Disclaimer: I am a behavior analyst, not a psychiatrist. In behavior analysis, or in therapy, we do not use hypnosis. Just enjoyed reading this article, sharing its translation with you. References are given below.
Certain events occur during the use of hypnotherapy, which then allows the therapist to explore those important events. Lori was brought back to those times through hypnosis when Laura brought up her severe sexual self-abuse at various times, forgetting that she had amnesia. It seemed that Laura, suddenly a tender, soft-spoken girl, quickly became a rather angry and rude Laurie; And he was quite proud to admit that he tortured Laura. When Lori was asked why she was hurting Laura like that, she said, ‘I was tired of being ignored’. Lori added, ‘I wanted to get out, he held me… I was like a trapped goose… he wouldn’t let me out. Until I promised him I wouldn’t do anything, but then I was really bad.’
Hypnotherapy allows Laura to talk about her adoptive mother’s death, something she would not otherwise have had the opportunity to discuss. In the hypnotic state, Laura could tell everything accurately. Everything from her father coming home and breaking the news of her mother’s death, to finally getting dressed for the funeral, and finally, when she touches her mother’s cold face in the casket. Although Laura’s voice and speech patterns were as soft as ever, and halting under hypnosis, she still did not present herself as childish as at other times.
After the hypnosis began, the conversation with Amy took the form of two therapists discussing a client they both had in common. Amy’s insights and suggestions for treating Laura’s problems at this time were generally sound and well-founded.
Laura’s behavior began to change once hypnotherapy began. Her self-abuse and use of dirty pads stopped. He began to behave in a more appropriate and relevant manner.
In both the hypnotherapy and psychotherapy sessions it was clear that the sub-personalities were slowly fading away and Laura was becoming a more organized and integrated person.
By the time she was released from the hospital, Laura’s multiple personality had completely disappeared. A year and a half later, Laura is doing well at a therapeutic boarding school, and her multiple personalities have not recurred. When discussing her past problems, she no longer showed any interest or concern about her previous dissociative experiences.
discussion
According to the DSM-3, “the essential characteristic of multiple personality is the existence within an individual of two or more distinct personalities, each of which is dominant at a given time. Each personality is a fully integrated and complex unit with unique memories. Patterns of behavior, and social relationships that characterize the individual’s functioning.” determines when that personality is dominant. The main personality has no knowledge of the existence of other personalities. The main personality and sub-personalities are aware of the time lost but usually do not volunteer that information.”
Laura’s case clearly displayed features of the disorder, the only exception being that her sub-personalities were not “fully integrated and complex”. This lack of complexity was interpreted as a function of his young age, in which personality was not yet fully developed. Laura’s behavior suddenly changes when she becomes Lori. As Kuhn (1980) points out, the main character in Laura’s case is usually a shy, introverted, gentle person who cannot cope with powerful influences. Lori’s personality was strikingly different, being overly sexually aggressive, uncomfortable, and lacking in anxiety. In Angel’s gentle but confident demeanor, a further contrast can be seen between Amy’s practicality and Henry’s friendliness towards Laura.
The varying degrees of amnesia between different parts of Laura’s experience, especially in relation to Lori, was quite noticeable. Laura was either unaware of her subpersonalities, or she was only vaguely aware of them. In contrast, all the sub-personalities knew Laura as well as each other. Amy and Angel, on the other hand, carried on conversations with each other, as did Laura and Lori. The description of the disorder in DSM-111 mentions that this is how the subpersonalities talk to each other.
It should also be noted that sometimes the sub-personalities of individuals with this disorder may also include characters of the opposite sex. As in the case of Laura, Henry is the opposite sex, who in this case emerges with a structured male identity.
Laura’s delusional behavior was initially interpreted as denial, regression, or use of an imaginary playmate. The sub-personality’s presence forced her to reconsider her behavior as it now became clear that without Laura’s awareness, the sub-personality Lori had been abusing her, dressing her in dirty, wet, excrement-covered clothes.
