The Dissociation and Dissociative Disorders Treatment

Dissociative Personality Disorder

In our time until about the 1980s, psychologists and psychotherapists saw frustration in the form of multiple personality (and its related structures of the psyche based on the dissociation) is so rare, that psychology and psychotherapy exclude them from consideration in a number of personality types and disorders. However, the accumulation of data in psychoanalysis and psychotherapy, it became clear that many people often dissociate and some do it on a regular basis so that we can talk about dissociation as their main mechanism of functioning under stress. If the multiple personality was not a “pathology,” in which the patient is often unaware of the existence of other individuals and with the confidence that the psychoanalyst is so difficult that even his own part, “I”, is very reluctant to divulge his secret, the psychologist’s office have long known how to identify and help dissociative patients.

In fact, some people knew about it long time ago. The flip side of what Freud studied was distancing us from studying the fine examples of dissociation that were available at the end of the XIX century. The psychologist-psychotherapist Janet P. (P. Janet, 1890), for example, explained the participation of many of the hysterical symptoms of dissociative processes, rejecting Freud’s preference for repression as the main explanatory principle. In the USA the psychologists William James and A. Binet serious were interested in dissociation. M. Prins published a detailed dissociative case of “Miss Byuchamps” at about the same time began to pay attention to the “Interpretation of Dreams,” which influence is only eclipsed by the effect of the publication. Psychoanalysts S. Ross, and F. Putnam devoted their work fascinating history of this phenomenon and various etiological reasons for this.

Psychotherapists, psychoanalysts engaged in counseling and psychotherapy of dissociative clients, consider the multiplicity of the individual, not as a bizarre aberration, but as an understandable special kind of individual adaptation to his peculiar history – or chronic post-traumatic stress syndrome, which occurs in childhood. In this aspect, dissociative identity does not differ qualitatively from other types of structures or the nature of the disease. The described in detail the differences between dissociated states of their own “I” in individuals suffering from multiple personality, is a condition perceived as a kind of sensation. Such differences (subjective age, sexual orientation or preference, systemic diseases, allergies, wearing glasses, EEG pattern, use the left or right hand – including in the letter – and depending on a variety of language features) are so impressive that people see it as a violation form of multiple personality most exotic of all mental illness, who had heard of. The same happens with many therapists providing psychological assistance. None of the above violations are causing so much controversy over the fact whether it exists by itself, or is iatrogenic, as a multiple personality.

In this context, the term of “multiple personality” is not so wrong. The study of dissociative states, and, hypnosis (dissociative individuals are truly spontaneous hypnotic trances) reveals the remarkable abilities of the human body and puts the exciting questions of consciousness, brain functioning, integrative and disintegrative mental processes and hidden opportunities. However, psychoanalysts, psychologists know that any of the dissociative patient is an ordinary man – a man with his subjective experience of the various “I” whose suffering (be it depression, fear, loneliness or other) is quite real.

Philosophical attempts to solve the problem of multiple personality have a tendency to commit a fundamental error. They are based on the belief that there really are different different personalities, and not a man with a subjective sense of plurality. A notable exception is the work of Braude.

The first described example of multiple personality in recent decades has become Eve of the “Three persons …” Christine Costner Sizemore nickname. Christina, now fully integrated woman with impressive energy and achievements, is a good example of high-functioning dissociative personality. It is noteworthy that the former suffers from dissociative nature of the patient who requested the advice of a therapist or psychologist help in this period was characterized by significant basal confidence, ego strength and permanence of objects. More broken dissociative people, even if they have a multiplicity of abuse are too afraid to allow the therapist to his depressing (filled with fear and depression) inner life – especially in the early stages of psychotherapy or psychoanalysis.

