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Billy Milligan Case Study: Psychology,
Crime, and the Split Mind
⚠️ Content Advisory. This article explores sensitive psychological themes, including childhood trauma, sexual assault, dissociative identity disorder (DID), and institutional care. It includes descriptions of real-life events that some readers may find emotionally distressing. Reader discretion is advised.
(Huge thanks to Sue Mainwaring for introducing me to the Billy Milligan case).
Introduction
In 1977, 22-year-old William Stanley “Billy” Milligan was arrested in Ohio and charged with kidnapping, armed robbery, and the rape of three women near the Ohio State University campus. The case took a startling turn when Milligan’s defense team claimed he was not consciously responsible for these crimes – instead, several alternate personalities or “alters” residing in his mind had committed them without his knowledge. In December 1978, a judge found Milligan not guilty by reason of insanity (NGRI) on the basis of what was then called multiple personality disorder (now known as dissociative identity disorder, DID). Milligan became the first person in U.S. history to be acquitted of major violent crimes by invoking multiple personalities as an insanity defense.
This landmark ruling made the “Campus Rapist” case infamous and set a precedent at the intersection of law and psychology. It underscored profound questions in forensic psychology: How should the legal system handle a defendant with fragmented identities? Is a person with DID culpable for crimes one alter commits? The Milligan case also brought unprecedented public attention to DID, a rare and controversial disorder. His trial and treatment in the late 1970s catalyzed debates about the legitimacy of DID and its origins – whether it is a genuine response to childhood trauma or a phenomenon shaped by psychological suggestion and manipulation. As such, Billy Milligan’s story has become a touchstone in both the study of dissociative disorders and the jurisprudence of the insanity defense.
This article provides an in-depth exploration of the Milligan case. We begin with an overview of the trial, Milligan’s diagnosis of DID, and the public’s response. We then delve into The Minds of Billy Milligan, both the plurality of personalities documented in Milligan and the popular Daniel Keyes book about his case. Next, we examine neuropsychological and clinical perspectives on DID – discussing diagnostic criteria, theoretical models, and ongoing debates in the field. We also consider media representations of Milligan’s story (from a Netflix docuseries to fictionalized dramas) and how they have influenced public perception of DID. Finally, we reflect on Milligan’s legacy and the legal and ethical implications of his case, including questions of responsibility, trauma, and justice that remain salient today.
Trial, Diagnosis, and Public Response
Billy Milligan’s trial in 1978 was nothing short of extraordinary. After his arrest, police and examiners quickly noticed odd inconsistencies in his behavior. An Ohio State University investigator remarked that talking to Milligan felt like “talking to different people at different times”. One victim described her assailant as having a German accent, even though Milligan was an American with no such background. These peculiar observations foreshadowed the defense’s claim: Milligan was suffering from multiple personality disorder.
During psychiatric evaluations in custody, Milligan would speak in different voices and even referred to himself in the third person. In one early interview, a psychiatrist addressed him as “Billy,” and Milligan responded flatly, “Billy’s asleep. I’m David”. This was a startling indication that distinct identities might be occupying his consciousness. Milligan’s public defenders, Judy Stevenson and Gary Schweickart, informed prosecutors that they intended to argue an insanity defense on the grounds that multiple personas within Milligan had committed the crimes.
A team of expert witnesses was brought in to examine Milligan. Among them was Dr. Cornelia B. Wilbur, the psychoanalyst famous for treating “Sybil” – a prior patient with alleged multiple personalities whose case became a bestselling book and TV movie.
Along with Dr. George Harding (medical director of Harding Hospital), Dr. Wilbur spent months evaluating Milligan. In sessions, they observed Milligan cycling between various identities: Wilbur reported seeing at least four alters emerge in a single two-hour examination, each with unique demeanor and worries. In one session, she had to persuade several personalities to “let Billy wake up,” after which the core Billy personality “scuttled across the room” in terror, saying “Every time I come to, I’m in trouble”. Such episodes convinced the experts that Milligan’s psyche had indeed fragmented into multiple selves.
Ultimately, Dr. Harding and Dr. Wilbur concluded that Milligan hosted ten distinct personalities (eight male and two female), ranging from a toddler to adults in their twenties. They believed this extreme dissociation was rooted in Milligan’s childhood abuse (discussed later). Crucially, Harding and Wilbur identified two alters as responsible for the campus crimes: Ragen Vadascovinich, a 23-year-old Slavic male personality described as aggressive and lacking empathy, and Adalana, a 19-year-old female personality who was lonely and “curious” about sex. According to the psychiatric report, it was Ragen who robbed the victims (even framing his theft as a misguided “Robin Hood” act) and Adalana who physically committed the rapes – all while the core Billy and the other alters remained unaware of these actions. The core Billy personality was described as deeply depressed and suicidal, having “been asleep” or suppressed for years leading up to these events.
The defense presented this multiple-personality insanity defense in court, a groundbreaking strategy at the time. Dr. Wilbur and a total of nine psychiatrists testified that Milligan suffered from dissociative identity disorder and was not consciously in control during the assaults. The prosecutors – initially skeptical and calling the story “ludicrous” – witnessed Milligan switch personas in real time and began to acknowledge the phenomenon. In a highly unusual move, the prosecution ultimately did not contest the insanity plea. The trial was decided by a judge (after Milligan waived a jury) and resulted in a verdict of not guilty by reason of insanity, with Milligan remanded to a state mental hospital rather than prison.
