Part 38

This subject has herself written at my request two introspective analyses of her own case, one by the normal personality and the other by the secondary personality. These analyses are of great value.[268] They give different versions of the same facts in accordance with the differing memories, knowledge and points of view of the differing personalities. The second also gives an account of the claimed co-conscious life as experienced by herself and unknown to the normal personality. We cannot do better than take them as a basis for a genetic study of the case and reproduce portions of them here. In this study I have made use, in addition to this material, of a large number of personal observations extending over five years, of numerous letters and analyses written by the subject at different times in her various phases of personality, of the memories in hypnosis, in which state many subconscious and dissociated perceptions and thoughts not otherwise remembered are brought to light, and of numerous analyses of her memories made on many occasions, at the expense of many hours of labor. Other sources of information have also been made use of. This investigation has resulted in a voluminous collection of records filling several large portfolios. In making the analyses and in many of the letters the subject, with extreme frankness and in the interests of psychology has gone in great detail into and has laid bare the most intimate facts of her mental life. This is true of each of the phases of personality, so that the point of view from which the same facts were seen in different moods has been obtained. This is a matter of no small consequence as the same fact often acquires a different aspect or meaning according to the view point of the mood in which it is experienced. A large amount of data pertaining to the inner life of the subject has thus become accessible. It is obvious that data of this sort are necessary if the psychological status of any given period of an individual’s life is to be related to antecedent mental experiences as etiological factors. But this sort of data is that which usually is most difficult to obtain. Our inner lives we keep hidden as in a sealed book from the world. In all published reports of multiple personality these data are lacking, the studies dealing almost entirely with such facts only as were open to the observation of the investigator. It necessarily results from such a study of the inner life of a person living in the circle to which this subject belongs that many of the data are too intimate and personal for publication. However much one may be interested in science there is a point beyond which one shrinks from exposing one’s self in print. I am, therefore, at many points very properly limited to the use of general phrases and summarizing expressions instead of explicit statements of particular facts which, I am aware, would be more satisfactory to the critic. This limitation cannot be helped, but is probably compensated for by the fact that, if it did not exist, the subject would be one whose introspective observations would be of much less value.

I will only add to this statement that the data were not collected in support of a preconceived theory or even of a working hypothesis, but only after they were gathered—in fact, after much of this material was forgotten—were they brought together and studied. It was then found that when the different pieces of evidence were pieced together they allowed of only one conclusion, namely, that which the subject herself in the main reached independently as the facts were laid bare and brought into the field of her consciousness by the means I have described.

By way of preface to the subject’s introspective analyses I reproduce here the following remarks, which I wrote as an introduction to the “Life,” but slightly expanded and with a few verbal changes to make the matter clearer.

An account of the various phases of dissociated personality written by the patient after recovery and restoration of memory for all the different phases cannot fail to be of interest. If the writer is endowed with the capacity for accurate introspection and statement such an account ought to give an insight into the condition of the mind during these dissociated states that is difficult to obtain from objective observation, or, if elicited from a clinical narration of the patient, to accurately transcribe. In that remarkable book, “A Mind that Found Itself,” the author, writing after recovery from insanity, has given us a unique insight into the insane mind. Similarly the writer of the following account allows us to see the beginnings of the differentiation of her mind into complexes, the final development of a dissociated or multiple personality, and to understand the moods, points of view, motives, and dominating ideas which characterized each phase. Such an account could only be given by a person who has had the experience, and who has the introspective and literary capacity to describe it.

The writer in publishing, though with some reluctance and at my request, her experiences as a multiple personality, is actuated only, as I can testify, by a desire to contribute to our knowledge of such conditions. The experiences of her illness—now happily recovered from—have led her to take an active interest in abnormal psychology and to inform herself, so far as is possible by the study of the literature, on many of the problems involved. The training thus acquired has plainly added to the accuracy and value of her introspective observations.

A brief preliminary statement will be necessary in order that the account as told by the patient may be fully intelligible.

