Are You Aware of the Disagreements About Dissociation?

We are in the midst of a largely unacknowledged disagreement about what dissociation is. A few parties to this disagreement are quite explicit about their difference of opinion (e.g., Steele, Dorahy, Van der Hart, & Nijenhuis, 2009). Most of us, however, have little to say about different views of dissociation. In fact, many of us do not seem to notice that there is any disagreement. But there is.

How Can So Few of Us Be Aware of These Disagreements About Dissociation?

Easily. And for at least two excellent reasons:

(1)   Most people who deal with dissociation are front-line clinicians (and their patients). They tend to be basically pragmatic. They just deal with what comes up and they don’t think a lot about the nature of dissociation.

(2)   The deep reason that we are not aware of disagreements is that present-day clinicians and researchers ‘grew up with’ a bastardized concept of dissociation.

So, let’s try to dismantle our colloquial understanding of dissociation. I think you will find this excursion to be more than just educational. It should actually be a bit revealing.

Pierre Janet

Janet is the originator of the concept of dissociation, but his model of dissociation has remarkably little to do with today’s colloquial understanding of dissociation.

Janet described dissociation as a structural phenomenon. What does that mean? According to Janet, separate parts of the personality are dissociated. Separate parts = separate structures. Thus, the essence of Janetian dissociation is the existence of separate parts of the personality (each of which can autonomously assume executive control, or intrude into, the functioning of the person).

How or why did these separate parts of the personality come into being? Here is where our colloquial understanding of dissociation starts to enter the picture. Janet said that dissociation was caused by a lack of ego strength (actually, he described it as a low level of mental functioning). According to Janet, a debilitating deficit of ego strength can undermine a person’s capacity to psychologically ‘take in’ a stressful event. When this occurs, these stressful events ‘fall to the side,’ thereby creating a separate part (separate compartment, separate structure) that now ‘holds’ those events.

Did you feel it? Did you feel the challenge to the notion of dissociation that you ‘grew up with?’ Note: Janet did not say that something traumatic or aversive was ‘pushed away,’ or ‘split off,’ or ‘repressed.’ Our colloquial notion of dissociation, however, is completely centered around this idea – i.e., the idea that dissociation takes something unacceptable and pushes it away, splits it off, denies its existence, rejects its reality, disowns it, etc. The problem is that Janet never said that.

For Janet, dissociation was a ‘falling apart’ due to mental weakness. To make this easy to grasp, I will reduce Janet’s model to two points:

(1) The nature of dissociation: separate structures/parts of the personality.

(2) The cause of dissociation: a deficit of mental strength that undermines a person’s capacity to ‘take in’ a distressing event or an unpleasant reality.

Our colloquial understanding of dissociation decisively (but unknowingly) rejects Janet’s cause of dissociation.

OK, let’s finish dismantling our colloquial understanding of dissociation so that we can see what it is – and where it came from. Time for Freud.

Sigmund Freud

After a very brief flirtation with Janetian dissociation in 1893 (Breuer & Freud, 1893), Freud explicitly rejected Janet’s concept of structural dissociation. He also explicitly rejected Janet’s cause of dissociation (i.e., mental weakness). By the way, in doing so, Freud became an early rejecter of the concept of multiple personality. In fact, Freud so thoroughly rejected dissociation and multiple personality that he made it difficult for subsequent Freudians or psychoanalysts to pay any attention whatsoever to either multiple personality or dissociation.

Freud’s big contribution to our colloquial understanding of dissociation is his concept of repression. Repression is very different from Janetian dissociation – for two important reasons:

(1) Repression does not create any dissociated structures. Repressed material is simply no longer conscious; it does not create some new compartment to hold it.

(2)   The cause of repression is not a ‘falling apart’ due to mental weakness, but instead, an active, motivated (albeit usually unconscious) mental rejection or disowning of some aspect of reality (pertaining to others or the self). Bottom lineRepression is a psychological defense.

Freud essentially invented the concept of psychological defense. Janet and Freud had an ongoing disagreement about this. For Freud, everything was defense. For Janet, defense was largely irrelevant.

