Chapter 2. History of Dissociation (1) Psychoanalytical Viewpoint (5)

When I reflect on the cases that we found difficult to diagnose in Japanese clinical settings, many of them ended up being considered as probably having borderline personality disorder, just like A. They often self-harm, suddenly change their remarks and behaviors, and are very sensitive in their interpersonal relationships. In fact many of them could actually have matched the diagnosis of BPD. However, they had a problem in common. Quite often they don’t remember some of their behaviors, and again that was what A also had. Thus, it was very likely that I already had many contacts with dissociative patients in Japan, except that I did not know the fact.
I remember the first case conference that I attended at the Menninger Foundation where a DID case was presented. I was totally clueless as to what was talked about among clinicians who attended the conference. The case presented sounded pretty much like a schizophrenic who was reported to have hearing voices and to identify herself as someone different. I could not grasp a notion that a person can posses several identities. My response could have been well understandable as it was my initial experience of facing a DID case. Although astounded, I did not have much problem accepting the existence of DID as soon later I took charge of some of these patients. What troubled me rather was that I did not know how to come to terms with the psychoanalytic theories that I was studying which did not presuppose existence of multiple identities in a mind.
Then I began to realize that learning dissociative disorders made me appreciate some of the analytic theories that I had some difficulty accepting. I show an example of a theory that I was learning at the Menninger. Here is a well known diagram that Ronald Fairbairn presented in his book (Fairbairn, 1952)

It depicts different types of internal objects, such as Central Ego, Internal Saboteur, Libidinal Ego, and so on. I thought that they were just figurative notions, not that they really exist in our self.