst relative prosperity, although her relation- shipwith hermother, who had alwaysseemed to favor Annette's younger sister, at times seemed strained. Annette continued to be visited by Luke, and now also by a Hispanic-looking man narned 'Juan. ~Juan seldom molested her sexually, pre- 52 ferring to molest her psychologically instead. For example, he would arrive on her doorstep in the middle of the night and pound on her door, apparen t1y to make herpanic. Annette also occasionally was visited by her dead father, although these visits seemed entirely benign. On at least one occa- sion, Annette noted that a pillow thrown at her dead father went tluough him, indicating that he was only a ghost; her other visitors were unfortunately more substantial. Annette's strange experiences, and in particular her tendency to disappear suddenly, made relationships with men difficult; in one case, she disappeared from a house one night during a date wi th a potential boyfriend. She awoke in a remote part of the house in the morning, amnesic for the period of her disappearance, and attempted to explain that she didn't know what had happened. The young man., who had slept alone for the night, called her a liar and angri- ly departed. One day in the late 1980s, at a bookstore on her uni- versity campus, Anne tte saw a copy of'Whi tley Strieber's best- selling book Communion, with the face of a gray alien on its cover. The shock of recognition was so great that she sank to her knees and began sobbing uncontrollably. Later, she read Communion and other books about aliens and abduc- tions, and contacted a prominent abduction researcher, ''Frank Taylor" (a pseudonym), who interviewed her abouther expe- riences and began a series of regression hypnosis sessions that continues to this day. In each such session, Taylor would elicitmemories ofone or more ofAnnette's numerous abduc- tion episodes, which apparently stretched back to her child- hood, and continued with remarkable frequency in the pre- sent, occurring every few days. At first, Annette withheld from Taylor the information about Luke andJuan, fearing that he would not believe her story ifnon-alien beings were involved. Taylor therefore interpreted Annette's odd expe- riences, fugues, and anxieties as relatively uncomplicated alien-abduction experiences. The fact that Annette often awoke from her amnesic episodeswith bruises, scars, orother signs ofalien manipulation helped to convince him that her experiences were real. In the early 1990s, Annette told Taylor abou t Luke and Juan, but because they now often appeared in conjunction with the aliens, it began to seem to her, and lO Taylor, that they might be "screen-memo:ry~aliens, or perhaps hybrids orhumans working with the aliens. Under hypnosis,Annette now decided that Luke's firsl appearance in her backyard had been in association with a luminous object, and that J nan seemed anatomically non-human, with fingers that ended abruptly at his wrists. Luke and Juan and the aliens seemed to appear most frequently at night, during sleeping hours, and when Annette was abducted, she frequently found herself in the company of other abductees, either in spaceships or in apparently earth-bound locations such as furnished offices and caves. During waking hours, beginning approximately in early 1992, Annette began lO experience frequentseveral-hollr amnesic episodes from which she would awaken, dishevelled, par- tially un dressed, and occasionally with cuts and bruises. On at least one occasion, the experience was followed (a) by a D1SS0CIATlO\. \'01. \'11. \0. 1. ~Ial eh 199~ feeling of extreme thirst which was only quenched by a gal- lon or so ofwater, and (b) by inappropriate sensations, over about 24 hours, ofambientwarmth or chill. Hypnotic regres- sionwithTaylor often revealed thaton these occasionsAnnette had been abducted by men in dark suits and driven in a black limousine to a secluded place where she had been gang-raped. This began to suggest to her and to Taylor a government conspiracy related to the aliens' abduction pro- gram. Occasionally, Annette's disappearances or abductions would occur during her visits to Frank Taylor's house. On at least one occasion, Taylor prevented her from leaving the house in the middle of the night, and told her later that she had been in a trance-like state, insisting that she had to go outside to meetsomeone. On another occasion, she was met by several men outside Taylor's house who gave her a bot- tle of wine to give to Taylor. On yet another occasion, after an abduction experience at her home, she noticed alien residue of some kind on her sheets. She sent the sheets to Taylor, but they disappeared in the mail. Once, when attend- ing an abduction conference with Taylor, she rose in the middle of the night and Taylor, who was sleeping nearby, attempted to prevent her from leaving the house. She <,;xplained that she was only going to the bathroom. Taylor returned to bed and in the morning Annette, who herself awoke fully clothed, reported that she had been abducted again. She wasn't sure why she had deceived Taylor during the night. Annette usually could "feel" when an abduction was about to occur, sensing a certain pain above her right ear, but even so, both the daytime and nighttime experiences interfered with Annette's sleep patterns and with her work as a secretary in a large office. She seldom had a full night's sleep, and often went to bed only in the early hours of the morning. She frequently took sick leave, and her occasion- al disappearances during work hours brought her into con- flict with her employers. Annette was seeing a professional therapist during this time, and in the summer ofl992, after she experienced anoth- er abduction during a UFO abduction conference in the cen- ter ofa large east coast city, she complained to the therapist that her repeated abduction experiences were making her suicidal. The therapist referred her to a neurologist, who arranged for a temporal lobe epilepsy test with nasal EEG probes and a strobe light in her eyes. The strobe light quick- ly put her into a pleasant trance within which she experi- enced