There is an increasing suspicion that Multiple Personality Disorder is one extreme along a continuum of dissociative phenomena, ranging from children’s pretend play and dreams at one end, through borderline personality disorder, posttraumatic stress syndrome, dissociative disorders not originally specified to a severe and complete personality fragmentation at the other. In this essay, we address the questions of whether a continuum view is correct and how to characterize the differences among the various disorders through distinguishing multiplex (...) from multiple selves. This analysis has implications for how the symptoms of MPD should be characterized and treated as well as shedding some light on the relation between conscious experience and selfhood. (shrink)

Dissociative identity disorder is a dissociative disorder that gained a significant rise in the past few decades. There has been less than 50 DID cases recorded between 1922 and 1972, while 20,000 cases are recorded by 1990. Therefore, it becomes of great significant to assess the various concepts related to DID to further understand the disorder. The current review has a goal of understanding whether an individual suffering from DID is legally responsible for the committed crime, and whether (...) or not he or she can be considered competent to stand trial. These two questions are to be raised in understanding DID, by first shedding a light on the nature of the disorder and second by examining the past legal case examples. Despite the very nature of the disorder is characterized by dissociative amnesia and the fact that the host personality may have limited or no contact with the alters, there is no consensus within the legal system whether the DID patients should be responsible for their actions. Further to that, courts generally deny the insanity claims for DID suffering patients. In conclusion, more studies in the field are suggested to incorporate primary data into research, as the extensive reliance on secondary data forces us to believe the conclusions that were previously made, and no opportunity to verify those conclusions is present. (shrink)

_Treating Dissociative and Personality Disorders_ draws on major theorists and the very latest research to help formulate and introduce the Relational/Multi-Motivational Therapeutic Approach, a new model for treating such patients within a clinical psychoanalytic setting. Supported by her fellow contributors, Antonella Ivaldi provides an overview of existing theories and evidence for their effectiveness in practice, sets out her own theory in detail and provides rich clinical detail to demonstrate the advantages of the REMOTA model as applied in a clinical (...) setting. The narratives in this book show how it is possible to integrate different contributions within a multidimensional aetiopathogenic treatment model, which considers the mind as a manifestation of the relationship between body and world. From a conceptual perspective, according to which consciousness emerges and develops in the interpersonal dimension, this book shows how it becomes possible to understand, in the therapeutic space, what stands in the way of sound personal functioning, and how to create the conditions for improving this. Treating Dissociative and Personality Disorders will be highly useful in addressing the particular clusters of symptoms presented by patients, stimulating therapists of different backgrounds to explore the complexity of human nature. On reading this book, it will become clear that theories can truly become useful instruments, if approached with a critical mind and with humbleness, in order to venture into what we do not know and will never know completely: the relationship with the other, unique and irreplaceable. Treating Dissociative and Personality Disorders provides an integrative and comparative new approach that will be indispensable for combining relational clinical knowing and motivational theories. It_ _will appeal to psychoanalysts and psychotherapists, especially those in training, clinicians of different backgrounds interested in comparative psychotherapy, as well as social workers and graduate and postgraduate students. (shrink)

If someone with dissociative identity disorder commits a wrongful act, is she responsible? If one adopts the Multiple Persons Thesis, it may seem that one alter cannot be responsible for the actions of another alter. Conversely, if one regards the subject as a single person, it may seem that she is responsible for any actions she performs. I will argue that this subject is a single person, but one who suffers from delusions of disownership and therefore does not fulfill (...) ordinary requirements for responsible agency. This is because she suffers from extreme ambivalence: her deep-seated needs and desires conflict, and she forms alter-personalities as a way to cope with inner discord without abandoning any of these contradictory impulses. However, although the ability to exercise autonomous agency is eroded in such cases, the capacity for autonomous agency is preserved. The subject with DID is weakly responsible for her wrongful acts. (shrink)

If someone with dissociative identity disorder commits a wrongful act, is she responsible? If one adopts the Multiple Persons Thesis, it may seem that one alter cannot be responsible for the actions of another alter. Conversely, if one regards the subject as a single person, it may seem that she is responsible for any actions she performs. I will argue that this subject is a single person, but one who suffers from delusions of disownership and therefore does not fulfill (...) ordinary requirements for responsible agency. This is because she suffers from extreme ambivalence: her deep-seated needs and desires conflict, and she forms alter-personalities as a way to cope with inner discord without abandoning any of these contradictory impulses. However, although the ability to exercise autonomous agency is eroded in such cases, the capacity for autonomous agency is preserved. The subject with DID is weakly responsible for her wrongful acts. (shrink)

