From Detached Concern to Empathy: Humanizing Medical Practice

In the health professions there is widespread agreement that dissociative identity is dysfunctional and needs to be cured. This position is based on the assumption that the healthy self is unitary and therefore multiplicity must be disordered. The cure, a requirement of oneness, is integration: the multiple selves must be unified into a single, integrated personality. To uncover themes and assumptions of this dominant approach to dissociative identity, five main texts were examined. From the many discourses identified, two central discourses were selected for further exploration. This paper explores how the identified discourses construct individuals with dissociative identity and how they inform and limit psychological theory and practice. Being exploratory, this paper offers a platform for further in-depth deconstruction and critical evaluation of the underlying assumptions and implications.

Current Opinion in Psychiatry, 2005

The aim of this article is to investigate psychopathology in order to illuminate the nature of personal identity. Predominantly, the authors reviewed here defend a more robust version of the narrative self against Dennett's claim that narrative self is ultimately a useful fiction. Authors explore the limit case of dissociative identity disorder in order to explore how apt an embodied, socially interactive and autonomous narrative self is for addressing legal and moral paradoxes intertwined with establishing personal identity. Psychiatric practice should embrace therapeutic approaches that restore the unity inherent to the capacity to narrate a life.

International Journal of Psychotherapy, 2001

This issue focuses on the themes of certainty and doubt, fragility and tenacious identity, in the psychotherapeutic process. Newman's paper explores some central tensions in the relation between consciousness and unconsciousness. Rowan offers a masterly account of what he plausibly claims are established salient features of the psychotherapeutic process, in terms of the analogy of alchemy. Balick's account of the 7 th UKCP Professional Conference evokes the tensions activated by the interface between neuro-science and psychotherapy. And Tan and Zhong face us with the challenge of a communally and certainty based method, in relation to some antisocial sexual patterns, which appears to be more effective than more cautious established 'Western' approaches. The three main papers in this issue [alas, at this end of year point, page budget considerations have led to the deferral to next issue of a fourth, a major paper on the relations between psychotherapy and philosophy], though in very different ways, all face us with the questions of the foundations of our work, in respect of the relations between what is conscious (or what is part of consciousness), and both what is non-conscious, and what is transformational. They seize upon important themes with a puzzlingly tenacious persistence which has become the more important as, in the light of the attacks on America, and the war mounted in response to them, the divisions in our world, and the emerging (not always an unmixed blessing) unity of our world, enter more deeply into our re ections. We are faced, in these papers, with recognitions of the fragility of both our conscious existence and our work, and its extraordinary tenacity, grounded in vast realities which are largely beyond our ken. These, however,-but only if we maintain a right balance between consciousness, and that which is not conscious, but yet which intelligently sustains our searchings and our purposes,-may be wellsprings of strength and resource. Kenneth Newman: Is there consciousness outside the Ego? Kenneth Newman's fascinating exploration, of what he considers in effect the overvaluation, and the imputed over-endowment, in the depth psychologies, of 'the unconscious', leads eventually on into a searching discussion of how this overvaluation, in both Freudian and Jungian contexts, leads to a depletion of the sense of responsibility and of the signi cance of social action in social context. Newman argues that we mistakenly attribute qualities of consciousness to unconsciousness. In effect, he argues that, in virtue of the (instinctive) compensatory intelligence shown by non-conscious processes in all manner of ways, explored by depth psychology, not to

Sociological Review, 1999

Sociological responses to the increase in recent years of psychiatric reports of multiple personality (latterly redefined as Dissociative Identity Disorder) have focused upon its discursive production as a diagnostic category. Drawing on life-history interviews with survivors of extreme childhood abuse - some of whom defined themselves as having ‘multiple personalities’ - this paper suggests that an adequate sociological account needs to combine analysis of the popular and clinical discourses of dissociation/multiplicity, with an understanding of the relationship between these and particular individual auto/biographies. The production of a narrative of fragmented subjectivity is considered as an active engagement with previously denied and silenced autobiographical experience and with the dominant contemporary discourse that allows for the episodic denial of self-reflexive selfhood. In the light of DID diagnoses being largely applied to/adopted by women, questions are raised con-cerning the possible impact of the adoption of a multiple identity on individual integrity and autonomy.