Today, our 21st century understanding of human nature has so totally assimilated Freud’s ideas about psychological defense that we find it hard to imagine a human psychology that does not include defenses.

Although largely unrecognized, Freud’s notion of repression lies at the heart of our colloquial understanding of dissociation. That is why we think of dissociation as a pushing away or splitting off of something aversive. In Janet’s hands, dissociation was a consequence of mental weakness, not a defensive maneuver of the mind. Nevertheless, today’s colloquial understanding of dissociation is that dissociation is a defense.

To summarize, our colloquial understanding of dissociation:

(1) Has lost its Janetian cause (i.e., a mental weakness that causes a ‘falling apart’ of the personality)

(2) Has adopted the Freudian cause of repression (i.e., a motivated pushing away or suppression)

(3) Often seems to reject Janet’s structural model (i.e., that what is dissociated are separate parts or structures of the personality)

(4) And seems most comfortable with a repression-like model of dissociation (where something distressing is unconsciously suppressed, but does not create a new compartment or dissociated structure to ‘hold’ it.

This post is already much too long. I will close by noting that the most vocal challengers of our colloquial understanding of dissociation are modern-day Janetians – namely, the proponents of structural dissociation. They insist that dissociative phenomena must be driven by dissociated structures. And yet, as we will see in future posts, most colloquial and contemporary understandings of dissociation make no mention of any dissociated structures.

More to come in future posts.

So, what do you think about all this? Is dissociation a defense? If you dissociate, do you experience it as a defensive response or reaction? Must dissociation involve dissociated structures? [To comment, or to read the comments of others, click on Comments (in gray immediately below)]

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33 Responses to Are You Aware of the Disagreements About Dissociation?

  1. Lynette Danylchuk says:

    Paul,
    In my practice, I see signs of ‘all of the above’. Sometimes the dissociation appears to be structural, sometimes it seems to be primarily defensive, and sometimes I see definite signs of repression, either systemically or compartmentalized. I think the range and quality of dissociation is far more complex than we currently realize, and that adds to the fragmentation of the field.

    • Teresa says:

      I agree with your stance in general. In my experience there is no dissociation without defense/repression. Fugue states, memory loss, identity changes…these always seem to accompany trauma. I have never encountered anyone with DID wherein there has been no (very) traumatic memories to defend against. I reject the structural notion because there is simply no logic therein. Vietnam vets were perfect examples of repression and defense. Iraq/Afghanistan vets are beginning to show the signs, but of course the VA will not want to fund treatment at all possible, due to the expense.

  2. Lynette,
    Thank you for saying this. In doing so, I think that you have validated the experience of almost all of us. The issue that I am wrestling with here is: “How many of these different kinds of ‘dissociation’ should be called “dissociation?” All of them? Some of them? Only one of them? Do they have different mechanisms? If they have different mechanisms does that mean that they are truly different from one another? I struggled at length with these questions in my book chapter, “Understanding Dissociation” [Hey! Good title! :)] in the Dell and O’Neil (2009) book. I concluded that there were many different ‘dissociations,’ but I could not decide how many deserved the name (i.e., dissociation). On the other hand, Steele, Dorahy, Van der Hart and Nijenhuis (2009) insist that only one kind deserves the name (i.e., structural dissociation).

  3. Teresa says:

    Dear Dr. Dell,

    Your differentiation of the Janetian and Freudian concepts of dissociation are so helpful. As a behavioral health practioner since the eigthes, I have known only two certain cases of (what was formerly called MPD) DID–I agree entirely with the repression hypothesis, not the mental weakness idea.

    I know that health insurance policies have a lot to do with the way we view dissociative disorders, in all their forms. Nohealth insurance company wants to fund what is required to really address DID: Treatment takes a long time for many people, and the quick fix of meds do not solve the problem. Thus, in my opinion as a clinician, that money is involved whenever we speak of DID.

