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Christopher D. Green
York University, Toronto, Ontario
ISSN 1492-3173
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By William H.R. Rivers (1920)
Posted March 2000
CHAPTER X
DISSOCIATION
At the end of the last chapter I have referred to the activity of suppressed experience which is exemplified, for instance, by the case of claustrophobia which I have chosen to illustrate the nature of "the unconscious." This activity is usually known by the name of dissociation and it now becomes necessary to consider exactly what is meant by this term and how it may be used so as to be of most service in the study of psychopathology.
It is not unusual to find the terms "suppression" and "dissociation" used as if they denoted one and the same process. I have myself been guilty of this confusion, or have at any rate used language which might be supposed to indicate that I regard the two terms as synonymous.[1] I have now, I hope, made it clear what I mean by suppression, and it remains to make equally clear the sense in which I shall speak of dissociation.
Before I do so, one possible source of confusion must be mentioned. In their work on the nervous system, Head,[2] Riddoch and others use "dissociation" in a manner very different from that in which the term is used by writers on morbid psychology. When Head and his colleagues speak of "dissociation" they refer to a process, pathological or experimental, whereby one set of nervous functions are separated from others with which they are normally associated so that they become capable of independent study. A good example is given in the spinal cord where the selective action of certain [p. 72] morbid processes removes the activity of some forms of sensibility and allows others to remain. Thus, interference with the conductivity of the posterior columns will abolish the power of appreciating two points placed on the skin simultaneously while leaving touch unaffected, -and Head speaks of this occurrence as one in which the power of appreciating compass points has been dissociated from touch. Again, Riddoch finds[3] that in pathological states of the occipital cortex the power of appreciating movement may remain intact while other visual activities are destroyed, and he again speaks of this process of separation as "dissociation." To Head and Riddoch dissociation is pre-eminently a method provided by disease which makes it possible to analyse complex nervous processes into their component elements. It is a process which on the psychological side stands in a definite relation to the process of fusion, but has none of the special relation to suppression which is so definite in the connotation of dissociation as I shall use the term, and as it is used by most writers on morbid psychology. The dissociation of Head is predominantly a physiological rather than a psychological term, and it might therefore be thought that there is no danger of confusion, but the physiological processes for which the term is used stand in so close a relation to the psychological that there certainly is such a danger. I was at one time inclined to use dissociation as Head and Riddoch propose and find some other word for the psychological process, but the term is now so firmly established in psycho-pathology that it will be very difficult to give it up. Moreover, the word "dissociation" is particularly appropriate to the nature of the psychological process. I believe it would be more practicable for Head and his colleagues to find some other term for the process so essential to the method by which they are making such momentous contributions to the physiology of the nervous system and at the same time to the foundations of any scientific study of mental process.
I can now pass to the definition of "dissociation" as I shall use the term. I have already stated that I regard it as a [p. 73] process which experience undergoes when it has been suppressed. The special feature of dissociation, as I understand it, is that the suppressed experience does not remain passive, but acquires an independent activity of its own. It is this independence of activity which I wish to regard as an essential character of dissociation. The most characteristic example of dissociation is the fugue in which a person shows behaviour, often of the most complicated kind, and lasting it may be for considerable periods of time, of which he is wholly unaware in the normal state. The fugue usually comes into being owing to the fact that some unpleasant experience has become unconscious by the unwitting process of suppression or is tending to pass into the unconscious through the agency of the witting process of repression. One day the subject of this suppressed or repressed experience goes out for a walk and suddenly finds himself in some part of the town remote from that in which he had been, it seems to him, only a few minutes before. On looking at his watch he finds that it is an hour since he left home, though he would have thought he had only been out a few minutes. On putting his hand in his pocket he finds two cigars which were certainly not there when he left home, and on counting his change he finds that he has one shilling and eightpence less than when he put his money into his pocket in the morning. On going to his tobacconist he finds that he had already visited him that morning, although he had no recollection of the visit, and had bought three sixpenny cigars, although he was accustomed to smoke either a pipe or cigarettes. He may also discover, perhaps a week later, that he had met a friend with whom he had talked, and may be able to ascertain that the friend noticed nothing out of the way in his conversation or demeanour, he himself having no recollection whatever of the meeting. On piecing the evidence together it would seem that he had had a fugue in which he had visited a tobacconist and bought three cigars of which one had been smoked or given away during the fugue. He had then found his way to the distant part of the town where he, as we say, came to himself. The distance he had traversed made it probable that he had [p. 74] travelled by tram, thus accounting for the twopence he had spent in addition to his expenditure at the tobacconist's. The description I have given is not that of an actual case but is compounded by putting together incidents from several of the many fugues which I have had the opportunity of studying during the war. In such a fugue the dissociation is complete. On return to the normal state there is no memory of the behaviour during the fugue or of any conscious processes which accompanied this behaviour, though these memories can be recovered in the hypnotic or hypnoidal states or under other conditions which favour the recall of suppressed experience.
