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When one rereads the classic descriptions of what used to be called multiple personality, one is struck by the rather sharp dissociation of various aspects of the ego or, to use Erikson's terminology, the wide diffusion of ego identity. With the further development of psychoanalytic ego psychology, such observations seem to be less frequent and the reported clinical pictures less sharply delineated. Fugue states show a split in the feeling of ego identity, and in some extreme cases the dissociation allows the individual to act out two different aspects of ego identity, or, if one prefers, two different ego sectors. Usually one aspect is more syntonic with the status of the individual; the other an expression of repressed or denied fantasies which are derivatives of less ego-syntonic id impulses.
In certain rare instances dissociation serves to repress an entire sector of the personal history, a feat which, however, cannot be accomplished without repressing or denying the entire feeling of ego identity. As a result, the individual ignores everything that might help to disclose his personal identity. The discriminating selectivity of this dissociation is indicative of the purposefulness of the whole process. The hysterical nature of the dissociation is confirmed by the therapeutic result of deep hypnosis which alone, according to my experience, can undo the dissociation and restore knowledge of personal identity.
With the changes in the clinical pictures that come within the range of our observation, these cases, well known to older psychiatrists, are rarely seen by contemporary psychoanalytic clinicians. While in these extreme instances the act of repression or denial of personal identity must be considered to be unconscious, psychoanalytic experience with forms of partial dissociation