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"Analysis of Patty Duke and her book, 'Call Me Anna: The Autobiography of Patty Duke' "

By: Patricia D. McClendon, MSSW candidate

Date: April 7, 1994

Note: I sent a copy of this article to Ms. Patty Duke and Ms. Gloria Hockman, co-author of Patty Duke's subsequent book, "A Brilliant Madness: Living with Manic-Depressive Illness" in 1994 through their publisher and I received no replies before I posted this article.

Note 2: This was a class assignment in which I was expected to give a diagnosis.

Note 3: Patty Duke links

INTRODUCTION

Call Me Anna is actress Patty Duke's autobiography in which she reveals her long-kept secret that she has been suffering from manic-depressive illness. I believe that she probably does have classic manic-depressive illness (specifically, bipolar affective disorder, type I) because she claims Lithium has stabilized her mood swings. Yet, I think she probably could be diagnosed as having a concurrent dissociative disorder (specifically, multiple personality disorder) with mixed personality disorders, especially borderline personality disorder. I believe she has plenty of reasons to be dissociative; living in a chaotic home with an alcoholic father and a depressed/suicidal mother; being severely physically and emotionally abused; being emotionally and physically abandoned by her parents; not being allowed to be a child; being striped of her identity; not being allowed to have personal boundaries; being treated as an object; being sexual abused in her mid-teens by an authority figure, and more. She describes many experiences in this book that sound dissociative in nature.

Frank Putnam, M.D., works at the NIMH (National Institute of Mental Health) and is Chief of the Unit on Dissociative Disorders. In an article on the switch process in state- change disorders (i.e., infant state of consciousness, bipolar disorders, multiple personality disorder, panic attacks, "specific" phobic disorders, posttraumatic flashback, and others.) Putnam writes:

...(W)e will define a state-change or switch as the psychobiological events associated with shifts in state consciousness as manifest by changes in state-related variables such as affect, access to memories, sense of self, cognitive and perceptual style, and often reflected in alterations in facial expression, speech, and motor activity, and interpersonal relatedness (Putnam, 1988, p.26).

Putnam et al., 1986, found that mean duration for switching for MPD patients was typically within five minutes. Bipolar patients switch speed ranged from five minutes to several days (from retarded depression to mania), yet the majority of these switches occurred in about an hour. Putnam discusses triggers for switching (cognitive stimuli, olfactory stimuli, drugs and alcohol, pain, fatigue, sleep deprivation, social situations or expectations, and others) and outlines a suggested therapeutic intervention for state-change disorders: medication maybe appropriate to stabilize or modulate their state, chronobiologic manipulations, behavioral desensitization techniques, and psychotherapy (Putnam, 1988, p.24- 32). Putnam writes:

Psychotherapy may help patients stabilize or modulate their state by enabling them to identify state-change triggers (e.g., depressive trains of thoughts, anniversary reactions, etc.) and provide them with alternative outcomes for these triggers. Psychotherapy may also act to disrupt the discreteness of some states, e.g., dissociative states, by bringing emotionally charged state-dependent material into non-dissociative states of consciousness to be worked through and integrated (Putnam, 1988, p.30).

Colin A. Ross, M.D., believes bipolar affective disorder is:

a biological brain illness, that the primary treatment is medical, and that psychosocial intervention are required. This is the majority, mainstream view in contemporary psychiatry. Manic-depressive illness is a disorder of switching. Patients with the disorder switch states in a pathological manner. Their problem is several-fold: They switch into states, switch out of states, and get stuck in states in an abnormal manner.

There is a severe discontinuity of mood, speech, thought, and behavior. What about identity? What about memory?...

I am not suggesting a reclassification of mania or depression as dissociative disorders. They are affective disorders. But the discontinuity of identity across states in MPD might shed light on the switch process in manic-depressive illness...This disorder might have prominent dissociative mechanisms (Ross, 1989, p.173).