If we accept the fugue as a typical and characteristic instance of dissociation, we are at once faced by another problem of definition. The subject of a fugue is certainly not unconscious. So far as we know, he is capable of experiencing all the modifications of consciousness which are open to the mind in its normal state. We have not at all to do with an example of the unconscious, but with consciousness cut off or dissociated from the consciousness of the normal waking life. A person in a fugue usually behaves in a manner somewhat different from that of his normal state, and shows what is usually described as a difference of personality, but the difference may be very slight. I have myself met one of my own patients in a fugue without recognising that such was the case. I noticed that his manner was not quite as usual, but the difference was so slight that though I knew about his fugues, and had hoped to have the opportunity of observing him in one, I failed to recognise the occasion when it came. Slight, however, as the change of personality may be, it is certainly there. All gradations may he met between a change so slight as that which I failed to recognise in my patient, and the pronounced cases of double or multiple personality which are described in psychological literature, reaching their climax in the classical case of Miss Beauchamp.
The existence of independent consciousness which thus shows itself in the fugue, and in cases of double personality, separates [p. 75] these cases very definitely from those, such as that of my claustrophobic patient, in which experience becomes unconscious and, though active, gives no evidence of any independent conscious existence. It is wholly out of place to speak of the unconscious or of unconsciousness in the case of a fugue, and Dr. Morton Prince[4] has suggested that we shall use the term "co-conscious" and "co-consciousness rather than "unconscious" and "unconsciousness." These terms are especially appropriate to the examples of double or multiple personality such as that of Dr. Prince's patient, Miss Beauchamp. In this case there seems to have been definite co-existence of independent consciousnesses. One conscious personality performed acts definitely designed to act upon another personality which was also at the time conscious, the former personality being able to perceive and reflect upon the consequence of her acts. In an ordinary fugue we have no evidence of such co-existence of independent consciousnesses. The use of the terms "co-conscious" and "co-consciousness" in the case of the fugue would indicate a decision in a matter of the utmost difficulty in which it is essential to maintain an open mind. I do not propose, therefore, to adopt Dr. Morton Prince's terms for the more ordinary cases of dissociation, though I recognise them as appropriate to such a case as that of Miss Beauchamp. It will, however, be convenient to have a term for such examples of independent consciousness as characterise the fugue, and for this purpose I shall speak of "alternate consciousness." It is possible that during a fugue the normal personality may be independently conscious, and that the fugue-consciousness may persist beneath the surface in the normal state, though the two are so completely dissociated that neither ever become accessible to the other. We have, however, no evidence that this is so, and till we have such evidence it will be more satisfactory to speak of alternate consciousness, the reality of which is now well established.
If we accept the fugue as a characteristic example of dissociation, the question arises whether we should not include in [p. 76] its definition the character of alternate consciousness, and I believe that we shall best be meeting the needs of the situation by doing so. I propose therefore to use the term "dissociation," not merely for a process and state in which suppressed experience acquires an independent activity, but shall assume that this independent activity carries with it independent consciousness. In some cases in which we have obviously to do with independent activity as shown by behaviour, it may not be possible to demonstrate the existence of independent and dissociated consciousness, but I believe it will be convenient to limit the term "dissociation" to cases where there is evidence of this independent consciousness.