floating sensations, and from which the neurologist and his staff had difficulty in retrieving her. There were no EEG abnormalities and the neurologist subsequently diag- nosed her as having a susceptibility to "reflexive trance." Her therapist, after reading the neurologist's report, told her that the aliens and her other abductors were most likely the hallucinatory product of her trances, which her mind used to avoid or to distract her from stressful situations. Annette disagreed, explaining to the therapist that the aliens, when they abducted her, often did the same thing that the neu- rologist had done, putting her on a table and flashing lights in her eyes and forcing her into a trance, and they had been doing this all her life, which was why she slipped into trances so easily. The same, she told him, was true ofother abductees. The therapist, however, continued to disbelieve her abduc- tion accounts, andwould prescribe her onlyValium (diazepan) for her sleeplessness. Annette flushed the medication down the toilet and terminated hervisits to the therapist. She began to see another therapistwho believed in the reality ofabduc- tions. At about this time, Annette missed her period and it seemed as though she were pregnant. She believed the father to be an alien or a government rapist. Then one day she began to bleed heavily, and eventually lost consciousness. When she awoke, covered in blood on the floor of her bath- room, she noticed that she had passed what may have been a large blood clot or a dead fetus. She flushed it down the toilet and afterwards her periods resumed. In the autumn of 1992, Annette began to have the feel- ing that she could eat only certain foods. Under hypnosis with Frank Taylor, she learned that the aliens had forbid- den her to eat anything besides eggs and vegetables. Annette began to experience abdominal pains. Whenever she attempt- ed to eat a proscribed food, she would break out in hives and become nauseous. One night in early 1993, Annette experienced a joint abduction with another abductee, "Beth," who had been staying in her room at the time. Afterwards, Beth described a human-looking entitywho had abused her during the abduc- tion; Annette recognized him as Luke. Beth, an accomplished artist, drew Luke and gave the drawing to Frank Taylor, who displayed it at several abduction conferences where, to his surprise, a number of abductees came forward with claims that they too had seen Luke during their abduction expe- riences. Annette had a history of numerous hospital visits, for various ailments including heart problems, ear problems, and wrist problems, and in the late winter of 1993, having quit her job and having moved several hundred miles to a town near her parents where she lived in a single apartment, Annette consulted a gastroenterologist about her abdomi- nal pains. The gastroenterologist asked for a stool sample, whichAnnette promptlydelivered andwhich contained blood. Additional stool samples also contained blood. A number ofinvasive examinations, including colonoscopy, gastroscopy, and upper and lower barium radiography, were carried out without finding a lesion which might be the source of the blood. After further tests it was revealed that Annette had a malfunctioning gall bladder. However, a residual uncertainty on the part of the consulted physicians led to further tests and an indefinite postponementofany operation to remove her gall bladder. One series of tests suggested that Annette mighthave hypoparathyroidism. Afterfurther testswere con- ducted by an endocrinologist, this condition was confirmed, the endocrinologist expressing surprise because the condi- tionwas unusual in individualswho had not previouslyunder- gone thyroid surgery. Annette was given a course of calci- um injections andwas later prescribed calcium pills andvitamin D. Within a month her serum calcium level, which had been low at 6.9 [mg/dl], rose to about 7.2 [mg/dl]. The lower 53 D1SS0CIHIO\. Yol. \11. \0. 1. \laldllq9~ C] IRONIC CL-\lht'i OF ALIEN ABDUCTiON limit of the normal range is 8.5 mg/dl (Alfrey et al., 1992). However, she continued to experiencegastrointestinal prob- lems, and presented herselfto th e local hospital's emergency room at least once in the month following the initiation of her calcium treatment. She began a course of "sulfa" for sus- pected colitis. She also experienced further dramatic abduc- tions and abuse. In one such episode, she was driving back from a visit to Frank Taylor when she felt ill and pulled her car over to the side of the highway. She went into the woods to vomit, but was there accosted by Juan, who abused her physically and sexually over a period of several hours, leav- ing bruises and abrasions on her back, and rope-burns on her wrists, and smearing the blood of a mutilated cat upon her face and breasts. She lost consciousness intermittently throughout this experience, but remembered the abuse and thatJuan told her that this was in retaliation for her having told Taylorabouta previous abduction she had experienced, involving drugged wine in a Manhattan restaurant, and a hazily-remembered cross-tOwn journey to a secret meeting with several military officials in a Hasidic Jewish neighbor- hood in Brooklyn. Juan .,.,earned her that he and the others could confrontand abuse heran}'\vhere, whenever they liked. Annette believed him, later telling this author, "My life is over." Even so, Annette afterwards took a gun secretly from her parents' house, loaded it, and placed it beside her bed - to protect herself from Juan and the others. She wrote a long letter, addressed to her persecutors, pleadingwith them LO leave her alone. She also secretly took Valium from her parents' house, to help her sleep, although she discarded it when the Valium seemed to produce vivid nightmares from which she found it difficult to escape intowaking consciousness. This was Annette's story. Most of it is obviously uncon- firmable, but in conversations with Frank Taylor, other abductees, one ofAnnette's former roommates, and Annette's parents, it was possible to obl..:-Un corroboration for the fol- lowing: Annette had 