The Concept of Dissociation: Breuer, Freud, and the Break from Janet

 

 

Late in the nineteenth century dissociation paraded under names championed by the French researchers like dédoublement de la personnalité, existences successives, désagrégation mentale, état second, and many others. It was even acknowledged as an integral mechanism in traumatic experience by Josef Breuer (1842-1925) and Sigmund Freud (1856-1939) who, after documenting their clinical observations in various neurological journals, published an exposition titled Preliminary Communications (1893) that postulated:

“[W]e have become convinced that the splitting of consciousness which is so striking in the well-known classical cases under the form of “double conscience” [fn: the French term (“dual consciousness”)] is present in a rudimentary degree in every hysteria, and that a tendency to such a dissociation, and with it the emergence of abnormal states of consciousness (which we shall bring together under the term “hypnoid”), is the basic phenomena of this neurosis. In these views we concur with Binet and the two Janets… These hypnoid states share with one another and with hypnosis… one common feature: the ideas which emerge in them are intense but are cut off from the associative communication with the rest of the contents of consciousness.”

Following in the footsteps of their French contemporaries, Breuer and Freud make it clear that hysterical neurosis is underpinned by trauma and psychological weakness, aetiological factors that force a schism of consciousness and leave the individual nursing an intrusive bundle of negative and positive symptoms. Yet they differed from Janet in stressing that splitting was an inadvertent repercussion of the dissociative state rather than an individual propensity stemming from biological predisposition. In the years following this publication, Freud plummeted into the Stygian darkness of a creative illness, a polymorphous condition vacillating between depression and psychosis that facilitated a metamorphosis in the deepest strata of his being. Recalling the adage ‘To ascend, one must first descend,’ this inwardly-turned endeavour spurred morbid fascination with half-formed ideas that would coalesce to form the dynamic scaffolds of psychoanalysis. He began to transpose leitmotifs central to the conceptual threads of Darwinian evolution into the psychological stratum and proceeded to speculate in typical philosophical fashion: did intrapsychic conflict and instinctual drives play a much greater role in the evolution of hysteria than formerly supposed? Curiosities of this class tapered his perception of hysterical neurosis down to an inaugural defence mechanism begot by an ego wishing to defend the psyche against intense affect. Aetiological dignity was bequeathed to childhood trauma and abuse, further undermining the role of dissociation. After cogitating the rudimentary framework of what would later become his repression model, Freud distanced himself from Breuer and the hypnoid (somnambulistic) states to which the latter had remained faithful:

“Strangely enough, I have never in my own experience met with a genuine hypnoid hysteria. Any that I took in hand has turned into a defence hysteria… I was able to show afterwards that the so-called hypnoid state owed its separation to the fact that in it a psychical group has come into effect which had previously been split off by defence… I am unable to suppress a suspicion that somewhere or other the roots of hypnoid and defence hysteria come together, and that there the primary factor is defence. But I can say nothing about this…

[A]t the basis of retention hysteria, too, an element of defence is to be found… It is to be hoped that fresh observations will soon decide whether I am running the risk of falling into one-sidedness and error in thus favouring an extension of the concept of defence to the whole of hysteria.”

In hindsight, there’s no way of knowing Freud’s intent; was he genuinely convinced by assertions bound to reductionist empiricism or was he unconsciously trying to further a psychoanalytical agenda in statu nascendi through shameless, deliberate indulgence in clinical misapprehensions? Whatever the motivation, his decisions to exclude all conceivable defence mechanisms save for repression from neurotic and immature defence was a categorical error with far-reaching consequences. The first was an erection of gargantuan walls separating the splitting of consciousness, degeneracy, hereditary predisposition, hypnosis, and complimentary concerns to do with the Janetian understanding of dissociation from repression, instinctual drives, libido, defence, conversion, free association, and other contributions that were pioneered by Freud. On one flank was the prepsychoanalytic perspective, the tendency to conceptualize dissociation as integrative failure at the behest of traumatic experience that ensued in dissociative multiplicity, and on the other an antithetical psychoanalytic perspective relegating dissociation to an epiphenomenological process of failed integration afforded by an ego operating within the parameters of self-defence. The first order was anachronistic, conceptually flawed, and subjectively placed; the second modern, ground-breaking, and objectively orientated. Freud’s unashamed recourse to a Platonic dualism, an either-or mentality where only one psychological denomination monopolized objective truth obfuscated the rationale that the autohypnosis inherent in hypnoid states could also serve as an unconscious mechanism for defence. Moreover, it led to excessive and unwarranted generalizations concerning the origin of posttraumatic pathology. There can be no doubt, for instance, that a significant proportion of cases in Studies on Hysteria (1895) imprudently elucidated under the banner of childhood sexual trauma had nothing to do with the latter at all, but were instead examples par excellence of alterative kinds of psychopathology whose existence and proper diagnosis were supressed by the new phenomenology. Freud would soon jettison childhood sexual trauma from the scope of defensive repertoires in favour of juvenile sexual wishes in order to account for an obvious yet hitherto unacknowledged oversight that repressed material spewing forth from the unconscious was not always authentic in nature (i.e. actual memories). Many years later, the intellectual cul-de-sac which Freud had wrought from confounding repression, sexuality, and defence was evaluated by Breuer as an ‘absolute and exclusive formulation’ that scientific inquiry would repudiate in the near future.

Conversely, the parenthetical dismissal of Janet’s constitutional liability for dissociative hysteria coupled with the unacknowledged appropriation of ‘hypnoid’, ‘defence’ or traumatic stimuli, and ‘retention hysteria’ (concepts pioneered by Janet) heralded the beginning of mutual polemics between the two greats; Freud, in particular, became notorious for either downplaying or conveniently oversighting Janet’s contributions every opportunity he got. The professional depravity did not go unnoticed, nor would one expect it to. When the International Congress of Medicine finally took place in London on the 8th August 1913, Janet emerged with a swift counterattack on Freudian psychoanalysis, arguing that the psychoanalytic elucidation of traumatic origins allegedly resulting in the cathartic cure of neurosis had been plagiarized from his own work. To this he added that Freud’s symbolic interpretation of dreams and his attribution of neurosis to childhood sexual trauma were quintessential exponents of a singular ‘metaphysical system’ with no solid grounding in empiricism.

Freud could have averted these two calamities, the professional and the intellectual, simply by acknowledging his sources and sublimating his mentation to the mount of rumination from which hypnoid states are assimilated as a defensive dissociation rather than rejected. The acceptance of hypnoid states into his repression model under that banner would have made permissible a conceptual frontier between dissociation and repression, and furthermore amplified his conceptual repertoire to include other likely aetiologies for normal-neurotic psychopathology. But the oeuvre which Freud was pursuing wasn’t malleable, and the idea of dissociative multiplicity was soon ejected from the twentieth-century psychoanalytic mainstream in the manner that purpled fruits are cast from the sturdy branches of every emerald-green heaven. Not surprisingly, the early Freudians accepted their master’s one-dimensional view without so much as batting an eyelash.

 

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