Dissociative Multiplicity and Unformulated Experience: Commentary on Diamond

Comparing Dissociation and Repression Across Theories

Diamond believes that the fact that dissociation and repression have seldom, if ever, been integrated into a single theory of defense has been due to an unnecessary commitment to the belief that the theories in which these two ideas originate clash with one another (or at least that they clash in this particular way) and therefore cannot coexist. Janet’s thinking (1889; Ellenberger 1970), the hypnoid states theory of hysteria of Freud and (especially) Breuer (Breuer and Freud 1893), and Ferenczi’s model of mind (e.g., 1931), too, writes Diamond, were unnecessarily vilified in the mainstream psychoanalytic literature of most of the twentieth century.They were portrayed as contradictions to the concept of repression that Freud developed as he moved into a theory in which the mind derives not from relations with the outside world (as in Janet’s thinking, or Freud’s seduction theory) but from the inner one. Dissociation, in other words, was thought to contradict the theory of mind shaped by drive theory, the topographic model, and eventually the structural model.

Diamond believes that this rejection of dissociation was unnecessary, a theoretical development motivated politically for the most part. The same kind of politically fueled rejection of dissociation by North American Freudians, Diamond believes, was the consequence of the theoretical chasm that opened early in the twentieth century between their theory, which employed repression, and interpersonal and relational psychoanalysis, which were (and still are) often grounded in dissociation. As a result of these underlying schisms, what Diamond believes is the simple fact that dissociation and repression coexist has gone largely unrecognized, and psychoanalysis has been denied important clinical and theoretical ideas.

It is time, Diamond tells us, to understand the underlying pairs of theories (seduction theory and drive theory; Freudian theory and relational theory) as complementary, not contradictory. If we rethink repression and dissociation without what Diamond considers unnecessary theoretical “baggage”—that is, if we understand them from the bottom up, avoiding a theory-driven definition of the issues involved—Diamond believes we will be able to give a coherent account in which repression and dissociation (and splitting) can each be accommodated. Diamond’s desire to bring repression and dissociation together is an attempt to create unity where he believes its absence is a political matter, an accident of intellectual politics.

I hardly disagree with the pursuit of parsimony. But dissociation as it was used by Janet, Breuer, and Ferenczi, and then by interpersonal and relational writers, simply isn’t dissociation as Diamond employs the term. (I address the details of this problem of definition just below.) One can’t just pluck dissociation and repression from their contexts in their theories of origin and then simply use them in different contexts, the way one might take a plain white button off one shirt and sew it onto another. What the terms dissociation and repression mean is shaped by the roles they play in the theories in which they function. If dissociation and repression were each separately fungible—that is, if each way of using the terms were interchangeable with alternative versions—Diamond’s argument for parsimony would work. But that’s not the case in our field today. One of the great bugaboos for comparative psychoanalysis is the embeddedness of ideas in their larger theoretical surrounds: often, even usually, we can’t depend on what appears to be a relationship of identity, or even similarity, between two ideas drawn from different theories (Stern 2013).

I want to be clear that I am not rejecting Diamond’s ideas in and of themselves. While writers may or may not agree with Diamond’s characterization of dissociation, his way of using the term can at least be accommodated by any theory in which dissociation is used in a model of the mind as unitary (e.g., Blass 2015; Lombardi 2016). Diamond’s thinking, that is, does not contradict the underlying premises of such theories. But, as we shall see in a moment, Diamond’s way of defining dissociation does contradict the defining aspects of contemporary psychoanalytic views in which dissociation leads to the multiple self. In particular, it contradicts the interpersonal/relational understandings of dissociation that Bromberg and I have proposed over the last several decades.

Dissociative Multiplicity

In a recent article, O’Neil (2018), addressing what he calls the “polysemy” of the term dissociation, offers three different definitions of the phenomenon.The first two are helpful in defining the issues I want to bring up about dissociation as Diamond discusses it. Here are the three definitions.

