Chapter 5. Further Discussions on the “Relational stress” (2)

Another theory that is well recognized among clinicians is Colin Ross’s “four pathway theory”. According to Ross, these pathways are 1.Childhood Abuse Pathway, 2.Childhood Neglect Pathway, 3.Factitious Pathway, and 4.Iatrogenic Pathway. Among them, factitious and iatrogenic pathways are related only to exceptional cases and childhood neglect pathway has to do with emotional distance between child and her parental figures, unlike in the relational stress. Therefore, childhood abuse pathway is the only pathway which might have some bearings on the notion of the “relational stress”. Ross thinks that the child abuse pathway is the most typical one and states.:
The most common etiological theory for this subtype, which I subscribed to in the first edition of this book, is that DID arises during severe, chronic childhood trauma, which in North America is most commonly sexual and/or physical abuse. The little girl being sexually abused by her father at night imagines that the abuse is happening to someone else, as a way to distance herself from the overwhelming emotions she is experiencing. (p64). Thus, with his idea of childhood abuse pathway, Ross appears to have only overt childhood sexual and physical abuse in his mind.
In summary, these dominant theories on the origin of DID do not seem to take into account any possible subtle forms of stressful situations between child and her parent as the relational stress assumes.

Balint’s notion of basic fault and its relation to the Relational Stress

I personally consider that the notion of “basic fault” by Michael Balint（Balint, 1969） depicts the condition closest to the relational stress. Balint is a psychoanalyst and a disciple of Sandor Ferenczi, a direct follower of Freud. Being from Budapest Hungary, he fled Nazis and went to England and became active as a middle school analyst.