    Dr. Dell, I will also say that I so appreciate your continuing interest and concern with DID (or MPD, whatever the press decides is more socially acceptable) Since “Sybil” there has been a backlash against the notion of dissociation in any form. As I have learned the hard way, there is no doubt at all that dissociation is a defensive mechanism that is entirely outside the individual’s control. But, not surprisingly, insurance companies do not want any part of this, knowing that they cannot dictate a simple medication solution.

    Thank you again for your contribution on this issue, which should not be controversial but is.

    Teresa

  4. Holly Gray says:

    I don’t think I clearly grasp Janet’s concept of dissociation as an entirely structural phenomenon. Is the idea that dissociation, any dissociation, manifests via separate parts? If I’ve got it right there then I don’t see what’s so different about his theory and the way we think of dissociation today.

    As for dissociation being a defense, it certainly feels like that. But I don’t see how Janet’s theory that dissociation is caused by a mental deficit objects to that. I mean, let’s assume for a moment that Janet is absolutely right. I have DID because my mind is weak and cannot, as you say, ” … ‘take in’ a distressing event or an unpleasant reality.” I continue to dissociate for the same reason. Doesn’t it make sense that the mental deficit, the inability to process trauma, would engender both defensiveness and repression? How does Janet’s perspective preclude dissociation as a defensive response? How does it reject Freud’s repression ideas? Why can’t they both be true?

    Maybe I’m trying to participate in a discussion that’s over my head, but right now I’m confused as to why those ideas are mutually exclusive.

    • Hi Holly,

      You conclude by saying that maybe you are trying to participate in a discussion that is over your head. No, I don’t think that is so. You are wrestling with a multifaceted phenomenon, with competing descriptions and models, that we have far too little clarity about. I started this blog in hopes of gathering a community to think this through. This is complicated territory and your thoughts are good ones.
      First, Janet unquestionably insisted that dissociative events were caused by the activities of autonomous structures. In contrast, many current views of dissociation (e.g., Depersonalization Disorder) describe solely a process of inhibited or suppressed emotions and body sensation (but no dissociated structures). There are, I think, just too many different phenomena that currently are classified under the same heading — “dissociation.”
      Second, your point about mental weakness and repression/defense maybe being exactly the same is well taken, but a slippery issue. Janet and Freud fought rather fiercely on this same terrain. But Janet said defense was beside the point, and Freud said that mental weakness was irrelevant — that only defense determined what happened. Note that I am not siding with either view. I hope that we can continue to discuss this conundrum. Hang in there! Remember, you have a lot of ‘insider’ knowledge about dissociation (and I love the fact that you are contributing to this discussion).

      • Holly Gray says:

        Paul – Thanks for the clarification. Your use of the word “autonomous” helped me understand better the difference between Janet’s and Freud’s positions.

        My experience of dissociation is divided up into two general categories. The first, and perhaps the most dramatic, seems to fit Janet’s perspective. This is when self-states, of what appears to be their own free will, command control and behave in ways that are a natural expression of who they are, how the perceive the world, etc. It follows, then, that the dissociation I and others experience as a result is ” … caused by the activities of autonomous structures.”

        The second is much different. There is no “take over” so to speak. There’s just a disappearance. No one’s home. For other people’s benefit I generally call this “zoning out” but that doesn’t quite do it justice. The point is, this feels escapist to me and not the result of autonomous structures. I’m not sure I’d classify it as repressive, but it’s certainly defensive, protective.

        If Janet is right, the scene you described from the movie is not dissociation and neither is my type 2. If Freud is right, both the scene from the movie and my type 2 are dissociation and my type 1 is a result of repressed aspects of self. I’m guessing.

        This is definitely a thinker. Thanks for the encouragement. It’s not only interesting, it’s also therapuetic to consider questions like these.

        • Holly,

          You said: “There’s just a disappearance. No one’s home. For other people’s benefit I generally call this “zoning out” but that doesn’t quite do it justice.”
          Thank you for bringing this up. You are describing a classic dissociative symptom. It has been reported in traumatized children for over a hundred years. And I see it in many of my adult DID patients. I call it “trance.” Others may call it something else. I would love for you (and others who know this experience ‘from the inside’) to talk more about it.