'witnessed her father's death in a gun acciden twhen she was eight years old. She claimed freg uent abductions, and was a frequentvisitor to FrankTaylor's house for hypnotic regression. Beth claimed that she had been involved in a traumatic double-abduction involving Annette and Luke. Beth's drawing of Luke was recognized by other abductees at an abduction conference. Annette had been seeing a therapist in the citywhere she had lived before mov- ing closer to her parents. Annette had been seen on sever- al occasions with inexplicable bruises or scars. Annette did present with a gastrointestinal problem the nature of which was elusive, and did undergo a battery of medical tests con- cerning a possible gastrointestinal and gall bladder prob- lem. Anneue was diagnosed with hypoparathyroidism - although a CT scan of her brain was negative for the calci- fication that sometimes accompan ies parathyroid disorders. This author is not aware of any direct disconfirmations or contradictions byother individuals ofanyaspecls ofAnnette's story, although relatively few of her claims were checked. This author also had the impression that relations between Annette and her family were quite good, considering her claims. 54 CASE DISCUSSION Dissociathm Itis difficult to know precisely howto interpretAnnette's story, since so little ofit has been confirmed by othersources. .Also, this author is not a trained mental healtll profession- al, and his observation of Annette was made in a non-clini- cal setting in which tilere was tolerant listening, but no ther- apy was attempted. It can be said, however, that although Annette's expe- riences are generally more complex and much more fre- quen t than tllOse of other abductees, they encompass most ofthe standard abduction phenomenology. Itshould be noted that abductions involving human orsemi-human en Iities occur infrequently in the abduction literature but at presentwould appear to be rapidly on the increase, following the sensa- tional case ofanother female abductee in Frank Taylor's cir- ele, Linda, who has claimed, with sometimes elaborate phys- ical "evidence," that she is the target of harassment by government agents with whom she, and a major political fig- ure whom they were guarding, were once abducted by aliens (Schnabel, 1994).1 Annette's history as reported, and to some extent as confirmed, seems to reflect a dissociative disorder. Some of the more prominent features in this regard are her report,; of (a) chronic sexual abuse from childhood, (b) childhood imaginary plaYJnates, (c) frequen t somnambulism or fugue- like states with bruising or other injuries, and (d) an abnor- mally high susceptibility to trance states (Coons, 1984; Bliss, 1986; Pu lOam, Guroff, Silberman, Barban, & Post, 1986; Ross, 1989). It could be argued that Annette's behavior during her amnesic fugues represents the behavior of an alter or semi- alter who is not sufficiently distinct to meet the criteria for MPD. Alternatively, it could be that Luke and Juan are for- mer imaginary playmates who, like t.he more recently cre- ated aliens, confront Annette within "internal landscapes" (Ross, 1989, p. 115) but do not take full executive control, and perhaps only manifest behaviorally as self-wounding impulses. Both interpretations would seem consistent with a diagnosis, according to DSM-JIJ-R criteria, of Dissociative Disorder Not Otherwise Specified (American Psychiatric Association, 1987), although Coons (1992) notes thatin cases of non-executive influence the other characters are usually not experienced as completely separate entities. It is possi- ble that Annette's fugues, bruises, and horror stories reflect the fully executive actions of alters who woule emerge with clinical investigation and would justify a diagnosiS of MPD. Other features of Annette's history which are consis- tent with a diai,,'TIosis of dissociative disorder or at least of dissociation-proneness include eatingdisorders, unexplained somatic symptoms, suicidal ideation, complex and chronic (presumed) visual hallucinations, an occasional abnormal insensitivity to pain, insomnia and abnormal sleep patterns, paranormal-type experiences, an apparent history of disso- ciative or paranormal-type experiences in near relatives, and a childhood experience ofsevere llon-abuse-related trauma (the death of herfather) (Coons, 1984; Pettinati, Horne, & lllSSOCI.mO:\. \'01. \'II. :\0. 1. ~[~Ich 1991 Staats, 1985; Putnam et al., 1986; Bernstein and Putnam, 1986; Bliss, 1986; American Psychiatric Association, 1987; Ross, 1989; Ross, Heber, Norton &Anderson, 1989; Demitrack, putnam, Brewerton, Brandt & Gold, 1990). Annette's mys- terious "pregnancy" is difficult to evaluate since it is unclear whether it ever occurred, but itmay have represented a men- strual problem or pseudocyesis-type episode which was then interpreted by Annette in accord with the standard abduc- tion motifofmissing alien-induced pregnancies. Pseudocyesis does appear to have a relationship to dissociative potential (Wilson & Barber, 1983). Organic Psychosis Some of Annette's reported symptoms, of course, are consistent with other disorders. The most obvious of these disorders would seem to be the psychoses, and the corrob- orated report thatAnnette had hypoparathyroidism suggests an organic psychosis. Hypoparathyroidism is one of several endocrine abnormalities which apparently result in the cal- cification of brain areas, especially the basal ganglia; these calcifications have been associated with a variety of neuro- logical or psychiatric conditions including seizures, hallu- cinations, and persecutorydelusions (Tambyah, Ong, &Lee, 1993; Bilous et al., 1992; Fulop & Zeifer, 1991; Friedman, Chiucchini, &Tucci, 1987; Cummings, Gosenfeld, Houlihan, & McCaffrey, 1983; Francis & Freeman, 1984; Dimich, Bedrossian, & Wallach, 1967). In Annette's case, however, there apparently was no finding of brain calcification, and her pre-treatment serum calcium level was only moderate- ly low compared to the levels ofother reported hypoparathy- roid patients (Dimich, et al., 1967). There was no unequiv- ocal evidence in her self-reported