I propose now to consider some of the cases of suppression with which I have dealt in this book and inquire how far they do or do not bear signs of the independent activity and independent consciousness which I am taking as the signs of dissociation. In, several of the instances which I have taken as my examples of suppression, especially the definitely organised suppression which I have supposed to exist in the lower animals, there is no reason to suppose that there is either independent activity or independent consciousness. In the case of Man also there is every reason to suppose that in many instances suppression may be complete, and the suppressed content wholly free from any kind of independent activity and from any accompaniment of consciousness. Thus, in the normal healthy man the special kind of fear which reveals itself in night-terrors, or nightmares, seems to be wholly suppressed and devoid of any kind of independent activity. A person may pass through life, and even through dangers of an extreme kind, without showing any trace of this kind of fear, though its occurrence in nightmares or in other pathological states shows that it is there lying ready to appear in consciousness if the suitable conditions should arise.
Again, there is no reason to associate any independent activity, or any form of consciousness, with much of the suppressed experience of early childhood. The knowledge derived from psycho-analysis goes to show that this suppressed early [p. 77] experience may have a great effect on character and may play an important part in determining likes and dislikes and tendencies to special lines of activity in later life, but we may regard influences of this kind as due to fusion rather than suppression or dissociation. The most natural explanation of these influences is that they are due to fusion between the suppressed tendencies, or certain parts of them, and the products of later experience, exactly comparable with the fusion between protopathic and the later epicritic elements by which the sensibility of the normal skin is produced.
I assume, therefore, that suppression often exists without anything which we can regard as dissociation, that in many cases the suppressed content exhibits no form of independent activity with no evidence that it is accompanied by any form of consciousness. In other cases in which there is definite activity of the suppressed content, there is no clear evidence of consciousness accompanying this activity, but yet cut off from the general body of conscious experience. This seems to be so in the case of claustrophobia which I have taken as my most characteristic example of suppression. I shall now consider whether we ought to regard this disorder as an example of dissociation. The dreads to which the patient was subject are most naturally explained if the memories of his four-year-old experience existed in a state of suspended animation, always ready to be aroused whenever the boy or man was brought into contact with circumstances which resembled those of his experience with the dog in the narrow passage, circumstances which would tend to stir up the buried memory. The simplest way of regarding this case is to suppose that the suppression was not complete, but that the suppressed experience lay for thirty years so near the threshold of consciousness that it was capable of being roused into activity by any conditions resembling those of the events in which the suppression had its origin. On these occasions all that reached consciousness was the affective side of the experience and then only in a more or less vague form. To use a metaphor, it is as if the activity of the suppressed body of experience is accompanied by an affective disturbance which boils over on [p. 78] certain occasions, so that some of the steam reaches the conscious level, while the main disturbance still continues to be wholly cut off from consciousness.
I have now to consider whether we should or should not include such a state in our definition of dissociation. It is clear that we have to do in this case with suppression and with independent activity of the suppressed experience. If we regard independent activity as the distinguishing mark of dissociation we should clearly have to do with an example of the process. If, on the other hand, as I propose, we hold independent consciousness to be necessary to the definition, we cannot find any evidence of such independence. In this case we have clear evidence of consciousness associated with the activity of the suppressed experience, but this consciousness is clearly linked with the general body of consciousness of the normal life. So definitely was it linked therewith in the case of claustrophobia that it determined the behaviour of the patient in many respects, and especially in respect to the conditions which he knew from experience would arouse his dread. Not only was there no evidence of any dissociated consciousness, but there was clear evidence that such consciousness as accompanied the activity of the suppressed experience was associated with the consciousness of the normal mental life. I propose, therefore, to exclude this case of claustrophobia, and, of course, with it other similar states, from the category of dissociation. I believe that this course could be justified on other grounds: The object of using such technical terms as "dissociation" is to conduce to clearness of thought and to assist the classification of psychological and psycho-pathological states according as they resemble or differ from one another in their essential nature. A phobia and a fugue are so unlike one another that it should be comforting to be relieved of the necessity, which would follow on the ordinary use of the term "dissociation" of regarding both as exemplars of this process. I shall return to the nature of the phobias later. I am only concerned here to show why they should be excluded from the category of dissociation.
The conclusion to which I am tending is that the definition [p. 79] of dissociation, which will make the term of most service to psychology and pathology, is: one which lays special stress on the feature of alternate consciousness. The term "dissociation" will then be used for a process of activity of suppressed experience in which this activity is accompanied by consciousness so separated from the general body of consciousness that the experience of each phase is inaccessible to the other under ordinary conditions, in which the two phases can only be brought into relation with one another by means similar to those by which experience can be recovered from the unconscious.
