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)]

Posted in defense, dissociation, first-person accounts, PTSD, repression, structural dissociation | Tagged , , , , , , , | 33 Comments

Welcome to the Launch of UnderstandingDissociation.com!

UnderstandingDissociation.com seeks to advance our understanding of dissociation and its relationship to trauma. To that end, I will present my own thoughts as well the latest thinking from the literature, recent presentations, and discussions at conferences.

I anticipate that your comments will rapidly cause hidden ‘vaguenesses’ about the concept of dissociation to surface. Points of disagreement will be identified. These, in turn, will push us all to think more clearly.

Our conversation will inevitably suggest specific research projects. I will encourage both established researchers of trauma and dissociation and graduate students to consider these research ideas.

Finally, UnderstandingDisssociation.com is designed to educate and ‘spread the word’ about trauma and dissociation. Clinicians who want to learn about dissociation (or who want to learn more about dissociation) are strongly encouraged to comment and ask questions.

So, where to start? Let’s have some fun and go to the movies.

Have you seen The Kids Are All Right, the current film with Annette Benning, Julianne Moore, and Mark Ruffalo? It’s one of the first four star movies of 2010. Well worth seeing. And great fun!

I mention The Kids Are All Right because it contains a wonderful portrayal of dissociation. I won’t give away what happens in the film — I hate it when reviewers ruin cinematic surprises by disclosing critical events in the film. I don’t even like Spoiler Alerts. So, no spoiler alerts here. No spoilers at all.

I think that Annette Benning and Julianne Moore are two of our finest actresses. Somewhere during the film, one of them encounters a situation that is psychologically threatening — and deeply destabilizing. Then, for exactly the correct reason (i.e., profound psychological threat), she experiences an episode of derealization (and, presumably, depersonalization as well).

Suddenly, her life and her environment become strange. She is disconnected (or, at least, profoundly distanced) from all that is going on around her. Sounds become distant and fuzzy. The length of this episode is brief (a minute?), but the psychological distance that she travels in this moment is great. Cinematically, very well done!

This episode of derealization reminds me of a significant fact about movies. I have seen derealization in other films — e.g., ones that portray a person suddenly in the midst of lethal gunfire (e.g., Saving Private Ryan and other films).

Bottom line: Many directors and script writers seem to be quite aware that life threatening danger can trigger an acute episode of depersonalization/derealization. I suspect that directors and script writers understand these matters better than many mental health professionals.

When Is Dissociation Not Dissociation?

In the dissociative disorders field, we live in interesting times. Do you remember the Chinese curse? “May you live in interesting times!”

The proponents of the structural model of dissociation — Ellert Nijenhuis, Onno van der Hart, and Kathy Steele — would insist that the episode of derealization in The Kids Are All Right is not dissociation. Why? Because this episode of derealization is almost certainly not a manifestation of a dissociative part of the personality. That is, it isn’t caused by structural dissociation. In other words, no structural dissociation, no dissociation at all. Just something that looks like dissociation, but isn’t.

There is a lot of this going around these days — disagreements about what is and what isn’t dissociation. I have made such statements myself. What do you think about this? Is the derealization in The Kids Are All Right (or on the beach during the D-Day invasion in Saving Private Ryan) dissociation? [Comments strongly invited] Note: To comment (or to read others’ comments) on this post, click on the word “Comments” immediately below in gray.

Posted in depersonalization, derealization, dissociation, films, peritraumatic dissociation, research ideas, structural dissociation, trauma | Tagged , , , , , , , | 37 Comments