Comment on ‘The multiple self’

I found this article full of valuable clinical observations, and moving, because of the good affective contact which the author was able to maintain with the various ‘selves’ of the patient. By the time of writing, the patient, learning from the therapist, was well on her way towards getting to know and owning some of her previously dissociated subpersonalities, and helping them to relate more positively to each other.

But who is ‘the patient’, who is learning more and more about her different selves, her varying moods and states of mind and attitudes on life and people? It is of course mainly, but not only, Chris, who is developing a secure enough sense of self in her relationship with the therapist, in the improving mother transference, to be able to be helped to face and share the pain, fear, and destructive anger which originally brought about the dissociations.

In my experience it is usually counterproductive to have theoretical preconceptions about the ‘cause of the fragmentation’ or about the ‘real’ traumatic events which then triggered, or now trigger, the dissociative changes of identity. These become clear as therapy enables the relevant affects to emerge and integrate, as the therapist's non-judgemental yet affectively sensitive attitudes towards the different selves are taken on board (I mean taken in, digested, and made her own) by the patient. We see this happening in the clinical vignettes we have been given. The psychic level of the relation between ego and unowned affects in a case may be anywhere from ‘hysterical’ to ‘psychotic’, as the terms ‘dissociation’ and ‘splitting’, if used accurately, indicate. The therapy and the affects respectively involved in dissociation and splitting are of course of a different order of difficulty and duration, and the classic cases are fortunately more at the dissociative end of the spectrum. ‘I cannot be X in the presence of Y’ can change tricksterishly at various psychic levels to ‘I am Z: X is not-I’; or, ‘This is