Frank Putnam, M.D., in his recent book, he writes:

Although a substantial percentage of MPD patients are diagnosed as having a bipolar disorder, in most cases the superordinate diagnosis is actually MPD...Some cases of MPD with genuine concurrent affective have been reported, however ...Experience with lithium in MPD patients is limited, and the scanty data available suggest that most MPD patients do not respond to lithium...There is some suggestion that lithium may suppress personality switching in a few MPD patients...(Putnam, 1989, p.257).

In an article by Robert D. Miller, M.D., Ph.D., he presents a case of a man who was initially diagnosed as having dysthymic disorder with mixed personality disorder. After a second evaluation, the man was given a tentative diagnosis of bipolar affective disorder, depressed type because the man had mentioned incidents which sounded dissociative in nature. The man described amnesias or "blackout spells" lasting from minutes to days and fugue states (i.e., He would "wake up" and not know where he was or how he got there.). Also, the man would occasionally refer to himself in the third person, "Sam". The man's mood was stabilized with antidepressants and lithium. During hypnotherapy for his most recent and serious amnesia, an alter personality emerged and eventually told the author what had happened during the amnestic period. After extensive evaluation by the author, the man's diagnosis was determined to be both bipolar disorder and multiple personality disorder (MPD) (Miller, 1984, p.236-247).

Multiple personality disorder can be viewed as an attachment disorder according to Peter M. Barach, Ph.D., Barach discusses Bowlby's theory of attachment and the child's normal response to separation (protest, despair, and detachment) (Barach, 1991, p.117-123). Barach writes: "My reading of Bowlby's work is that the detachment he describes is actually a type of dissociation. Although Bowlby uses the term detachment in describing how children respond to abandonment, he is really describing a dissociative process" (Barach, 1991, p.118).

Patty Duke's father was physically detached from her for most of life, while her mother was emotionally (and sometimes physically) detached much of the time due to her severe bouts of depression. Patty found surrogate parents at every opportunity and re- experienced abandonment by them when the show was over.

Is Patty Duke really suffering from bipolar disorder or has the antidepressants and lithium suppressed the switching of her alter personalities? Does she have both? I am expecting another book from her. Here's a glimpse of her history or what she remembers and is willing to tell.

HER STORY

Patty Duke's real name is Anna Marie Duke (born December 14, 1946), but she was called affectionately, Re-Re (a diminutive of Marie) by her father.

Patty's father, John Patrick Duke, was Irish and an alcoholic, and his father was a bartender with a nasty temper. John never got passed the 8th grade in school.

Patty's mother, Frances, was German and had three children; Carol (8 years older than Patty); Raymond (5 years older than Patty) and Anna Marie (or Patty). Frances has less than an 8th grade education and low self-esteem. Frances' mother had eleven children (Frances was the youngest child) and she died when Frances was only six years old.

Most of Patty's pre-teen years were spent in New York City with her family. Patty describes how "it seemed that every holiday...turned into a nightmare for my family...with the melancholy and fire of the Irish" (p.8). There were fights between her parents in which her father was finally kicked out of the house when Patty was about six years old. Her father moved to an apartment and eventually died in a boarding room at age fifty of alcoholism. Patty doesn't remember must of her father because she didn't see much of him after she was six years old. "In my memory he is very dignified...I'm not sure if that image is the man who really existed or just a terrific ideal I've created...What I really remember is so little, just brief flashbacks" (p.10).

Patty's mother, Frances, was violent towards her children, but especially towards Raymond (perhaps as Patty speculates, that it was rage that never got directed towards John, her husband). Carol and Raymond had terrible fights because Carol was put into the mother role and Raymond resisted taking orders from her. "I don't ever remember my sister as being young, being a kid. She was always the responsible one" (p.16). As for Patty, she writes, "Though I got threatened more than I got hit, my mother was very, very physical. The steam would build up in her, she'd go completely out of control, and all of a sudden we'd get a whack, a real unpremeditated backhand whack" (p.9).

Patty's mother had severe bouts of depression and was first hospitalized when Patty was five or six years old. She was later hospitalized two more times and finally diagnosed as having manic-depressive illness. As a young child, Patty says, "I was desperately attached to my mother. If she was around, my hand was always in her hand. It wasn't always the nicest hand-holding...but my hand was there, even when she did some things that were very hard for me to forgive" (p.15). She describes how she tried to help her mother, who would be "staring at the walls in utter misery" due to her depression (p.90).

