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


The Concept of Dissociation: Pierre Janet

Paul Kiritsis - Sunday, July 07, 2013

The next momentous step in the evolutionary development of the concept of dissociation was made by the great philosopher and experimental psychologist Pierre Janet (1859-1947). Unwaveringly pragmatic in his professional and personal dealings, Janet succeeded in backpedalling against the occult backwash of psychiatric Romanticism and the philosophy of nature by adopting scientific empiricism as the chief kaleidoscope for his investigations into the nature of consciousness. Contrary to popular belief Janet was not an atheist; he was an agnostic who went so far as to confess that the history of mankind was preserved in an intangible storehouse incomprehensible to the contemporary human intellect: “Everything that has ever existed still exists and endures in a place we do not understand, to which we cannot go.” He actually made it a point to repeat this speculative philosophy in many of his publications, adding that time travel would one day be as feasible as intercontinental flights. But these metaphysical musings were subservient to the experimental spirit within, one striving to draw conclusions from strict methodological delegations rather than accepting wholesale what the psychical forefathers had imparted to the literati as gospel.     

In 1883 Janet transferred his professional operations as professor of philosophy from the Lyceum of Châteauroux to Le Havre, enabling him to divide his attention between teaching and psychiatric research carried out independently at the Le Havre Hospital. During these formative years, Janet’s fervent interest in psychotic hallucinations and the phenomenology of perception became the primary motivator behind his short-term resolution to attain institutionalized recognition as a physician; without it there was simply no way he could engage in comprehensive medical research and concomitantly gain professional recognition for it. This eagerness to delve into a medical dissertation, the doctorat ès lettres, was dutifully matched by renowned physician Dr. Gilbert’s aptness at finding him appropriate experimental subjects, parenthetically individuals riddled by bouts of somnambulism.

One that proved pivotal to his theorizations on neurasthenia was Leonie, a poor, bucolic woman trapped amid the inertia of a rather monotonous and uneventful married life. When Janet resorted to hypnotic regression during the treatment sessions, she underwent an unprecedented metamorphosis into a lively, boisterous, and sarcastic woman who emphatically repudiated all associations with the ‘normative’ stream of consciousness. Unleashed like a Jeanie from a bottle, the second Leonie evoked her quick-wittedness and intellectual superiority in claimed biological and psychological independence from the first; her argument rested on intrinsic convictions that the cerebral chasm separating the two was far too great to assume that they were one and the same person. Garnering support for a psychological model that regards intrapersonal relations as belongings of integrated personalities, the second Leonie asserted, quite candidly in fact, that the children belonged to her but that the husband was a complete stranger. In time, a third Leonie materialized from the penumbra of consciousness, a narcissistic, pejorative, and creative subpersonality that branded the first Leonie as “a good and stupid woman, but not me” and the second as “a crazy creature”. After seven months of clinical work, Janet realized that the fragmented personality system resembled an actualization hierarchy: the third alter knew about the second and the first; the second only about the first; and the first was completely oblivious of the existence of the others. Moreover, Janet was studious and conscientious enough to conduct painstaking investigations into the phenomenon of suggestion from a distance that became evident under Leonie’s magnetization. To his surprise, the thread coursed back to an agglomeration of historical literature on artificial somnambulism and associative phenomena described by the likes of Puységur and the early magnetists, a wealth of overlooked knowledge that he revived, collated, and evaluated for the historiographical component of his medical thesis, Les Médications Psychologiques.

Another case that facilitated Janet’s circumscribed definition of what constitutes dissociation was that of Achilles, a businessman in his early thirties. The latter was admitted to the Salpêtrière hospital at the conclusion of 1890 with all the tell-tale signs of diabolic possession–phenomena that included voluntary acts of self-mutilation, proffering verbal atrocities, and radical vicissitudes in the intonation of voice. Methodically scrutinizing the patient’s history, Janet discovered that six months prior Achilles had embarked on a business trip from which he’d returned inert, melancholic, and taciturn. Caught in a mental vacuum and spiralling deeper and deeper into an asthenosphere of chaos, the systematic physical examinations conducted urgently by a band of medical doctors did little to shed any light on Achilles’ psychological mystery. After a brief detour onto the psychic isle of catatonia, Achilles came to with a bloodcurdling ululation that would have awoken the eternal dead before mentally somersaulting into a diverse continuum of histrionics; he bewailed and accursed his fallen state, avowing that he had been burnt and marked by conflagrations in Hell and that the Devil had deposed him and take possession of his body. The hysterics culminated with a series of failed suicide attempts, after which his family were left with no recourse other than to incarcerate him at the Salpêtrière under Jean-Martin Charcot (1825-1983), who then relinquished medical command to Janet. In the beginning, Janet’s meticulous and subtle attempts to engage Achilles through conversation proved futile. The patient’s fierce resistance to extrinsic cues–an insurmountable barrier preventing psychotherapeutic intervention–tested Janet’s patience beyond reckoning, and for a while it seemed as through dissolving the impasse would require nothing less than a petition to the existing corpus of knowledge on hysterical neurosis. Eventually, Janet worked out that most operative manner of entry into the unconscious humus of a neurotic sufferer was to directly appeal to the ‘hidden observer’ of the penumbral state or the subliminal self, which in the case of Achilles had manifested consciously under the veneer of ‘the Devil’.

