Copies of the following papers are available upon request.
1993 On Multiple Personality – Presented to the Toronto Psychoanalytic Society
This paper will present an introduction to multiple personality, clinical material from three cases and a discussion of a process by which the syndrome originates.
2006 Ferenczi on Multiple Personality
Ferenczi’s “Child-Analysis in the Analysis of Adults” (1931) and “Confusion of the Tongues between the Child and the Adults – The Language of Tenderness and of Passion” (1933, 1949) are reviewed, with particular reference to Ferenczi’s ideas on the biphasic nature of the trauma of sexual abuse in childhood and to his ideas on the nature of the child’s response to such trauma, including altered states of consciousness with subsequent amnesia and splitting of the personality. A clinical example of multiple personality is provided, in order to illustrate that the clinical phenomena described by Ferenczi are typically found in cases of multiple personality. I will argue that Ferenczi may have been describing patients with multiple personality and I will suggest some reasons why he may have avoided being explicit on this point of diagnosis.
2006 From Baby Jesus in the Countertransference to Oedipus on Cavalry
This essay explores the theme of the relationship between culturally generated religious experience and the unconscious mental functioning of the individual. I begin with a vignette illustrating a countertransference resistance derivative of an unconscious primary identification with the Baby Jesus and then propose and discuss the concept of a ‘cultural/religious unconscious’. Freud’s views on religion are briefly reviewed, as are some selected commentaries on them, and Freud’s psychological use of his own religious experience, both Catholic and Jewish, is discussed. The theme of identification with Christ is highlighted, as is the thematic congruence between the story of Christ and the myth of Oedipus. A recently discovered Freudian text relevant to this discussion is quoted in full in an Appendix. The essay concludes with a second vignette illustrative of its central theme.
2006 From Bick on Autism to Ogden on the Autistic-Contiguous Position
In this paper the original contributions of Bick, Meltzer and Tustin to the psychoanalytic study of autism, and to the study of autistic phenomena and dynamics in neurotic patients, are reviewed. Next, Thomas Ogden’s extension of their work in his conceptualization of the presymbolic, sensory-dominated, autistic-contiguous mode of generating human experience is examined. Ogden’s formulations of the functional relationships between the autistic-contiguous, paranoid-schizoid and depressive modes of generating experience are highlighted. Features of these three modes are summarized in tabular form in the Appendix. Features characteristic of pathological collapse into each of these three modes are presented in brief clinical examples.
2007 Have the Social Processes of Discussion of Multiple Personality Replicated the Psychological Process of the Disorder – and Why?
This paper addresses the question: “Have the social processes of discussion of multiple personality replicated the psychological processes of the disorder itself – and why?” A brief introduction to the modern history of multiple personality is presented and the question is then explored, in the context of: (a) a review of the debate on the status of multiple personality as a diagnostic entity; (b) a review of the debate as to whether multiple personality develops as a consequence of traumatically induced dissociation or whether it develops as a consequence of social and cognitive influences, with iatrogenesis being an important contributing factor; and (c) a review of the broader context of the recovered-memories controversy within which the debate centring on multiple personality has taken place. A discussion follows in which an attempt is made to formulate an understanding of how the professional discourse on multiple personality has unfolded as it has.
2007 Towards a Fairbairnian Understanding of Multiple Personality
This thesis explores the applicability of Fairbairnian thought to the syndrome of multiple personality. To locate the current project in relation to its historical antecedents, Part I presents a review of the seminal work of Charcot, Janet, Breuer, and Freud. Concepts and themes relevant to modern understandings of multiple personality in these earlier works are nominated.
The psychoanalytic concept of auto-hypnosis is central to the earliest formulations of the dynamics of multiple personality, and is of critical importance to my perspective. Part II presents a historical review of the concept. Part III reviews the many-layered concept of dissociation. Current neurobiological perspectives on traumatic dissociation and the contributions of attachment theory and research are summarized. The concept of chronic recurrent maternal decathexis is introduced and its relevance to multiple personality suggested.
Part IV outlines Fairbairn’s ideas on object relations and endopsychic structure. Part V discusses Grotstein’s and Clarke’s relevant contributions.
Part VI proposes a restricted usage of the terms dissociation and auto-hypnosis and suggests that named alternate personalities develop in a tri-phasic process. It also reviews Fairbairn’s ideas on the origins of alter-personalities, and attempts to integrate the development of endopsychic structure with the findings of neurobiology and attachment theory in dissociative disorders. Alternate personality states are considered in relation to Fairbairn’s ideas on functioning structural constellations and further clinical applications of Fairbairnian thought to multiple personality are presented.
Part VII briefly reflects on the value of Fairbairnian thought to the understanding of the syndrome of multiple personality. The thesis ends with some thoughts on the clinical and theoretical themes to be further explored in order to advance the project started here.