history of the epileptoid seizures, tetany, parkinsonism, dementia, or skeletal defects which are often found in adults with idiopathic hypoparathy- roidism (Tambyah et al., 1993; Fulop & Zeifer, 1991; Friedman et al., 1987; Cummings et al., 1983, Dimich et al., 1967). It also should be noted that in a review of267 patients with hypoparathyroidism, only 1.9% manifested clinical psy- chosis (Denko & Kaelbling, 1962). Eyen if hypoparathyroidism were not directly respon- sible for Annette's hallucinatory experiences and delusions, however, it may have represented a background source of neurological or psychological stress. Lawlor (1988) has described a patientwith acute organic anxietysyndromewhich apparently resulted from surgery-related hypoparathyroidism and resolved with the return of the patient's serum calcium levels to normal. Lawlor has argued from a review of the lit- erature that there is a frequent association between hypoparathyroidism and anxiety states. Temporal Lobe Lability Annette's history, despite the apparent negative TLE test, also includes a number of features which one could argue are indicative oftemporal lobe liability. These include premonitory aura-type sensations, apparent hallucinations, floating sensations, paranormal-type experiences, apparent paranoid delusions, apparent "ictal" sexual sensations, ther- moregulatoryabnormalities, possible mild hypergraphia (the letter to her persecutors) , dependence and passivity, depres- sion, and unusual somnambulatory-type behavior followed by full or partial amnesia (Dewhurst & Beard, 1970; Bear & Fedio, 1977; Bear, 1979; Remillard et al., 1983; Persinger, 1989; Trimble, 1991; Mikati & Holmes, 1993). A number ofauthors have described patients with con- current MPD-type symptoms and temporal lobe epilepsy or otherEEG abnormalities (Coons, Bowman, & Milstein, 1988; Benson, Miller, & Signer, 1986; Schenk & Bear, 1981; Mesulam, 1981; Brende & Rinsley, 1981).Jacobs (1992), a UFO abduction investigator, has noted that one of the abductees he has worked with has temporal lobe epilepsy, although he has argued that this was a coincidence. Persinger (1989) has reported the termination ofUFO abduction expe- riences in one abductee with the anti-convulsant drug car- bamazepine, and has argued that UFO abduction experi- ences and other "visitor" experiences are mediated by temporal lobe microseizures or electrical abnormalities which may not be detectable by ordinary EEG surveillance. Most MPD patients, however, not only appear to have normal EEGs, and are unresponsive to anti-convulsant med- ication, but are otherwise clinically distinguishable from patients with temporal lobe epilepsy (Devinsky, Putnam, Grafman, Bromfield, & Theodore, 1989; Loewenstein & Putnam, 1988; Ross et at, 1989; Ross, 1989). Annette, for example, displays none ofthe religiosity, expansion ofaffect, hypermoralism, or humorlessness that are commonly report- ed in temporal lobe epileptics (Bear &Fedio, 1977). Ofcourse, the fact that she does not seem to display these factors could be due in part to the constraints posed by Frank Taylor's "nuts-and-bolts," anti-metaphysical view of the alien abduc- tion phenomenon (Klass, 1989; Schnabel, 1994) .Moreover, even Devinsky et al. (1989), who discount a primary role for epilepsy in the etiology of MPD, argue that: "the high inci- dence of non-epileptiform abnormalities in our [MPD] patients suggests that a neurophysiologic abnormality may contribute to the pathogenesis ofMPD."Alternatively, it could be speculated that whatever causes MPD also contributes to the development of neurophysiological abnormalities (Putnam, 1984). The literature on shamanism (Eliade, 1989; Lewis, 1989; Kalweit, 1992) also indicates that epilepsy, or a disorder like it, is regarded in some cultures as a precursor to chronic supernatural encounters. One of the abductees this author met through his research reported that she had a history of convulsions as a child, usually following illness, and usuallysignallinga sudden recoveryofher health, although she no longer seemed to have these convulsions as an adult (Schnabel, 1994). This would be consistent with the hypoth- esis, somewhat after the argument ofDevinsky et al. (1989), that neurological abnormalities may underlie or promote an overall psychological abilitywhich the individual can uncon- sciously or consciously learn to suppress or control. In this regard it should be noted that reflexive epileptic seizures, like dissociative states, are often manifested during episodes of psychological stress (Zifkin & Andermann, 1993). 55 b-- ---'-__-J__ ~~~__ CHRONIC CLAI~'{S OF AJ~.Ir~\T .ABDUCTION MiincJuwsen's Syndrome 'Whether the causes of Annette's experiences are neu- rological or psychosocial, or both, there are specific aspects of her reponed history which, although they cannot be con- clusive, do suggest deliberate rather than unconscious deceit; for example, the disappearing alien-stained sheets, the wine proffered by strange men, and the nocturnal deception of Frank Taylor - none of which was associated by Annette with amnesia. Indeed,Annette'sstory, with its central theme of frequent fantastic injury or mysterious illness requiring hospital investigation bears a strong resemblance to stories told by individuals with Miinchausen's syndrome (Asher, 1951). In particular, Annette's presen tatio n with abdomi- nal trouble requiring extensive and invasive but inconclu- sive diagnostic techniques fits well within th eMiinchauseniall pattern. Of course, it is true that in routine medical prac- tice stool blood occasionally has no obvious internal source, but it is also true that the addition of blood to laboratory samples is a classic Miinchausenian technique (Spiro, 1968; Atkinson &Earll, 1974; Ifudu, Kolasinski, &Friedman, 1992). Miinchausen'ssyndrome occasionally has been suspected to have an organic etiology: there are repons of Mi:i.nchausenians with severe hypothyroidism (Brecker & Trepte, 1990), brain MRl abnormalities (Fenelon etal., 1991); histories of meningitis, neurosurgery, and head injury (Barker, 1962); abnonnal EEGs (Barker, 1962; Ireland, Sapira, & Templeton, 