Patty describes her early relationship with her mother when she was a teenager:

I was scared of my mother. She was very unpredictable emotionally, one step away from suicide most of the time, so I never knew what was going to happen. She might turn into an iceberg, with a really mean expression on her face and a rigid body, and withhold any and all affection. At other times everything would be fine and then all of a sudden she'd be screaming and yelling (p.41).

The diagnosis of manic-depressive illness, in 1982, was a relief to Patty and made events in her life seem more understandable. Patty's relationship with her mother is now much better since both Patty and her mother are more stable because they are both taking Lithium for their manic-depressive illness. In fact, her mother lives in an apartment near her and they spend time together on a regular basis. This reconciliation was possible due to the passage of time, psychotherapy, and medication.

As bad as things were at home, things only got worse for Patty when she became a child actress at age eight. Her managers, John and Ethel Ross, wanted to turn her into another Grace Kelly. "Okay, we've finally decided, we're gonna change your name. Anna Marie is dead. You're Patty now" (p.23). That was "the beginning of the little by little murder of Annie Marie Duke and the rebuilding of the Frankenstein's monster that became Patty Duke" (p.24). This "killing" of Anna Marie caused her to have an obsession about her own death. They also decided to say that she was six years old instead of eight. Almost everything about her was not good enough and had to be changed. Patty compares the "programming" that the Rosses put her through to what a new recruit experiences in basic training. "The idea was the same - taking away individuality, breaking the will in order to control it, erasing the slate so it could be filled in by the authorities" (p.30).

John Ross was a public relations man who was dominated by his wife. John was a surrogate father to Patty and at one point, John had made a serious suicide attempt and was hospitalized for six weeks. John was a perfectionist when it came to her performances. Patty called him Mr. Ross or Uncle John. When he drank, however, "he would get increasing sexual with (her)" (p.102). Patty blocked these "incestuous" attempts from her consciousness and "...spent years in therapy without remembering them - I had totally blocked them out" (p.102). The memories of being fondled by Mr. Ross and Mrs. Ross came back to her when she was in her mid-twenties, while watching television with John Astin, who eventually became her third husband.

Ethel Ross, John's wife, was an ex-dancer with street smarts and really got things moving. Ethel treated Patty as an object, rather than as a person. Ethel would become violent when she drank liquor and/or took prescription pills.

Although they managed other child stars, eventually Patty Duke became their sole "meal ticket". They spent most of the money that Patty had made over the years, while placating her mother and father with small amounts of money. Frances, Patty's mother, was treated as "hired help": She did their laundry and babysat her daughter when the Rosses told her to. This was hard on the mother-daughter relationship. They employed every trick in the book to control Patty and her parents, including providing Patty with alcohol and prescription drugs (i.e., Thorazine, Stelazine, phenobarbital, and Percodan), not allowing her to have friends, or any privacy of any sort.

Patty started using alcohol when she was thirteen or fourteen and went through periods of heavy drinking as she got older. She has some denial about her alcoholism:

Yet the fact that I come from a very long line of alcoholics means that I have had some problems with liquor. I have gone through periods of drinking very heavily, never while I'm working, but either in the privacy of my own home or at parties...When I finally recognized the effect drinking has on me, which was more than a dozen years ago now, I just stopped cold. Never missed it. Though I now seem able to have a glass of wine, if I never have another drink, I won't even notice (p.12).

Patty's describes what effect drinking had on her personality: "And when I drink, my personality is sometimes altered to such an extent as to be destructive or disruptive. I could be funny, witty, the belle of the ball, but then, the minute I'd get in the car to go home, I'd become venomous...I was Dr. Jekyll turning into Mr.Hyde" (p.12).

Patty's recalls that as a child, she was "very good at those little pretend games. I really felt like a nun when we were playing nun. I had a good imagination...That's what John Ross was able to bring out, the confidence to let my imagination run free" (p.22). In fact, as a child she wanted to be a nun because she never saw them drink or scream.