The public reaction to the Milligan verdict was intense and polarized. Many had never heard of “multiple personalities” outside of novels or movies, and some observers struggled to accept it as a legitimate mental illness. The case’s sensational nature – a rapist claiming “it wasn’t me, it was my other personalities” – led to heated debate in the media about whether Milligan was genuinely ill or perpetrating an elaborate hoax. One outraged relative of a victim lamented that the media was “making a folk hero of this guy” and turning attention away from the victims. Prominent psychiatrists also voiced concern about the precedent. Dr. Hervey Cleckley (co-author of The Three Faces of Eve) warned that accepting a multiple-personality defense could be “a very dangerous precedent”, noting that these personalities are “fragments” of one person and that a criminal alter still reflects a part of the individual’s psyche. Other experts drew analogies to intoxication, arguing it should be no different than holding someone accountable for actions in a drunken dissociative state.
Some mental health professionals flat-out rejected the diagnosis. The noted psychiatry critic Dr. Thomas Szasz declared, “Multiple personality is just a figure of speech. It’s nothing but a hoax”, likening alter behaviors to actors playing roles. Szasz and others in the skeptic camp suggested that suggestible individuals could fake or unconsciously produce multiple personalities, especially if reinforced by eager therapists. Indeed, the Milligan case amplified fears that criminals might feign DID to escape punishment – a theme that would re-emerge in later cases and media portrayals. At the same time, supporters of the defense argued that Milligan was a victim of severe trauma who needed treatment, not incarceration, and that the legal system was right to recognize his disorder.
This public dispute – genuine mental illness versus clever manipulation – made the Milligan case a watershed moment for forensic psychology. It forced courts and clinicians to grapple with how to define legal insanity and personal responsibility in the context of dissociative disorders. As we will see, the case also anticipated many controversies that continue to surround DID to this day, even as it validated the disorder in the eyes of many professionals.
The Minds of Billy Milligan – The 24 Personalities
In the wake of the trial, intensive psychiatric treatment and documentation of Billy Milligan’s condition continued. He was committed to secure psychiatric facilities, where doctors probed deeper into the mosaic of identities inhabiting his mind. Originally, only 10 alters were known (the ones identified by Harding and Wilbur). But soon, Milligan’s doctors discovered even more personalities lurking beneath the surface. Dr. David Caul, Milligan’s psychiatrist at the Athens Mental Health Center, attempted a therapy known as “fusion” – integrating the separate identities into one cohesive self. In the course of this effort, Caul uncovered an additional 14 personalities that had been hidden. These were labeled “The Undesirables,” as they were alters deemed violent, antisocial, or problematic by the others. This brought Milligan’s total count to 24 distinct personalities, ranging from young children to mature adults.
Among the newly discovered alters was one called “The Teacher,” who turned out to be critical. The Teacher was essentially a fused version of Billy – a personality in which all of the others’ knowledge and memories coalesced. In therapy sessions, Dr. Caul realized that Milligan had already undergone a partial self-fusion: the Teacher personality “had already fused [the others] himself”, teaching the other alters special skills and knowledge. Caul managed to bring The Teacher into consciousness in December 1978 by playing an audio recording of Ragen’s voice to the core Billy, thus providing proof to Billy of his other personalities’ existence. When The Teacher emerged, Milligan felt, for a brief time, “like one person” for the first time since childhood.
This remarkable therapeutic breakthrough – essentially unifying Milligan’s identities – did not last long. When local news media learned that Milligan was being granted unsupervised furloughs from the hospital after The Teacher appeared (a sign of clinical progress), a public outcry ensued in 1979. The intense publicity and criticism caused Milligan significant stress, and reportedly The Teacher receded, while the hodgepodge of separate personalities re-emerged in force. In the turbulent years that followed, Milligan was transferred between various institutions (from Athens to the more secure Lima State Hospital and others) as doctors struggled to manage his shifting personas and occasional behavioral issues.
Throughout this period, Billy Milligan’s inner world captured widespread fascination. In 1979, author Daniel Keyes, best known for Flowers for Algernon, began an extensive series of interviews with Milligan, coinciding with the therapeutic revelations of the Teacher. Keyes chronicled Milligan’s life story and the detailed profiles of his 24 personalities in the 1981 book The Minds of Billy Milligan, which became a bestseller. For many readers, Keyes’s book was a first introduction to the concept of multiple personalities beyond pop culture fiction. It humanized Milligan’s alters, showing them as distinct individuals born from extreme childhood trauma and need for survival. The book also revealed new details that hadn’t come out at trial, including graphic accounts of Milligan’s early abuse, and painted a vivid portrait of each alter’s traits, desires, and conflicts.
