2017年8月10日木曜日

Dまた推敲 ⑦

Dissociation with capital “D”

As I stated earlier, what I would like to attempt in this communication is to expand the understanding of dissociation that Stern and Bromberg are proposing, so it can be applied more widely to those suffer from dissociative pathology. Their work went back to the origin of psychoanalysis, and proposed the re-examination of the very notion of repression stated by Freud. The notion of dissociation in the history of psychoanalysis was treated without due respect, unclarified, left alone, and remained “unformulated.” Stern and Bromberg practically revived the notion of dissociation, drawing on the works of Winnicott, Sullivan, and other authors. It was to their great merit that they provided a new narrative for the notion of dissociation based on the rich history of analytic theories. However, while they summed together non-conscious and unformulated part of the mind and describe it as dissociative, they seem to have overlooked a point: their theories are based on an assumption that there is only one subjectivity that is involved. 
If we consider the experiences of patients with DID (dissociative identity disorder), my point can be readily taken. What has not been experienced and not formulated for a subject (S1) could have been already experienced and formulated for another subject (S2, or another part of the personality). Stern states that “not-me” described by Sullivan is basically maintained as unformulated experience (Dbook, p.660). However, when Sullivan referred to a dissociated part as “not-me”, it might be “not-me” for the S1, but it might
be “me” at the same time for S2.
According to Stern’s understanding, severe trauma is often what has not been experienced and therefore, dissociated. That is true for the S1 who is present at the traumatic moment. However, this theory does not preclude a possibility that somewhere else in his psyche another subject, S2, has been present and has actually experienced that trauma. Stern and Bromberg simply did not take that possibility into consideration. They are not to be blamed that psychoanalytic tradition never allowed, or even anticipated, the co-existance of two subjectivities in the same psyche. Current psychiatry clearly indicates with evidence that that seems to be what is happening in patients with DID.
Existence of another subject in dissociative condition is clearly documented in the psychoanalytic literature, as early as the Studies on Hysteria (Breuer, Freud, 1895). Let us take Anna O, described by Joseph Breuer, as an example. This is a part of his description about her.
Two entirely distinct states of consciousness were present which alternated very frequently and without warning and which became more and more differentiated in the course of the illness. In one of these states she recognized her surroundings: she was melancholy and arxious, but relatively normal. In the other state she hallucinated and was naughty-that is to say, she was abusive, used to throw the cushions at people, so far as the contractures at various times allowed, tore buttons off her bedclothes and linen with those of her fingen which she could move, and so on (p.24).

She now spoke only English and could not understand what was said to her in German.”(p.26)

In one subject state, Anna O only spoke English and German that she was addressed to was not “formulated” and understandable. However, Anna in the normal state, English phrases are foreign to her and more or less “unformulated”. Here, we are invited to assume that there be another notion of dissociation, which might need to be indicated as “Dissociation” (dissociation with capital D). In Dissociative state, two, or even more subects can be involved (S2,S3,S4….) and in charge of speech and behavior which appear to be that of S1. A behavior which appears to be “unformulated” and enacted one according to Bromberg can be an intentional and willed behavior of S2.
Here is a diagram of the comparison between Dissociation and dissociation.  



  As anyone could assume, the theory of Dissociation proposes an existence of multiple subjects, which is far beyond the scope of psychoanalytic theories which are entirely based on an existence of a single subject. The implication of Dissociation can potentially deconstruct the analytic system, and discussing it is far beyond the capacity of the author. I only limit myself to propose a new scope of analytic theory by just providing a glimpse to it.