The well-known patient of J. Breuer, “Anna O.” (Bertha Pappenheim), who had a great influence on the history of psychoanalysis – is another case of multiple personality functioning well. Breuer and Freud viewed her only as a dissociation of the aspects of her hysterical misery, but most contemporary psychoanalysts would consider her primarily dissociative, and not a hysterical person. There are two very different conscious states, which often follow one another without warning, and which became more and more differentiated in the course of her illness. Staying in one of these states, she will recognize her surroundings. There was a melancholy and alarming, but relatively normal. In another state – she was hallucinating, more “obscene”: insulting people and throwing them in a pillow … If something fell into the room, or someone enters or exits out of it (while the other states), she complained that “loses” the time and point to a gap in the stream of conscious thoughts … In those moments when her mind was perfectly clear, the woman suffered … from what had two “I” – one now, and the other evil forces her to behave badly. This remarkable woman, cut short after her treatment, Breuer, remained loyal and highly effective social worker.

The stark contrast with Christine Sizemore and Bertha Pappenheim form self-destructive patients who dissociate both automatically and randomly that experience themselves as individuals, with hundreds of “personalities.” And it seems that most of them have only a few properties that are directly related to some current issues. This category applies to T. Chase, of which so much has been written in the popular press, though, perhaps, if her therapist did not put as much effort to the publication of her description, maybe she would not be such a split. Many people are psychotic dissociative level in prisons rather than in hospitals for the mentally ill (though this fact does not mean that they do not need to consult a psychologist.) The parts of their personality that rape and kill, often under the influence of the illusory state of mind, born as a result of traumatic abuse (violence), which creates a split. It is reasonable to also assume that other people with dissociative psychotic level structure adjacent to the cults, which legitimizes the dissociative experiences – sometimes to the benefit of their dissociative participants, and sometimes – to the apparent detriment of everyone involved in them.

There is an interesting mutual ambivalence between the psychoanalytic community, and therapists who head over to the latest knowledge about the distribution of dissociation. On the one hand, psychoanalysts understand the power of the unconscious better than therapists, psychologists, most of the other directions. Hence, the idea of the unconscious other “personalities” that have resulted from trauma, do not require them to supernatural. Moreover, the psychological counseling they work with clients for many years, and during that time can create the conditions for the manifestation of their own pieces, “I”, “host personality”. In other words, probably, analysts and analytical psychotherapists more often than other professionals working with people, discover their splitting, and are more inclined to take them seriously.

On the other hand, psychoanalysts have inherited the explanatory preferences of Freud, who paid attention to personal injury and attempted less attention than the fantasies and their impact on development. Funny, that Freud said very little about the abuse in the form of multiple personalities – a status which was recognized at the time by several psychiatrists, whom he revered. It contributed to the development trends of his followers to regard reports of incest and seduction as fantasy. The own “theory of seduction” of Freud is adjacent to the problem, which again is found in the assessment reports of victims of sexual violence: trauma violates the perception and paves the way to later facts and fantasies (and dreams).

Following this hypothesis, Freud, therapists who work in psychoanalysis, sometimes incorrectly use the concept of object relations theory, and, apparently, believe that this shift of awareness of different personalities is when you receive a signal of danger (stress reaction). But they are more than other professionals, are inclined to interpret such change is not as damaging awareness, as well as evidence of primitive defense – splitting. As a result, they often bypass the issue of splitting the difference between splitting and dissociation.

Some of the therapists involved in “multiplicity”, hardly forgive Freud and the psychoanalysts the underestimation of the frequency and destructiveness of sexual abuse in children. Some also complain about the influence of thinkers such as psychoanalyst Kernberg, because they are confused with dissociation splitting and therefore misdiagnosed many patients with dissociative personality as a borderline or schizophrenic – a mistake that could cost the patient few years of dissociative misdirected psychotherapy or psychoanalysis. Experts on the dissociation of right regret that so many desperate people have been misunderstood, and even got re-injured after many years as a result of unnecessary medical procedures (large doses of drugs, electroshock, etc.). Critics of the dissociation of researchers believe that if you specifically look for, you can find a “plurality” of each. Fads of psychopathology known, especially in conditions related hysteria, where suggestibility plays a huge role.