Milligan’s 24 Personalities. The table below summarizes the 24 documented personalities that constituted “the minds of Billy Milligan,” based on Keyes’s account and contemporaneous reports. These alters varied in age, gender, nationality, abilities, and temperament. Each played a different role within Milligan’s dissociative system, with some taking control (“on the spot”) to handle situations and others remaining in the shadows. Understanding this cast of characters is key to appreciating the complexity of his DID.
| Name | Gender | Age | Nationality/Accent | Role/Traits |
|---|---|---|---|---|
| Billy (William Stanley Milligan) | Male | 26 | American | The core personality; reportedly unaware of the others until integration therapy began. |
| Arthur | Male | 22 | British | Intellectual; speaks with a British accent; knowledgeable in science and medicine; controls who gets to “go out.” |
| Ragen Vadascovinich | Male | 23 | Slavic | “The keeper of hate.” Yugoslavian, speaks broken English; responsible for strength and weapons; committed the robberies. |
| Allen | Male | 18 | American | The manipulator and conman; good with people; the only one who smokes; right-handed (unlike Billy, who is left-handed). |
| Tommy | Male | 16 | American | An escape artist and electronics expert; often confused with Allen; plays the saxophone. |
| Danny | Male | 14 | American | Painfully shy and withdrawn; afraid of people and especially men; was buried alive in Billy’s childhood. |
| David | Male | 8 | American | The “keeper of pain”; comes out to handle emotional trauma or physical pain. |
| Christene | Female | 3 | American | A child who paints and writes poetry; diagnosed with dyslexia until helped by Arthur. |
| Christopher | Male | 13 | British | Christene’s brother; also speaks with a British accent; plays the harmonica. |
| Adalana | Female | 19 | American | Shy, lonely, and lesbian; confessed to committing the rapes out of a need for affection and intimacy. |
| Phil | Male | 20 | Brooklyn | Criminal-minded; engaged in illegal activities; speaks with a New York accent. |
| Kevin | Male | 20 | American | Worked closely with Phil; involved in planning crimes, including robberies. |
| Walter | Male | 22 | Australian | A wanderer and outdoorsman; excellent spotter and hunter; speaks with an Australian accent. |
| April | Female | 19 | American | Holds deep resentment toward Billy’s stepfather; plotted revenge but was not allowed “out.” |
| Samuel | Male | 18 | Jewish | A devoutly religious personality who practiced strict dietary laws and spiritual reflection. |
| Mark | Male | 16 | American | The “zombie”; performed monotonous tasks and labor without complaint; had little personality. |
| Steve | Male | 21 | American | The jokester and impersonator; enjoyed mimicry and comedic roles. |
| Lee | Male | 20 | American | The prankster; took the blame for trouble caused by others; sarcastic and confrontational. |
| Jason | Male | 13 | American | Had seizures; his emergence sometimes triggered episodes in the body. |
| Robert (Bobby) | Male | 17 | American | Dreamer; fantasized about leading a carefree life as a drifter; romantic and naive. |
| Shawn | Male | 4 | American | Deaf; communicated through sign language and gestures. |
| Martin | Male | 19 | New Yorker | Snobbish and condescending; believed himself superior to the others. |
| Timothy | Male | 15 | American | A skilled woodworker and craftsman; took pride in building and creating. |
| The Teacher | Male | 26 | Composite | Believed to be the final personality; represented a fusion of the others and held all memories. |
The 24 personalities of Billy Milligan, as described in Daniel Keyes’ book and psychiatric reports. Ages are as of 1977–78. Each alter had distinct traits and roles, illustrating how DID can compartmentalize different aspects of a person.
Keyes’s The Minds of Billy Milligan elaborated on each of these personas in novelistic detail, helping the public appreciate the internal logic of Milligan’s dissociative world. Readers met, for instance, Arthur the Englishman who liked quiet contemplation and books, versus Ragen the Slav who harbored rage and was capable of violence, versus little Christene who embodied childhood innocence. The book portrayed Milligan’s mind as a crowded house of characters, each with “his or her own wishes, impulses, and memories” interacting in complex ways. This portrayal was empathetic to Milligan: the personalities were shown as emergent coping mechanisms formed to shield the original Billy from unbearable abuse. While some critics later questioned Keyes’s uncritical acceptance of Milligan’s narrative, the book undeniably increased awareness of DID. It painted the condition not as some gimmick or parlor trick, but as the desperate splintering of a psyche – a survival strategy in the face of extreme trauma. The title itself – The Minds (plural) – emphasized that Milligan had, in effect, 24 minds sharing one body.
Notably, Keyes’s work and Milligan’s treatment records also highlighted how these personalities interacted. They weren’t simply isolated; they formed a sort of internal society. Some, like Arthur, acted as rational leaders. Others, like Ragen and Adalana, broke the rules and were “punished” internally by being exiled from control after the crimes. The existence of The Teacher alter suggested that integration was possible and perhaps even underway naturally. By the late 1980s, after about a decade in hospitals, experts reported that Milligan’s personalities had fused back into a single self – essentially The Teacher’s integration was achieved – allowing his release (discussed in Legacy below).
Milligan’s many minds invite us to ponder psychological questions: How can one brain generate such distinct personae with unique memories and skills? To what extent were these selves truly independent, versus dramatized facets of one identity? The Milligan case became an exemplar for studying DID, demonstrating both the remarkable power of the mind to compartmentalize and the challenges in treatment (as seen when The Teacher vanished under media pressure). Before turning to those broader clinical issues, we will first examine the scientific understanding of DID and the debates it has engendered, many of which connect back to reactions people had to Billy Milligan’s story.
