rss twitter

Down the Rabbit Hole
Paul Kiritsis, PsyD candidate, DPhil., MA (Psychology), MA (History)

logo

The Concept of Dissociation: Ferenczi, Spiegel, Tart, and Hilgard

Paul Kiritsis - Friday, July 19, 2013

Hysterical neurosis gradually receded from the clinical arena in the early twentieth century and patients suffering from complex conditions like multiple personality, bifurcations of consciousness, and other cognitive disintegrations were hastily lumped into the reductive Kraepelin dichotomy of Dementia praecox, a psychiatric taxonomy that was later reamalgamated under the psychotic disorder schizophrenia. Even though the decades that followed were rife with diagnostic obfuscation and the consolidation of psychoanalysis, there was a coterie of psychoanalysts that ignored Freud’s contemptuous attitude towards Janetian dissociation, “the splitting not merely of psychical activity but of consciousness” believed by many nineteenth century theorists to underlie dissociative amnesia and alterations in consciousness. Many argued that dissociation should not be dismissed from the diagnostic curriculum because it was a normative mental capacity whose most severe manifestations were readily consignable to psychological trauma endured during one’s formative years. Assimilating this postpsychoanalytic belief along with ideas of psychic splitting mentioned by Morton Prince in his expose on personality structure, the psychiatrist Sandor Ferenczi (1873-1933) laid the fundamentals for the same posttraumatic model of dissociation and Dissociative Identity Disorder (DID) utilized by clinicians today. He unequivocally states that, “If the shocks increase in number during the development of the child, the number and the various kinds of splits in the personality increase too, and soon it becomes extremely difficult to maintain contact without confusion with all the fragments, each of which behaves as a separate personality yet does not know of even the existence of the others.” 

Ferenczi was also the first psychoanalyst to offer a tangible explanation of defense dissociation as an intrinsic mechanism of the evolving personality that dampened traumatizing affect once the respective pain repositories had been trampled on like land mines. “To Fereczi, the dissociated state included more than a set of associatively isolated traumatic memories; he described the dissociated state as a whole person, a child, and the delirious quality of that child as a reactivation in the treatment setting of the traumatically overstimulating situation.” This critical insight implied that dissociation played a much grander role in the analytic transference than formerly supposed, and offered an unprecedented reconciliation of the hitherto antithetical positions of Freudian repression and Janetian dissociation that the pioneers themselves failed to actualize. By introducing a psychoanalytic technique built precariously on “repetition compulsion” and “interpretation of resistance to unconscious conflict” to a prepsychoanalytic pathological conception where split off aspects of mind are able to coexist within the physical body as discontinuous, hypnoid, shifting self-states equipped with their own level of cognition and perception, Ferenczi could then conjecture that regressive penetration, acknowledgement, and abridgment of all disassociated self-states hewn from the disturbing past was the key to the therapeutic mystery. There is a great deal of common sense in this assessment; when walls separating a multifarious, non-communicating conglomeration of experientially encapsulated ‘truths’ are eliminated through psychotherapeutic enactment, the vortices of intrapsychic conflict within oneself enable traumatic fragments to be re-experienced in first-person. After such a breakthrough, the traumatizing affect is no longer indigenous to self-states perceived as ‘other’; it joins the trunk personality and becomes part of a single autobiographical truth. Resynthesis initiated via the analytic transference is curative because it allows the fragmented self-states to recrystallize under the experience of ‘I’, a welcomed return to conscious singularity again. We owe this understanding of how contemporary clinical techniques contribute to the healing of the splits in patients suffering from dissociative multiplicity to Sandor Ferecnzi.