To do this Janet had to stroke ‘the Devil’s’ narcissism. To start he asked for an unhindered demonstration of absolute dominance over the acquiescent Achilles, a request which ‘the Devil’ enthusiastically fulfilled by making the latter stretch his arm out without awareness of the fact. Following this ‘the Devil’ made Achilles indulge in all sorts of embarrassing acts like dancing, pulling peculiar physiognomies, and smooching a bit of paper. He also induced hallucinations involving sightings of a bouquet of beautiful roses and the interoception of bodily pain from a pricked finger. Janet’s last request was also a cunning machination; he asked ‘the Devil’ to inveigle Achilles into a death-like languor, knowing full well that a hypnotic state would both unveil and allow unhindered communication with the subliminal self. At last, the objective truth streamed from his subconscious in the manner that magma erupts from a sleeping volcano. It just so happens that during the aforementioned business trip he’d committed a ‘grave misdeed’, a promiscuous, impulsive act with a working girl that he no doubt regretted. Constricted and torn apart by ambivalent feelings–on one side the desire to banish the whole thing to the furthest recesses of consciousness and on the other a will for immediate confession born from a proliferating sense of guilt–the only way to cope was to slump into a self-induced psychosomatic dumbness and then cautiously emerge into the phenomenal world again under the umbrella of an elaborately constructed religious fantasy. Janet exploited hypnotic regression to demote the severity of the misdeed and dressed memory of immediate past with fabricated details designed to convince Achilles that his wife had forgiven him of his marital treason. Tampering with authentic memories would be chastised by many a contemporary psychologist, however it did have the desired effect. The hallucinations of diabolical torments gradually receded from waking mechanisms of perception, withdrawing to the periphery of dream consciousness from whence they eventually pinched out. In December 1894 Janet publicized the celebrated cure of Achilles in a paper, citing that from the cessation of treatment he had remained hitherto unburdened of any relapse.

Working with patients like Leonie and Achilles enabled Janet to made conceptual associations between artificial somnambulism and hysterical neurosis where the latter became paradigmatic of the former. In his theoretical suppositions, Janet professed that hysteria was “an illness of personal synthesis” that could be described as “a form of mental depression [i.e. lowered integrative capacity] characterized by the retraction of the field of consciousness and a tendency to the dissociation and emancipation of the systems of ideas and functions that constitute personality.” When disconnected from one another, these systems operated like little conscious islets comprised of an integrated sense of self replete with semantic and linguistic capacities, affects and behaviours, and the capacity to construct past and future scenes. Such cognitive-affective disintegration could, for the most part, be attributed to a lethal cocktail of intrinsic vulnerability and the progressive or sudden emergence of ailments, physical exhaustion, and traumatic memories. Salient reminders of such would reactivate the pain repositories, which would then intrude upon or usurp the habitual personality, again and again, until the aetiological stressors were removed with the aid of psychotherapeutic interference.

As a scrutinizing observer of phenomena, Janet made critical distinctions when speaking about traumatic memories or what he called primary idées fixes. These were all pathological in nature and yet they could be further subdivided into mental stigmata, the functional losses in cognition symptomatic of trauma, and mental accidents, sensorimotor and perceptual changes in the respective individual triggered by an unconscious longing to recreate the trauma. Sprouting from the traumatic memories were secondary idées fixes, dreams and paramnesias not grounded in the authentic experience but nonetheless correlated. In Achilles’ case the hallucinations of burning in hell and being possessed by the Devil would have been interpreted by Janet as fixed ideas of the secondary type; they are fantastical by-products streaming forth from the subliminal self but not one and the same with the underlying aetiology, the brooding guilt. Perhaps the most interesting observation regarding Janet’s archetypal model of hysteria involves the absence of phenomenological frontiers between cognitive and somatic forms of dissociation. In all truth, what might this failure to distinguish between the psychological stratum (i.e. thoughts, feelings, emotions) and the physiological stratum (i.e. somatosensations, movements, proprioception, etc.) infer? A professional oversight seems unlikely given his superfluous empiricism, and so it becomes exceeding likely that Janet employed holistic scaffolds in couching his pathological conceptualizations of mental stigmata and accidents. Intentional or not such nebulousness on his part is admittance, to some degree, that mind and body form a coherent synergistic mechanism that cannot be ontologically divided.

On the whole Janet believed that the severity of fragmentation was contingent on the depth of traumatization, a belief that preponderates in contemporary dynamic psychiatry today. Hence neurosis, hysterical psychosis, and multiple personality were all frequencies on the multi-coloured spectrum of dissociation whereby the disintegrative effects experienced during each state reflected outright the concentration, interval, and recurrence of extrinsic stressors. In multiple personality, by far the most severe and complex form of dissociation, each fragmented subpersonality subscribed to its own bundle of psychological and biological impulses; possessed its own repository of memories and chronological history, persona, and ‘physical characteristics’; and believed itself to be autonomous of the fragmented whole. Moreover, Janet came to realize that in some instances autobiographical knowledge diffused across subpersonalities whilst in others memories and experiences were not mutually shared. Another resourceful observation concerned the individual field of presentation or seat of constricted consciousness; two or more alters could take turns at driving the ‘body’ or cohabit it, or alternatively they could shift erratically between the two variant conditions. To enforce reintegration Janet would create external contingencies tailored to stimulating the individual integrative capacities of the patient; then offer psychic conduits for the resolution of traumatic memories; and finally promote reorientation of the stabilizing personality within the greater community. Widely recognized as the pioneer of the first practical intelligence test, the experimental psychologist Alfred Binet (1857-1911) successfully duplicated these conceptual and therapeutic novelties in his own work and explored the degree of autobiographical transmission purported to occur between subpersonalities on an unconscious level.


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