Neuropsychological and Clinical Perspectives on DID
What is Dissociative Identity Disorder? Dissociative Identity Disorder (DID) is a complex psychiatric condition characterized by the presence of two or more distinct identity states within a single individual, accompanied by memory gaps (amnesia) that cannot be explained by ordinary forgetfulness. These identities – often called alters – may have their own names, ages, genders, moods, and recollections. At any given time, one identity or another takes executive control of the person’s behavior, a phenomenon sometimes described as “switching.” DID was formerly known as Multiple Personality Disorder (MPD) until 1994, when the name was changed in DSM-IV to emphasize that it is not truly separate personalities in one body, but a fragmentation of a single personality. The DSM-5 (2013) further clarified diagnostic criteria, noting that the disruption in identity may be observed by others or self-reported, and that the alternate identities often involve marked discontinuities in sense of self and agency, along with persistent gaps in memory. DID is classified among the dissociative disorders, which are conditions involving disruptions or discontinuity in consciousness, memory, or identity.
Epidemiological data on DID vary, but a systematic review suggests approximately 1% of the general population might meet criteria, with higher rates in clinical settings. It is often misdiagnosed (or goes unrecognized) for years; patients may present with symptoms of depression, anxiety, PTSD, substance abuse, or self-harm before the dissociative nature of their condition is identified. In Milligan’s case, for example, he had prior diagnoses (like “hysterical neurosis” in adolescence) and encounters with psychiatric hospitals that did not pin down DID. Many DID patients report extensive histories of childhood trauma, and comorbid disorders (like post-traumatic stress) are common. The condition is also associated with high rates of self-injurious behavior and suicidality – aspects certainly seen in Milligan, whose core personality repeatedly attempted suicide and who was considered a danger to himself.
Origins and Mechanisms. The prevailing Trauma Model of DID posits that the disorder is a chronic response to severe early trauma, usually repeated physical and/or sexual abuse in childhood. The theory is that a young child, unable to escape or fully comprehend the abuse, copes by mentally escaping – they “dissociate” or compartmentalize the experience. In cases of DID, this extreme dissociation results in the formation of distinct identity states: parts of the psyche that hold the painful memories or emotions, shielding the core self. Over time, these states can become more differentiated, developing their own memories and roles. In Billy Milligan’s case, psychiatric evaluations concluded that his stepfather’s brutal abuse (which allegedly included sodomizing him, burying him alive, and hanging him by his fingers and toes) was the crucible in which his multiple personalities formed. Starting around age 3 or 4 – the time of these traumatic events – Billy’s mind is believed to have split into different identities as a survival strategy. Indeed, by the time he was a teenager, Billy reported frequent blackouts and trance-like episodes, indicating his dissociative coping mechanism was well established. Multiple lines of research support this trauma-based explanation: DID patients almost invariably have documented histories of horrific abuse or neglect, and the identities often serve functions directly tied to protecting the individual (e.g. an angry protector alter, a child alter who holds painful memories, etc.). In this sense, DID can be seen as an extreme form of post-traumatic stress disorder, where the fragmentation of identity allows the person to compartmentalize trauma and continue to function.
However, DID is not without controversy. A vocal minority of experts endorse a Sociocognitive Model (or fantasy model), arguing that DID might not arise spontaneously from trauma, but is iatrogenically created or culturally influenced. According to this view, vulnerable individuals come to believe they have multiple personalities due to therapist suggestions, media portrayals, or personal fantasy, and then behave in a manner consistent with that belief. In other words, the sociocognitive model claims that alters are not naturally occurring split identities, but social constructs – a kind of role-playing (conscious or unconscious) induced by external cues. Skeptics of DID often point out that the surge in cases in the late 20th century followed popular books/films like Sybil (1973) and that certain clinicians (e.g. Dr. Wilbur with Sybil) may have unintentionally prompted patients to exhibit more personalities. They also note that the number of reported personalities per patient ballooned over the years (from the typical 2–3 alters in early cases to dozens in some 1980s cases, as with Milligan’s 24), suggesting a possible inflation effect. During Milligan’s trial, such skepticism was highlighted by Dr. Szasz’s comments that “We are all actors…But there is only one person” – essentially accusing the DID diagnosis of being a convenient fiction or “hoax” to excuse behavior.
What does science say? Modern research has increasingly validated DID as a legitimate disorder (while acknowledging it is relatively rare). Neuropsychological studies have found intriguing differences between identity states at the level of brain and physiology. For instance, different alters in the same individual have shown distinct patterns on EEG and fMRI scans, varying visual acuity and handwriting styles, and even differences in allergic responses or handedness – changes that are difficult to consciously fake. One study noted that each alter may perform differently on psychological tests, including IQ and personality measures, almost as if they were separate people Machine-learning research in 2023 even demonstrated that brain scans could distinguish DID patients from healthy controls with high accuracy, suggesting a discernible “brain fingerprint” of the disorder. Such findings undercut the notion that DID is “just acting” and indicate genuine neurological correlates to the identity shifts.
Additionally, the trauma connection has a strong evidence base. For example in his article Dissociation debates: everything you know is wrong, Richard J Loewenstein notes that “Multiple lines of evidence support a powerful relationship between dissociation/DD and psychological trauma, especially cumulative and/or early life trauma,” whereas little empirical data support the purely sociocultural/iatrogenic model. Most experts today agree that while therapy and culture can influence how DID manifests, they generally do not create it from scratch in someone who did not already have a propensity for dissociation due to trauma. For example, it’s likely not a coincidence that Billy Milligan, given his harrowing childhood, developed DID, whereas another person without such trauma would not, even if both were exposed to similar media or therapists. That said, clinicians are now more aware of avoiding leading questions or excessive suggestion in therapy to prevent inadvertently shaping a patient’s alter behavior.
