Multitudes: Dissociation and our Multiple Selves.

In everyday conversation we have come to use the word “ambivalence” to mean “indifference”:

“Where do you want to go to dinner tonight?”
“I dunno. I’m ambivalent, you decide.”

But when psychotherapists use that word that isn’t what they are suggesting at all. They mean they suspect or sense that you are chock full of strong and conflicting feelings.

And how fortunate we would be if it were a simple conflict between only two states of mind. Often it is a cacophony of internal voices, needs, impulses, prohibitions, and logical assertions all arguing, interrupting and all talking over each other so that we have no idea what to do:

“I just can’t make up my mind” (into one mind).

We are all multitudes. Everyone contains splits and compartments and many different selves.

We like to pretend this isn’t so. It’s easier to move through the day immersed in the illusion that we are one solid person, one known and knowable entity, fixed and definable, with our names sharpied clearly on our sticky nametags in black squeaky letters: “Hi, my name is JOE.”

But our inner truths are more complicated than that.

And Jesus asked him, saying, What is thy name? And he said, Legion: because many devils were entered into him. ~ King James Bible

Our demons and our better angels are often in heated argument. The debate rises into awareness whenever our most primal needs are activated – about whether to suppress or obey, give in or rise above, take one stance or another – or rest upon any compromise spot along the continuum.

“I really want a cheeseburger with fries, and a milkshake, but I should probably just get a big salad…”

“I’d like another beer but probably I shouldn’t…”

“Oh god, I really want to call in sick and sleep all day, but I have so much to do! Maybe I can just go in for that meeting and then sneak out early.”

These aren’t indifferences. These are internal debates. These are conflicts.

And here is the tricky question:

Between whom and who?

Freud’s theory and tripartite structuring of the self would say between the id (primal drives) ego (conscious self) and superego (internalized moral prohibitions and conscience).

Object-relational psychotherapists, such as D.W. Winnicott might speak of a split between the True Self (the core, most personal realities) and the False Self (our socialized façade that filters and protects our True Self). C. G. Jung might speak of The Persona, The Ego, The Unconscious, and the Collective Unconscious – including all the grumblings and tugs and seductions of an entire pantheon of archetypes.

Jung wrote of the moment, around age twelve, after being severely scolded by a classmate’s father, when he began to consider, for the first time in his life, that maybe more than one distinct Self resided within him:

At the same time I was seized with rage that this fat, ignorant boor should dare to insult ME. This ME was not only grown up, but important, an authority, a person with office and dignity, an old man, an object of respect and awe… Then, to my intense confusion, it occurred to me that I was actually two different persons, One of them was the schoolboy who could not grasp algebra and was far from sure of himself; the other was important, a high authority, a man not to be trifled with, as powerful and influential as this manufacturer. ~ C. G. Jung, Memories, Dreams Reflections

Jung goes on to visualize this authoritative ME as an eighteenth-century gentleman in a powdered wig and gold buckled shoes.

Psychotherapists often find themselves meeting such disparate selves residing in the skin of one person. In my first year of training, I served at a program that supported clients with long-term psychiatric disabilities. I was assigned one young man, who I will call Ezra, who had been there for several years and whose case record described him a “challenging” to work with. I began the relationship with trepidation, but after three or four months of work together I was mystified by the warnings. He was delightful. Agreeable. Responded to all my questions, and he seemed to find me extremely helpful, insightful, dare I say wise even? Every word I uttered was taken as a pearl, treasured, reflected upon, implemented into his life with consistently positive outcomes. I mean, he didn’t seem to like his psychiatrist much, and he did complain bitterly about the other counselors in the rehab program, but maybe they just didn’t understand Ezra the way I did?

Until one afternoon. He had been discussing an argument with his mother, whom he lived with, and I agreed with him, that even though he suffered from mental illness, it wasn’t helpful that his mother treated him like a child (as he said she did). Did he want to invite her in to talk the dilemma through together? In the moment, he agreed that was a fine idea, and I said I would await a phone call from his mother so we could schedule.

Evidently he left session to call her from the payphone on the unit, because within a half an hour – my phone rang and I picked up to hear a shrill bloodcurdling rant as his mother cursed and chewed me out – so loudly that her words were incomprehensible to me – while simultaneously Ezra pounded on my office door, emitting raw feral screams like an enraged wolf from a Grimm fairy tale.

“Oh shit, ” I thought. “I fell right into this just like a rat in a trap.” It was a frightening and dramatic way to learn that clients often introduce us to their false, compliant selves first, before more their injured, wounded, despairing, feral, rageful, vulnerable, terrifying self-aspects are allowed to show up. Winnicott even says the client’s “inner” nanny first arrives in psychotherapy and chats nicely for several months, to make sure that the space is secure and safe enough to allow child-like states to enter.

And then there is what happens to a Self that encounters traumas too intense to be protected or integrated – a kind of fragmentation of the true self – a word that is also entering the common lexicon: Dissociation.