In Diamond’s paper, dissociation is understood according to the second of these definitions, “dissociation of mental faculties of a given consciousness.” Diamond’s dissociation, that is, takes place in a mind or self conceptualized as unitary. Both Diamond’s primary dissociation and his secondary dissociation are forms of this way of thinking: psychic contents (memories, fantasies, and so on) are segregated from awareness by being denied verbal-symbolic representation.

Theories of the multiple self, on the other hand, such as Bromberg’s and my own, are ways of accounting for O’Neil’s first form of dissociation, “dissociative multiplicity.” Let me quote Bromberg (2003), who offers in the following passage an overview of this way of understanding dissociation:

Interestingly, dissociation, in human beings, is fundamentally not a defense but a normal hypnoid capacity of the mind that works in the service of creative adaptation. It is a normal process that can become a mental structure. As a process, it can become enlisted as a defense against trauma by disconnecting the mind from its capacity to perceive what is too much for selfhood and sometimes sanity to bear. It reduces what is in front of someone’s eyes to a narrow band of perceptual reality (“Whatever is going on is not happening to me”). As a defense against the recurrence of trauma, it creates a mental structure that serves as an early warning system. Its key quality is its ability to retain the adaptational protection afforded by the hypnoid separateness of incompatible self states, so that each can continue to play its own role, unimpeded by awareness of the others [p. 560].

And so in dissociation as a hypnoid phenomenon, or as what O’Neil calls dissociative multiplicity, trauma results in the creation of states of mind, being, or self that are, in important respects, independent of (dissociated or sequestered from) one another. Trauma, from this perspective, is not limited to terrifying or life-threatening experiences. Indeed, in Bromberg’s frame of reference (1998, 2006, 2011) each of us experiences as we grow up, in various ways, “developmental” or “relational trauma,” which may be deeply distressing but is not life-threatening. And so all of us dissociate along the way. As a consequence, we have all created multiple, structuralized states of mind.

Diamond cites Bromberg and me as writers whose contributions he wishes to integrate into a unitary theory of dissociation and repression. Either Diamond doesn’t recognize the conflict between his theory and ours, or he believes that our views can simply be folded into the model he proposes—as if his model is commodious enough to contain our ideas, as well as those of Janet, Breuer (who championed the hypnoid view in his early work with Freud), and Ferenczi. If we were to accept this perspective, “dissociative multiplicity” would simply disappear as a separate point of view, absorbed by “dissociation of mental faculties of a given consciousness.” This outcome, of course, is unacceptable to those of us who think of the self as multiple, as a dynamic amalgam of states of mind. While I accept that Diamond’s model is a viable model of dissociation if the mind is taken to be unitary, I cannot accept that it either replaces or contains dissociative multiplicity.

Symbolization and Unformulated Experience

There is another aspect of Diamond’s thinking that, if I were to accept it, would require me to sacrifice my own point of view. This contradictory aspect has to do with the role of symbolization in Diamond’s views, on the one hand, and, on the other, in my theory of unformulated experience (Stern 1997, 2010, 2015, 2018). I am often asked whether dissociation and repression can coexist in my frame of reference. I reply that, no, they cannot. This commentary offers me an opportunity to explain why I see things that way.

In most psychoanalytic models, when experience that has reached verbal-symbolic form is too anxiety-provoking, it must be removed from consciousness. It must be repressed, that is, forced out of consciousness into the dynamic unconscious. Sometimes such experience is removed after it has become conscious; more often its impending appearance in awareness sets off signal anxiety, and that anxiety in turn sets defensive processes in motion even before the experience becomes the focus of awareness. In either case, though, defense in the repression model is a matter of preventing access to meanings that already exist in symbolic form, and that, even when they are banished from consciousness, continue to exist, fully formed, in another, unconscious part of the mind. ³ This, as we shall see, is not the case when experience is maintained in its unformulated state for unconscious defensive reasons.