While many theorists have argued that dissociative identity disorder is a case of multiple selves or persons in a single body, I maintain that DID instead should be understood as involving a single self who suffers from significant disruptions to self-consciousness. Evidence of overlapping abilities and memories, as well as the very logic of dissociation, supports the claim that DID results from internal conflict endured by a single self. Along these lines, I will maintain that alter-formation should be understood (...) as the result of extreme emotional ambivalence. While it is true that subjects with DID exhibit volitional conflict, as Frankfurt [1988. The Importance of What We Care About. New York: Cambridge University Press; 1999. Necessity, Volition, and Love. New York: Cambridge University Press] maintains, I argue that these incompatible volitions have a deeper source: conflicting desires and affective stances concerning basic emotional needs that are not easily abandoned. A single subject turns to... (shrink)

In this paper we argue that dissociative identity disorder (DID) is best interpreted as a causal model of a (possible) post-traumatic psychological process, as a mechanical model of an abnormal psychological condition. From this perspective we examine and criticize the evidential status of DID, and we demonstrate that there is really no good reason to believe that anyone has ever suffered from DID so understood. This is so because the proponents of DID violate basic methodological principles of good causal (...) modeling. When every ounce of your concentration is fixed upon blasting a winged pig out of the sky, you do not question its species' ontological status. James Morrow, City of Truth (1990). (shrink)

Obsessive compulsive disorder is a debilitating psychiatric condition where people become obsessed by remotely possible harm, error, bad luck, and compulsively repeat mental or behavioural rituals to neutralize these possibilities. This tendency to draw inferences on the basis of remote rather than more likely possibilities is termed 'inferential confusion' and can lead to immersion in possible worlds accompanied by feelings of dissociation between: knowing and doing, imagination and reality, and authentic and inauthentic self. These dissociation experiences in OCD may inform (...) us on the relational 'possibilistic' nature of consciousness. In a relational model of consciousness, the boundaries of consciousness are located between the person and the world, and shift according to the 'aboutness' of self-world interaction. A key element of 'aboutness' is projecting into the future to what is 'about to be', so sense of reality is constructed through a consensus about what could be, operationalized as a personal possibility distribution. Experiences such as derealization and depersonalization occur in OCD when there is a clash between personally possible worlds and the person ends up living in simultaneously a possible and an impossible world. Recognizing this confusion may be a key to alleviating dissociative symptoms. (shrink)

In a serial reaction time task, procedural memory was examined in Dissociative Identity Disorder . Thirty-one DID patients were tested for inter-identity transfer of procedural learning and their memory performance was compared with 25 normal controls and 25 controls instructed to simulate DID. Results of patients seemed to indicate a pattern of inter-identity amnesia. Simulators, however, were able to mimic a pattern of inter-identity amnesia, rendering the results of patients impossible to interpret as either a pattern of amnesia or (...) a pattern of simulation. It is argued that studies not including DID-simulators or simulation-free memory tasks, should not be taken as evidence for amnesia in DID. (shrink)

This article elaborates on Putnam's ''discrete behavioral states'' model of dissociative identity disorder (Putnam, 1997) by proposing the involvement of the orbitalfrontal cortex in the development of DID and suggesting a potential neurodevelopmental mechanism responsible for the development of multiple representations of self. The proposed ''orbitalfrontal'' model integrates and elaborates on theory and research from four domains: the neurobiology of the orbitalfrontal cortex and its protective inhibitory role in the temporal organization of behavior, the development of emotion regulation, the (...) development of the self, and experience-dependent reorganizing neocortical processes. The hypothesis being proposed is that the experience-dependent maturation of the orbitalfrontal cortex in early abusive environments, characterized by discontinuity in dyadic socioaffective interactions between the infant and the caregiver, may be responsible for a pattern of lateral inhibition between conflicting subsets of self-representations which are normally integrated into a unified self. The basic idea is that the discontinuity in the early caretaking environment is manifested in the discontinuity in the organization of the developing child's self. (shrink)

Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder) is a condition in which a person appears to possess more than one personality, and sometimes very many. Some recent criminal cases involving defendants with DID have resulted in "not guilty" verdicts, though the defense is not always successful in this regard. Walter Sinnott-Armstrong and Stephen Behnke have argued that we should excuse DID sufferers from responsibility, only if at the time of the act the person was insane (typically (...) delusional); otherwise the presumption should be that persons with DID are indeed responsible for their actions. We find their interpretation of DID and of the way in which the requirements for criminal insanity relate to this condition worrying and likely to result in injustice to DID sufferers. Our thesis is that persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency (namely, autonomy and self-control). (shrink)