1967); and serious brain dysfunction based on other neuropsychological testing (Pankrantz, 1981; Pankrantz & Lezak, 1987). Lawrie. Goodwin, & Masterson (1993) describe a patientwho exhibited a personality change following a cholecystectomy, and within several years began overdosing on co-proxamol, dramatizing her medical con- dition and using a variety of aliases and addresses to obtain the drug. Co-proxamol abuse in this patient was associated with fugues and tonic-clonic seizures. Three months after her use ofthe drugwas terminated by clinicians, SPECT imag- ing and neuropsychological testing revealed evidence ofseri- ous brain dysfunction, including fronto-temporal lobe deficits, poor concentration and short-term memory, con- structional apraxia, and an accounting ofevents whose "bla- tant" inconsistency seemed lost on the patient. Lawrie, Goodwin, & Masterson suggest that during cholecystectomy the patient incurred a brain injury which led to an organic anxiety syndrome, which in turn led the patient to alleviate her anxiety through psychotropic drug abuse. Munchausen's also has been linked to the dissociative disorders. Goodwin (1988) and Toth and Baggaley (1991) have noted cases inwhich Multiple Personality Disorder coex- isted with Munchausen's-type behavior. In the cases report- ed by these authors, the suspicions of a coexistence of Miinchausen's and MPD was supported by a reported histo- ry of childhood abuse, neglect, or trauma plus an early his- tory of receiving attention in a medical setting. Both such conditions appear in Annette's self-reported history. Goodwin (1988) has noted that in general, there are numerous behavioral parallels between Munchausenians and patients with dissociative disorders, including compulsive self-injury, pseudoseizures, active imaginations with elabo- 56 rate pseudohistories, the use of different names, and claims of childhood abuse, neglect, or trauma. Good,vin has pro- posed on this basis that Mi:i.nchausen's syndrome be reclas- sified as a dissociative disorder. Mi:i.nchausen's-type behavior has been reported in a woman who claimed Satanic ritual abuse (Coons & Grier, 1990). SaL:'U1ic abuse claims are similar to alien abduction claims not only in their themes of "sudden remembering" of childhood abuse or trauma, and in the dissociative his- tories of their claiman ts, but also in their reported imagery which typically features the claimant prone and naked, under- going sexual or gynecological manipulation and later giv- ing birth to babies which are harvested by the ritualists or aliens (Ganaway, 1989; Schnabel, 1994). Post-traumatic stressdisorder, which is occasionallydiagnosed in IvlPD patienl~ (Ross, 1989) and, less formally, in UFO abductees Uacobs, 1992), also has attracted Munchausenialls (Lynn & Belza, 1990). As for UFO abductions, some authors (Bullard, 1987; Klass, 1989; Jacobs, 1992) have noted cases in which alien abduction claimsappeared to have been presentedwith delib- erate deception. Klass (1989, p. 174) reports the case of a young woman who, following her confession, argued that the kind ofdeception that she had perpe trated was,videspread among other abductees: "the only way they can get any kind of satisfaction is to fabricate some sort of story to get the focus of attention that they need." THE ISSUE OF ABUSE Goodwin (1988) has attempted to forge an etiological link between MPD-type disorders and Miinchausen's by sug- gesting that in some cases the self-mutilating behavior ofthe Miinchausen's patient may be explained as: (a) an attempt to overcome the sense ofvictimization from childhood trau- ma by re-assuming the victim's role but controlling it secret- ly; (b) an attempt to deny traumatic memories by weaken- ing the cogni live-mnemonic divide between fan tasy and reality; (c) an enactment of a conflict between wan ti lJ g childhood abuse to be diagnosed and "wanting to maintain the lies and the secrecy"; and/or (d) a straightforward compulsive re- enactment of childhood abuse. Toth and BaggaJey (1991) discuss t.he additional possibilities that Mi:i.nchausenian behavior may occur in the MPD patient because: (e) it rep- resents a re-enactment of childhood abuse in a hospital sel- ting, this setting having been identified by the patient with child abuse because of an early hospitalization requiring aggressive and painful medical treatment; and/or (f) the patient has the hope of redeeming her tolerance of child- hood abuse through masochistic behavior. Note that in all of the above explanations it is assumed that the unifying fea- ture of coexistent MPD and Mi:i.nchausen's is an actual his- tory of childhood abuse or trau ma - wi th a strong empha- sis on abuse. Annette's narrative appears to include episodes ofabuse which, as presently described, have fantastic overtones, sug- gesting that they should not be taken literally. Indeed, their apparent commencement so soon after the sudden loss of D1ssocr ITlO~. 1'01. \'II, \0. I. \larch 1991 her father suggests that they are more related to the latter than to any actual ongoing exogenous trauma. Annette's comments about other family members' dissociation-relat- ed experiences, and her self-reported history of childhood imaginary playmates, among other things, suggest that the trauma ofher father's death occurred against a background of relatively high psychological lability, and, perhaps aided byAnnette's perception that she was neglected by her moth- er, triggered chronic dissociative episodes in a process sim- ilar to that suggested in the usual etiological models of MPD (KIuft, 1984a) - in the absence, however, of an actual his- tory of chronic sexual or physical abuse. This author has interviewed a number of other chron- ic UFO abductees, none ofwhom reported a history ofchild- hood abuse or trauma. Linda, the alleged government-har- rassment victim referred to above, has reported that her childhood included neither abuse nor trauma (Hopkins, 1993), but rather a variety of paranormal experiences - which, she says, her parents also endured. "Theywere never believers in the unnatural," she has told an interviewer, "but we had our home