It is worth noting that acceptance of DID within the mental health community has evolved. In 1980, DID (as MPD) was officially recognized in DSM-III, but skepticism remained high; a 1999 survey found only 21% of U.S. board-certified psychiatrists felt there was strong evidence for DID’s validity. By the publication of DSM-5 in 2013, the diagnosis was retained (with refined criteria) and backed by greater research, reflecting growing legitimacy. Treatment guidelines now exist (e.g. from the International Society for the Study of Trauma and Dissociation), and while DID is still debated by some, it is generally approached as a real and serious disorder. Contemporary treatment typically involves long-term psychotherapy aimed at stabilization, trauma processing, and integration of alters into one functional identity (or at least harmonious co-existence). In Milligan’s era, the concept of integration was nascent – Dr. Wilbur’s fusion of Sybil’s personalities was one famous example, and Dr. Caul’s work with Milligan’s Teacher alter was another – but today integration is a central therapeutic goal.
In summary, the Milligan case encapsulated many core issues in DID: extreme trauma leading to identity fragmentation, dramatic alter switches that challenge our notions of self, and the controversy of whether it’s “real” or role-play. Neuroscience and clinical research increasingly affirm that DID is a genuine condition rooted in trauma, even as they strive to better understand its mechanisms. This scientific backdrop will help us now consider how the Billy Milligan story has been portrayed in popular media, and how those portrayals have, in turn, shaped public understanding of DID.
Media Representations and Public Perception
Billy Milligan’s saga, with its mix of crime, mental illness, and courtroom drama, has proven irresistible to storytellers. Over the decades, his case has been recounted in documentaries, books, and dramatizations – each contributing to the public’s perception (and misperception) of dissociative identity disorder. Here we examine a few notable representations and their impact:
- Documentary – Monsters Inside: The 24 Faces of Billy Milligan (Netflix, 2021): This four-part Netflix docuseries offers an in-depth look at Milligan’s life and the controversy surrounding his case. Directed by Olivier Megaton, Monsters Inside weaves together archival footage (including eerie tapes of Milligan’s therapy sessions where he shifts accents mid-sentence), interviews with key players, and dramatic recreations. The series revisits the 1970s trial and the psychiatric evaluations, giving viewers a chance to see and hear Milligan’s different alters as recorded. It also features interviews with Milligan’s sister and brother, the prosecutors from the case, journalists who covered the story, and experts like Dr. Harding. The documentary is notable for its even-handed tone – it presents both those who believed Milligan’s DID was genuine and those who suspected he was faking. For instance, it highlights that even at the time, some observers felt the case became more about “the state of Milligan’s psyche than about his victims,” and raises the uncomfortable possibility that Milligan might have consciously used his alter defense to avoid prison. In fact, one of the provocations of the series (reflected in a UK review’s title) is asking: Did Billy Milligan use his 24 personalities to get away with murder? By the end, the docuseries doesn’t give easy answers – it acknowledges the evidence of Milligan’s trauma and dissociation, but also the lingering doubts. The release of Monsters Inside rekindled discussion about DID in the media, showing how public opinion remains divided. Some viewers came away more sympathetic to DID as an illness, while others echoed the skepticism that it could be an elaborate act. What the series undeniably did was bring Milligan’s story to a new generation, ensuring that the ethical and psychological questions it raises continue to be debated.
Television Drama – The Crowded Room (Apple TV+, 2023): A fictionalized retelling of Milligan’s story hit streaming TV in 2023, starring Tom Holland and Amanda Seyfried. The Crowded Room is inspired by Daniel Keyes’s book (in fact, an early working title of the show was the same as the book) and by Milligan’s case, though it takes creative liberties. In the series, Holland portrays a character named Danny Sullivan, who is based on Milligan, and the narrative unfolds as a psychological thriller. The show dramatizes the discovery of Danny’s multiple alters in the context of a crime and a subsequent investigation by a psychologist (played by Seyfried). While it draws from the real events – for example, Danny’s alters parallel some of Milligan’s, and his backstory of abuse mirrors Billy’s – it also invents new plot elements for suspense. The Crowded Room attempts to depict the subjective experience of having alters, using different actors and visual effects to represent Danny’s dissociations. However, it received mixed reviews regarding its handling of DID. Some praised it for bringing nuance to a misunderstood condition, but others criticized it for perpetuating confusion (the show initially conceals the DID twist as a mystery, which some felt was a gimmick that could reinforce the idea that DID is just a shocking plot device). Importantly, the series stirred conversation about accuracy: advocates noted it tried to show DID as rooted in trauma – “a self-preservation technique” – yet some mental health experts felt it still dramatized DID in a way that might mislead viewers. The very title The Crowded Room (a nod to the many “people” in one mind) reflects how Milligan’s narrative entered popular culture; the project itself had been in development hell for years (with reports as far back as 2015 that Leonardo DiCaprio would play Milligan in a film adaptation). That it finally materialized as a big-budget series underscores how enduring the fascination with this case is. For students of psychology, the series offers a case study in how Hollywood balances fact and fiction when portraying mental illness – sometimes educating, sometimes veering into sensationalism.