When we talk about dissociation – people have historically thought of it in its most extreme psychological forms: as what used to be called “Multiple Personality Disorder” now called Dissociative Identity Disorder in the diagnostic manual, and which refers to self states that operate as fully autonomous and separate “personalities,” divided by a kind of internal amnesia, loss of awareness, and loss of time and memory when other self-states are “out” and others are sent back “in.”

Other kinds of dissociative memory losses are commonly associated with PTSD, where traumatic memories are pressed out of awareness into forgetting in order to keep functioning. We are also capable of leaving our bodies to head skyward, dissociating from our own skin, to look down upon our traumatized bodies from a greater, more comfortable distance.

But we need to acknowledge that we all live on a dissociative continuum, and the “self” that emerges at work is not the same “self” that emerges when we are a patient in a sick bed, is not the same self that sees red in a pique of rage, or while singlemindedly courting a lover, or taking our child to the zoo.

“I just wasn’t myself today.” (who were you then?)

“I really need some me time.” (who else’s time was it?)

Even if we are able to remember and communicate internally across all of these self-states, even if these do not live within us as fully distinct and differentiated personalities, we are not singletons.

We are legion.

Phillip M. Bromberg, in a brilliant work called Standing in the Spaces, (written primarily for mental health professionals – for layreaders I’d suggest his more accessible book of case studies Awakening the Dreamer) suggests that dissociation is not something that only happens to the severely traumatized “other” – that all of us are comprised of a multiplicity of selves – including psychotherapists – who, hopefully, have developed the capacity to notice when we are switching between self-states,  and can explore the ways that such shifts in their own state of being, and between client and therapist, might correspond to the client’s having shifted in some way too. In this way, Bromberg, suggests, psychotherapy can really, finally, get us talking and listening to ourselves:

Psychoanalysis, at its clinical best, facilitates the same interplay between seemingly incompatible states of mind ~ Phillip Bromberg, Standing in the Spaces, Dissociation and Conflict

Dreams of hives, of swarms, of flocks  and dreams of riding on crowded buses and trains, can be dreams about our internal multiplicities  – as all of our discrete parts travel together as if we are one. And dreaming, in and of itself, can be seen as the local watering hole – (a cheap and handy trick for quick self-interpretation of dreams is to contemplate the possibility  that all or some of the characters in your dream to are different parts of you) the gathering place for all our different self-states to converge,  fight, forge alliances and to solve, create or anticipate problems together.

Often, we don’t experience these “self-states” at all, as we simply discharge them instantly into impulsive or compulsive action, before the next state emerges to be instantly discharged, like Ezra, who was in a fully behaviorally complaint self-state followed by a completely enraged one.

Others of us contain our behavior, but still experience these states (sometimes we just call them “moods”) one at a time. Sequentially. But, as we develop our ability to talk and debate within and among our “selves” we build up our capacity to withstand ambivalence – we can create an awareness, in real time, that we have at least two, if not many more – different and contradictory and quarrelsome feelings and experiences of the events and tasks in front of us, and take our time to fully hear ourselves out before we act or commit to a time limited perspective.

Health is the ability to stand in the spaces between realities without losing any of them – the capacity to feel like one self while being many.

“Standing in the spaces” is a shorthand way of describing a person’s relative capacity to make room at any given moment for subjective reality that is not readily containable by the self he experiences as “me” at that moment. Phillip Bromberg, Standing in the Spaces

Psychoanalytically informed therapies, CBT, journal writing, mindfulness meditations, Gestalt, all are various methods of trying to help people build an observation deck,  to stand in a central space, and survey the three hundred and sixty degree reality of all of our internal states and fragmented selves.

And when we have built up the capacity to observe our internal dialogues and conflicts – the work is still not done. We now have to listen deeply to all points of view – no matter how heated or contradictory:

It is exactly as if a dialogue were taking place between two human beings with equal rights, each of who gives the other credit for a valid argument, and considers it worthwhile to modify the conflicting standpoints by means of thorough comparison and discussion or else to distinguish them from one another. ~ C. G. Jung, Collected Works, The Transcendent Function

It is at first hard work to bring the chorus of voices inside to some decision about how to move forward and what is in the best interests of both ourselves and others in this world. But like a skilled and practiced clerk of a contentious Quaker meeting, who learns how to clearly and efficiently discern the “sense” of the meeting, we can build up our function as non-partisan Speaker of the House as it guides a split and fractured congress through heated discussion to a constructive action.

But in order to proceed and build any kind of satisfying life for ourselves that is not controlled by impulse, or defined by regret, we must first make sure all inner voices are heard, and treated respectfully and weighed, and considered.

“I have mixed feelings about it and could be persuaded otherwise, but I think I’m in the mood for Italian tonight – I’ll get a side of broccoli rabe and just avoid a cream sauce…”

(I am large, I contain multitudes.) ~ Walt Whitman, Song of Myself