blessed by a priest on a regular basis. It didn't help" (Amendola, 1993, p. 4). The role of abuse and trauma in the etiology of MPD and its variants has long been controversial. It has been sug- gested, for example, that MPD represents merely an acting- out, consciously or unconsciously, of suppressed impulses or fan tasies by attention-seeking individuals whose behavior may be explained as much by their emotional lability and suggestibility as by exogenous stress (see Ellenberger, 1970; McHugh, 1992). Modern authors who otherwise support the validity of MPD and other dissociative disorders as distinct and often post-traumatic disease entities (e.g., Bliss, 1986; Young, 1988; Ganaway, 1989; Powers, 1991) also have argued that the narratives ofthe dissociative disorder patient may include fantasy to an indeterminate degree. The work ofWilson and Barber (1983) and Lynn and Rhue (1988) suggests that at least some (although not necessarily all) highly-hypnotiz- able individuals - of which MPD patients would seem to comprise a subset-maybe prone to fantasy. Ganaway (1989) in particular has suggested that the themes of patient nar- ratives may be determined less by straightforward factual abuse and trauma than by certain othershapingfactors (Kluft's Factor 3 in the etiology of MPD [KIuft, 1984a]). These fac- tors would include books, films, hypnotic trance logic, and the need to please one's therapist. Ganaway appears to believe that actual abuse and trau- ma plays an important role in the etiology of MPD and its variants. He suggests that UFO abduction claims (see also Powers (1991» and Satanic ritual abuse claims may repre- sentvarian ts ofan unconscious, dissociation-mediated defen- sive system against (relatively prosaic) trauma and traumat- ic memories. This argument seems similar to Goodwin's hypothesis (b) noted above. It should be noted, however, that Annette's apparently dissociative episodes do not obvi- ously represent an attempt to screen out or to deny the trau- matic memory of her father's death, since she has seemed wiIIing to discuss this memory quite openly. The possibility thatAnnette's "alien-abduction"episodes represent instances of actual but prosaic sexual and physical abuse seems espe- cially remote considering their frequency, their locales, the competitive dynamic which seems to pertain among Frank Taylor's abductees, and the overall Miinchausenian pattern ofAnnette's claims. SELF-VICTIMIZATION SYNDROMES An alternative hypothesis, which puts even less empha- sis on actual trauma, is that the major unifying feature of some (not necessarily all) cases of MPD, of other dissocia- tion-related syndromes, ofMiinchausen'ssyndrome and other factitious disorders, and of other claims or fabrications of trauma or injury, is the deep-seated need to assume the role of the victim. This hypothesis is similar to those which posit MPD as one of many socially-defined forms of manipulative disease-simulation or role-playing, and also largely parallels sociological/anthropological analyses ofspirit-possessionsyn- dromes (Lewis, 1989).2 In such cases, self-victimization would not be restrict- ed to, but might be manifested more easily and with more equanimity by, those with a facility for dissociation, whether this facility arises from genetic or developmental factors, or both. Dissociation-related or neurocognitive lability-related experiences such as amnesic fugues, non-specific anxiety, eating disorders, pseudocyesis or other fantasies concern- ing pregnancy, out-of-body experiences, bedroom paralysis and a sense of "presence," and archetypal or culture-bound hallucinations (Hufford, 1975) would also serve as the basic features of certain self-victimization syndromes. In the case of the UFO abduction syndrome,3 such features would be made .meaningful with consciously- or unconsciously-gen- erated abduction narratives, and might be supplemented, for example, with fabricated "alien" artifacts (Keel, 1975). Once such a syndrome is defined and publicized, it mayquickly attract those prone to self-victimizationwho already suffer from such background symptoms. This would help to explain why sensational reports ofdissociation-related expe- riences or conditions are often followed, as MPD, Satanic rit- ual abuse claims, and UFO abduction claims have been since the 1970s, by exponential increases in the number of cases presentedand diagnosed (Ross, 1989; Wright, 1993; Schnabel, 1994). At the same time, the mimicry which would facilitate the adoption of the victim's role also would help to drive the thematic evolution of the self-victimizer's chosen genre. The theme of stolen fetuses only became prominent in the UFO abduction lore in the late 1980s, following a sensational bookon the subject (Hopkins, 1987); abductee themeswhich have become prominent since then include the belief in a conspiracy between aliens and the U.S. government, claims that some abductees are themselves part-alien, and claims that aliensfrequently abduct abductees' (actual human) chil- dren (Jacobs, 1992; Hopkins, 1993; Schnabel, 1994; Mack, 1994). The same mechanism might explain recent themat- ic changes (Ganaway, 1989) and the ostensible postwar eti- ological revolution (Ross, 1989; see below) within the MPD 57 DISSOnmO\. rol. \lI. \0. 