The book Sybil Exposed is the unmasking of the falsehoods of Sybil (1), a biography of a woman with dissociative identity disorder. After its publication in 1973, Sybil was an absolute sensation, with an initial printing of 400,000 copies. The book spawned two made-for-TV movies, one in 1976 starring Joanne Woodward and Sally Field and one in 2007 starring Jessica Lange and Tammy Blanchard. Sybil was probably more popular in its era than most of the contemporaneous celebrity biographies.

That Sybil turns out to be far more fiction than fact should not surprise us. Before Sybil,the best known story of a person with dissociative identity disorder was The Three Faces of Eve (2). Years after the publication of this biography and case history, Eve herself (real name Chris Sizemore) published books informing the reader of how she purposely misled her psychiatrist, Corbett H. Thigpen, with a primary objective of keeping him fascinated with her (3–5). There are many subsequent examples of fantastical, autobiographical tales of psychiatric disorders and substance use disorders, aimed at—and sometimes succeeding at—creating blockbuster sales. Sometimes the exposure of truth is forced from the author, as in James Frey and his book A Million Little Pieces (6). Sometimes some of the principals in the book claim the author has simply made most of it up, as in Augusten Burrough's Running With Scissors (7), in which the Turcotte children (Dr. Turcotte was both Burrough's psychiatrist and head of the household in which Burroughs lived) claim it just isn't so (8).

There is a highly significant twist in Sybil Exposed, however. In the other revelations of claims of fiction masquerading as fact, the manipulator of the truth is a single individual. What Nathan exposes is that Sybil was a result of the collusion of a self-serving, manipulative troika of patient, psychiatrist, and author: Shirley Ardell Mason, Cornelia B. Wilbur, and Flora Rheta Schreiber, respectively. The director of the troika is Dr. Wilbur; the individual who fares by far the worse is Mason. The surprise in Sybil Exposed is not that an author would bend truths on the one hand and ignore facts on the other to achieve a best-seller. Nor is it that a highly dependent patient could be seduced, orally bludgeoned, and drugged into all manner of bogus self-reports, especially after her attempts at coming clean were rebuffed as further evidence of her psychopathology. The real surprise is just how evil a self-aggrandizing psychiatrist can be at the expense of not only her patient but also her other patients, her colleagues, and her profession. The real problem for psychiatry is that many outside the field will proclaim it is simply naive to be surprised by this; there are coalitions of ex-patients, for example, who shout out in leonine eruptions that all psychiatrists are malevolent.

Although Sybil Exposed unravels many mysteries, some remain hard to understand. First, why was it so hard to find out the real identity of Sybil? Actually, Nathan acknowledges it was not she who identified her, but rather two individuals best known for their examinations of Freud and psychoanalysis, Mikkel Borch-Jacobsen and Peter Swales. But it turns out that many people who actually knew Shirley/Sybil knew who Sybil really was. Who were they protecting in withholding this information? And many of these individuals knew the portrayal of Sybil in print and on the screen was not an accurate picture. Why did they remain silent?

The second mystery is a corollary of the above—the explanation, on more than a simplistic level, as to why this all took place. Why would Wilbur destroy a person? Why would an author, already successful in her field, watch and even participate? How does a patient become so enveloped by her psychiatrist that she doesn't take simple measures to free herself from the web? How is it that not only the public but also the profession of psychiatry was duped?

Nathan has written an excellent “story,” but she has really only written the first half of a book. By the end of Sybil Exposed, the reader knows all about how it happened, maybe even more than anyone would want to know. What's missing is part II, why did it happen? And, if we can add an appendix, what needs to be fixed so it doesn't happen again?