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VOLUME 2, ISSUE 2   THE INTERPSYCH NEWSLETTER          NOV, 1994
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                       SECTION A: NEWS

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                          * INDEX *
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          1.   SUICIDE COUNSELING BY E-MAIL
          2.   MULTIPLE PERSONALITY DISORDER ELECTRONIC
               CONFERENCE REPORT

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1.   SUICIDE COUNSELING BY E-MAIL
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When the power and reach of the Internet joins with the caring
and compassion of a friend, a new and valuable asset is
created.Suicide Counseling by E-mail was launched on July 14,
1994 and proved so successful that an Internet domain was
opened.  The Samaritans, a non-religious charity in
Cheltenham, England, now offers emotional support to the
suicidal and despairing via the Internet.  At the launch of
their new Internet domain, Mike Haines, Director of the
Samaritans, said: "During the test month we received over 200
messages. Many were from well- wishers,journalists and
academics but there were around 15 very desperate people as
well.  The need for a full launch of our service with an
easier address was amply demonstrated."  In the first 2 months
of operation, 48 people in at least 4 countries have contacted
the Samaritans, demonstrating the need for the service. Since
then,  the number of E-mail users has increased to 3 per day
and the numbers continue increasing as the resource becomes
better known.

E-mail's anonymity has helped in the success of  the pilot
project. Statistically, the suicide rate among males is four
times that of females but females are more likely to contact a
Suicide Counseling group for help.  E-mail has changed the
contact statistics and it appears that equal numbers of men
and women are contacting the Samaritans. The Samaritans have
offered support to the suicidal and despairing  for over 40
years by phone, visit and letter and E-mail expands their
services to a wider area. Callers are guaranteed
confidentiality and retain the right to make their own
decisions including the decision to end their life.
Samaritans are unpaid Volunteers who are carefully selected
and trained for this work.  Those working with E-mail have
additional training and volunteers read and reply to mail
every day of the year. A nominal end date of December 31, 1994
had been set for the E-mail service but initial results have
been so encouraging that it is likely to run indefinitely.

The  idea for  an Internet service was born when  a volunteer
was exploring the UK - based Compulink Information  Exchange
(CIX)conferencing service. Here, he discovered the "suicide
help" self-help group and Newsnet groups such as
"alt.support.depression".After discussions with The Samaritans
General Office, it was decided to try the E-Mail service from
Cheltenham. US Robotics assisted the project by donation of a
modem and the staff at CIX assisted in the creation of the
Internet domain.

Is working over the Net good "treatment"? Steve 305 at the
Samaritans' help-line says: "What we see is raw emotion and
openness from our callers. Some of them would be unable to
express their feelings in any other way. It also provides
access and privacy for the disabled and geographically
isolated. Our confidentiality rules prevent me from quoting
what callers have written to us but it would be very familiar
to people in the Usenet groups alt.suicide.holiday,
alt.sexual.abuse.recovery,etc."

The Samaritans can be reached at:
     The Samaritans of Cheltenham and District
     3 Clarence Road
     CHELTENHA, Glos, United Kingdom
     Emergency phone: +44 242 515777
     Press enquiries: +44 452 854017
     E-mail: jo@samaritans.org
     Anonymous E-mail: samaritans@anon.penet.fi

(SK)

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2.   MULTIPLE PERSONALITY DISORDER ELECTRONIC CONFERENCE REPORT
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On Sunday, October 30, 1994 at 12 PM EST, a conference on
Multiple Personality Disorder (MPD), organized by Dr. Ivan
Goldberg (psydoc@netcom.com) was held.  During the
approximately two hours the conference lasted,  17
participants enjoyed a lively discourse in an informal
atmosphere that elucidated some of major concerns around the
diagnosis of MPD. This issue is currently  hot  as news media
and professionals are identifying and publicizing it more. It
is surrounded by controversy both in the courts and in
clinical circles.  Is it  a true diagnostic category?  Is
there a successful treatment  intervention?  These were some
of the questions participants were interested in answering. A
brief summary follows:

Dr. Goldberg provoked a substantive exchange of ideas by
sending his own paper on the subject, and a recommendation of
readings prior to the conference (Multiple Personality
Disorder, Paul R. McHugh, unpublished paper) and  (August,
Piper, Jr.  Multiple Personality Disorder. British Journal of
Psychiatry. 1994, 164, 600-612.)  Both of these papers can be
obtained through Dr. Goldberg.

It was apparent, that the main issue to be addressed was the
viability of the diagnosis MPD.  The issue of its  ubiquitous
symptom picture, its sensitivity to iatrogenic influence, and
its relationship to other syndromes and diagnostic entities
were debated.  Iatrogenic is defined as, Induced
unintentionally by a physician through his diagnosis,
manner, or treatment; of or pertaining to the induction of
(mental or bodily) disorders, symptoms, etc., in this way.
(OED).  Several cases were presented by conferees currently
working with MPD patients or with some prior experience with
them.

One of the first lines of discussion dealt with current DSM
III-R and DSM IV terminology,  particularly the inclusion of
an amnesia  criterion.  The DSM IV categorizes MPD under
Dissociative Identity Disorder. This quickly led to an
exploration of the use of "dissociative units" in some
hospitals, and the possible influence of MPD patients   on
each other in their experience and reporting of symptoms. An
interesting discussion of the "alt.support.dissociative"
newsgroup ensued.  The potential for self-reinforcement of
multiple personalities  as well as the benefits of "support"
was pointed out.  It was suggested that the "simulations" and
"histrionic" expressions of MPD might prove to be helpful in
determining that MPD is a unique disorder. The point was made
that the public (and some clinicians) often does not
discriminate between people who falsely believe they have
multiple personalities and people who "actually (have) a
multitude of personalities that do exist within them."
Moreover, there is an inherent difficulty in empirically
demonstrating such a difference.  Patients who are diagnosed
as such may be merely displaying a unique facility for
partitioning experience, a kind of self-hypnosis.

The discussion quickly moved to clinical interventions and
strategies with everyone agreeing that respect for the
experience of the patient while at the same time focusing on
the "whole" of unified personality was the preferred overall
treatment approach.  However, specific treatment modalities
were not discussed.

Dr. Goldberg, cogently summarized by asking,  "Am I correct
in thinking that we all agree that DID/MPD is a dissociative
disorder that may arise without iatrogenesis but that
iatrogenesis is relatively common too?*  This received
unanimous endorsement. The success of these conferences
clearly depends on participants being able to voice questions
and comments without  stepping  on one another while at the
same time focusing on one issue at a time. Dr. Goldberg, a
veteran "e-conferencer",  facilitated such an exchange of
thoughts and ideas.  (JL)