          • Holly Gray says:

            Paul,

            Trance is precisely the right word. Thank you. I touched on it briefly elsewhere in a discussion of the contributing factors in the development of DID, but I’ve never thought about dedicating more word space to it. It’s always been such a normal, everyday part of life for me – like putting on shoes – that it didn’t occur to me it might be in interesting topic for discussion. But now I’m working on a post about it – thanks for the inspiration!

          • M F says:

            I seem to have a scout. I don’t know if it is like this for everyone like myself. The scout alerts me if I need to come back out again. I guess I spend a lot of time in my head. The scout I believe was created after I walked head first into a tree while walking back to school with my class from a swimming lesson. I was 9 I think. I got bullied enough at school without doing stupid things like that. I realised it couldn’t happen again – but I couldn’t give up going into my head. The scout was born.

            You ask for descriptions. 2 nights ago I was sitting on my therapist’s couch with her on the other. I started slipping away – this is pretty common. We weren’t talking about anything terribly distressing I don’t think (I can’t remember). It is almost as if I enter a second version of her office, far smaller and in my head, where it is safe. I am still aware of her – and my scout doesn’t let me forget that I need to come back. Her actual office is almost tangibly foggy though. I don’t know if I would have been able to move my arms – certainly trying as an experiment now brings me back out of that deep place (I am not as deeply within it when trying this experiment right now – I have never experimented with this before) – but it seems to me that if I could I would literally find the fog to be present – making it as hard to move my arm through the air of her office as if it were thick treacle. My therapist almost disappears. If she speaks it is as if her voice is coming from a distance. I care about things far less, it is almost like a relaxation occurring. Whatever happens will matter less. When I eventually give in to my scout and resurface it is a lot like coming up from underwater – minus the wetness. The fog clears and my ears can hear more clearly as well. It usually takes some time to fully recover though – if I do at all. By this stage I can at least converse again though.

            I wonder if that makes any sense at all?

  5. You said, “So, what do you think about all this? Is dissociation a defense? If you dissociate, do you experience it as a defensive response or reaction?”

    I’m no researcher, but having lived with these experiences for nearly 50 years my opinion is that it isn’t necessarily an either/or phenomenon. Dissociation may be a defensive responsive in certain circumstances and may be driven by different factors in other circumstances. There is no doubt to me, from what I can see in myself, that the temporary “dissociation” depicted in the film and the more extreme “dissociation” I’ve long dealt with spring from common ground.

    I’ve read “The Haunted Self” and other works by some of those same researchers. While I think the “structural dissociation” concept actually makes a great deal of sense and usually seems to reflect what I experience pretty well, I think that saying the scene depicted in the movie isn’t a type of dissociation is kind of like saying you haven’t lost a part of your body if you’ve only lost a fingernail instead of losing the whole finger.

    The fingernail will probably grow back but it’s still part of your body that was disconnected one way or another. The fact that the experience was temporary and more easily recovered from than losing other body parts doesn’t mean you didn’t lose a body part.

    There’s quite a difference between having a fingernail ripped off or having a finger ripped off but either way it’s part of YOU. And in my experience, when you lose your sense of continuity, self, memories, etc, you’re losing parts of YOU. And that’s what dissociation is like, basically. A part, or parts of you are distanced or disconnected from your perception.

    By the way, I’m a screenwriter, so your post about the movie and the comment about people in Hollywood seeming to have some insight into dissociative experiences caught my eye the other day. You might be surprised at the number of writers I know who are in therapy for trauma-related issues, and at some of the conversations we’ve had about how characters in film and television “should” react based on story events, etc. We may not call it “dissociation” when we draft a scene like you described the other day, but we all recognize it as “human experience” that a lot of the audience will intuitively connect to, whether they understand it on an intellectual level or not.

