Dissociative Multiplicity and Psychoanalysis
Some features of the 125-year relationship of dissociative multiplicity, the existence in one human being of more than one center of consciousness, and psychoanalysis are discussed. Dissociative multiplicity was present at the dawn of psychoanalysis, as hypnoid hysteria, in Breuer’s celebrated case of Anna O. When Freud broke with Breuer and abandoned hypnoid hysteria, the subsequent development of psychoanalysis largely put dissociative multiplicity aside as pre-psychoanalytic error. Most of the ensuing psychoanalytic models of the human mind failed to account for the genesis or structure of such a multiple mind. At the same time, these psychoanalytic models still shine light on all psychopathology, including the dynamics of every center of consciousness in somebody with dissociative multiplicity. The current best exceptions to this overall pattern have arisen from the conjunction of object relations theory and attachment theory, both of which have contributed to relational psychoanalysis, where dissociative multiplicity is given a central explanatory role by some authors. I conclude that psychoanalysis can best reappropriate dissociative multiplicity by returning to the roots of the split: to hypnoid hysteria and rethinking both hypnosis and dissociation.
Potential to Distress: No
At the conclusion of this presentation, participants will be able to:
- Discuss the essential difference between psychoanalysis and dissociation theory regarding the human psyche or mind
- Explain the between dissociative multiplicity and splitting and how the two may be co-present in the same patient
- Distinguish between dissociative multiplicity and repression in the topographic model and the distinction between somatoform flashbacks and classic conversion symptoms; and again how the two may be co-present in the same patient
- Describe how theories invoking intrapsychic schemas (self states, relational psychoanalysis, attachment theory, etc.) resonate with dissociative multiplicity and how they differ
- Discuss how psychoanalytic theories may fail to account for dissociative multiplicity, but continue to apply to the dynamics of each center of consciousness
Presenter: John A. O'Neil, MD, FRCPC
Presenter Bio: Dr John O'Neil is a psychiatrist and psychoanalyst in private practice. He was assistant professor of psychiatry, McGill University, and attending psychiatrist at the Douglas Hospital for 16 years, then at St. Mary's Hospital for 20 years, until he retired from McGill in July 2018. Dr O’Neil is a Fellow of the International Society for the Study of Trauma and Dissociation (ISSTD), which granted him a Lifetime Achievement Award in 2020. Dr O’Neil presented frequently at ISSTD Annual Conferences and, since 2002, teaches in the ISSTD Dissociative Disorders Psychotherapy Training Program, currently online. Dr O'Neil co-edited, with Paul Dell, the book Dissociation and the Dissociative Disorders (Routledge, 2009), for which Dr O'Neil received the ISSTD Pierre Janet Writing Prize. Dr O’Neil was co-editor, with Emanuela Mundo (of Milan, Italy), of a chapter of the Psychodynamic Diagnostic Manual – 2nd edition, in 2017, co-edited by Vittorio Lingiardi (Rome) and Nancy McWilliams (New Jersey). Dr O’Neil is co-editor, with Martin Dorahy, PhD, of Christchurch, New Zealand, and Steven Gold, PhD, Professor Emeritus of Nova Southeastern University, Fort Lauderdale, of the 2nd edition of Dissociation and the Dissociative Disorders – Past, Present, Future, whose official publication date is 2023. Dr O’Neil wrote 2 chapters, the first an update on his 2009 chapter, Dissociative Multiplicity and Psychoanalysis; and the second, Dissociation in the ICDs and DSMs, which reviews the official take on dissociative disorders from 1900 up to ICD-11 (2022).
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