Due to being emotionally and physically abandoned by her parents, Patty had fears of abandonment that affected her for the rest of her life. Due to the Rosses' messages of don't be yourself, Patty is still confused about her identity. Patty's identity was filled by the roles she played and the cast became her surrogate family. At the end of each show, she would lose her sense of belonging, her identity, and would feel abandoned. Patty finally got away from the Rosses when she was eighteen, but due to being constantly monitored, she has trouble being alone as an adult.

The preparation for and making of The Miracle Worker had a profound affect on Patty. That is when she first became conscious of her weight, began drinking/drugging with the Rosses, slept a lot due to depression. The preparation for the role of Helen Keller, in which she was to be deaf and blind, helped to develop her "ability to concentrate. I was eventually able...to put myself in another place mentally..." (p.59). Playing Helen Keller with her eyes opened and a fixed stare was accomplished by Patty "practicing staring at something for a long time, until (her) consciousness went elsewhere" (p.66).

In 1965, she was married for the first time when she was almost nineteen to Harry Falk, who was about thirty-two. During that marriage, she used alcohol and drugs excessively, slept excessively, experienced severe bouts of mania and depression, made numerous half-hearted suicide attempts, and became anorexic (she went from 105 lbs. to 76 lbs.). She says, "I know now that one of the explanations for anorexia is the refusal to grow up: you starve yourself to get smaller, you attempt to physically match how small you feel mentally, and I think that's what I was doing" (p.163).

One time during this marriage, she was hospitalized for her manic-depressive illness. There was the typical "flight to health" and normal functioning for a few days after getting out of the hospital, then she says, "I'd find myself in the middle of Wilshire Boulevard, for instance, trying to drive home and not knowing where I was, just sitting in the car with everyone honking at me" (p.166).

This roller-coaster behavior caused problems between her and her husband, Harry. Harry ended up having an affair and eventually the marriage ended. Patty was obsessed at first in attempting reconciliation with him, but finally gave up.

Patty had an affair with John Astin, who was still married to his wife at the time. She became pregnant with John's son, but didn't tell him until months later.

During one of her manic episodes in June, 1970, Patty married Michael Tell, a man she barely knew. The marriage lasted only thirteen days. She thought maybe she should be married because she was pregnant, but her reasoning for the marriage is still somewhat a mystery to her.

John Astin eventually left his wife to marry Patty. Their son Sean was eighteen months old at the time. His three sons by his previous marriage moved in with them. Patty was not emotionally prepared to raise children who were 12, 11, and 8 years old when she was only 24 years old. They had another son, Mackenzie, before they were divorced. Patty says, "...I came to believe that there was indeed a strong father-daughter link between us...(it) eventually turned out to be abhorrent to me when I was old enough to want to be an equal partner. As long as I was dependent and subservient and John was the caretaker, everything was fine...The false dependency...we bled each other" (p.289).

In 1986, Patty married Michael Pearce, her fourth husband, after knowing him six months. She met him when she was preparing for a role as a woman who joins the army. He was the drill sergeant selected to put her through a brief basic training. Michael was married but estranged from his wife at the time. After his divorce from his wife, he married Patty. Soon after, he left the army.

Despite her illness and her lack of a formal college education, Patty Duke has accomplished a great deal. She is the youngest person to win an Oscar (for her portrayal of Helen Keller in The Miracle Worker) and also, has won three Emmy's for her television performances. She was the President of the Screen Actors Guild, the fifth largest labor union in the United States. She is also a political activist for issues such as the ERA (Equal Rights Amendment), AIDS, and nuclear disarmament.

Patty says, "I don't mind being thought of as someone who was crazy, because I had no control over that situation. What I don't like is for people to think that I chose to do destructive things. I was someone who didn't have a choice about my actions..." (p.4). In retrospect, Patty says,

"...it exhausts me in precisely the way you get tired when you hear someone else talk about a particularly daunting trip they took. Because so much of it now seems to have happened to someone else...And there's another part of me, that's really tickled by the whole thing, that can say, `yup, wasn't that funny?'...I'm still my own harshest critic and most demanding taskmaster, but I have moved into a time much more accepting of whoever it is I am" (p.298).

