Medicolegal Work
While Dr Blair-West's practice is primarily clinical work, his sub-specialisation in trauma and dissociation has meant that over the last 30 years, he has been called upon to provide medicolegal reports and perform expert witness testimony. Of the cases he has been involved in, two were landmark cases that became precedents in the legal world.
The first case was that with his patient Jeni Haynes - with whom he co-authored The Girl in the Green Dress. In 2019, Dr Blair-West was the expert witness for the prosecution of her father, who was accused of sexually abusing Jeni and causing her to develop Dissociative Identity Disorder (DID) - previously known as multiple personality disorder.
DID only develops while the brain is plastic enough to separate into multiple 'alters'. This plasticity is lost from around the age of eight. Unlike schizophrenia or bipolar mood disorder, there is actually no underlying pathophysiological disturbance of the brain. DID is a creative and sophisticated response to unrelenting abuse over an extended period, typically years. DID is most frequently found as a result of what is called "betrayal trauma" where the perpetrator of the abuse is a primary caregiver of the child, typically a parent. The separation between the alters is a result of 'amnestic barriers' such that memories, particularly of abuse, are not shared by the different alters. This allows certain alters to continue to interact with the perpetrator to maximise whatever care they are able to provide them. It also allows him to go into the outside world looking relatively normal, so as not to draw attention to what is happening at home. Any child of abuse knows that to bring home any form of attention is to unleash enormous pain on themselves and their family - perpetrators make this consequence crystal clear.
For the first time in the world, DID was the very basis of the prosecution - rather than being used as a defence by an accused. The prosecution recognised that the presence of a diagnosis of DID meant that serious crimes had been committed on a very young child. Accordingly, the prosecution relied on this as central to the case. For further reading, here is the case as reported by Sixty Minutes, and this is the story by The Sydney Morning Herald.
The first case was that with his patient Jeni Haynes - with whom he co-authored The Girl in the Green Dress. In 2019, Dr Blair-West was the expert witness for the prosecution of her father, who was accused of sexually abusing Jeni and causing her to develop Dissociative Identity Disorder (DID) - previously known as multiple personality disorder.
DID only develops while the brain is plastic enough to separate into multiple 'alters'. This plasticity is lost from around the age of eight. Unlike schizophrenia or bipolar mood disorder, there is actually no underlying pathophysiological disturbance of the brain. DID is a creative and sophisticated response to unrelenting abuse over an extended period, typically years. DID is most frequently found as a result of what is called "betrayal trauma" where the perpetrator of the abuse is a primary caregiver of the child, typically a parent. The separation between the alters is a result of 'amnestic barriers' such that memories, particularly of abuse, are not shared by the different alters. This allows certain alters to continue to interact with the perpetrator to maximise whatever care they are able to provide them. It also allows him to go into the outside world looking relatively normal, so as not to draw attention to what is happening at home. Any child of abuse knows that to bring home any form of attention is to unleash enormous pain on themselves and their family - perpetrators make this consequence crystal clear.
For the first time in the world, DID was the very basis of the prosecution - rather than being used as a defence by an accused. The prosecution recognised that the presence of a diagnosis of DID meant that serious crimes had been committed on a very young child. Accordingly, the prosecution relied on this as central to the case. For further reading, here is the case as reported by Sixty Minutes, and this is the story by The Sydney Morning Herald.
In 2024, Dr Blair-West was engaged to provide expert testimony in the case of 'LN' against her father 'SN' for childhood sexual abuse.
Again, the diagnosis of DID became the basis for the prosecution. This case also created a precedent, but this time for a very different reason. For the first time, each one of LN's alters who gave evidence was separately sworn in. (Jeni's trial did not get to this point as her father pleaded guilty as soon as the first alter, 'Symphony' gave highly credible evidence.) This recognised the inherent nature of the condition and the fact that different alters had different perspectives and different memories. Again, the prosecution was successful in securing a guilty verdict and a significant term of imprisonment for the perpetrator. You can read about this case, as reported by the ABC here.
Dr Blair-West has also been involved in a third major matter where, again, DID formed the basis of the case - in this instance it was a civil action. This case was against a state government for neglect and was settled out of court, in favour of the patient, for an undisclosed sum.
Again, the diagnosis of DID became the basis for the prosecution. This case also created a precedent, but this time for a very different reason. For the first time, each one of LN's alters who gave evidence was separately sworn in. (Jeni's trial did not get to this point as her father pleaded guilty as soon as the first alter, 'Symphony' gave highly credible evidence.) This recognised the inherent nature of the condition and the fact that different alters had different perspectives and different memories. Again, the prosecution was successful in securing a guilty verdict and a significant term of imprisonment for the perpetrator. You can read about this case, as reported by the ABC here.
Dr Blair-West has also been involved in a third major matter where, again, DID formed the basis of the case - in this instance it was a civil action. This case was against a state government for neglect and was settled out of court, in favour of the patient, for an undisclosed sum.