Having now, I hope, made clear what I mean by dissociation, it becomes my task to attempt to fit the process into the biological scheme which I am formulating in this book. I have to show that there has been some biological need to account for the presence of dissociation among the potentialities of human behaviour. I have given examples of suppression from several different aspects of animal psychology and have attempted to show that it is a process essential to the success of many of the reactions by which animals, even animals very low down in the scale of development, adapt behaviour to the needs of their existence. I regard dissociation as one of the modifications which suppressed experience may undergo, and it is now necessary to inquire whether it is possible to discern any similar biological significance in this process.
I have already considered[5] the need for suppression which is created in the amphibian by the complex nature of its life-history. I have supposed that it is essential to the comfort, if not to the existence, of the frog that it shall not be disturbed by the memories of its experiences as a tadpole, and that it is convenient, if not necessary, that these memories shall be suppressed. Let us now carry our imagination to the two kinds of existence which enter into the life of the adult amphibian. The frog has a certain set of experiences which arise out of its life in the water and another set of experiences which arise out of its life on dry land. I now suggest that the amphibian has [p. 80] associated with these two modes of existence two different sets of memories, dissociated from one another. If the amphibian when in the water should only be liable to recall experience associated with this mode of existence and when on dry land should similarly not be liable to be disturbed by memories of his aquatic existence, but is only open to memories of a terrestrial kind, we should have a perfectly characteristic example of dissociation and of alternate consciousness amounting to double personality. If, as there is every reason to believe, Man in the course of his evolution has passed through such an amphibian phase, one in which it was necessary that he should be adapted to two very different kinds of existence, we seem to have the clue to the presence in his make-up of the property of dissociation of behaviour and splitting of consciousness.
I have taken the frog as an instance of an amphibian because it is one with which we are especially familiar, but the process of dissociation and the property of alternate consciousness would be still more necessary to such an amphibian as the newt, which is for long spaces of time the subject of purely aquatic experience and then for long periods leads a life upon the ground. In such an animal, the process of dissociation might be expected to be even more complete than in an animal, such as the frog, which passes habitually and quickly from one mode of existence to the other.
At a later stage of human development we come to a transition which must clearly have provided another occasion for dissociation. Whenever the ancestors of Man took to an arboreal existence, there would have been another opportunity for the occurrence of dissociation between the experience proper to life upon the ground and that of the existence in trees. It seems however, far more likely that in this case there was no dissociation. The transitions between the two kinds of existence would be so habitual that in place of dissociation we might expect a very full integration of the experience connected with the two modes of existence, an integration perhaps more complete than any which had been present in consciousness up to [p. 81] this stage in animal development. Professor Elliot Smith has pointed out[6] how greatly the necessities of an arboreal existence, with the need for delicate co-ordination of eye and hand, must have acted as the stimuli to cerebral development. I now venture to suggest that another motive and stimulus to such development are to be found in the need for the integration of experience connected with two different modes of existence in place of the independence of experience and absence of integration which I assume to have accompanied the prolonged phase in which the ancestors of Man were passing from an aquatic to a terrestrial existence.
It may be worth while to point out a corollary of the proposition that the process of taking to an arboreal existence was accompanied by a substitution of fusion and harmonious integration for the dissociation which had been characteristic of earlier phases of development. On the one hand, the need for integration would lead to the formation of many and complex nervous connections, thus making up the association-tracts which form so large a part of the neo-pallium. On the other hand, the need for the delicate co-ordination of movements of eye and hand would, as Elliot Smith has pointed out, naturally lead to other developments of the kind we call intelligent. Thus, furtherance of the growth of intelligence would follow even more naturally from the substitution of a process of integration for an earlier phase in which experiences which did not readily harmonise were kept in the separate compartments provided by the process of dissociation. If at this point of Man's development, a process of fusion and integration were substituted for dissociation as the normal means of dealing with experiences difficult to reconcile with one another, we seem to have a most important clue to the vast development which at this stage led, on the one hand, to the growth of intelligence and on the other to the growth of the cerebrum. If we assume that before this point of development it was habitual to keep in separate compartments bodies of experience such as those arising [p. 82] out of an amphibian existence, we shall not only be provided with an explanation of the potentialities of dissociation in Man, but we shall also be enabled the better to understand the great development of intelligence and of the neo-pallium which is the distinctive feature of Mankind.