The subject was under my observation for about four years. When first seen the case presented the ordinary picture of so-called neurasthenia, characterized by persistent fatigue and the usual somatic symptoms, and by moral doubts and scruples. This condition, at first unsuspected, was later found to be a phase of multiple personality and was then termed and is described in the following account as state or personality A. Later another state, spoken of as personality B, suddenly developed. A had no memory of B, but the latter had full knowledge of A. Besides differences in memory A and B manifested distinct and markedly different characteristics and traits which included moods, tastes, health, emotions, feelings, instincts, sentiments, points of view, habits of thought, and controlling ideas. In place, for instance, of the depression, fatigue, and moral doubts and scruples of A, B manifested rather a condition of exaltation, and complete freedom from neurasthenia and its accompanying obsessional ideas. A and B alternated during a long period of time with one another. After A, for example, had existed as a personality for a number of hours or days she changed to B, and vice versa. After the first appearance of B it was soon recognized that both states were only fragments, so to speak, or phases of a dissociated personality, and neither represented the normal complete personality. After prolonged study this latter normal state was obtained in hypnosis (c´), and on being waked up a personality was found which possessed the combined memories of A and B, and was free from the pathological stigmata which respectively characterized each. This normal person is spoken of as C. Normal C had, therefore, been split and resynthesized into two systems of complexes or personalities, A and B. Leaving out for the sake of simplicity certain intermediate hypnotic states, A and B could be hypnotized into a single hypnotic state which was a synthesis that could be recognized as a complete normal personality in hypnosis. All that remained to do was to wake up this state and we had the normal C. This process could be reversed and repeated as often as desired: that is, C could be split again into A and B, then resynthesized in c´ who when awakened became C again. This relationship may be diagramatically expressed as follows:[269]

The various traits which characterized and differentiated the different personalities will appear in the course of this genetic study. With this introduction we will proceed to the latter.

II THE DISRUPTION OF PERSONALITY

The first of the accounts above mentioned by the _normal_ personality, C, written after recovery, is in the form of a letter. She had complete memory for both her phases A and B. It will be noticed in passing that this normal self speaks of the phases A and B as herself, transformed to be sure, but still herself in different “states.” “As A, _I_ felt” so and so, “as B, _I_ felt” thus, etc. On the other hand, the secondary personality, B, in her account, always refers to the other personalities as distinct personages, and uses the third person “she” in speaking of them. In this matter of differentiation of personalities B was very insistent, maintaining, as has been frequently noted in other cases, that she had no sense of identity of her own self-consciousness with that of the others. “I am, at any rate, a distinct personality,” she remarks. In her consciousness there was no feeling that the self-consciousness of C and A was identical with her own, but the contrary. This frequent phenomenon presents a standpoint from which the problem of the “I” may be studied. What is it that determines the self-consciousness of an ego? We are not concerned with this old question at present, but it is worth noting that cases of dissociated personality offer favorable material for the solution of the problem.

The following extracts from the accounts by “C” and “B” have been taken as a basis for our analysis which will further attempt to coordinate the two accounts and to clarify the psychological development of the case.

FROM ACCOUNT GIVEN BY THE NORMAL PERSONALITY C AFTER RECOVERY

MY DEAR DR. PRINCE,

You have asked me to give you an account of my illness as it seems to me now that I am myself and well; describing myself in those changes of personality which we have called “A” and “B.”

It is always difficult for one to analyze one’s self accurately and the conditions have been very complex. I think, however, that I have a clear conception and appreciation of my case. I remember myself perfectly as “A” and as “B.” I remember my thoughts, my feelings, and my points of view in each personality, and can see where they are the same and where they depart from my normal self. These points of view will appear as we go on and I feel sure that my memory can be trusted. I recall clearly how in each state I regarded the other state and how in each I regarded myself.

As I have said, I have now, as “C,” all the memories of both states (though none of the co-conscious life which, as B, I claimed and believed I had). _These memories are clearly differentiated in my mind._[270] It would be impossible to confuse the two as the moods which governed each were so absolutely different, but it is quite another thing to make them distinct on paper. I have, however, been so constantly under your observation that you can, no doubt, correct any statement I may make which is not borne out by your own knowledge.