Many contemporary bioethicists claim that the possession of certain psychological properties is sufficient for having full moral status. I will call this thepsychological approach to full moral status. In this paper, I argue that there is a significant tension between the psychological approach and a widely held model of Dissociative Identity Disorder (DID, formerly Multiple Personality Disorder). According to this model, the individual personalities or alters that belong to someone with DID possess those properties that proponents of the psychological (...) approach claim suffice for full moral status. If this account of DID is true, then the psychological approach to full moral status seems to entail that the two standard therapies for treating DID might, on occasion, be seriously immoral, for they may well involve the (involuntary) elimination of an entity with full moral status. This result should give proponents of the psychological approach pause, for most people find the claim that current treatments of DID are ethically suspect highly counter-intuitive. (shrink)

ICD-10 and DSM-5 do not provide clear diagnosing guidelines for DID, making it difficult to distinguish ‘genuine’ DID from imitated or false-positive cases. This study explores meaning which patients with false-positive or imitated DID attributed to their diagnosis. 85 people who reported elevated levels of dissociative symptoms in SDQ-20 participated in clinical assessment using the Trauma and Dissociation Symptoms Interview, followed by a psychiatric interview. The recordings of six women, whose earlier DID diagnosis was disconfirmed, were transcribed and subjected (...) to interpretative phenomenological analysis. Five main themes were identified: endorsement and identification with the diagnosis. The notion of dissociative parts justifies identity confusion and conflicting ego-states. Gaining knowledge about DID affects the clinical presentation. Fragmented personality becomes an important discussion topic with others. Ruling out DID leads to disappointment or anger. To avoid misdiagnoses, clinicians should receive more systematic training in the assessment of dissociative disorders, enabling them to better understand subtle differences in the quality of symptoms and how dissociative and non-dissociative patients report them. This would lead to a better understanding of how patients with and without a dissociative disorder report core dissociative symptoms. Some guidelines for a differential diagnosis are provided. (shrink)

Dissociative identity disorder (DID; called multiple personality disorder in DSMIII-R) is a psychiatric condition in which two or more identity states recurrently take control of the person's behavior. A characteristic feature of DID is the occurrence of apparently severe amnestic symptoms. This paper is concerned with experimental research of memory function in DID and focuses on between-identity transfer of newly learned neutral material. Previous studies on this subject are reviewed and a pilot study with four subjects is described. This (...) study is specifically concerned with the question whether self-reported asymmetries in between-identity transfer can be replicated on experimental memory tests. A secondary aim was to examine whether, in the absence of explicit transfer, implicit transfer of information would occur. The results showed that the apparent amnestic asymmetry for explicit information was substantiated in the laboratory, although at least some leakage was present between the apparently amnestic identities. No evidence was found for better performance on implicit than on explicit memory tests in the apparently amnestic identities. In the discussion, parallels between apparent amnesia in DID and state-dependent memory are drawn, and the question of simulated amnesia is addressed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 161-167 [Access article in PDF] Social, Cognitive, and Neural Constraints on Subjectivity and Agency:Implications for Dissociative Identity Disorder Peter Q. Deeley In this commentary, I consider Matthew's argument after making some general observations about dissociative identity disorder (DID). In contrast to Matthew's statement that "cases of DID, although not science fiction, are extraordinary" (p. 148), I believe that there are natural (...) analogs of the disorder that, when considered, make it seem less puzzling and exotic. After discussing these examples, I examine the relations between social, cognitive, and neural processes supporting subjectivity and agency, to identify sources of personal identity in cases of DID that can be used as a basis for assessing Matthew's points against Behnke and Sinnott-Armstrong. I am not proposing a comprehensive theory, but rather identifying what I believe are components of such a theory. I then outline an approach to determining criminal responsibility in DID, drawing on analogies with other psychiatric disorders. Dissociative Identity Disorder DID is a disorder described in DSM-IV, which "is characterised by the presence of two or more distinct identities or personality states that recurrently take control of the individual's behaviour accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness" (American Psychiatric Association, p. 519). Recognizing Personal Identity How is personal identity recognized in normal cognition? If we take personhood to involve recognition of continuity of social, psychological, and physical identity for a given individual, then such judgments are routinely made rapidly and automatically as an aspect of what has come to be termed social cognition (Adolphs 2003). There is likely to be considerable redundancy in [End Page 161] the types of information used to make judgments about whether a person is the same as one who was previously encountered, or perhaps heard about—for example, facial features, movement patterns, speech prosody, dress, speech content, gender, ethnicity, social role, among other features, all provide information about individual identity, and hence personhood. When uncertainty exists, it is likely to reflect a loss or alteration of cues that would ordinarily be used in a rapid, automatic, unexamined way (Adolphs 2003). In such extreme cases (for example, severe mental illness or disfigurement), the problem of identification becomes the subject of explicit reasoning (and hence of potential disagreement, because we then engage in post hoc rationalizations to establish criteria for determining personhood, whereas normally we rely on essentially automatic, implicit abilities that work in most circumstances, some of which make little use of linguistic representations and formal reasoning—for example, individual facial identity recognition, which may occur as quickly as 170 ms after stimulus onset [Adolphs 2003]). Nevertheless, examining our judgments and intuitions in cases that force us to explicitly consider whether personal identity is preserved may provide analogies and clues for how we should proceed with DID. Let us consider, then, some natural analogs of DID. Natural Analogs of DID Method Acting I suggest that method acting is an analog of DID (Manderino 1985). Method acting refers to an approach to acting training and performance in which emphasis is placed on intensely imagining and identifying with the mental life of the character being portrayed. Training courses and manuals list many techniques and practices that can be used to facilitate absorption in a role, drawing on different kinds of memory—for example, experiential memories, memories of others, general knowledge (semantic memory), and memories of sensations and feelings, to creative a vivid sense of the subjective experience and actions of the character. Manderino, a method acting teacher, comments: "it is important to investigate the way in which your own mental makeup can improperly influence a character. Insecurities, self-consciousness, shyness or self-doubts can maintain a strong hold, and permitting any of these feelings to enter a performance is to remain the actor and not enter into the mental life of the character. For some, acting allows personal problems to be left behind, and they are thankful for the complete escape that... (shrink)