REFERENCES

Barach, P.M. (1991). "Multiple Personality Disorder As An Attachment Disorder". DISSOCIATION, IV(3), 117-123.

Duke, P. and Turan, K. (1987). Call Me Anna: The Autobiography of Patty Duke. New York, NY: Bantam Books.

Miller, R.D. (1984). "The Possible Use Of Auto-Hypnosis As A Resistance During Hypnotherapy". The International Journal of Clinical and Experimental Hypnosis, XXII(2), 236-247.

Putnam, F.W. (1988). "The Switch Process in Multiple Personality Disorder and Other State-Change Disorders". DISSOCIATION, I(1), 24-32.

Putnam, F.W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York, NY: The Guilford Press.

Ross, C.A. (1989). Multiple Personality Disorder: Diagnosis, Clinical Features and Treatment. New York, NY: John Wiley & Sons.

BIBLIOGRAPHY

Barach, P.M. (1991). "Multiple Personality Disorder As An Attachment Disorder". DISSOCIATION, IV(3), 117-123.

Beahrs, J.O. (1982). Unity and Multiplicity: Multilevel Consciousness of Self in Hypnosis, Psychiatric Disorder and Mental Health. New York, NY: Brunner/Mazel.

Bliss, E.L. (1986). Multiple Personality, Allied Disorders and Hypnosis. New York, NY: Oxford University Press.

Bloch, J.P. (1991). Assessment And Treatment of Multiple Personality And Dissociative Disorders. Sarasota, FL: Professional Resource Press.

Braun, B.G. (Ed.). (1986). Treatment of Multiple Personality Disorder. Washington, DC: American Psychiatric Press.

Casey, J.F., & Wilson, L. (1991). The Flock. New York, NY: Alfred A. Knopf.

Castle, K. & Bechtel, S. (1989). Katherine, It's Time: An incredible journey into the world of a multiple personality. New York, NY: Harper & Row.

Chase, Truddi (1987). When Rabbit Howls. New York, NY: Dutton.

Cohen, B.M., Giller, E., & W., L. (1991). Multiple Personality Disorder from the Inside Out. Baltimore, MD: The Sidran Press.

Duke, P. and Turan, K. (1987). Call Me Anna: The Autobiography of Patty Duke. New York, NY: Bantam Books.

Duke, P. and Hochman, G. (1992). A Brilliant Madness: Living With Manic-Depressive Illness. New York, NY: Bantam Books.

Freeman, L. (1987). Nightmare. New York, NY: Richardson & Steirman, Inc.

Keyes, D. (1981). The Minds of Billy Milligan. New York, NY: Random House.

Kitt, E. (1989). Confessions of a Sex Kitten. U.S.: Barricade Books, Inc.

Kluft, R.P. (Ed.). (1985). Childhood Antecedents of Multiple Personality. Washington, DC: American Psychiatric Press.

LaCalle, T.M. (1988). Voices. New York, NY: Dodd, Mead, & Co.

Loewenstein, R.J. (Ed.). (1991). Psychiatric Clinics of North America: Multiple Personality Disorder, 14:3, 489-791.

Mayer, R. (1988). Through Divided Minds. New York, NY: Doubleday.

Miller, R.D. (1984). "The Possible Use Of Auto-Hypnosis As A Resistance During Hypnotherapy". The International Journal of Clinical and Experimental Hypnosis, XXXII(2), 236-247.

Putnam, F.W. (1988). "The Switch Process in Multiple Personality Disorder and Other State-Change Disorders". DISSOCIATION, I(1), 24-32.

Putnam, F.W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York, NY: Guilford.

Ross, C.A. (1989). Multiple Personality Disorder: Diagnosis, Clinical Features and Treatment. New York, NY: Wiley.

Schreiber, F.R. (1973). Sybil. New York, NY: Warner Books, Inc.

Sizemore, C.C. (1989). A Mind Of My Own. New York, NY: Morrow.

Thigpen, C.H. & Cleckley, H. (1957). The Three Faces of Eve. New York, NY: McGraw-Hill.

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