A multiple identity crisis

TVScope: Being Pamela, Channel 4, Wednesday, June 8th

TVScope: Being Pamela, Channel 4, Wednesday, June 8th

Andrew, Margaret, Susan and Sandra. These are the four people who have developed in the mind of Pamela Edwards, a young woman aged 31, who suffers from dissociative identity disorder (Did), more commonly known as multiple personality disorder.

This is a horrendous story. The TV producers spent two years filming Pamela's world where reality can easily become blurred. Pamela was not born this way, the experts think, but developed the disorder because of gross emotional, sexual and physical abuse in childhood.

When Pamela was finally "rescued" by social services, she was four years old and the damage had already been done. At five, she was still not toilet trained and had severe urine burns up to her armpits.

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Valerie, the therapist and expert in Did, explained how many normal people dissociate themselves from the world from time to time. For example, the autopilot we switch into when driving a car on a route we know well. However, the degree of dissociation exhibited by Pamela results from early childhood experiences and is a "running away of the mind" to try to create a safe place.

Andrew is described as a shy anxious boy in need of love and attention, whereas Sandra is dominant and very aggressive. Margaret is violent and dangerous, whereas Susan is relatively okay (if that isn't a contradiction) and doesn't appear that often.

These four characters are Pamela's internal family who interact with each other like real people. It was strange to watch as the voices and body language changed with each character and it was possible to see that they were very different. All hell can break loose with all characters giving out and arguing with each other.

Pamela can be very violent and needs a team of 20 carers round the clock to take care of her in her own home in a special care project, which began in 2000 and costs the health service £500,000 a year, which is about twice the price of institutional care.

Born in 1972, in Merseyside, Pamela is one of five girls and two boys. She was taken into care at five and at that time was a small, pretty girl, preoccupied with food and drink.

This is not surprising as the whole family were starved almost to death and had to resort to extreme measures to survive. One of these measures was drinking their own urine.

The children were beaten and sexually abused.

One of Pamela's sisters, Kiera (33), was also interviewed. Although she was not as badly damaged as Pamela, she was obviously traumatised and her face was dead and plastic looking. She courageously asked to see her files to try to understand her life and move on. Kiera went into care at the same time as Pamela but was sent back one and half years later when the sexual abuse started and she was repeatedly raped by her father.

Pamela was fostered by Judy at 14 and then sent to a residential home at 17 when Judy couldn't cope, which is not surprising. The care project started because Judy didn't want to leave Pamela in a residential unit.

The Did was not diagnosed properly until 1999, when Pamela was 25, and she is now getting expert help for the condition. She is slowly making progress.

However, it is unclear what the ultimate outcome will be. To me, she looked the same as before like someone who had had plastic surgery and had a whole lot of dead faces vying with each other for dominance.

No legal action was ever taken against the parents.

Jacky Jones is regional health promotion manager, HSE Western Area and a member of the National Obesity Task Force.

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