Chapter 10 A Self-Psychological Perspective on Multiple Personality Disorder

There is a Janus-faced quality to multiple personality disorder (MPD), consisting on the one hand of a rejection of traumatic early experiences, and on the other of an attempt to maintain and solidify those very experiences. Because the parents of these patients never acknowledged the painful affect states their children were enduring, these states cannot be acknowledged by the patients. But they are an essential part of the child's self-experience and must therefore be maintained at all costs. The child's dilemma is how to preserve some measure of self-organization when her experiences are intolerable handled alone; when they are treated by others with indifference or disbelief; and when their outward expression is extinguished by means of punishment and threats of death. What can happen is that the huge empathic gap between the child's affective experience and the parents' response is replicated in the patient's self-organization by means of dissociations and the subjective experience that the walled-off affects are not real, or not hers. This allows the child to preserve a tie to the caregiver who is still needed but who, for his or her own reasons, cannot acknowledge the child's reactions. However, the more the affects are treated as unreal, the more they have to be reified in order to maintain the self. The MPD patient's creative solution to this dilemma is not only to dissociate the painful affect states but also to concretize them in the form of individual personalities with their own names, ages, voices, looks, memories, and characters.