It is one of the principles of psycho-pathology, with which I shall deal more fully later under the heading of regression, that in morbid states early instinctive modes of reaction tend to reappear. If the occurrence of dissociation under morbid conditions is such an example of regression, we are not only enabled to understand its occurrence, but light is also thrown upon one of the most important periods in the history of human development.
I will close this chapter on dissociation by considering its relation to certain features of normal mental process. We are all familiar with experiences of ordinary life which have much similarity with dissociation, and especially those in which we switch off from one occupation to another of a very different kind, and are in no way disturbed by impulses or memories proper to the occupation which has been given up in favour of another. The case differs from one of morbid dissociation in that the experience of each phase is readily accessible to the consciousness of the other. The passing from one phase to the other has not the unwitting character of the morbid process, but takes place wittingly, and under full control, so that it can be produced and repeated at will.
This power of switching from one set of interests to another may perhaps be regarded as a kind of epicritic dissociation in which Man has utilised the instinctive property of, or tendency to, dissociation, in which he has brought it under control and to a large extent graduated it to meet the special needs of the developed mental life. At the least we seem to have here a feature of normal mental process, with certain points of resemblance to morbid, or, as it may be called, protopathic, dissociation, which may help us to understand its nature. There is little doubt that different persons possess the power of keeping their mental processes in distinct compartments in very different [p. 83] degree, and it would be interesting to know with what other mental characters this power is correlated.
Another feature of the normal mental life may be mentioned which probably stands in an even closer relation to dissociation. All of us in some degree, and many persons in a high degree, keep their beliefs and thoughts in separate compartments which have been called "logic-tight compartments." In these cases each of two sets of beliefs or thoughts is accessible to the other, but no effort is ever naturally made to bring them into relation with one another. The special feature of these cases is a failure of fusion or integration which brings them definitely into relation with dissociation. The state may be regarded as another epicritic form of dissociation in which any suppression is of a very incomplete kind. This form of imperfect integration is of great importance in psycho-pathology because it shows itself in a most pronounced form in cases of delusion. In such cases a system of thoughts, affects, and beliefs may exist definitely connected with the delusion, the different parts of which are in harmony with one another. This system co-exists with another set of thoughts, affects, and beliefs which are of the same order as those of the rest of the society to which the person belongs. When this latter system is dominant the person seems to be a normal member of society, but if anything happens to arouse the delusion-system, his conduct may be wholly inappropriate to social needs, and he is regarded as insane, or rather whether such a person is or is not regarded as insane depends on the degree in which the delusional system is out of harmony with the conventions of the society to which he belongs.
I have pointed out that different persons differ in respect to the degree in which their opinions are subject to logic, and it has been supposed that similar differences characterise different races of Mankind, or at least varieties of Mankind differing in cultures. It has been supposed by the French writer, Lévy-Bruhl, that savages are incapable of integrating their beliefs, and are so prone to accept ideas which are incompatible with one another that he has supposed savage Man to be in what he calls the prelogical state of development. It is probable that [p. 84] the ideas of people of lowly culture are rather more shut off from one another by logic-tight compartments than those of the members, at any rate the more educated members, of a civilised community, but most of the examples upon which Lévy-Bruhl founds his prelogical stage are capable of explanation on other lines. Many of the ideas and practices which Lévy-Bruhl believes to be logically incompatible with one another are found to be perfectly logical, sometimes even more logical than our own ideas and practices, when we understand their real meaning.[7] In other cases, especially in the religious sphere, ideas are held by many savage peoples which are definitely incompatible with one another, but in such cases the incompatibility seems never to have been questioned. According to the interpretation of the school of ethnology to which I belong, these incompatible beliefs belong to different cultural influences, indigenous or introduced, which have never been harmonised and integrated. They have been accepted uncritically and in this respect do not differ from the religious beliefs of many a more civilised people, or at any rate from those of the less educated members of their societies.
Footnotes
[1] Brit. Jour. Psych., vol. x. (1919), p. 5·
[2] Brain, vol. xli. (1918), p. 57.
[3] Brain, vol. xli (1917), p. 16.
[4] See The Unconscious, New York (1914), p. 249.
[6] Presidential Address, Section H, British Association, 1912; Rep. Brit. Ass., 1912, p. 583.
[7] See W.H.R. Rivers, "The Primitive Conception of Death," Hibbert Journal, vol. x. (1912), p. 393.