Dissociative experiences have been associated with diachronic disunity. Yet, this work is in its infancy. Dissociative identity disorder is characterized by different identity states reporting their own relatively continuous sense of self. The degree to which patients in dissociative identity states experience diachronic unity has not been empirically explored. This study examined the degree to which patients in dissociative identity states experienced diachronic unity. Participants were DID adults assessed in adult and child identity states, adults with (...) a psychotic illness, adults from the general population, children from the general population and adults imagining themselves as children. They completed the Diachronic Disunity Scale, the Dissociative Experiences Scale, and the Self-Concept Clarity Scale. Diachronic disunity was not limited to psychiatric groups, but evident to some degree in all adult and child samples. The DID adult sample experienced more dissociation and self-confusion than the psychosis and adult comparison groups, but did not differ on the diachronic measure. DID patients in their child identity states and child comparisons showed disunity and were significantly different from child simulators, who showed relatively more unity. Results suggest that DID patients in either adult or child dissociative identity states, like those in other samples, do not universally experience themselves as having a consistent sense of self over time. (shrink)

Dissociative Identity Disorder is an uncommon disorder that has long been associated with exposure to traumatic stressors exceeding manageable levels commonly encompassing physical, psychological and sexual abuse in childhood that is prolonged and severe in nature. In DID, dissociation continues after the traumatic experience and produces a disruption in identity where distinct personality states develop. These personalities are accompanied by variations in behaviour, emotions, memory, perception and cognition. The use of literature in psychiatry can enrich comprehension over the subjective (...) experience of a disorder, and the utilisation of 'illness narratives' in nursing research have been considered a way of improving knowledge about nursing care and theory development. This research explores experiences of DID through close textual reading and thematic analysis of five biographical and autobiographical texts, discussing the lived experience of the disorder. This narrative approach aims to inform empathetic understanding and support the facilitation of therapeutic alliances in mental healthcare for those experiencing the potentially debilitating and distressing symptoms of DID. Although controversies surrounding the biomedical diagnosis of DID are important to consider, the lived experiences of those who mental health nurses encounter should be priority. (shrink)

The Disordered Mind, Third Edition is a wide-ranging introduction to the philosophy of mental disorder or illness. It examines and explains, from a philosophical standpoint, what mental disorder is: its reality, causes, consequences, compassionate treatment, and more. Revised and updated throughout, the third edition includes enhanced discussions of the distinction between mental health and illness, selfhood and delusions about the self, impairments of basic psychological capacities in mental disorder and the distinct roles that mental causation and neural mechanisms play in (...) mental illness. The book is organized around four questions: What is a mental disorder or illness? What makes mental disorder something bad? What are various mental disorders and what do they tell us about the mind? What is mental health and how may it be restored? Numerous disorders are discussed including: addiction, agoraphobia, delusion, depression, dissociative identity disorder, obsession-compulsion, schizophrenia, and religious scrupulosity, among others. Several neurological disorders are examined. Various problems associated with DSM-5 and with psychiatric diagnosis are explored. Including chapter summaries and suggestions for further reading at the end of each chapter, The Disordered Mind presupposes no special background in philosophy, and as such will be of interest to those in related disciplines such as psychology, psychiatry and mental health, and professions such as nursing and social work. (shrink)

