The Concept of Multiple Self States: Clinical Advantages

As I think and write more about the subject of dissociation, I find the idea that the mind consists of multiple self states increasingly useful in my clinical thinking. I am aware that many self psychologists and intersubjectivists are leery of this relational idea, believing that it runs contrary to central self psychological beliefs that the aim of treatment is a greater sense of cohesion and continuity of self experience and that a divided self is indicative of pathology. Accordingly, I would like to suggest some ways that thinking clinically about self states, while also acknowledging the universal striving toward a sense of integrity, can enrich self psychology.

First, I find that patients find interpretations about their different “states” experience-near. In my view, most people don't experience themselves as having one self but, rather, as having quite distinct “modes” which come into being in different relational contexts. Indeed, individuals who feel “unitary”— in the sense of being stuck in one narrow state rather than able to flow freely through many—can usually be diagnosed with some kind of obsessional or other psychiatric disorder. They are not, as Slavin and Kriegman (1998) suggest, as able to adapt to an inherently conflictual relational world.

Second, I think a view of the mind as composed of self states contributes to our efficacy in working with empathic failures. As contemporary self psychologists steeped in infant-mother research, we think of ruptures as involving bi-directional dysregulation of self and interactive regulatory patterns within complex systems of interaction. I think we gain even greater clarity if we further understand an empathic break as a sudden shift into a disjunctive self state—a self state which grew out of some kind of relational trauma from the past and which has its own affective “truth,” behavior, sensations, knowledge, and transference. Learning more about all the different aspects of a particular state