1. ~Iarch 199~ literature. The hypothesis !.hatsome foons ofMPD representmani~ ulative self-victimization, more or less in the sense described by Lewis (1989), is hinted at by Ross (1989), who approv- ingly recites Lewis's argument that spirit-possession syndromes and possession cultscan representsocially-acceptable expres- sions of otherwise forbidden, subversive, and often frankly libidinal impulses: ''women living in cultures in which they are politically powerless can acquire power, influence, auton- omy, and partial satisfaction of thwarted needs through pos- session ... Demon possession in western Europe made pos- sible the ritualized expression of Dionysian impulses and opinions that could not be stated directly... " (Ross, 1989, p. 21) .Thus, it appears to be accepted that possession can come about via relatively mild stresses, and can serve merely as an alternative form of expression or manipulation. As for the connection between possession and MPD, Ross is unequiv- ocal: MPD, he says, is "a secular version of demon posses- sion" (1989, p. 19). Similarly, Goodwin (1988), after the his- torian Judith Brown (1986), has retrospectively diagnosed MPD in a 17th century "possessed" Italian nun, who report- edly faked stigmata and a varietyofother ailments and asceti- cisms, and manifested a system of male alters who appar- ently enabled her to express both her lesbianism and her somewhat grandiose mystical ambitions. Ross (1989) accounts for the apparent etiological dis- crepancy between these old forms of MPD and the late twen- tieth century forms with the following hypothesis: "Since 1944 MPD has evolved into a syndrome with a post-traumatic etiology, whereas before it tended to have less severe exter- nal precipitants; our society has gotten sicker, and the abuse ofchildren more bizarre; earlier clinicians missed the abuse history in many MPD patients, which was not as severe, on average, as that experienced by contemporary patients. The incidence of MPD, then, is an indicator of the amount of child abuse occurring in Western society" 0989, p. 42). It would seem that such hypotheses are about all that separate modern MPD, etiologically, from possession syn- dromes like those described by Lewis (1989). There is, of course, a body of literature noting corroboration of child abuse in some MPD cases (Goodwi n, 1982; Kluft, 1983; KIuft, 1984a; Kluft, 1984b; Bowman, Blix & Coons, 1985; Coons & Milstein, 1986;Bliss, I986, Hornstein &Putnam, J992); how- ever, this body ofliterature accounts for relatively few cases (Frankel, 1993), and ~corroborations"ofabuse bysocial work- ers are often highly controversial (Schnabel, J993). Social workers are typically empowered to make judgments about whether abuse is occurring in the absence of evidence suf- ficient for a criminal conviction (SL:'lte of Maryland, 1993). Innocent parents may even be induced to "confess" inces- tuous abuse if (a) they face pressure to plea-bargain for a relatively mild pun ishmentorface expensive trials and lengthy jail terms, and/or (b) they, like their children, have disso- ciative tendencies and high suggestibility which cause them to believe falsely, and perhaps even elaborate upon, what they are accused of (Wright, 1993; see also Robbins, 1959; Douglas, 1970). The beliefthat MPD is a subtle disorder requir- ing intensive questioninf{ by therapists may also lead to a 58 false diagnosis or even induction of MPD in those who actu- ally have suffered child abuse. It may be that child abuse, whose prevalence and range ofseverity today are perhaps not significantly different than they were before 1944, often plays a direct, traumatic role in the development of MPD. However, it may also be that a claim of child abuse, whether true or not, serves primarily not as the traumatic stimulus to defensive dissociation, but as the medically-acceptable complaint through which, in part, the role of MPD victim is adopted by a self-victimizing indi- vidual. 5i milarly, the fact that MPD victims who claim Satan ic ritual abuse may have an actual history of membership in occult groups does not necessarily mean that occult abuse has led to defensive dissociation; instead it may be that dis- sociation-proneness manifests first and leads to exotic spir- itual beliefs and group memberships (Persinger, 1990; Persinger & Makarec, 1993). Lewis's analysis (1989) depends heavily upon sociological arguments concerning the status and the resultant strate- gies ofwomen and other apparently peripheral members of certain societies- arguments which may not apply in mod- ern western cultures where MPD is believed to be epidemic. However, a femin ist analysis (cited in Ross, 1989) argues that modern western women suffer under oppressive conditions which seem effectively the same as those claimed for Lewis's possession-pronesubculturesofthe Third World. Moreover, it may be that not only current sociological factors but also evolved neurocognitive and behavioral differences between men and women help to explain why women seem over-rep- resented among possession victims, spiritual mediums, and "channders," individuals with somatization disorders, UFO abductees, Satanic ritual abuse claimants, and MPD patients. In any case, the concept ofa spectrum ofmore or less adap- tive, empowering self-victimization syndromes need not be gender-specific; in theory, self-victimization in various forms can be adopted by anyone to whom other roles or behaviors are less attractive, for sociological, psychological, neuro- physiological, and/or circumstantial reasons. These reasons may combine and evolve in an individ- ual case to ensure the periodic or chronic manifestation of self-victimization in one or more forms, perhaps in an oppor- tunistic or even a reflexive and relatively uncontrolled man- ner involving a mixture ofself-victi mization mo tiEs. The high incidence of somatic symptoms reported by MPD patients would conceivably be one example. As another example, Wright (1993) has noted that the principal complainant in the Ingram ritual-abuse case, who fabri cated letters from her allegedly abusive father, also had a history of making unsub- stantiated and vaguely-directed charges of prosaic sexual assault. Keel (1975) has noted more exotic examples includ- ing an alien contactee/abductee who reportedly gave off sulphurous smells (a relatively common feature of demon- ic possession cases [Oesterreich, 1974]), and other con- tactees/abductees who reportedly enjoined Keel to prevent them from contractually assigning !.heir souls to the aliens. The apparent eat's blood ritual hinted at by Annette in her narrative also suggests an intrusion of Satanic/witchcraft themes. DlSSOWTIOX. ,"01. \'II. ~'(I.l. ~l,ll'ch 1994 Lewis (1989) has argued that in some cases of posses- sian, "initiation into the ranks of the chronically possessed is in the nature ofa cure" (p. 61). In other words, the role of victim may represent a substantial and therapeutic ele- vation over other available roles. This might help to