_The Disordered Mind: An Introduction to Philosophy of Mind and Mental Illness, second edition_ examines and explains, from a philosophical standpoint, what mental disorder is: its reality, causes, consequences, and more. It is also an outstanding introduction to philosophy of mind from the perspective of mental disorder. Revised and updated throughout, this _second edition_ includes new discussions of grief and psychopathy, the problems of the psychophysical basis of disorder, the nature of selfhood, and clarification of the relation between rationality and (...) mental disorder. Each chapter explores a central question or problem about mental disorder, including: what is mental disorder and can it be distinguished from neurological disorder? what roles should reference to psychological, cultural, and social factors play in the medical/scientific understanding of mental disorder? what makes mental disorders undesirable? Are they diseases? mental disorder and the mind–body problem is mental disorder a breakdown of rationality? What is a rational mind? addiction, responsibility and compulsion ethical dilemmas posed by mental disorder, including questions of dignity and self-respect. Each topic is clearly explained and placed in a clinical and philosophical context. Mental disorders discussed include clinical depression, dissociative identity disorder, anxiety, religious delusions, and paranoia. Several non-mental neurological disorders that possess psychological symptoms are also examined, including Alzheimer’s disease, Down’s syndrome, and Tourette’s syndrome. Containing chapter summaries and suggestions for further reading at the end of each chapter, _The Disordered Mind, second edition_ is a superb introduction to the philosophy of mental disorder for students of philosophy, psychology, psychiatry, and related mental health professions. (shrink)

The condition known as Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) is metaphysically strange. Can there really be several distinct persons operating in a single body? Our view is that DID sufferers are single persons with a severe mental disorder. In this paper we compare the phenomenology of dissociation between personality states in DID with certain delusional disorders. We argue both that the burden of proof must lie with those who defend the metaphysically extravagant Multiple Persons (...) view and that there is little theoretical motivation to yield to that view in light of the fact that the core symptoms of DID bear remarkable similarity to the symptoms of these other disorders where no such extravagance is ever seriously entertained. (shrink)

One of the central problems of personal identity is to determine what we are essentially . In response to this problem, Lynne Rudder Baker espouses a psychological criterion, that is, she claims that persons are essentially psychological. Baker’s theory purports to bypass the problems of other psychological theories such as Dissociative Identity Disorder and the problem of individuating persons synchronically. I argue that the theory’s treatment of Dissociative Identity Disorder leads to untenable results, is invalid, and consequently fails (...) to individuate persons. (shrink)

The conflict and dissociation between the Body and the Mind have determinant implications in the context of our current clinical practice, and are an important source of internal and relational disturbances. Body-Mind Dissociation in Psychoanalysis proposes the concept as a new hypothesis, different from traumatic dissociation or states of splitting. This approach opens the door to a clinical confrontation with extreme forms of mental disturbance, such as psychosis or borderline disorders, and strengthens the relational power of the analytic encounter, (...) through a focus on the internal sensory/emotional axis in both analyst and analysand. The book details this importance of the analyst's intrasubjective relationship with the analysand in constructing new developmental horizons, starting from the body-mind exchange of the two participants. Body-Mind Dissociation in Psychoanalysiswill be of use to students, beginners in psychotherapy, mental health practitioners and seasoned psychoanalysts. (shrink)

Research targeting emotion’s impact on relational episodic memory has largely focused on spatial aspects, but less is known about emotion’s impact on memory for an event’s temporal associations. The present research investigated this topic. Participants viewed a series of interspersed negative and neutral images with instructions to create stories linking successive images. Later, participants performed a surprise memory test, which measured temporal associations between pairs of consecutive pictures where one picture was negative and one was neutral. Analyses focused on how (...) the order of negative and neutral images during encoding influenced retrieval accuracy. Converging results from a discovery study (N = 72) and pre-registered replication study (N = 150) revealed a “forward-favouring” effect of emotion in temporal memory encoding: Participants encoded associations between negative stimuli and subsequent neutral stimuli more strongly than associations between negative stimuli and preceding neutral stimuli. This finding may reflect a novel trade-off regarding emotion’s effects on memory and is relevant for understanding affective disorders, as key clinical symptoms can be conceptualised as maladaptive memory retrieval of temporal details. (shrink)