I am, perhaps, of a somewhat emotional nature, and have never been very strong physically though nothing of an invalid. I have always been self-controlled and not at all hysterical, as I would use the word. On the contrary, I was, I am sure, considered a very sensible woman by those who know me well, though I am not so sure what they may think of me now. I am, however, very sensitive and responsive to impressions in the sense that I am easily affected by my environment. For instance, at the theatre I lose myself in the play and feel keenly all the emotions portrayed by the actors. _These emotions are reflected vividly in my face and manner sometimes to the amusement of those with me and, if the scene is a painful one, it often takes me a long time to recover from the effect of it. The same is true of scenes from actual life._[271]

Before this disintegration took place I had borne great responsibility and great sorrow with what I think I am justified in calling fortitude, and I do not think the facts of my previous life would warrant the assumption that I was naturally nervously unstable. It does not carry great weight, I know, for one to say of one’s self,—I am sensible, I am stable, I am not hysterical,—but I believe the statement can be corroborated by the testimony of those who have known me through my years of trial. The point I wish to make is that my case shows that such an illness as I have had is possible to a constitutionally stable person and is not confined to those of an hysterical tendency.

A year previous to this division of personality a long nervous strain, covering a period of four years, had culminated in the death of one very dear to me—my husband. I was, at the end of that period, in good physical health, though nervously worn, but this death occurred in such a way as to cause me a great shock, and within the six days following I lost twenty pounds in weight. For nearly three months I went almost entirely without food, seemingly not eating enough to sustain life. I did not average more than three or four hours’ sleep out of the twenty-four, but I felt neither hungry nor faint, and was extremely busy and active, being absorbed both by home responsibilities and business affairs. The end of the year (5 years after the beginning of my husband’s illness), however, found me in very poor health physically and I was nervously and mentally exhausted. I was depressed, sad, felt that I had lost all that made life worth living and, indeed, I wished to die. I was very nervous, unable to eat or sleep, easily fatigued, suffered constantly from headache, to which I had always been subject, and was not able to take much exercise. The physician under whose care I was at this time told me, when I asked him to give my condition a name, that I was suffering from “nervous and cerebral exhaustion.”

_It was at this time that the shock which caused the division of personality occurred_ [_resulting_ in period III].

Although this last statement is true so far as concerns the complete dissociation of personality which resulted in the birth of an independent alternating personality, the first beginning of the genesis of that personality can be traced back to a far earlier period when she was about twenty years of age, that is to say _nineteen years before the final cleavage. These beginnings were an embryonic cluster or unitary complex of rebellious ideas, “floating thoughts, impulses, desires, inclinations” and intense feelings which came into being at this early period in consequence of an emotional trauma._

I propose to trace in the course of this study, first, the gradual growth by successive syntheses of this rebellious cluster with other idea-clusters during a period of _fourteen_ years.

Second, its incubation, organization and segregation from the main personality during a second period of _five_ years as a fairly well defined unitary complex known as the _B complex_.

Third, the culmination of the incubating process and, as the result of an emotional shock, final bursting into flower of the B complex as the _B personality_ (i.e., nineteen years from the time of the beginning of disaggregation through rebellious thoughts).

Fourth, the reversion to the original personality, but now one so disintegrated, shorn and shattered by the segregation of the autonomous B complex and of certain instincts as to be a so-called secondary disintegrated _personality_, _A_.

Fifth, the alternation of these two strongly contrasted abnormal personalities.

Finally, the reintegration of the two abnormal personalities into one normal original personality, C.

In following the evolution of the personalities my main purpose will be to bring to light the psychological forces which brought about the disaggregation, on the one hand, and the synthetic construction of the new personal systems, on the other. The following arrangement of these changes in the personality by periods will be convenient for reference.[272]

Period I. From wedding to beginning of husband’s illness (14 years) characterized by a group of rebellious ideas.

Period II. During husband’s illness (4 years) and one year thereafter (5 years), characterized by B _complex_ and terminating with shock.

Period III. Beginning with shock, characterized by B _personality_ and terminating one month later by another shock in

Period IV. _Personality_ A, plus B complex, lasting one week, followed by

Period V. Characterized by alternations of A and B personalities and lasting several years until reintegrated in original normal personality, C.

All these changes from period I to IV inclusive were caused by emotional shocks awakened by a common factor in closely associated situations. In period IV the A personality had no amnesia for personality B. This amnesia developed in period V.

