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The first speaker, Dr Prisciliano de León, read a paper entitled ‘Incest, theory and clinical reality’, based on a clinical-statistical study of child sexual abuse cases conducted between 1991 and 1997. De León gave some preliminary ideas based on the statistical data. (He had expected to read this in Spanish, so his presentation was curtailed.)
Then, Margaret-Ann Fitzpatrick presented her paper ‘Trauma, Sexuality and Dissociation’. She reported on the emergence of separate personalities during the analysis of a 54-year-old woman. She referred to the dissociation described in Ferenczi's classical paper, ‘Confusion of tongues between adult and child’, brought about by the intrusion of adult sexuality into the body and soul of the child. If the shocks suffered by the child continue, the personality splits are intensified. Finally, it is very difficult to keep the connection between these fragments, the failure of which brings about the appearance of separate personalities.
Fitzpatrick endeavoured to explain how separate personalities that take control of perception and of psychical and motor activity may emerge. She thinks that identification with the aggressor, the vertical splitting described by Freud in perversions, the denial and isolation defences that have been described as intensely at work in dissociated personalities that have suffered from sexual abuse, and the schizoid mechanisms acting in borderline personalities, are insufficient to explain how a separate personality takes control over the whole psychic life.
The author thinks that Glover's ego nuclei concept, that is, diverse clusters of instinctive experiences and the reactions to them, opens the way to understanding the appearance of separate personalities described by Ferenczi. Thus, separate personalities may be understood in the light of a regression to primitive patterns in which ego nuclei may be formed or existing ones may be reactivated. During the analysis of her patient the author observ