- Unproduced Film Adaptations: Milligan’s story has long enticed filmmakers. In the 1980s and 90s, Hollywood producers vied for the rights to Keyes’s book. At one point, acclaimed director James Cameron (of Titanic fame) was developing a movie about Milligan, and later Joel Schumacher was attached. Various high-profile actors were rumored or signed on over the years – John Cusack, Leonardo DiCaprio, Colin Farrell, among others. DiCaprio’s project, tentatively titled The Crowded Room, was announced around 2015, generating buzz because it would require the star to portray 24 characters in one (an actor’s dream challenge). These projects struggled to get off the ground, likely due to the complexities of the story and perhaps sensitivities around portraying sexual violence and mental illness. According to a 2007 report, at least some of these efforts faltered amidst lawsuits and financial issues – Ohio’s government even sued Milligan at one point to reclaim profits from book royalties that were funding his treatment. Ultimately, none of the planned feature films were made, and it wasn’t until the 2020s that streaming platforms picked up the torch. The long trail of unrealized adaptations demonstrates both the lasting allure of the narrative and the difficulties in telling it responsibly. Each new announcement often sparked discussions in the media: would the film glamorize a criminal? Would it treat DID respectfully or contribute to stigma? The stop-and-go nature of these projects itself became part of Milligan’s lore, symbolizing how tricky it is to package such a thorny true story for popular consumption.
- Other Media Influences: Milligan’s case has been referenced indirectly in numerous books, TV shows, and movies about dissociative disorders. For example, the success of Sybil in the 1970s set the stage, and Milligan’s case reinforced the public notion of DID as something dramatic and extreme (24 personalities!). Later thrillers like M. Night Shyamalan’s film Split (2016) – while not about Milligan – featured a villain with multiple personalities committing crimes, a premise clearly echoing the fears raised by the Milligan case. Such representations often draw criticism from mental health advocates for exaggerating or vilifying those with DID. On the other hand, first-person accounts (like Truddi Chase’s autobiography When Rabbit Howls or the memoir Switching Time) have tried to educate readers about DID from the patient’s perspective, offering a counter-narrative to the sensationalism. In recent years, conversations on social media (and even trends on platforms like TikTok) have brought DID back into the spotlight, sometimes in questionable ways (with some users claiming to have DID and showcasing their alters, leading to debates about authenticity). The enduring presence of Billy Milligan’s name in discussions of DID – whether in scholarly articles, as a benchmark legal case, or in TV show discussions – indicates how deeply his story penetrated into both professional and popular consciousness.
In terms of public perception, the media portrayals have been double-edged. On one side, they have increased awareness of DID as a condition – many laypeople can recall “that guy with 24 personalities” as an example of how trauma can manifest in mental illness. The Netflix documentary, in particular, provided historical context that may foster empathy for individuals with DID by emphasizing the abuse that precipitated Milligan’s fragmentation. However, the dramatizations and headlines have also sometimes skewed understanding, making DID seem almost mythical or exclusively tied to extraordinary criminal cases. Clinicians point out that most DID patients hurt themselves far more often than they hurt others, and they live quieter lives than what Hollywood depicts. The focus on extreme cases like Milligan and Sybil can thus distort public expectations, leading some to think DID is inherently linked to violence or to highly florid, obvious manifestations, which is not always true.
Overall, Billy Milligan’s portrayal in media has kept the conversation about DID alive over the years, evolving with each new retelling. For psychology students, these representations are worth analyzing critically: they reflect changing societal attitudes toward mental illness (from the more stigmatizing tone of some older accounts to the more nuanced approach of recent ones) and they illustrate the ethical responsibility in portraying real psychiatric conditions. As one psychology commentator noted, every time Milligan’s story is told, it “perpetuates a dialogue about whether we view those with DID with fascination, fear, or understanding” – a dialogue that is important for destigmatization.
Legacy and Legal Implications
What became of Billy Milligan? After the sensational trial, Milligan spent the following decade confined in Ohio’s psychiatric institutions rather than in prison. His journey through the system was eventful and not without controversy. Initially sent to the Athens State Hospital in 1978, he later was moved to facilities with higher security such as Lima State Hospital for the Criminally Insane, especially after concerns arose about his behavior and risk (for instance, reports that he had access to dangerous items, or an incident of shots fired from a hospital farm truck he was driving). Despite the hospitalizations, Milligan had moments of freedom: in 1986, he escaped from Central Ohio Psychiatric Hospital, managing to elude authorities for months. During that time he lived under an alias (ironically, using the name of one of his own alters, Christopher Carr), and traveled as far as Washington state and eventually to Florida. He was recaptured in late 1986 in Florida and returned to Ohio. The escape further stirred public fears – raising the specter of whether a potentially dangerous individual, acquitted by reason of insanity, was being supervised strictly enough. Milligan even recorded videotapes during his fugitive period, sending them to news outlets to protest his treatment in the hospital, which showed a savvy understanding of manipulating his public narrative.
By 1988, a panel of experts evaluated Milligan and concluded that his personalities had fused (once again, suggesting he was clinically stable and no longer dissociating). That year, after approximately 11 years in state custody, Billy Milligan was released from the Ohio mental health system. In 1991, he was fully discharged from all court supervision, deemed “sane” and not a threat to society. This outcome – release rather than lifelong confinement – was in line with the insanity verdict (NGRI is not an acquittal that sets one free immediately; it typically results in hospitalization until recovery). Milligan’s release was met with mixed reactions. Some Ohioans were outraged or incredulous that a man who had committed violent rapes could ultimately walk free. Others accepted that he had received treatment and was effectively a different (integrated) person now. Milligan mostly vanished from the public eye after the early 1990s, moving to California for a time and attempting to start an independent film production company. Public records show he struggled financially – he declared bankruptcy in San Diego in the mid-1990s. A Ohio court also ordered him to pay back some of the costs of his state-provided treatment using profits from Keyes’s book, a move allowed by Ohio law (they recovered about $120,000 of the ~$450,000 in royalties).