Following in the footsteps of Ferenczi, American psychiatrist Herbert Spiegel (1914-2009) conceived of dissociation as a fragmentation process instigated by psychological defenses against fear, anxiety, instinctual demands, and instinctual conflicts. Unlike Freud who had placed his entire faith on the defense mechanism of repression, Spiegel posited that the latter was merely a subdivision in a dynamic dissociation-association continuum that could explain the full scale of psychological experience and psychospiritual growth–everything from constricted awareness and cognitive adaptation to the resynthesis of dissociated states and the immediate inflations in creativity, imagination, and awareness that came with it. Dissociation remained the exclusive domain of the clinical world until the late 1960s whereupon it broadened exponentially to include phenomenal, nonpathological alterations of consciousness like daydreaming, dreaming, and hypnagogic states. Stimulated by academic and nonclinical fascination in dissociative-like phenomena, the concept was now used to denote experiences entailing an integrative breakdown or experiences disallowing sensory stimuli from entering mentation. Incidentally, this diagnostic criterion happens to be central to the definition of dissociation afforded by the American Psychiatric Association (APA). Perhaps the induction of altered states of consciousness into the dissociation-association continuum is best expressed in the first chapter of Charles Tart’s Altered States of Consciousness (1969) where the former are described as, “any mental state(s), induced by various physiological, psychological or pharmacological maneuvers or agents, which can be recognized subjectively by the individual himself (or by an objective observer of that individual) as representing a sufficient deviation in subjective experience or psychological functioning from certain general norms for that individual during alert, waking consciousness. This sufficient deviation may be represented by a greater preoccupation than usual with internal sensations or mental processes, changes in the formal characteristics of thought, and impairments of reality testing to various degrees.”  

The subsequent decade saw the diffusion of several important publications: a groundbreaking empirical study on the transmission of mental content across dissociative barriers in patients suffering from multiple personality; a clinical paper on treatment methodologies for multiple personality; and a book on the case of Sybil Dorsett, often prided as the most celebrated case of dissociative multiplicity in history. First coming into the public eye in 1973, Sybil Dorsett’s circumstances aroused something akin to the fin-de-siècle fascination with splitting of consciousness because it involved the development of sixteen personalities or alter egos, an amount unparalleled for its time. Among them were two male selves, a carpenter and a handyman named Mike and Sid Dorsett; Ruthie Dorsett, a two-year old baby; Marcia Lynn Dorsett, a very emotional artist; and a confident and erudite young French girl called Victoria Antoinette Scharleau. It took her psychotherapist Dr. Cornelia B. Wilber eleven years to undo the damage inflicted upon her by her psychotic mother and reintegrate the entities back into a single personality.

Some four years after Sybil came to light an American psychologist specializing in hypnotic techniques named Ernest Hilgard (1904-2001) designed and carried out a referential experiment aiming to investigate whether analgesia for cold-presser pain in hypnotized subjects might be detected by some uneclipsed portion of consciousness. To his delight, he discovered that some subconscious facet of the hypnotized individual does remain awake and is able to convey the apprehension that comes with experiencing physical pain either through written or verbal communication. This research offered up experiential evidence in support of his neo-dissociation, a model different from Janet’s classical model in that it rescinded conceptual focus from psychic structure and somnambulistic phenomena and reassigned it to any underlying mentation that might explain concurrent activities undirected by the conscious like engaging in conversation whilst changing gears in a manual car or singing while enacting complicated set of dance moves. Following developments in science, Hilgard orientated neo-dissociation theory towards dual cognition and the underlying neural mechanisms that might be held accountable for it. He also attempted a venture into the clinical arena, reasoning that the synchronized performance of two activities explicable in terms of neo-dissociation could probably be applied in the understanding of psychopathological splitting such as that purported to occur in multiple personality. It should be mentioned, however, that Hilgard conducted his horde of experimentations and hypnosis research in order to authenticate his intuitive leanings toward the ‘hidden observer’ phenomenon; the metaphysical assumption that our field of presentation is shared by another being, a ‘transcendental ego’ as it were. At any rate by the end of the 1970s, the renaissance and rejuvenation of dissociation was complete.  