A definition of virtual or virtuality is not an easy task. Both words are of recent application in Philosophy, even if the concept of virtual comes from a respectable Latin tradition. Today’s meaning brings together the notions of potentiality, latency, imaginary representations, VR, and the forms of communication in digital media. This contagious, and spontaneous synonymy fails to identify a common vein and erases memory as a central notion. In the present essay, I’ll try to explain essential features of the (...) concept of virtual, taking the investigation of memory troubles in Pierre Janet’s work as an exemplification. Pierre Janet’s work represents a rare combination of medical observation and description of symptoms of mental illnesses, therapeutic guidance in hypnosis and philosophical writing about the main psychological themes of an epoch in transition from a Metaphysics of the Soul to the modern Experimental Psychology. Pierre Janet’s intellectual evolution since the 1880s until the end of his life is dominated by the philosophical project of a theory of the psychic system supported by three basic pillars: a concept of personality, a theory of memory and a sketch of a general theory of conduct. Such complex endeavour cannot be abstracted from the initial connections with Jean-Martin Charcot’s school at La Salpêtrière which meant a turning point in the tradition of the “animal magnetism” concerning the treatment of epileptic-hysterical symptoms along with the contributions of Hyppolite Bernheim’s “Nancy School” of hypnotism. J.-M. Charcot’s or H. Bernheim’s theorising about the organic and psychological aspects of the hypnotic treatment of the hysterical symptoms was already aware of the difficulty in dealing with the extent of the dissimulation of the patients regarding the symptoms of the illness, under hypnotic suggestion, even if Charcot insisted in the identification and cataloguing of the organic expressions, such as contractures or the posture of the body in arc during the attacks. The precise location of the “great hysteria” in the organic-psychic corridor was itself a riddle. If a symptom is a special type of sign, in the case of the “great hysteria” nobody knew for sure what it stood for. The clinical symptom of the attack stood for an organic trouble with cerebral causes, a psychological interruption of the normal sensorial and muscular movements or a disguise of the female desire? Pierre Janet described many hysterical patients, somnambulism and multiple personality since his articles in La Revue Philosophique de la France et l’ Étranger, a Journal founded by the philosopher, experimental psychologist and his intellectual predecessor Théodule-Armand Ribot. The description of the case of the “great hysterical” Lucie, treated by him, is an example of a theoretical hypothesising on multiple personality and discontinuity of memories fragments. There are more cases revealing the same relation between hysteria, somnambulism, personality dissociation and “alternating memory”. Decisively inspired by and corroborating P. Janet’s ideas, S. Freud conceived also the essential of the hysterical sicknesses as disorders of memory. The theme of memory came even more to the foreground in the dissertation L’Automatisme Psychologique. Here, the strange world of somnambulism was scrutinised along with hysterical contractures and convulsions, anaesthesia, the compulsion to repetition, obsessions, “automatic writing” in hysterical patients, multiple personality and “alternating memories”. In the depicted cases memory could not be taken as a homogenous series of remembrances or as a stock of disposable information but as a variable of the depth of the personalities’ inner formation. The so-called “seconde existence” of some somnambulists referred not only unconscious representations and unconscious thoughts but complete or inceptive latent personalities provided with multiple virtual existences and multiple memories. Hypnosis was the privileged technique to access to such multiple memories ignored by the official personality. Later and after the writing of his M.D. Dissertation, Contribution à l’ Étude des Accidents Mentaux chez les Hystériques, P. Janet addressed again the themes of memory and alternating memories in a series of lectures at the Collège de France but now according to the larger framework of a general theory of conduct which included a description of the social actions participating in the narrative construction of personal memories, and the role of social memory. (shrink)

Now that consciousness is thoroughly out of the way, we can focus more precisely on the kinds of things that can happen underneath. A contrast can be made between dissociation and repression. Dissociation is where a memory record or set of autobiographical memory records cannot be retrieved; repression is where there is retrieval of a record but, because of the current task specification, the contents of the record, though entering into current processing, are not allowed into consciousness. I look at (...) hypnotic amnesia and dissociative identity disorder in relation to this contrast. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders-IV-TR treats dissociation as a disruption in the usually integrated functions of consciousness (American Psychiatric Association, 2000). Survey instruments used to measure dissociation incorporate questions that focus on depersonalization, de-realization, and dissociative-identity disorder (DID). The self-administered Structured Clinical Interview for DepersonalizationDerealization Spectrum (SCI-DER) asks a subject if they ever felt that your body did not seem to belong you or you were outside your body (Mula et al. 2008). This last question (...) references what is also known as the out-of-body experience (OBE). In some cultures and religious practices OBE is considered desirable. Research has shown that OBE can be induced. For users of the virtual world Second Life, OBE is the default point of view (POV). Users are represented as avatars that look unreal and one's surroundings look unreal. Yet reality testing is intact (American Psychiatric Association, 2000). Many users have multiple avatars, which enact distinct identities or personalities, and this fits the criteria for dissociative identity disorder. To experience any of these disorders in real life may be considered undesirable, even pathological. But for users of Second Life such dissociative experiences are considered normal, liberating, and even transcendent. (shrink)