THE REBELLION

PERIOD I

The writer C in her account passes over the early first period, but she remembers clearly the historical facts and has given a very precise description of them in the many analyses which have been made and recorded. Moreover in the second account,[273] written in the secondary B phase of personality, she recognizes the embryonic emotional complex of this first period, and its genetic relation to the later B _complex_, and to her own still later developed B _personality_. “This complex” she (B) wrote, “it seems to me is the same, though only slightly developed, as that which appeared later and is described as complex B. In trying to explain this condition, which it seems to me was the first start of what ultimately resulted in a division of personality, I will divide the time into periods, and I will call this period I.” (This same division into periods I have thought it well to follow.) She also identified the ideas of this early complex with ideas and feelings which she still entertained and which formed a marked characteristic of her own dissociated (B) personality.

For the sake of clearness and simplicity of phraseology it will be well from now on to speak of the subject when in the dissociated B state simply as B, and when united in the normal state as C. In this way, as C points out, we shall avoid constant repetition and circumlocution in such phrases as, “when the subject was in the B state,” etc. You must not, however, be misled by the connotation of terms and read into this nomenclature more than the psychological facts warrant, or make distinctions of personality which transcend in any way psychological laws. Dissociated and multiple personality are not novel freak phenomena, but are only exaggerations of the normal and due to exaggerations of normal processes, and it is for this reason that they are of interest and importance. For, being exaggerations, they accentuate and bring out into high relief certain tendencies and functional mechanisms which belong to normal conditions, and they differentiate mental processes, one from another, which normally are not so easily recognized.

They are caricatures, so to speak, of the normal. In one respect they may be likened to the staining of an anatomical specimen prepared for the microscope by which the various anatomical structures are brought out into strong contrast with one another and easily differentiated, like the boundaries of countries on a colored map. Without the staining all would have a homogeneous appearance and differentiation would be difficult. So, though a secondary personality is in one sense but a phase of the whole personality, it is characterized largely by an accentuation or domination of particular constituents to be found in the given normal everyday personality, and by the subordination or suppression of others, both being effected by the exaggeration of the normal processes of dissociation and synthesis. In such a secondary personality these constituents and processes are easily recognized though they may be hidden under normal conditions. In saying that a secondary personality is a phase of the whole personality the latter term—whole personality—must be taken in the sense of including all the past experiences of life which have been organized, deposited and conserved in the unconscious, and all the instincts and innate dispositions of the individual. These past experiences form, as we have seen,[274] a storehouse of formative material which, for the most part, under ordinary conditions, may lie dormant though potential; but any elements of this material may, under special influences, be awakened to activity and, uniting with particular constituents of the normal everyday personality, take part under the urge of their own instinctive impulses and dispositions in the formation of a new personality. The remainder of the normal personality then becomes submerged and dormant in the unconscious.

To return to the evolution of the B personality. If this final phase be correctly traced back 19 years to the early antecedent rebellious complex above referred to, we shall see that the evolution of multiple personality in this case passed through several successive stages and was of slow growth. Speaking generally, it may, indeed, be ascribed, primarily, on the one hand, to the disruptive or dissociating effect of continuous _conflicts_ between the opposing impulses of innate dispositions and instincts (emotions), and, on the other, to the gradual synthesization of the components of personality repressed by these conflicts into the subconscious. The secondary incubation of these repressed and other deposited experiences of life followed, with the final setting free of all this formative material, when fully matured, by the force, awakened by a trauma, of the conative emotional impulses belonging to it. The analogues of these phenomena and mechanisms are observed in sudden religious conversion which in principle is an alteration of personality.[275]

All the historical evidence at hand, derived from searching investigation, goes to show that at the early period to which I have referred (period I) the subject received an emotional shock, “which,” B wrote, “it seems to me, as I look at it now, resulted in the first cleavage of personality. This emotion was one of fright and led to rebellion [in the form of rebellious thoughts] against a certain condition of her life, and formed a small vague complex [of thoughts and emotions] which persisted in the sense that it recurred from time to time, though it was always immediately suppressed.”[276] And this vague complex of rebellious thoughts necessarily soon gave rise to and included other “floating thoughts, impulses, desires, inclinations,” all of which the subject suppressed or endeavored to suppress during a long period of years. “This complex,” she adds, as quoted above, “it seems to me, was the same, though only slightly developed, as that which appeared later, and is described as complex B.”