2011 Fairbairn’s Thinking on Dissociative Identity Disorder and the Development of his Mature Theory [Graham Clarke and Paul Finnegan] ATTACHMENT: New Directions in Psychotherapy and Relational Psychoanalysis, Vol. 5, July 2011: pp. 131–153.
While investigating a recent suggestion (Finnegan, 2007) that a new interpretation of Fairbairn’s theory was ideally suited to the understanding and treatment of multiple personality,1 we became convinced that looking at the way that Fairbairn addressed multiple personality disorder (now more commonly known as DID) throughout his work would provide fresh insight into the development of his model of endopsychic structure. DID represents one extreme end of a spectrum of dissociations that Fairbairn saw as the foundation of inner reality and its dynamics – his ‘psychology of dynamic structure’ (Fairbairn, 2002d , p. 128). In this paper, we show that the development of Fairbairn’s thinking about the structure of inner reality, from his MD thesis in 1929 (Fairbairn, 1994a ) through to his 1954 paper on hysterical states (Fairbairn, 1994d ), is explicitly related to his thinking about DID. We also show that Fairbairn’s thinking about dissociation and its relationship to repression, his investigation into the nature of the Freudian superego, and his analysis of a patient with a ‘physical genital abnormality’ – all of which took place before 1931 – were intrinsic to the development of the mature model he put forward in a series of papers that started in 1940, which comprise Part One of his only book, Psychoanalytic Studies of the Personality (PSOP) (Fairbairn, 2002f ). After the historical review of the development of Fairbairn’s mature theory, and the importance of multiple personality to that process, we outline a Fairbairnian framework for the understanding and treatment of DID.
2012 Evelyn’s PhD in Wellness — A Fairbairnian Understanding of the Therapeutic Relationship With a Woman With Dissociative Identity Disorder [Paul Finnegan and Graham Clarke] ATTACHMENT: New Directions in Psychotherapy and Relational Psychoanalysis, Vol. 6, March 2012: pp. 50–68.
Fairbairn’s thinking about Dissociative Identity Disorder (DID) played an important role in the development of his own distinctive formulation of object relations theory (Clarke & Finnegan 2011). In this paper we present clinical material from Dr. Paul Finnegan’s work with Evelyn, a patient with DID, to illustrate how an extended version of Fairbairn’s model of endopsychic
structure might be used. First, to map particular commonly occurring alter personalities; second, to formulate an understanding of the relationships between alter personalities; third, to understand the transference-countertransference dynamics that emerge as internal object relations are externalised; and finally, to conceptualise the process of psychic growth as it takes place during the process of working with someone who has DID. The presentation of the clinical material will be followed by a brief introduction to the extended Fairbairnian model and a discussion of the clinical work from this perspective. The approach that we are presenting will then be discussed in relation to some other psychoanalytic approaches.
2012 Ferenczi and Multiple Personality [Presented at the Ferenczi Conference in Budapest, Hungary.]
While reading Ferenczi in recent years I was surprised to discover that much of what he spoke about in his later papers, and in his Clinical Diary, resonated for me with my experience with, and understanding of, the several cases of multiple personality that I have treated over the past 25 years. So today I will briefly present some clinical material from my practice and link this material to some of the things that Ferenczi wrote about that seem to me quite relevant to multiple personality and which have led me think that he might have had such cases in his care. And in this context I will offer some thoughts on what I think to be a ‘face of trauma’ often important in the aetiology of multiple personality - a trauma that I refer to as Chronic Recurrent Maternal Decathexis.
2014 Fairbairn and Multiple Personality [with Graham Clarke] In: Fairbairn and the Object Relations Tradition. Eds. Graham S. Clarke and David E. Scharff. Karnac Books (pp.209 - 222).
Throughout his career Fairbairn returned to multiple personality as a condition that his ‘intricate theoretical probing’ (Hinshelwood 1991, p. 307) might illuminate. This started with his MD thesis on ‘Dissociation and Repression’ (1994a) and his essay on the Super-ego (1994c) both of which only became available after their publication in the invaluable From Instinct to Self (Scharff and Birtles 2 vols 1994). The principle development of Fairbairn’s mature theory took place in a series of papers written in the early 1940’s and collected in his book Psychoanalytic Studies of the Personality (2002c). There are explicit references to multiple personality throughout this book and also to the usefulness of the object relations model he developed for the understanding and treatment of multiple personality (1946, 1994a, 1994b, 1994c, 2002a, 2002b, 2002e). Similar comments also appear in his paper on hysterical states (1994b). Fairbairn described his theory as one ‘...obviously adapted to explain such extreme manifestations as are found in cases of multiple personality...’ (2002c, p. 159). Our purpose here is to demonstrate the usefulness of Fairbairn’s theory to the psychoanalytic understanding and treatment of multiple personality.