In his later years, Billy Milligan lived a relatively quiet life. His acquaintances lost track of him for long periods. It was later revealed by family that he had returned to Ohio and was living on his sister’s property in the early 2010s while suffering from health issues. On December 12, 2014, Billy Milligan died of cancer at a nursing home in Columbus, Ohio, at the age of 59. With his passing, those who knew him reflected on the case without the burden of ongoing legal concerns – even Dr. Harding, decades later, wished more research and aggressive treatment could have been done, lamenting the “controversy” that hampered deeper study of Milligan’s condition.
Impact on Law and Forensic Psychology: Billy Milligan’s case remains a landmark in the annals of criminal law and mental health. It sharply highlighted the tension between the legal system’s need for accountability and the psychiatric understanding of severe mental illness. Legally, one immediate implication was precedent (though not binding precedent, since it wasn’t an appellate case) – it demonstrated that an insanity defense based on DID could succeed. After Milligan, there have been a handful of other defendants who have tried a multiple-personality insanity plea, though such cases are still exceedingly rare. A review of legal cases indicates that courts have generally been cautious: DID on its own does not automatically exempt one from responsibility unless it can be shown that the alter in control during the crime did not understand the wrongfulness of the act (meeting the McNaghten standard for insanity).
One key legal question raised by DID cases is competency to stand trial. If a defendant has alters, is the “dominant” personality aware enough of the proceedings and the charged offense to participate in their defense? In Milligan’s case, the issue was sidestepped by the fact that the personalities cooperated with his lawyers and psychiatrists, and presumably the core Billy or a few alters understood the situation. But imagine a scenario where the “person” who committed the crime is an alter that no longer comes out, and the core personality claims amnesia for the event – is it even constitutional to try that person? Legal scholars have debated whether a DID defendant might be found incompetent to stand trial if their mental state prevents a single, continuous identity from comprehending proceedings. Courts have generally handled this by ensuring that at least one “executive” personality of the defendant is present and can work with counsel, and by treating the person as an integrated whole for the purposes of trial (while allowing evidence of their disorder in an insanity defense).
Another concern is the possibility of malingering – could defendants fake DID to avoid culpability? The Milligan case, due to its outcome, did spark a caution among forensic evaluators to be diligent in assessing DID claims. Modern forensic psychiatrists use structured interviews and tests (such as the Dissociative Experiences Scale) and look for corroborating evidence (like documented childhood trauma, observed switches under controlled conditions, etc.) to validate a DID diagnosis. They are also aware of the phenomenon of iatrogenic DID, so they gather data carefully to ensure they are not themselves “creating” the symptoms. The consensus is that while difficult, it is generally possible to distinguish genuine DID from feigned cases by looking at the consistency of symptoms over time, physiological markers during switches, and the individual’s history. Thus, Milligan’s legacy to forensic practice is a more rigorous protocol for evaluating such defenses, combining skepticism with open-mindedness. As one review noted, because DID trials are so scarce, each one is scrutinized heavily and contributes to a slow refinement of how experts testify about the disorder and how juries or judges are instructed on it.
In a broader sense, the Milligan case pushed forward the dialogue about the insanity defense itself. It came just a few years after the famous Hinckley case (1981) where John Hinckley Jr. was found NGRI for the attempted assassination of President Reagan – another verdict that stirred public anger and led to reforms in some jurisdictions (like the option of a verdict of “guilty but mentally ill”). Milligan’s acquittal similarly raised public policy questions: Are we comfortable releasing someone who committed violent crimes if they recover their sanity? How do we balance public safety with humane treatment? Ohio, for instance, tightened some release review processes after the publicity around Milligan’s furloughs and escape. Some U.S. states have since modified insanity defense rules to require that the defendant, if found NGRI, be committed for evaluation for a minimum period, etc., to assuage public fears. Milligan eventually walking free illustrates the core principle of the insanity defense – that it is not meant to be punitive, but rather therapeutic. Yet, his brief freedom during the escape also exemplified the potential risks.
For forensic psychology as a field, Milligan’s case underscored the importance of expert testimony and the weight it carries. The spectacle of a courtroom effectively accepting that two “people” inside Milligan committed the crimes while the rest did not, challenged experts to explain DID clearly and responsibly. Dr. Wilbur’s involvement also was met with some criticism; she was an advocate for the validity of DID, and skeptics accused her of being too credulous (especially in light of the later controversy that her famous patient Sybil had recanted some claims). This taught a lesson that expert witnesses must be objective and that the court will closely examine their potential biases or theoretical leanings. The Psychology Today article recounting Milligan’s and a later DID case (Tom Bonney in 1987) noted how another expert, Dr. Paul Dell, was criticized for essentially diagnosing DID before even meeting the patient – demonstrating how not to handle such evaluations. By contrast, a more skeptical DID expert, Dr. Phillip Coons (who helped define MPD in the DSM-III), provided balanced testimony in that later case, emphasizing careful differential diagnosis. These contrasts can be traced back to Milligan’s trial setting the stage: it became a reference point on how to approach DID in court and how much skepticism to apply.