    • A screenwriter and 50 years of experience with dissociation! I am delighted that you are contributing to this effort to think more clearly about dissociation. I began this discussion by highlighting (in my inaugural post) the strong position taken by the structuralists in the dissociative disorders field — that an event is dissociative only if it is a manifestation of a dissociated structure. I was implicitly asking, “But what about everything else that seems dissociative?! What about the derealization that is portrayed in The Kids Are All Right? And, apropos of my implicit question, you say, “when you lose your sense of continuity, self, memories, etc, you’re losing parts of YOU. And that’s what dissociation is like, basically. A part, or parts of you are distanced or disconnected from your perception.” With those words, you have articulated a different (and quite respectable) model of dissociation from that of the structuralists. Namely, that dissociation fundamentally involves losing or being disconnected (or distanced) from some part of YOU. Now, let’s see what our new little community of dissociation aficionados think of that.

    • Holly Gray says:

      ” … I think that saying the scene depicted in the movie isn’t a type of dissociation is kind of like saying you haven’t lost a part of your body if you’ve only lost a fingernail instead of losing the whole finger.”

      Oh excellent! I love that description. I think of dissociation itself, to say nothing of dissociative disorders, as existing by degrees.

      “And in my experience, when you lose your sense of continuity, self, memories, etc, you’re losing parts of YOU. And that’s what dissociation is like, basically.”

      Yes. You summed it up nicely, I think. What I’m struggling with is that I don’t see why dissociation can’t sometimes be structural and sometimes not. Because you’re right, regardless of the cause, both structural dissociation and Freud’s view of dissociation as the result of suppression manifest as a separation between self and parts of self.

      • OK, you said: “What I’m struggling with is that I don’t see why dissociation can’t sometimes be structural and sometimes not. Because you’re right, regardless of the cause, both structural dissociation and Freud’s view of dissociation as the result of suppression manifest as a separation between self and parts of self.”
        This is exactly the point of this overall discussion. The Big Question is: “What is dissociation?”
        If you define dissociation as “a separation between self and parts of self,” then both structural dissociation and dissociation-like events that are not structural are BOTH, nevertheless, dissociation. But, if you define dissociation as “the manifestations of autonomous dissociated structures,” then dissociation-like events that are not structural are NOT dissociation. In short, these definitions have consequences.

        • The Big Question is: “What is dissociation?”

          Now I’m going to need to re-read “The Haunted Self” because I thought what they were saying in there wasn’t that only “structural dissociation” is dissociation, but that only “structural dissociation” really explains a condition like DID. Or maybe you’re talking about the vast amounts of other work they’ve produced, which I likely haven’t seen.

  6. A concise and very clear statement of their position is contained in Steele, Dorahy, van der Hart, and Nijenhuis (2009). See my summary and brief discussion of that article in today’s post — It Takes a Community To Understand Dissociation.

  7. SandraB says:

    Congratulations Paul! This blog is amazing. I´m concerned about how my own thinking process will end by the end of the day after reading your blog, but I think I will be able to handle this!
    I found a good explanation for some of the things I see in my clinical practice (especially with children) in a book chapter by Giovanni Liotti (1999, Attachment Disorganization, edited by Solomon & George). When explaining attachment disorganization and its relationship to dissociation, he states that when a child is abused by a parent to whom is bound by a disorganizaed pattern of attachment, the dilemma of seeking comfort and safety from the very source of danger is paramount. So it seems that there is no other outcome but high degrees of dissociation since (and will quote his own words) “there is no possible organized way of construing such a situation”. I really think that the psychological defensive purpose of dissociation is a “secondary gain” of dissociation itself. When the ANP is devoted to avoid any kind of intrusion of the EP, isn´t one of the outcomes a psychological defense against unbearable things? I guess so. I also think that dissociation as a psychological defense is a friendly explanation that many of us use with our own clients to explain to them in other words what they have been experiencing for so long. I think it makes sense for many of our dissociated clients.
    Whether it is or not we might find the answer in this blog! (Or maybe not…… who knows?????).

