"It's 2 a.m. and I don't know where I am or how I got here ….
"Should I … just keep driving until something seems familiar? I am alone and scared."
Karen Overhill found a knife under her pillow one night, with no memory of how it got there.
On a trip to a Las Vegas casino, she started the evening with $25. Her mind "went somewhere else," she would say later, and she came to with $2,500 in her purse.
The worst memory loss occurred after she gave birth by Caesarian section. She woke from anesthesia not knowing who she was, and not recognizing her husband and family members who came to see her.
Fearing that she was going crazy, Karen sought out psychiatrist Dr. Richard Baer in 1989. Together, they started an 18-year journey of therapy.
Karen (a pseudonym) revealed, painfully and in small doses, that she had suffered severe, long-term abuse and torture as a child.
And Baer discovered that she had developed 17 personalities as a coping mechanism.
With the permission of Karen, who has declined to do press interviews, Baer wrote "Switching Time: A Doctor's Harrowing Story of Treating a Woman With 17 Personalities" (Crown Publishing, $24.95). It arrived in bookstores last week.
"Dissociating (separating from one's reality in the present) is a defense mechanism," says Baer, who grew up in Addison and attended Addison Trail High School.
"It's one of many we have psychologically to cope with stress. It's an extreme method.
"When you have the kind of abuse Karen suffered, you call on whatever coping mechanism you can," he says in a measured tone, sitting in the living room of his Chicago townhouse.
The 'alters' appear
Experts say Dissociative Identity Disorder, once called multiple personality disorder, is rare -- hardly the first thing a doctor would suspect, even with a seriously troubled patient.
A suicidal Karen first walked into Baer's South suburban office in 1989, seeking help from depression. She was 29 years old, married to an abusive man and the mother of two children. She was having constant crises, and her bouts of missing time weren't helping.
After she was in therapy a while, Baer, past president of the Illinois Psychiatric Society, began to suspect multiple personalities. But it took three years of weekly sessions before he had proof.
Then, Baer says, he received a letter from an alternate personality called Claire, a sweet 7-year-old girl, asking for help.
Karen claimed she hadn't known about the "alters," but she occasionally heard their voices.
She frequently complained of "losing time," which is what happened when the alters took over.
Baer's book describes the bizarre events of Karen's wedding day. Alters kept "switching time," coming out one by one. Baer relates the story of how she fainted three times during the ceremony because, some of the personalities later told him, they didn't want her to marry.
During therapy, Baer put Karen under hypnosis, and he says the alters spilled out, one by one, to talk to him.
He learned that some were male, some were female. All were different ages.
Each time he put Karen under, she would transition from her own passive personality into one of the other personalities. Each one had his or her own posture, mannerisms and penmanship.
When a personality was done speaking, Karen's face would go blank until another emerged, Baer says. He could often tell who it was by the body language.
For example, Katherine, the mother figure, sat up primly and used phrases like "quite frankly." Miles and Sidney were fidgety, as little boys would be. And Sandy, a young woman whose role, according to Baer, was to placate the abusers, was fat and slouched.
Oddly, the personalities had different health conditions. Some suffered from bronchitis or diabetes; some needed glasses or were left-handed. At one point, several had a cold, while others felt fine.
Baer originally thought Karen had a core personality -- the part of her who came to his office -- but some of the alters told him she didn't.
"A lot of the writings on multiple personality disorder say that there's generally a core personality, but Karen's parts denied this," Baer says.
Under hypnosis, one personality told him that Karen's father abused her from birth on, and that when she was a toddler, her personality split into three: Katherine, a kind surrogate mother; Holdon, a loving father figure; and Karen Boo, who always stayed a baby.
The other personalities were born at stressful times in Karen's life. For example, Karen was terrorized at age 11 when her father sold her body to other men. The personality of Julie developed to take the abuse, Baer says.
"She would create an alternate personality when she experienced some episode of trauma where some other part was unable to manage," Baer explains.
"Holdon said there had to be a need -- a traumatic event -- and a wish to escape it."
Surviving the terror
For a mind to start splitting off into other personalities, life has to be horrific.
"One episode of abuse, or three, or five, doesn't do it," Baer says. "Only with repetitive abuse do alternate personalities form."
Over the years, Karen and her personalities revealed to Baer the extent of what her father, grandfather and others had done to her.
While it's impossible to corroborate Karen's account, Baer says her father was eventually arrested for sexually abusing his granddaughter, Karen's niece.
And Baer says the disgust and reluctance with which she talked about these things over the years convinced him the abuse was real.
The alters told Baer that when Karen was a baby her father choked her, threw her against the wall and bound her mouth, arms and legs with duct tape.
