Sunday, July 27, 2014

Dissociation and building a bridge

The local psychoanalytic professional society offers every year a discussion group as part of its extension division. This year, the readings will all come from Philip Bromberg’s 1998 book Standing in the Spaces, Essays on Clinical Process, Trauma, and Dissociation. In its introduction, and addressing the psychoanalytic process, Bromberg grapples with the human ability to allow “continuity and change to occur simultaneously.” He posits that the self is not unitary but that the mind is a “configuration of shifting, nonlinear states of consciousness in an ongoing dialectic with the necessary illusion of unitary selfhood.”  

Bromberg emphasizes the role of dissociation—a result of trauma— as equally significant and more powerful than repression and conflict, in shaping the psyche.  Psychoanalysis builds a bridge between dissociated (not-me) self states of the mind and thus, transforming it, allows for “the experience of intrapsychic conflict.” It enhances “a patient’s capacity to feel like one self while being many.” Dissociation, both normative and pathological, exist in both participants and the patient and analyst purposefully confront and engage each other’s (and their own) multiplicities and nonlinear realities as they organize their relationship.

In moments of intense affective arousal, when parents are unable to reflect upon a child’s mind, both staying in the appropriate affective experience with the child and bringing the parent’s new perspective to bear, the child may be “traumatically impaired in his ability to cognitively process his own emotionally charged mental states…and thus own them as ‘me’.” Bromberg continues, “[P]sychological trauma can broadly be defined as the precipitous disruption of self-continuity through invalidation of the internalized self-other patterns of meaning that constitute the experience of ‘me-ness’.” This threat to self is experienced as annihilation anxiety. Dissociation protects the sense of self continuity by keeping at bay traumatic disruption. Unfortunately, safety of this trauma based personality requires one to be at the ever ready for disaster such that one can never feel safe even when one is.

One poignant example of dissociation exists in the schizoid patient whose dissociation, Bromberg writes, is “so rigidly stable…that is tends to be noted only when it collapses.” To protect itself from annihilation anxiety, the schizoid personality prevents spontaneity by keeping a boundary between the inner and outer world such that things remain predictable and controllable. “The struggle to find words that address the gap that separates us is the most potentially powerful bridge between the patient’s dissociated self-states…Once the words are found and negotiated between us, they then become part of the patient’s growing ability to symbolize and express in language what he has had no voice to say.”

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