4. Establishing communication and understanding between the dissociated self-states as the Therapeutic goal
There are many discussions as regard to the purpose of the treatment of
dissociative disorders. Richard Kluft in his psychoanalytic understanding of
DID asserted that to establish“integration”and“fusion”is the final goal of the treatment. Following
his clinical advice and suggestions, many analysts consider that the integration
as the long term outcome of DID. However, recently more diverse ideas have been
proposed, indicated by his statement that we saw at the beginning. Itzkowitz further
states that “the goal of the working
through process is not necessarily the consolidation of self-states into a
single, integrated individual … [But to help] the person understand and
negotiate meaningful forms of relatedness with these heretofore unknown parts
of herself. A sense of unity or wholeness, even if illusory…..（p.152）”.
Modern analyst Bromberg speaks in a very
similar tone. He promotes respect for the uniqueness of each
personality and the attitude of “finding and directly engaging the patient's
dissociated voices as discontinuous but individually authentic expressions of
selfhood” instead of resorting to the promotion of premature integration
(Bromberg, 1998, p.199).
Thus, these authors integration
against understanding and negotiating relatedness with the parts. However, prioritizing
mutual understanding of the personalities over integration requires a new look
at the analytic tenet. Although psychoanalysis “analyzes” human mind Freud
acknowledged that “psycho-synthesis” is thus achieved in analytic treatment as
the final result.
"As we analyse...the great unity
which we call his ego fits into itself all the instinctual impulses which
before had been split off and held apart from it. The psycho-synthesis is thus
achieved in analytic treatment without our intervention, automatically and
inevitably." (Freud, 1918, 161).
Freud, S. (1918). "Lines of Advance in
Psycho-Analytic Therapy" SE. XVII. p.161