This book brings together insights from the enactivist approach in philosophy of mind and existing work on autonomous agency from both philosophy of action and feminist philosophy. It then utilizes this proposed account of autonomous agency to make sense of the impairments in agency that commonly occur in cases of dissociative identity disorder, mood disorders, and psychopathy. While much of the existing philosophical work on autonomy focuses on threats that come from outside the agent, this book addresses how (...) inner conflict, instability of character, or motivational issues can disrupt agency. In the first half of the book, the author conceptualizes what it means to be self-governing and to exercise autonomous agency. In the second half, she investigates the extent to which agents with various forms of mental disorder are capable of exercising autonomy. In her view, many forms of mental disorder involve disruptions to self-governance, so that agents lack sufficient control over their intentional behavior or are unable to formulate and execute coherent action plans. However, this does not mean that they are utterly incapable of autonomous agency; rather, their ability to exercise this capacity is compromised in important respects. Understanding these agential impairments can help to deepen our understanding of what it means to exercise autonomy, and also devise more effective treatments that restore subjects' agency. Autonomy, Enactivism, and Mental Disorder will be of interest to researchers and advanced students working in philosophy of mind, philosophy of action, philosophy of psychiatry, and feminist philosophy. (shrink)

Dissociation is an important aspect of responses to traumatic events. According to a number of influential theories, it negatively impacts cognitive performance including encoding of the trauma memories, leading to an increased risk of later conditions such as posttraumatic stress disorder . We tested this hypothesis experimentally in two studies by inducing dissociation in the laboratory and investigating the effects on several aspects of cognition, including time estimation, digit and spatial span, and story recall. Dissociation was related to decrements in (...) time estimation, digit span, and story retention, but did not affect perceptual attention, spatial span, or immediate story recall. The results are discussed in the context of theoretical models of PTSD and their implications for official questioning of traumatized individuals such as sexual assault survivors. (shrink)

For the last thirty years, cognitive scientists have attempted to describe the cognitive architecture of typically developing human beings, using, among other sources of evidence, the dissociations that result from developmental psychopathologies such as autism spectrum disorders, Williams syndrome, and Down syndrome. Thus, in his recent defense of the massive modularity hypothesis, Steven Pinker insists on the importance of such dissociations to identify the components of the typical cognitive architecture (2005, 4; my emphasis): This kind of faculty psychology has (...) numerous advantages (...). It is supported by the existence of neurological and genetic disorders that target these faculties unevenly, such as a difficulty in recognizing faces (and facelike shapes) but not other objects, or a difficulty in reasoning about minds but not about objects or pictures. Similarly, Simon Baron-Cohen writes (1998, 335; my emphasis; see also Temple, 1997): I suggest that the study of mental retardation would profit from the application of the framework of cognitive neuropsychology (…). In cognitive neuropsychology, one key question running through the investigator’s mind is “Is this process or mechanism intact or impaired in this person?” When cognitive neuropsychology is done well, a patient’s cognitive system is examined with specific reference to a model of the normal cognitive system. And, not infrequently, evidence from the patient’s cognitive deficits leads to a revision of the model of the normal system. However, in recent years, the use of developmental psychopathologies to identify the components of the typical cognitive architecture has come under heavy fire. In a series of influential articles, neuropsychologist Annette Karmiloff-Smith has argued that findings about the pattern of impairments and preserved capacities in people with developmental psychopathologies say nothing about the cognitive architecture of.. (shrink)

Abstract:This paper, presented as the 2019 Cambridge Quarterly Neuroethics NetworkCharcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum’s persistent vegetative state and subsequent refinements in the classification of disorders of consciousness—epitomized by the minimally conscious state, cognitive motor dissociation, and (...) the recently described chronic vegetative state—the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society’s normative and legal obligations to these patients. (shrink)

Dissociation is a phenomenon common in a number of psychological disorders and has been frequently suggested to impair memory for traumatic events. In this study we explored the effects of dissociation on visual memory. A dissociative state was induced experimentally using a mirror-gazing task and its short-term effects on memory performance were investigated. Sixty healthy individuals took part in the experiment. Induced dissociation impaired visual memory performance relative to a control condition; however, the degree of dissociation was not (...) associated with lower memory scores in the experimental group. The results have theoretical and practical implications for individuals who experience frequent dissociative states such as patients with posttraumatic stress disorder. (shrink)