Finally, Milligan’s story leaves a philosophical legacy that is perhaps as important as the legal one. It forces us to reckon with the concept of the unified self. If a person’s mind can truly shatter into different identities, who is the person in the eyes of the law and morality? One might ask, was “Billy Milligan” an innocent man carried along by the tides of alters he couldn’t control, or was he the ultimate author of those alters and thus responsible in a moral sense? Milligan’s own statements, such as “Every time I wake up, I’m in trouble”, evoke a profound empathy for someone who felt victimized by his own mind. It invites a compassionate view that perhaps justice was served by treating him, not punishing him. Yet, families of the victims understandably felt justice was thwarted – the women who were raped did not get the typical closure of seeing their attacker convicted in prison. The case thus sits at an uneasy intersection of justice for the individual vs. justice for society. It prompts questions that have no easy answers: How should we handle criminal acts committed under a severely altered state of consciousness? Can therapeutic security measures truly protect the public as well as incarceration would? Does acknowledging the reality of DID undermine the concept of personal responsibility, or merely refine it?
In the years since, forensic psychiatrists have suggested frameworks for dealing with DID offenders, such as ensuring they remain under supervision until all alters are integrated and the risk from any one identity is mitigated. Milligan’s eventual successful fusion and release can be seen as a validation of that approach – he did not reoffend to anyone’s knowledge after release. However, the specter of his case still looms large in hypothetical discussions (e.g., what if an alter committed murder? Would the system ever be comfortable releasing such a person?). Some have even mused whether each alter should be treated as a separate defendant – a legal can of worms that fortunately remains theoretical.
Conclusion
The case of Billy Milligan stands as a fascinating and haunting chapter in the history of psychology and law. It demonstrated, in dramatic fashion, the potential extremes of dissociation: a mind fractured into pieces to survive unspeakable trauma. For forensic psychology, Milligan’s trial was a proving ground for the insanity defense applied to DID, forcing experts and jurists to expand their concepts of mental illness and criminal responsibility. The outcome – freeing a man deemed to have been “insane” via multiple personalities – was and still is contentious, provoking debates about where to draw the line between compassion for the mentally ill and protection of society.
Billy Milligan’s story also propelled the study of Dissociative Identity Disorder. It brought what was then a little-understood diagnosis into public awareness, spurring research and discussion. Through books like The Minds of Billy Milligan and various media portrayals, generations of students and professionals have been challenged to confront the complexities of DID – its origins in childhood trauma, its perplexing manifestations, and its controversial nature. The case illustrated key theoretical models: it powerfully supports the trauma model of DID (with the abuse by Chalmer Milligan as the catalyst for Billy’s alters), yet it also exemplified why some pushed back with the sociocognitive model (pointing to how easily the narrative could be doubted or even, in the wrong hands, fabricated). In that sense, Milligan’s legacy in psychology is one of sharpening our understanding – by asking hard questions. Are alters truly discrete entities or roles the patient plays? Can integration heal such a fractured mind? How can clinicians earn the trust of the public when testifying about phenomena that sound unbelievable? These are questions practitioners continue to grapple with, and each time, the ghost of Billy Milligan’s case is in the background, reminding us of the stakes.
For psychology students, (and anyone else for that matter) examining this case is a valuable exercise in critical thinking. It invites you to consider multiple perspectives: the legal perspective (culpability and the insanity defense), the clinical perspective (diagnosis and treatment of DID), the ethical perspective (the rights of the accused vs. victims), and the media perspective (how narratives are constructed around mental illness). Billy Milligan himself lived a life that oscillated between tragedy and controversy. He was, by many accounts, a deeply hurt individual who committed heinous acts – a perpetrator who was also a victim. His 24 personalities symbolized the fragmentation that can occur when a mind tries to shield itself from pain. His court case asked society to show empathy for that psychological pain, even when it resulted in other pain (for the victims of his crimes).
In the end, Billy Milligan’s case does not offer simple lessons or clear-cut resolutions – instead, it leaves us with enduring questions. To what extent can trauma absolve someone of responsibility for their actions? Where is the line between genuine disorder and manipulation, and who gets to decide? How should justice systems adapt to the evolving understanding of the human mind? And perhaps most poignantly, Milligan’s story asks us to reflect on the profound resilience and vulnerability of the human psyche: faced with extreme adversity, the mind can shatter into pieces to save itself – but when those pieces harm others, we as a society face the uneasy task of picking up the fragments and determining what to do with them. In confronting these questions, we gain not only a deeper insight into dissociative identity disorder, but also into the broader human condition – the unity and disunity of self, the impact of childhood trauma, and the capacity for both violence and healing. Billy Milligan’s life and legacy thus remain a powerful reminder of the complexity of the mind and the need for compassion balanced with accountability in the realm of mental health and law.
References (Selected)
- Keyes, D. (1981). The Minds of Billy Milligan. New York: Random House.
- Mitra, P., & Jain, A. (2023). Dissociative Identity Disorder. In StatPearls. Treasure Island, FL: StatPearls Publishing.
- Phillips, J. (2007, Oct 28). Multiple-personality case of Billy Milligan still fascinates. The Columbus Dispatch.
- Split decisions in the courtroom: Multiple personalities and the insanity plea. (2017, March). Psychology Today.
- Tonguette, P. (2021, Sept 27). Movie review: Billy Milligan documentary offers even-handed look at complicated case. The Columbus Dispatch.
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