When I began to write about unformulated experience (Stern 1983), I was deeply impressed by a brief remark made by Harry Stack Sullivan: “One has information about one’s experience only to the extent that one has tended to communicate it to another or thought about it in the manner of communicative speech. Much of that which is ordinarily said to be repressed is merely unformulated” (Sullivan 1940, p. 185). This passage linked in my mind with my conviction that the process by which contents arrive in consciousness is not best described as the uncovering or revelation of previously shaped meanings, but as the emergence of new experience, as the creation of fully formed meanings and experiences from vaguer, more global, and affectively saturated precursors. I called this vaguely structured state “unformulated experience” and found evidence for it in experimental cognitive psychology, philosophy, literary criticism, and psychoanalysis. Unconsciousness, I proposed then (Stern 1983), is not composed of fully formed meanings. It is instead potential meaning. Unformulated experience is the preexisting, unconscious, raw form of what consciousness can, or might, become.

Then and now, my understanding of moment-to-moment psychic life is that consciousness is always in process, continuously being reshaped and reborn. Consciousness, that is, is in a ceaseless process of formulation and reformulation, in which each moment’s formulations are the heaviest influences on the nature of the formulations that come about in the moment after that. And yet there is always “wiggle room.” Never is the next moment’s conscious experience fully predetermined. Novelty is ensured; but the significance of history is unquestioned.

Defense, in this way of thinking, needed to be reimagined. Certain formulations could not be allowed to come into being, because they were what Sullivan (1953)—and later, Bromberg and I—referred to as “not-me.” Not-me, if it were to shape awareness, would lead one to feel that one was what one will not, cannot, must not be. If one were forced to accept the presence of not-me in consciousness, one would not be recognizable to oneself. Such an outcome is aversive for anyone, of course; but for highly traumatized people, it can provoke a psychotic episode.

The process by which consciousness is ceaselessly renewed should not be understood as a spontaneous, unfettered thing. The formulation of experience, that is, is hardly the result of idealized, pristine inner promptings. Rather, it is continuously compromised by the defensive avoidance of certain formulations, motivated by our need and demand for emotional safety. Some formulations must simply not be made. These “not-me’s” habitually go unformed; they remain unsymbolized. They have no shaped or structural presence in the mind. They are like the white spaces in a painting: they have no actual presence, and yet their absence gives shape to other presences. These white spaces—unformulated experience that, in an ongoing way, is continuously denied formulation for unconscious defensive reasons—are what I describe as “dissociated experience,” and the process by which their formulation is habitually prevented is my understanding of “dissociation.”

Experience is formulated, in other words, along familiar paths that tend to guarantee that conscious experience will continue to be safe—recognizable as one’s own. States of being that are emotionally safe in this way “feel like me” and can be “accepted” and “used” in the creative construction of spontaneous living (Stern 2018). Other states of mind, not-me, that do not promise this kind of safety are dissociated, maintained in an unsymbolized, defensively unformulated, dynamically unconscious state. This is a hypnoid view of dissociation, a model that, along with Bromberg’s, falls within O’Neil’s “dissociative multiplicity.” In these models, dissociation is not the enforced separation of particular experiences from a central consciousness, but the sequestering of states of mind from one another and the consequent fragmentation of the mind or self.

To maintain psychic stability in models of dissociative multiplicity is to make inaccessible, via unconscious defensive processes, portions of one’s own mind, or possibilities for one’s own identity. It is as if the doors of certain rooms in a mansion were locked, so that one could never go there. And yet the possibilities for other, different lives stay alive in those locked rooms.

The potential experience that is dissociated in this way cannot be interpreted in psychoanalytic treatment, because it is not symbolically realized. It would take far too long to offer an adequate description here of what this conceptualization means for the conduct of psychoanalytic work (see Stern 1997, 2010, 2015, 2018). Suffice it to say that therapeutic action has to do with “thawing” the “frozen” places in the interpersonal field, rigid forms of relatedness that have the function, and create the effect, of locking one into familiar forms of thought, feeling, and relatedness. These “frozen places” in the field manifest as enactments between patient and analyst, and enactments, in turn, are “the interpersonalization of dissociation” (Stern 2004, 2010). When we work successfully with enactments, the field thaws and some part of previously dissociated not-me becomes available for use in the creation of ongoing living.