The dynamic and structural aspects of this multiple personality have been conceptualized from various perspectives. Such concepts as Prince (1930), Thigpen and Cleckley (1954) emphasized early; According to them, the creation of the sub-personality enables the original person to express his or her own efforts, emotions and interpersonal attitudes that were previously blocked by the original person.
Meanwhile, Horton and Miller, 1972; Howland, 1975; According to Winer, 1978, this severe hysterical orientation equates with multiple personality disorder. Some authors have also seen it as analogous to the hypnotically induced state of multiple personalities, such as autohypnosis (Janet, 1899) or altering oneself through hypnotic induction (Kampmann, 1976).
Correlations between neurological phenomena and multiple personality have been noted, such as seizure status in patients with multiple personality (Horton and Miller, 1972; Schreiber, 1973), significant variation in neurophysiological states between different personalities (Ludwig et al., 1972; Putman, 1982; Thigpen and Cleckley, 1954) and as a possible etiological factor as neurological hypersensitivity (Allison and Schwartz, 1980). Laura’s possible fetal alcohol syndrome and encephalopathic findings on psychological testing must be noted, but there is no strong evidence that they were an essential etiological factor.
More recently, multiple personalities have been considered from the perspective of borderline states and pre-oedipal personality disorders in which intrapsychic splitting is externalized as a behavioral split (Gruenwald, 1977). Laura faced a lack of constant motherly figure and lack of care in her own childhood. These experiences during his symbiotic and dissociative personality periods may have been the underlying cause of his internal problems.
Laura lost two more mothers at ages 6 and 8. These losses may make both the proper resolution of his Oedipus situation and the attainment of a good, positive identification with same-sex parents more difficult.
Meanwhile, the patient’s Oedipal dilemma is intensified by the arrival of the stepmother during adolescence. The presence of the stepmother triggers a flashback with traumatic revelations related to maternal loss in childhood. Now she begins to feel anxiety about her father’s Oedipal loss in addition to her previous deprivation. His dissociation between multiple personalities probably also represents an attempt to cope with his overwhelming loss.
One might ask why a patient manifests multiple personality disorder instead of borderline or narcissistic personality? This question remains problematic today. Greaves (1980) suggests in this context that in multiple personality the individual alters the self to some extent in the ego, which is not the case in the borderline. It is a trait that allows oneself to change, age, experience and even add additional dimensions to one’s identity.
Despite the borderline state noted by the previous two examiners, Laura’s clinical condition and her Rorschach test performance did not rule in favor of her diagnosis. Rather, Laura is portrayed as a shy but warm, dependent girl, who is amorous and approval-seeking, and who displays hysterical and obsessive traits.
In Laura’s case milieu therapy and individual psychotherapy were the main treatment modalities. The use of hypnotherapy proved to be quite beneficial when his treatment progress appeared to plateau. Some authorities caution against the use of hypnosis in the treatment of multiple personalities because it may lead to further “splitting” (Bower et al., 1971). Others, however, speak of hypnosis as a means of resolving the splitting process (Brandsma and Ludwig, 1974; Howland, 1975).
In Laura’s case, various personality functions and traits were revealed and clarified through hypnosis. The therapist was able to reinforce the positive aspects of her personality structure by strengthening the core personality, reducing Laurie’s powers, and eventually making Amy, Angel, and Henry’s interventions unnecessary.
These therapeutic techniques seem to be consistent with the view of Allison and Schwartz (1980) who suggested gaining the cooperation of alter egos, specifically to strengthen the functioning of the helping parts of the personality and to appeal to the “oppressor’s happy side.”
Conclusion
This case alerts us to the possibility that a young child harboring multiple personality disorder may be receiving regular treatment, but the disorder remains undiagnosed. Abnormal, sudden, and unexplained changes in behavior, voice, and mannerisms that accompany the declaration of amnesia for a certain period of time make us think of this rare possibility.
An interdisciplinary approach used in this study may facilitate the diagnosis. Only when a case is correctly diagnosed can effective treatment be instituted. Finally, early treatment of a child with multiple personality may prevent further spread of the disorder.