  8. Sandra! Welcome to UnderstandingDissociation.com! You are the second of my close professional buddies from ISSTD to make a comment. Lynette was the first. I am fascinated by the relationship between disorganized attachment and dissociation. In some cases, there seems (to me) to be structural dissociation; in other cases not. I once had a colleague who was trained by Mary Salter Ainsworth. He showed me a bunch of tapes of disorganized attachment toddlers in the Strange Situation. Fascinating. Some seemed to dissociate and others seemed to be stuck in vacillating approach-avoidance behavior.
    I very much like your comment about defensive behavior and ANPs. I (and I think Kathy, Onno, and Ellert would) agree that the ANP is ‘all about psychological defensiveness.’ Finally, I definitely agree that describing dissociation as a defense is very helpful for clients. Thank you for commenting! See you in Atlanta in a few weeks.

    • Peter Barach says:

      Your blog is a great forum for discussing these important issues, and thanks for taking the time to do it!

      Concerning attachment issues, Liotti’s initial article about dissociation and attachment was published as a followup to my 1991 article on this topic. With all respect due to his contributions, IMO his assertions about **disorganized** attachment as the root of dissociation have been accepted as factual when in fact there is no strong evidence that he was right. It was Bowlby who first noted the detachment from parents who don’t respond to the child’s pain signals and called it “dissociation,” as I noted in my article. I think that this response of detachment from need states is the basis of the increasingly structuralized dissociation that we see in children who are chronically abused and emotionally neglected. Neither Liotti or anyone else has (to my knowledge) published data showing that people with DID have Type D attachment.

      Speaking of Ainsworth, she was my first psychology prof and got me interested in psychology. We were reading page proofs from Bowlby’s Attachment Vol. 2 as part of our classwork.

      • Peter,

        Thank you for mentioning the time it takes to do a blog. I gotta tell ya, I’m quaking in my boots at what I have committed myself to.

        And an even bigger thank you for challenging the myth that disorganized attachment = dissociation = DID. Don’t get me wrong; I am a big fan of attachment. Nevertheless, The degree of uncritical oversimplification of the relationship between Type D attachment and dissociation is problematic because it leads to fuzzy thinking and communal ‘understandings’ that are unwarranted.

        PS. I’m jealous of your classes with Mary Ainsworth. 🙂

        • Peter stated:
          “It was Bowlby who first noted the detachment from parents who don’t respond to the child’s pain signals and called it “dissociation,” as I noted in my article. I think that this response of detachment from need states is the basis of the increasingly structuralized dissociation that we see in children who are chronically abused and emotionally neglected.”

          If the parent who is neglecting or abusing the child is the one the child is depending on for protection, then would the purpose of the dissociation be to detach from parents or needs or could it be to compartmentalize awareness of the abuse or neglect to maintain the attachment and illusion of safety? Or do you think it is a combination of both?

          Either way, I think there would have to be structural dissociation but not necessarily disorganized attachment. I have one DID client who has predominantly dismissive attachment and I have at least one who has predominantly preoccupied attachment, with no evidence of disorganized attachment in the therapeutic relationship with either one.

          –Andrea

  9. SandraB says:

    Hi Paul
    I have a couple of drawings of a 4 y.o who showed me a fight with her mom. It’s really amazing to see how the disorganized pattern is represented in these figures. You can see how unable she is to organize a coherent narrative of the facts, you can see memory gaps, confusion of identity, inability to organize her own emotional states as a response to her mother’s perceived state. I agree with you: it can be fascinating. I would like to hear more about why you consider that some D attachment you say there seems to be structural dissociation and in others not. Sorry for the typing, I’m writing this comment from my Blackberry which seems to be dissociated from My typing intentions.

    • Hi Sandra,
      I guess I am just saying that I don’t believe that disorganized attachment status = structural dissociation. I know that people with disorganized attachment or unresolved issues have higher dissociation scores, but I would be very surprised if those higher dissociation scores always mean structural dissociation (i.e., PTSD, DDNOS, or DID).

  10. M F says:

    Dissociation feels like a defence to me, because it protects me. It is also, of course, a reaction – if the thing I couldn’t cope with hadn’t happened I would have had no reason to dissociate.