British Journal of Psychology, 1999

Rewriting the soul: Multiple personality and the sciences of memory. By Ian Hacking.

Journal of the American Psychoanalytic Association, 2010

Oxford University Press, 2024

This introductory chapter discusses the tension between biopsychosocial models and neurocentric approaches in psychiatry, motivating a turn to 4E (embodied, embedded, extended, and especially enactive) theories. The chapters that follow develop an interdisciplinary approach to integrative conceptions of psychiatry, distinguish between narrow and wide integration, and explicate a model based on the concept of self-pattern. According to this model, psychiatric disorders are self-disorders. This hypothesis extends the claim made by phenomenological psychiatrists about schizophrenia, namely, that schizophrenia is a disturbance affecting a very basic sense of self. The notion of self-pattern introduces a wider and more complex notion of self that facilitates the analysis of psychopathologies more generally. The chapter ends with a consideration of the difficulties involved in nosological classification.

The British Journal of Psychiatry, 2011

The Journal of Medical Humanities

The figure of the “double” or the other self is an important topic in the history of literature. Many centuries before Jean Paul Richter coined the term, “doppelgänger,” at the beginning of the Romantic Movement in the year 1796, it is possible to find the figure of the double in myths and legends. The issue of the double emphaszses the contradictory character of the human being and invokes a sinister dimension of the psychological world, what has been called in German as “umheimlich.” However, does multiciplicity always involve pathology? Related to this figure in literary history, a new perspective from clinical psychology called “dialogical self” defines the self as a multi-voice reality. Along the same line, postmodernist psychology considers the self a discursive construction. From these perspectives, the “self” is situated a long way away from the classical essential conception of the self. In this paper, we review briefly some important landmarks of the figure of the double in the literature, and we compare the coincidences of the “double” experiencies described in literature with the experiences of our patients. Finally, we discuss how this literary tradition can help us to understand new psychological perspectives.

Zenodo (CERN Avrupa Nükleer Araştırma Kurumu), 2022

dissociative patients to practice spontaneous hypnosis and some control over self-hypnosis mayallow them to control certain distressing symptoms and use their hypnotic abilities to easeconstructive self-care strategies. One formulation of this problem is that dissociative patients usevarious self-hypnosis strategies in an uninvited, uncontrolled, and unregulated way, often without realizing it. DID therapy have found a place for a variety of techniques based onthe DID patient's self-hypnotic abilities; these techniques can be used with or without formal tranceinduction (RP Kluft , 1982, 1988a, 1989, 1994; Phillips & Frederick, 1995). These techniquesinclude access to alternative identities that are not at once available, an intervention that mayfacilitate the emergence of identities critical to the therapeutic process, and/or help resolve thesituation of having a "stuck" infantile, disoriented, or dysfunctional identity. A related strategy,known as restructuring, involves "reorganizing" a system of alternative identities that is in adysfunctional state of disequilibrium. This is done by asking various identities to play importantroles in a safer and more stable constellation. Other hypnotherapeutic techniques are designed tomodulate affect , explore and resolve disturbing psychological problems, control flashbacks and processing of reactions and traumatic memories, and control flashbacks and processing ofinterruptions and traumatic memories. To place unstable identities in settings away from themental mainstream to preserve somatoform symptoms , functions, and safety, to put identities intoa therapeutic "sleep" between sessions, to restore overall rebalance, to encourage identities tocommunicate and to interact constructively with one another (e.g., Fraser's , 2003), the dissociativetable technique) and promoting or ensuring integration. It is important to place somatoformsymptoms and unresolved identities in settings away from the mental mainstream (for example,fusion rituals) to preserve function. For example, during Stage 2 (which deals with the treatmentof traumatic memories), hypnotic techniques such as internally visualizing memories on acontrollable screen can help regulate and modulate the impact of the memory on the person.