Prologue: On Disbelief

THIS ISSUE OF PSYCHOANALYTIC INQUIRY is about dissociative disorders and related subjects. It is this editor's effort to demystify area of inquiry that has had too long an association with disbelief. It was on my first day of residency training in psychiatry, a hot day at the beginning of July, that I was introduced to my first inpatients, two people with diagnoses of multiple personality disorder. I had thought this diagnosis to be quite rare. How did I get two patients, my first two, with the diagnosis? More provocative was the introduction to these people. I found their disorientation disorienting. I made appointments to see both of them in the next day or two. After I returned from the July 4th holiday, my service chief met me in the hall and invited me for an impromptu visit in her office. “Dr. Chefetz, do you really want to be here?” I was startled. Of course I wanted to be there! “Why did you make appointments with your new patients and then not keep them?” I was completely at a loss. I did not recall having made appointments, but I had a foggy sense that I had done so because that was on the agenda of my first inpatient day. I assured my chief that I very much wanted to be there and that I would promptly make new appointments and keep them. I was asked to stay “in touch.” I suppose that meant to contact her as well as to be in touch with reality. This was my introduction to fear in the countertransference and my own capacity to not know, to dissociate knowledge.

Recently, in a group supervision that I facilitate, an experienced clinician reported that their patient was being stalked and harassed by a group of sexual sadists, former friends of the patient, whom the patient had offended. With the report of the details of this case, other supervisees noted that they had become anxious, confused, and developed amnesia for portions of the clinical material presented. One supervisee offered her own recollections of a similar patient who on the first visit had enter