    I am a total lay person with DID. You ask about dissociated experience being stored in a “structure”. I suppose it must be stored somewhere – at what point does that “somewhere” stop being a structure? When the “structure” no longer has a mind of it’s own? This paragraph is obviously subjective for me.

    The discussion on attachment above is interesting. I have a 10 year old who seems to “hold” my attachment disorder. She has unintentionally caused all sorts of chaos in therapy. The therapy experience is very painful for her. This is embarrassing for me, and even more embarrassing for a couple of other adults who are more “competent” than I am. In some ways it has felt to some that they quite literally don’t want to be associated with her – in the way in which you wouldn’t want to be associated with a drunk man in a train carriage at rush hour. I am glad of the education which comes with both therapy and reading. Even seemingly obscure things like Maslow’s Hierarchy of Needs which helped us to see that until a certain need is met it simply isn’t possible to move onto getting the next one fulfilled. It has been good for me to see that we actually owe the 10 year old a debt of gratitude – she held that for us and we were liberated to move on. Not everyone is ready to accept this yet. For myself I hope to help the 10 year old to trust me. In particular to trust me to talk to our therapist without her flying out in a panic, disabling my attempts. I hope that as our therapist shows herself to be consistently trustworthy the 10 year old will slowly learn to relax a little more. Panic less.

    Once again, I am a total lay person – this is all simply my subjective experience.

    • MF,

      You may be a lay person, but your subjective experience is absolutely valid. You are giving ‘expert testimony’ about the internal experience of dissociation. And that is an invaluable contribution to us all — both external experts and other internal experts.

  11. I do not even know how I ended up here, but I thought this post was good.

    I do not know who you are but certainly you are going
    to a famous blogger if you aren’t already 😉 Cheers!

  12. Marty says:

    Can I throw a spanner in the works here (English expression) ? Just something I’ve had on my mind of late re mass global disassociation ( us English put an extra ‘a’ in it !)

    Is disassociation partly a psychological matter or a sociological one ? By this I refer to the internet itself. I’m 50 and given we are all first generation “screenagers” I’m guessing there may be some on here who can remember the days pre-internet ? Think hard. You can do it if you try. rather than tapping into keyboards and gazing at screens as we all do now for all manner of reasons, we found ways of living our lives without this tool which is now more necessity than luxury for most.

    The pre computer screen age seems almost like a vague dream now. People actually spoke to one another on the street. Is the Internet screen age partly responsible for disassociative traits ?

  13. Maybe I’m just a nobody, and maybe I have know right of speaking as a Tertiary SD diagnosed person. But I would like to ask you all to consider even an other option to research or think over as professionals:

    In all this, where are the concepts of:
    – a personality (biological action)
    – a identity (autobiographical influences)
    in conjunction with Dissociation

    Why can’t it be..
    Dissociation is a deformed mental state and is known by two major causes (et a deux causes principales)
    1. Dissociation is a deformed mental state which is caused by a weak and unstable personality – personality disorder or otherwise mental disorder (no Trauma) – eg secondary SD. (Janetiaans)
    2. Dissociation is a deformed mental state which is caused by a defense mechanism to avoid memories of the own autobiographical identify (Trauma) – an Identity disorder eg tertiary SD (autonomic personality states ANP’s – a bit Freudiaans)

    A long-lasting, description reason mental disturbance = known as Structural

    1+1=2 Structural Dissociation

    Much regards,
    simply Nique

  14. Hi – interesting discussion (and I sure don’t agree that Nique is ‘simply a nobody’).

    You are raising issues here that I have spent a fair few years (if not decades) reading and studying and also working with and half a century living with.

    I may be being presumptuous here but, I have to admit I’m rather shocked actually to read that “our colloquial understanding of dissociation seems most comfortable with a repression-like model of dissociation (where something distressing is unconsciously suppressed, but does not create a new compartment or dissociated structure to ‘hold’ it.)”. Do many people honestly still understand dissociation like this? Really?

    Firstly, can I simply say that in discussing these disagreements re “what dissociation is” it seems to me you are confusing 2 issues here: the “initial cause of dissociation” and “the need to continue to dissociate throughout life”.

