Multiple personality: Psychoanalytic perspectives

Multiple personality, which played a central role in psychiatry and psychology in the era of Janet and Prince, also attracted the interest of Freud and Breuer, and was utilized by Freud as a model for some of his early formulations. Later, with his distancing from Breuer and rivalry with Janet, and with the growing emphasis upon repression at the expense of dissociation, Freud's interest in multiple personality diminished. This change is reflected in the relative neglect of the topic in psychoanalytic literature. It is suggested, however, that psychoanalysis needs and is able to deal with this phenomenon, and several contributions are suggested as potential foundations: Freud's later thought on identification and on splitting; Fairbairn's work on object relations and ego splitting, which may be recast in terms of the representational world; Kernberg's writings on borderline personality organization; and Kohut's formulation of 'the vertical split'. Three recent cases of multiple personality are presented, and an attempt is made to analyse their development and dynamics. Severe deficits in mother-child relationship are evident in all three, and are seen as the primary source of splitting. An intense and unresolved compensatory oedipal involvement, followed by loss, leads to the open appearance of the split. The separate 'personalities' represent complex crystallizations of part object representations which evolve into split self representations. In view of the developmental arrest which can be observed, the therapeutic strategy suggested is not based on confrontation and interpretation of the distortions and denial involved, but rather on developing faulty ego functions and empathically strengthening the fragmented self.