Laying out the Moods
- Rewriting the Soul: Multiple Personality and the Sciences of Memory by Ian Hacking
Princeton, 346 pp, £12.95, May 1998, ISBN 0 06 910590 1
When I was a graduate studying psychology in the Seventies, I was taught that multiple personality was a rare, almost unheard of disease. One textbook said that there was one multiple per million people; another that there had been fewer than a dozen diagnosed cases in the past fifty years. I went through graduate school, internship, psychoanalytic training, and 15 years of clinical practice in Boston without ever meeting a patient who exhibited symptoms of multiple personality. I was never assigned, and never read, any book or article on the subject. And I never knew or heard of anyone who had such a patient in treatment.
A decade later, there has been an explosion in reported cases of multiple personality. First-year social-work students are routinely assigned several new cases for treatment. There are innumerable seminars, training programmes and weekend workshops that teach clinicians how to recognise and treat multiplicity. New estimates put the number of Americans suffering from multiplicity, not at one in a million, but one in 20.
What exactly has happened, or is happening? Have we just got better at recognising a disorder that has always existed to the extent it does today? And if so, have patients ‘hidden’ their symptoms or presented them in other forms? Or is there actually more MPD than before because the incidence of child sexual abuse, widely considered the root cause of multiple personality, has increased dramatically? Are we ‘creating’ MPD – a point of view advanced by many members of the medical community – because a group of therapists ‘committed’ to the diagnosis are manipulating their vulnerable and suggestible patients? Or is MPD simply a new symptom for an old disease?
Anthropologists teach us that psychiatric illnesses are cultural products. We have fallen ill and talked about our illnesses in different ways at different times and places. Neurasthenia and hysteria were once the ‘popular’ ways of being ill; they gave way to borderline personality and now to multiple personality. From this point of view, the question is not whether multiple personality exists but why it has appeared now and what purposes are served by our fighting about it, as patients sue their families and families sue therapists? In Rewriting the Soul, Ian Hacking suggests an answer: we are struggling with MPD because it is our current way of struggling with the nature of the soul.
In Hacking’s argument, we become sick with MPD because we no longer have cultural permission to be ‘soul sick’. When we can’t any longer talk about exorcising our demons, we turn to the cure of our secular memories. For Hacking, the turning point in the move from soul sickness to memory sickness was the development in late 19th-century France of the sciences of memory, which brought what used to be called the soul within the purview of science. So, on one level, preoccupations with MPD are a way of remaining preoccupied with the soul. On another level, however, fighting about the nature of MPD has become a new way of fighting about psychoanalysis. We may be at the end of the Freudian century, but psychoanalytic concepts such as the dynamic unconscious have a powerful cultural presence. Is fighting over the nature of MPD – whether it is real or ‘constructed’ – one of the ways we are sorting out our commitment to them?
The MPD epidemic has thrown into question the most fundamental tenet of psychoanalysis: the existence of a dynamic unconscious. This is not because sufferers from multiple personality do not suffer from the effects of the unconscious, but because the claim is that they do: they are multiple because their unconscious holds secrets so terrible that simple repression, a massive and motivated forgetting, cannot contain them. Pieces of the self need to be created that can function autonomously, thereby fencing off forbidden memories from the self as a whole.
This claim about the aetiology of multiple personality took shape in 1973, the year of the publication of F.R. Schreiber’s Sybil, a popular book, later made into an even more popular movie, about a case treated by the psychiatrist Cornelia Wilbur. Wilbur believed, and has persuaded many others, that the fundamental cause of multiplicity is repeated trauma at a young age, usually in the form of sexual abuse. When the trauma is severe enough, the child ‘dissociates’ – that is, splits off the personality who is suffering the abuse so that it is no longer experienced as part of the self. A six-year-old girl who sees her parents being murdered is traumatised, but it’s safe to remember the event because the horror may be spoken of and shared. A six-year-old girl whose father demands sexual intercourse at night and cheerily pours out the Shreddies for her and her mother in the morning has a different kind of problem. If she is to meet her needs as a child and a daughter, she must not be her father’s lover. So she defends herself by making this the case: she dissociates so that only one part of the self suffers the abuse. The rest of the self system does not know about it. The family’s videos of a jolly six-year-old playing catch with her father are true representations of the father-daughter relationship untroubled by the forbidden memories. In this picture, dissociation begins where repression is not strong enough to serve. It is massive in its power and ultimately too successful: it leaves an unintegrated piece of the self – an ‘alter’ – within.
Over time, there can be many of these splits, creating a cast of inner characters, each of which originally served a protective function, each of which has only partial knowledge of the world. The cure suggested by members of the MPD movement is paradigmatically Freudian: a taking cure in which the ghosts of the past, the repressed memories of abuse, are brought to light. The multiple selves who carry these memories are encouraged to ‘come out’ so that they can be actively engaged in the treatment.
Hacking points out that the majority of MPD professionals – ‘MPD proponents’, as he calls them – are not psychiatrists: they are psychologists and social workers, people left out of the drug revolution of the Eighties and Nineties. In the world of MPD, there is no Prozac, no silver bullet, no talk of an MPD gene; no prestigious dispenser of medication or scientific authority to contend with. To the grass-roots clinicians, the MPD model is reassuringly pre-psychopharmacological and non-biological. One can finally be alone with the patient’s memories.
The full text of this book review is only available to subscribers of the London Review of Books.