explain why MPD is so often complicated by an apparent resistance to therapy by the patient (Ross, 1989; Ganaway, 1989). Lewis also has noted that what he terms "the ranks of the chronically possessed" often amount to possession cults, within which the victim may encounter a range of new and attractive social opportunities which perhaps further reduce the chances of a return to her pre-victim role. Possession cults typically feature a group of chronic possession victims and a shaman, the possessees often competing for the lat- ter's attention (Lewis, personal communication, 1993). The same structure seems to exist for many modern medical con- ditions and traumas, in the form ofvictim "support groups" which are attended by a therapist or therapists. In the alien abduction syndrome, supportgroups typically are dominated by young women and focus upon a therapist who is an older male. In this respect the alien abduction syndrome seems similar to many of the European convent possession epi- demics of the 16th and 17th centuries, where confessors and exorcists played a role similar to that of modern therapists (Ross, 1989), and often seemed, merely through their pres- ence as males, to stimulate competitive self-victimization (typ- icallywith obvious sexual overtones) among possessed nuns. One notable feature ofpossessee competition, incidentally, was the occasional tendency for a possessee to manifest an increasingly large and complex system of demonic posses- sors (Robbins, 1959), in a manner reminiscent of today's expansion of alien abductee narratives to include govern- ment agents and alien-human hybrids. A similar dynamic might explain the proliferation of alters which sometimes occurs in MPD patients, for example as an apparent resis- tance to therapy (Ross, 1989) or following exposure to other MPD patients (Schnabel, 1993). CONCLUSION It is hypothesized that some cases of "UFO abduction," of other dissociation-related syndromes including MPD, of factitious disorders, and of other self-reported illnesses or traumas may be more usefully viewed as self-victimization syndromes. According to this hypothesis, these syndromes may be triggered by various social, psychological, neuro- physiological, and circumstantial factors or stressors which need not always include severe exogenous trauma or abuse. These syndromes maybeenactedunconsciouslyorconsciously, and may involve not only false narratives but also the fabri- cation ofevidence. The dynamics of patient support groups and ofthe patient-therapist relationship mayencourage com- petitive self-victimizationwith increasinglydramatic andbizarre narratives and fabricated evidence. Two or more distinct manifestations of self-victimization may exist in the same individual, and it may be that individuals who present with a recently developed self-victimization syndrome have a his- tory of presenting with other, more established self-victim- ization syndromes. The fact that self-victimization itselfmay be therapeutic for the patient implies that therapy may often be prolonged or interminable. This hypothesis may be incorrect; however, it involves reasonably specific predictions and implications, explains the rapid expansion ofMPDand its variants in recent years, and does not require an etiological divide between these syndromes and their pre-modern and non-western forms. The consequences of failing to recognize such self-vic- timization syndromes where they exist could be significant, since the above hypothesis predicts the elaboration of nar- ratives and fabricated evidence in some cases as a conse- quence ofpatient-patientand patient-therapistrelationships. Aside from the possible psychological harm done to the patient, there may be false narratives and other fabricated evidence directed against other, innocent people. Even in alien abduction claims, where the accused are beyond the reach ofsocial workers or prosecutors, there is now a trend accord- ing to which the scarred or otherwise marked children of alien abductees are presented to abduction researchers as evidence for the reality ofabductions (Mack, 1994; Schnabel, 1994); such practices have obvioussimilarity to Miinchausen's syndrome by proxy (Meadow, 1977), a vicarious self-victim- ization syndrome which is frequently lethal. NOTES 1Another researcher familiar with the Linda case, a prac- ticing psychologist (Donald Johnson, personal communi- cation, 1993), told this author that Linda had turned in an MMPI profile similar to those ofpsychics and MPD patients. 2ParapsychologistWilliam Roll's analysis ofsome "poltergeist" cases as an attention-seeking response to stress (1977; per- sonal communication, 1993) would seem to fit this general picture, too. 3rt may be that not all UFO abductions are psychogenic in the classic sense; some, especially pre-1980 cases, have been reported in association with separately-witnessed outdoor UFO encounters and have been interpreted as the result of seizures or trances induced by exogenous electromagnetic geo-atmospheric phenomena, combined with neurophysi- ological and psychosocialfactors (Persinger, 1989; Devereux, 1989). However, it is noteworthy that such encounters are often followed by reports of more or less chronic encoun- ters which are not necessarily associated with actual exoge- nous phenomena (Keel, 1975; Eliade, 1989), suggesting that a self-victimization - or even, "shamanic"~ reflex may be triggered by an initial crisis of this kind. • -- D15.'OrL\TIO:\. ,"oJ. "U. :\0. I. ~Iar,h 1m 59 REFERENCES Alfrey, E.,Perloff, L.,Asplund, M., Dafoe, D., Grossman, R., Bromberg, J., Holland, T., Naji, A., & Barker, C. (1992). Normocalcemia thir- teen years after successful parathyroid allografting in a recipient of a renal transplant. Surgery, 1] I, 234-236. Amendola, S. (1993). «Linda Cortile:" An interview. MUFON-NYC Newswller, 1(4), 3-8. American Psychiatric Association (1987). Diagnostic and Statistical Manual ojMental Disarders III - Revised. Washington, DC: Author. Asher, R. (1951) Miinchausen's Syndrome. Lancet (10 Feb), 339- 341. Atkinson, R., & Earll ,J. (1974). 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