    Yes, of course someone who dissociates may also use the ego defense mechanism of repression but – is this then an integral aspect of dissociation? Or simply another defense mechanism they are employing? Why confuse the two?

    Can’t we simply leave Freud out of this? There is absolutely no reason to even consider the Freudian concept of repression (a horizontal split – conscious to unconscious) in discussing dissociation which remains in all circumstances that I’m aware of a vertical split between degrees and states of consciousness. Why is there any need to confuse and conflate these two different ways of understanding the functioning of the mind/brain/body? Sure, there may still be many researchers and clinicians out there who do confuse these two ways of understanding (and ‘separating’) but – is there a need to still validate this confusion rather than simply refute it as advances in neuroscience seem to me to confirm the ‘vertical split’ understanding of dissociation and do not support the ego defence mechanism of repression as being the same thing at all?

    Then, back to Janet, “who said that dissociation was caused by a lack of ego strength (actually, he described it as a low level of mental functioning). According to Janet, a debilitating deficit of ego strength can undermine a person’s capacity to psychologically ‘take in’ a stressful event. When this occurs, these stressful events ‘fall to the side,’ thereby creating a separate part (separate compartment, separate structure) that now ‘holds’ those events.”

    Well, if we examine more closely the structural model of Nijenhuis van der Hart and Steele, to be honest, I see no conflict here at all (especially if looking at the work they have done since The Haunted Self was published to elaborate and clarify their structural model further). The only clarification that is missing in what Janet stated is the developmental aspect of how formed the actual “sense of self”/ego state/personality” which is experiencing the traumatic event that it is “unable to hold” is in the first place. This degree of understanding of infant/human development simply did not exist in his time.

    In adding a developmental perspective (from neurobiological, infant development and attachment theories) to the Janetian understanding of dissociation as a “falling apart”, we actually then find that dissociation begins as a lack of capacity to integrate what was not yet integrated at birth and what requires “good enough” care and environmental support to integrate.

    Here is our initial “cause of dissociation” – as Janet described – “dissociation was caused by a lack of ego strength (actually, he described it as a low level of mental functioning)” – a state that is actually ‘normal’ for a human infant experiencing extreme distress without the availability of a “good enough carer” to modulate that distress.

    Attachment theory has also offered much to the understanding of the development of dissociation (and I too am extremely jealous of anyone who actually was able to experience classes with Mary Ainsworth!) but, I also do not necessarily believe that ‘disorganised attachment’ must, of itself, indicate later “structural dissociation” though it can certainly be a pointer to a distinct possibility of it and most certainly to the fact that there is something very very wrong with the environment in which a particular child is being raised.

    Continuing to live in an environment that never provides enough support and modulation of the painful affect of ongoing severe trauma continues to not allow for the growth of the capacity to manage painful (or even pleasurable) affect. This is what then creates the need to continue to dissociate/compartmentalise, resulting in a vertical split/structural dissociation of what may have, in better circumstances, developed into one whole personality (dissociative disorder/MPD).

    It will be the degrees of trauma experienced together with the availability or otherwise of care and support and the ages and stages of development at which these occur that will determine to what extent on a spectrum any given person will need to continue to dissociate throughout life (structural dissociation) or, to what degree some aspects of affect are able to be modulated and integrated to any degree. And then, whether anyone will or may later on in life either need to resort again to dissociation as the only defense mechanism they are capable of employing to modulate affect too painful to manage or, may in future be able to use other defense mechanisms such as repression etc.

    Such a complex matrix of interactions in many dimensions, from neurobiological, developmental, physical, emotional and environmental over time that will form the final pattern of “defense mechanisms used” that any given person will present to any clinician at any given time in their lives.

    This still, though, does not mean that “dissociation” is the same thing as Freud’s ego defense mechanism of repression at all.

  15. PS – apologies, I think what I wrote there reads as a real mish-mash of a whole lot of things but, to really describe what I think “dissociation actually is” would take much, much more space in written format than available here.

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