Dissociation : Vol. 2, No. 2 (June 1989)

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    Dissociation : Vol. 2, No. 2, p. 092-098 : Iatrogenic factors in the perpetuation of splitting and multiplicity
    (Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-06) Torem, Moshe S.
    The purpose of this paper is to increase the awareness of clinicians who treat multiple personality disorder patients to the possibility that misuse of treatment techniques may perpetuate splitting and multiplicity, and thus contribute to chronicity in MPD patients. Many MPD patients tend to have rapidly dissociative switching from one ego-state to another. These trance-like states make the patients highly suggestible to outside influences which include the therapists' verbal and non-verbal communication. Some therapists may have an overinvestment in more alter- personalities, and thus ignore the needs of the whole person. Treating an adult patient who is in an age regressed ego-state, or alter personality, presents a particular challenge as to the patient's boundaries since violating those boundaries may too perpetuate splitting and multiplicity. The paper reviews and discusses such issues as therapeutic limit setting, the issue of trust, and counter-transference elements as they may contribute to the perpetuation of splitting and multiplicity in MPD patients. Case vignettes are used to illustrate the above points, and suggest ways to avoid potential pitfalls so that therapy will promote progress towards integration and improved functioning of the whole person.