Discussion
In this paper I discussed what Izkowich refers to as “the dissociative turn” and considered what might be its theoretical and clinical implications. I indicated that this issue was related to the way psychoanalysis started in the end of the 19th century. Freud encountered clinical cases where splitting of consciousness was indicated by Breuer and Janet, and chose to go along monopsychism. He might have felt that he needs to choose either monopsychism or polypsychism and practically picked the former. His choice must have been correct in that it resulted in this prosperity of the psychoanalytic movement that we all are familiar with. However, some analysts should have encountered dissociative cases and felt they need to take a second look at their theoretical approach to them, such as J. Rampl-de Groot (1981). She stated in her “Notes on Multiple Personality”(1981) that “the purpose of this paper is to draw attention to my experience that both ‘splitting’ and ‘multiple personality’ are originally present in all normal humans.”(p.615.)
It is remarkable that her “turn”
was so drastic that she concluded that multiplicity, polypsychism, not
monopsychism, is the natural state of mind.
It is worth remembering
that Freud himself did not hide that he could have been a similar situation somewhat
close to that of Rampl-de Groot. In a later stage of his analytic career, Freud
stated as follows.
Depersonalization leads us on to the
extraordinary condition of “double conscience”, which is more correctly
described as “split personality.”But all of this is so obscure and has been so little
mastered scientifically that I must refrain from talking about it anymore to
you. (Freud,
1936, p.245)
Freud’s candid
acknowledgement about his lack of scientific knowledge and experience about “split
personality” is impressive. It is unknown if, with more time and curiosity,
Freud might have developed a new view about dissociative phenomenon and make
his own “turn”. It is very fortunate that current analysts might not need to
make an exclusive choice that Freud faced: which of monopsychism or polypsychism
reflects the truth of human mind.
Here I reiterate beautiful
statement of Bromberg.
A noticeable shift has been taking place
with regard to psychoanalytic understanding of the human mind and the nature of
unconscious mental process- away from the idea of a
conscious/preconscious/unconscious distinction per se toward a view of the self
as decentered, and the mind as a configuration of shifting, nonlinear
,discontinuous states of consciousnesss in an ongoing dialectic, with the
healthy illusion of unitary selfhood.（Bromberg, 1998. p. 270.）
Lampl-de-Groot, J (1981) Notes on Multiple personality.
Psychoanalytic Quarterly, 50;614-624
Bromberg, P (1998) Standing in the Spaces. Psychology
Press, New York, London.
An inevitable question might arise. Can
we really take both of these two stances in a clinically useful way? If I
conjure up an image of a clinical case who demonstrates several different
personalities, I still think that she is a single person, perhaps that I would refer
to as “they”. However, I think I have different way of having relationship with
each of them as well. Usually a patient of DID has some sense of “we-ness” with
a recognition that they share the same body, and perhaps the same identity. As
much as they have this sense, a therapist develops some type of “generic”
transference as well as that with each personality. Clinically I cannot
determine whether I am dealing with one person or many. Instead of either or
attitude, modern clinicians should opt flexibility and latitude in choosing their
view about dissociative patients, depending on the clinical context they are in.
I hope that I discussed some of the points clinicians can bear in mind in choosing
their ways.