“Identity disorders” constitute a large class of psychiatric disturbances that, due to deviant forms of self-modeling, result in dramatic changes in the patients’ phenomenal experience of their own personal identity. The phenomenal experience of selfhood and transtemporal identity can vary along an extremely large number of dimensions: There are simple losses of content. There are also various typologies of phenomenal disintegration as in schizophrenia, in depersonalization disorders and in_ Dissociative Identity Disorder_, sometimes accompanied by multiplications of the (...) phenomenal self within one and the same physical system. It is important to not only analyze these state-classes in terms of functional deficits or phenomenology alone, but as _self-representational _content as well. For instance, in the second type of cases just mentioned, we confront major redistributions of the phenomenal property of "mineness” in representational space, of what is sometimes also called the “sense of ownership”. Finally, there are at least four different delusions of misidentification. Being a philosopher, I will discuss two particular types of identity disorder _ 2 _ in this contribution - disorders, which are of direct philosophical relevance: A specific form of DM, and the Cotard delusion. Why should philosophers do this? And why should psychiatrists care? (shrink)

Empathy is a lay term that is becoming increasingly viewed as a unitary function within the field of cognitive neuroscience. In this paper, a selective review of the empathy literature is provided. It is argued from this literature that empathy is not a unitary system but rather a loose collection of partially dissociable neurocognitive systems. In particular, three main divisions can be made: cognitive empathy , motor empathy, and emotional empathy. The two main psychiatric disorders associated with empathic dysfunction (...) are considered: autism and psychopathy. It is argued that individuals with autism show difficulties with cognitive and motor empathy but less clear difficulties with respect to emotional empathy. In contrast, individuals with psychopathy show clear difficulties with a specific form of emotional empathy but no indications of impairment with cognitive and motor empathy. (shrink)

AimTo evaluate the cognitive functioning of subjects practicing trance mediumship in Brazil.MethodThe study was based on the measurement of cognitive functions of 19 spirits mediums through neuropsychological tests such as the Brief Cognitive Screening Battery, the Verbal Fluency Test, the digit span test, the cube test, the five digit test and an evaluation of mental health through scales such as the Beck Depression Inventory, the Self-Report Questionnaire, and the Trauma History Questionnaire. The sample included the participation of spirit mediums divided (...) into two groups. The more experienced group with 11 subjects had more than 10 years of mediumistic practice, while the other less experienced group with 8 subjects had 1–5 years of experience. The inclusion criteria were psychophonic mediums with regular trance practices for at least one year. The data collected were analyzed using the SPSS statistical package.ResultsRegarding performance on the BCSB and digit span test, all subjects reached scores at the median or higher in comparison to standardized scores of Brazilians. Scores of 90% on the cube test and 42% on the FAS were reached in comparison to median or higher values, versus the median of standardized scores among Brazilians. On the FDT, we found statistical significance in the choice stage, with higher performance of subjects whose initial age of trance recognition occurred before 21 years old. On the BDI scale, no participant met the criteria for major depression. The SRQ showed an incidence of common mental disorders in 21% of the sample, which was more prevalent in the LEG.ConclusionThe cognitive functioning of subjects who practice trance mediumship in Brazil is associated with cognitive health. Executive dysfunction may be a tendency in LEG. However, an incidence of common mental disorders in the LEG was observed. Executive processing was higher in the subgroup with early practices of recognizing the phenomenon. (shrink)

This book addresses these and a cluster of other questions about changes in the self through time and about the moral attitudes we adopt in the face of these...

Williams syndrome is a genetic disorder that, because of its unique cognitive profile, has been marshalled as evidence for the modularity of both language and social skills. But emerging evidence suggests the claims of modularity based on WS have been premature. This paper offers an examination of the recent literature on WS. It argues the literature gives little support for mental modularity. Rather than being rigidly modular, the WS brain is an extremely flexible organ that that co-opts available neural resource (...) in a highly dynamic manner to cope in the world. (shrink)

Some patients, following brain injury, do not outwardly respond to spoken commands, yet show patterns of brain activity that indicate responsiveness. This is “cognitive-motor dissociation” (CMD). Recent research has used machine learning to diagnose CMD from electroencephalogram (EEG) recordings. These techniques have high false discovery rates, raising a serious problem of inductive risk. It is no solution to communicate the false discovery rates directly to the patient’s family, because this information may confuse, alarm and mislead. Instead, we need a procedure (...) for generating case-specific probabilistic assessments that can be communicated clearly. This article constructs a possible procedure with three key elements: (1) a shift from categorical “responding or not” assessments to degrees of evidence; (2) the use of patient-centred priors to convert degrees of evidence to probabilistic assessments; and (3) the use of standardized probability yardsticks to convey those assessments as clearly as possible. (shrink)