Dissociation, as I envision it, is the defensive prevention of symbolization. That much Diamond and I have in common. Diamond does acknowledge that dissociation can have to do with the defensive prevention of symbolization (at least verbal symbolization). That is what he means by “secondary dissociation.”

But for Diamond, secondary dissociation is only one possibility. Another is repression, the banishment of formulated verbal experience to the unconscious. In my model, there is no place for repression—or for splitting, for that matter—because those two processes are understood, by most of those who use the terms, including Diamond, to operate on previously accessible, symbolically realized experience, which continues to exist in the unconscious after the event of repression.

In my frame of reference, by contrast, previously formulated experience that must be rejected for dynamic reasons is (we could say) “shredded” in the continuous process of reformulation, as all experience is fated to be, and then is simply not created again in the next moment. Defense, in other words, is not the banishment of preexisting meaning to a mythical psychic geography, the unconscious, but the unconscious refusal to create those meanings in the first place. The same previously symbolized meanings that are repressed in Diamond’s model, that is, simply disappear, in my way of thinking, in the ongoing process of casting and recasting that is the continuous reconstruction of awareness. This part of the mind once again becomes unformulated, as it was before its initial construction. It may then become available for reformulation at some later time, if and when the interpersonal field changes in such a way that the meaning no longer feels intolerably alien. But in the meantime it is not simply “there” in the unconscious, like repressed meaning; it is not awaiting a relaxation of the grip of the defensive process that “put it there,” ready to emerge in the same form it had before its disappearance from consciousness.

Concluding Thoughts

I cannot accept Diamond’s portrayal of dissociation for two reasons: I would need to sacrifice dissociative multiplicity, which would invalidate both Bromberg’s theory and my own; and I would have to jettison my theory of symbolization, unformulated experience. While theoretical integration can be valuable under some circumstances, bringing conflicting ideas under the same roof can also run roughshod over differences that are better maintained and studied. The accounts of dissociation contributed by Bromberg and me cannot be used to support Diamond’s integrative project.

In the interest of considering Diamond’s perspective on its own terms, I have not even broached yet what is the most substantial difference between Diamond’s point of view and my own, and I want to do that briefly before ending this response to his paper. Diamond’s thinking is rooted in the long-standing tradition of North American psychoanalytic ego psychology, in which clinical work centers around knowing (insight), the achievement of symbolization, largely verbal symbolization, accomplished via the analyst’s interpretive activity. Diamond’s integration of repression, dissociation, and splitting is his account of how to conceptualize as mechanisms our difficulties in accessing certain mental contents, and how to reverse or otherwise deal with those mechanisms, thereby promoting awareness.

I respectfully disagree with the underlying assumptions of this portrayal. All analysts, of course, make interventions that qualify as interpretations. But for those who work as I do, even when we do interpret, the new thoughts we grasp and then convey to our patients are events in an ongoing, emergent process of unconscious, affect-laden, nonrational relatedness that has gone on for a substantial period before the new thought becomes available, and will continue to unfold as the present stretches into the future. The analyst’s interpretation is a way station, a location on the path. Much of therapeutic action, on this view, does not depend upon making unconscious meaning accessible in words; and very little of it has to do with the creation of rational understanding of what has been unconscious. ⁴

Let me hasten to say that this hardly means that those of us who think this way discard interpretation, or even that we would know how to do so. That is, it goes without saying that verbal symbolization not only retains great analytic value, but also is unavoidable when two people sit down together to tackle the analytic task. But any new understanding is the outcome of the shifts in the interpersonal field that made the new thought (or feeling, or perception) possible. Interpretation, in other words, is not simply an intervention the analyst consciously decides to employ. When it does happen, new understanding is a sign that the important change—the change in the analytic relatedness that made the new understanding possible in the first place—has already transpired (Stern 2015, 2018). And therefore, when we are trying to think about the processes that prevent symbolic realization, or the formulation of experience, processes such as dissociation, we focus more than Diamond does on the nature of what transpires in the analytic relatedness, and less on the rational assessment of mental contents and what to do with them.