Sometimes, her grandfather would say it was God's will that Karen be punished -- and then proceed to torture and sexually abuse her in horrific ways, Baer says.
The abuse went on for years. Her mother, who was also victimized, was in deep denial and never protected Karen, Baer disclosed in the book.
"The pathology of these two men is stunning to most people," Baer says.
As for why these men would act this way, Baer speculates that they were very immature and aggressive, and so was their sexuality. They wanted to feel powerful, but in the real world, they weren't. Dominating children gave them the feelings of power they craved, Baer says.
Because the father and grandfather threatened to kill Karen if she told anyone, she became invested in covering up the abuse.
One personality, Elise, was born simply to transition Karen from the middle-of-the-night abuse to being a normal-seeming girl when school started each morning.
Both Karen's father and grandfather died while she was in therapy. They never admitted they did anything wrong, nor did they express remorse.
"I don't think the father and grandfather were capable of feeling guilty," Baer says.
From 17 into one
Baer and Karen agreed to heal her disorder by integrating the personalities.
Baer put Karen into hypnosis and had her visualize herself in a safe room in her mental house, where the personalities all lived. Then, the personality to be integrated would enter, and Baer would introduce him or her to Karen. Karen would describe the alter's appearance and then the personality would hug her and they would merge, Baer says.
After each integration, Karen would need time to absorb that personality's thoughts, memories and even their physical traits.
"All the personalities had, for example, their own way of walking, and I'd see her walking awkwardly at first as she absorbed that personality's gait," Baer says.
She would absorb each personality's traumatic memories, but also its strengths.
For example, when Miles, a spunky 8-year-old boy, integrated, he gave Karen his memories of abuse. But Baer says Miles also gave her his strength, and his "don't mess with me" attitude -- a quality Karen needed since she had trouble standing up for herself.
Because integrating each personality was physically and mentally exhausting, it took years to merge all 17. When all were finally integrated, Baer writes, Karen had more emotion and energy.
"But she was still fragile and married to an abusive husband," Baer recalls. "So we worked on getting her divorced, and also getting her employed. That took a lot of strength building."
The two formally ended therapy after 18 years, but Baer still keeps in touch with Karen in what he describes as a warm and respectful friendship.
"Karen is employed full time, living independently, and her children are doing well," he reports. "All she needs to do is not get in her own way.
"Her life can only get better. She's been on a long path of healing."
Each of Karen's personalities had distinct traits and experiences, according to psychiatrist Richard Baer in his book, "Switching Time."
• Karen Boo, the abused baby
• Karen 1, a shy 10-year-old who emerged when Karen was raped
• Karen 2, a fun-loving 21-year-old who dated boys when Karen was in high school and felt no pain
• Karen 3, 30, who took the abusers' insults and was depressed and suicidal
• Juliann, a disorganized teen who spent years writing down episodes of abuse
• Sandy, a suicidal 18-year-old who ate junk food for comfort
• Julie, 13, who couldn't walk as a result of the abuse
• Katherine, 34, a mother figure who cooked, cleaned and took care of Karen's children
• Ann, an empathetic teen who went to Catholic school and taught Karen's children about religion
• Elise, 8, who transitioned Karen from episodes of abuse to life at school
• Karl, an angry 10-year-old boy who endured the worst abuse
• Miles, an angry 8-year-old boy who took a lot of the sexual and physical abuse
• Thea, 6, who absorbed the pain from Karen's two childhood surgeries
• Claire, a charming girl who emerged after Karen was sexually abused on her Communion Day
• Sidney, a mischievous 5-year-old boy who stole because Karen's father forced him to
• Jensen, an 11-year-old black boy who drew pictures to express Karen's experiences and emotions
• Holdon, the 34-year-old surrogate father who looked after the others and did the driving
Not all therapists agree on disorder
While most people know about multiple personality disorder from movies like "Sybil" or "The Three Faces of Eve," and some therapists have written about it, others have doubts over whether the disorder even exists.
Daniel Anzia, M.D., chairman of the Department of Psychiatry at Lutheran General Hospital in Park Ridge, says most psychiatrists believe this illness -- technically called Dissociative Identity Disorder -- does exist, but occurs very infrequently.
"It is a recognized diagnosis," he says. "It does occur, especially when people have had serious and significant trauma, especially in early life."
Both Anzia and psychiatrist and author Richard Baer emphasized that it has to be diagnosed carefully, since people who are suggestible can see movies like "Sybil" and think they have it.
Some psychiatrists believe people who claim to have multiple personality disorder are simply acting out, experiencing hysteria or going through a temporary state, Baer says. Baer, however, remains convinced that one of his patients, and the subject of his book, had the disorder.
-- Pam DeFiglio