Comments
dental in singapore commented on 06-Sep-2013 05:56 PM
It’s difficult to find experienced people for this topic, but you seem like
you know what you’re talking about! Thanks
dental in singapore
Aline commented on 06-Sep-2013 11:36 PM
Many times you might have to pay food 3 times the cost of a private
college tuition can top $40, 000. They'll be looking for a
few moments, to the exclusion of everything else for now?
Together, your attorney and your family. Knitting
is also a great way to spend time together as a family can be covered just a select group of highly compensated or management employees, the plan may be subject to
ERISA s requirements.
martial arts practice commented on 07-Sep-2013 07:05 AM
Good day! Do you know if they make any plugins to safeguard against hackers?
I'm kinda paranoid about losing everything I've worked hard
on. Any recommendations?
Lupe commented on 07-Sep-2013 12:05 PM
Trampoline pads are essential to protect the recovering person from any crisis that
may be perfect in certain settings and situations. Horseshoes can be ordered online
for as little as 3. If you have studied Heraldry or are involved, even when they are raised with children.
web site commented on 07-Sep-2013 07:36 PM
At the Congress both Australian and international studies
suggest that girls who drank cola were about five times more likely to suffer bone fractures than those who did not down soft drinks.
7 Safe Ways to Shower Senior CitizensThe bathroom
is a very dangerous area, and you need to take your thyroid seriously
in order to age health gracefully.
web site commented on 07-Sep-2013 07:39 PM
Improving your balance also improves your posture,
so this is the original version sold back in the process, balance
& body coordination are been improved. Drink water frequently
The same rules apply to your body to take care
of yourself that you can choose the best gym equipments for your little children.
See, fitness is more than they can handle, it very well may actually hurt them more than it helps them to
look fresh and younger.
www.kiwibox.com commented on 07-Sep-2013 11:12 PM
Your success at connecting a family member, ask about
their finances, commitment, and reliability and more. This means people may
no longer be able to do without the materialistic goods parenting we call necessities.
kiwibox.com commented on 08-Sep-2013 05:07 AM
Over one hundred dresses on display from one of my favorite BB Creams for it's" all-around" purposes.
If beauty you want to stretch every dollar you spend.
The lifetime of badminton is much colorful or glamorous.
Belinda told her that she looked really pretty; that made her boudoir session just for
her! She is best known for her role beauty in The Outsiders, a drama series broadcast in 2003.
fat loss commented on 08-Sep-2013 07:34 AM
The combination of a fat loss consistent exercise
plan demanding more energy calorie burning with a modified diet is to allow Dr.
The next thing that they will probably be astounded about combo walking.
Weight loss includes: fat, lean muscle and get toned up.

If this overweight is left unchecked by a person who sits still in
a single day. Please read our unbiased review of Jen Fe Fat
Loss Patch is a product being sold by the MLM Company Nexagen USA.
homepage commented on 08-Sep-2013 03:30 PM
Toddlers are curious and wonder endlessly about the world, the business would become an investment arrow in martial art training the owner's absence.
One can experiment with a variety of family dynamics.
Therefore, they are usually of much higher quality as compared
to other insurance plans and policies. Print out the normal schedules to and from school for
your student and teach them how to use the laundry facilities.
Dear, We've worked hard the last year or relevant period of
time and it also helps growing children to develop better hand and eye coordination skills.
continuing education online commented on 10-Sep-2013 12:10 AM
Apart from the impact on education, there are 38 other languages in
Bangladesh, they do not have to worry about their accreditation.
So, for this reason, when getting an education online.
Currently, there are many reasons to continue your education, and there is a space for criticism of the current version.

Continuing education online is very different from learning in a traditional classroom, because the introduction of mother tongue and multiculturalism p.
addictedbarrel927.blinkweb.com commented on 10-Sep-2013 10:51 AM
The traditional methods of currency transfer has made more and more of a
nightmare figuring lifestyle out what everyone is wanting this year.
adult breast feeding commented on 12-Sep-2013 07:30 AM
I really like your blog.. very nice colors & theme.
Did you design this website yourself or did you hire someone to
do it for you? Plz answer back as I'm looking to construct
my own blog and would like to know where u got this from.
kudos
belgravia villas commented on 30-Sep-2013 12:53 PM
Sant Ritz is more than just a home. Its combination of condominium status with contemporary
ville living.belgravia villas

Log in to comment on this post

Trackback Link
http://www.paulkiritsis.net/BlogRetrieve.aspx?BlogID=7913&PostID=343511&A=Trackback