Critiquing the Requirement of Oneness over Multiplicity: An Examination of Dissociative Identity (Disorder) in Five Clinical Texts

Abstract

In the health professions there is widespread agreement that dissociative identity is dysfunctional and needs to be cured. This position is based on the assumption that the healthy self is unitary and therefore multiplicity must be disordered. The cure, a requirement of oneness, is integration: the multiple selves must be unified into a single, integrated personality. To uncover themes and assumptions of this dominant approach to dissociative identity, five main texts were examined. From the many discourses identified, two central discourses were selected for further exploration. This paper explores how the identified discourses construct individuals with dissociative identity and how they inform and limit psychological theory and practice. Being exploratory, this paper offers a platform for further in-depth deconstruction and critical evaluation of the underlying assumptions and implications.

Full text

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 9
Critiquing the Requirement of Oneness over Multiplicity: An Examination of
Dissociative Identity (Disorder) in Five Clinical Texts.
Kymbra Clayton (kclayton@psy.mq.edu.au)
Department of Psychology, Macquarie University,
North Ryde, Sydney, 2109, Australia
Abstract
In the health professions there is widespread agreement
that dissociative identity is dysfunctional and needs to be
cured. This position is based on the assumption that the
healthy self is unitary and therefore multiplicity must be
disordered. The cure, a requirement of oneness, is
integration: the multiple selves must be unified into a
single, integrated personality. To uncover themes and
assumptions of this dominant approach to dissociative
identity, five main texts were examined. From the many
discourses identified, two central discourses were
selected for further exploration. This paper explores how
the identified discourses construct individuals with
dissociative identity and how they inform and limit
psychological theory and practice. Being exploratory,
this paper offers a platform for further in-depth
deconstruction and critical evaluation of the underlying
assumptions and implications.
Keywords: Dissociative Identity; Clinical Psychology,
Integration.
Shall my cure be a far greater burden
Than the one I now bear on my own?
For when the battle is won
You will go home
And it is I who must continue alone.
(Anon)
A concept which continues to arouse interest and
controversy in psychological circles is that of
dissociative identity, previously known as multiple
personality disorder (MPD). This phenomenon is best
understood and examined in the context of one’s notion
of self. Mainstream psychology tends to view the self
as individuated and autonomous, that is, as having core
properties that are universal, bounded, atomic and
somewhat detached from its cultural, social and
historical moorings. Many psychology and psychiatry
professionals rely on the traditional idea of a ‘true’ or
‘core’ self, a self which is individual, rational,
authentic, consistent and the origin of its own actions.
From this perspective, it is expected that a well-
integrated, healthy person should have a strong and
unitary self (O’Connor & Hallam, 2000).
This concept is in contrast to pre-enlightenment and
post modern thought that problematises the notion of
the unitary self. [For recent conceptions of the self in
psychological literature, see Lester, (1994) and Stam
(2004).] Those who embrace an alternate view of self
offer the concept of an inherently plural, fluid, flexible,
fragmented and decentred self, formed and constrained
by social processes. From this perspective a plural self
consists of a multiplicity of positions, voices, states of
mind and functions (Neimeyer & Raskin, 2000); each
self “is a source of differing interpretations of the
world, based on differing interpretive schemes” (Lester,
1994, p. 312). This self “has a plural personality, she
operates in a pluralistic mode” (Anzaldúa 1987, p.79).
For those who view the self as inherently unitary, two
main positions or groups regarding dissociative identity
can be identified. The first group either does not believe
that dissociative identity exists at all or believes that it
can exist but is extremely rare. This group views those
who present with multiple selves either as fakes or as
holding false beliefs of multiplicity that have been
created iatrogenically by misguided therapeutic
techniques (Spanos, 1994). The second group
acknowledges individuals’ use of dissociation as a
common response to trauma and/or neglect and reports
that there is a significant (perhaps around 1%) group of
individuals whose lived experience is one of multiple
selves or different identities (Kluft & Fine, 1993; Ross,
1997). As a result of this group’s efforts, dissociative
identity has become more recognised and was included
in the Diagnostic and Statistical Manual (DSM),
editions III and IV, published by the American
Psychiatric Association. The DSM is regarded as
providing the medical and social definition of mental
disorder and is a main diagnostic reference used by
psychiatrists and psychologists.
However, reflecting this second group’s perspective
that a healthy person requires an integrated and
essentially unitary self, the DSM-IV presents
dissociative identity as a disorder (DID) and describes
it as “a failure to integrate various aspects of identity,
memory and consciousness” (American Psychiatric
Association, 1994, p. 484). The criteria for diagnosis
according to the DSM are “the presence of two or more
distinct identities or personality states (Criterion A)
that recurrently take control of behaviour (Criterion B).
There is an inability to recall important personal
information that is too extensive to be explained by
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 10
ordinary forgetfulness (Criterion C). The disturbance is
not due to the direct physiological effects of a substance
or a general medical condition (Criterion D). The
distinctive assumption is that identity, memory and
consciousness should be integrated into a unitary self.
An alternative position in relation to dissociative
identity, partially informed by a post-modern notion of
self is that it is not a disorder per se (Rowan & Cooper,
1999), but rather an alternate and potentially functional
and adaptive way of being. This position invites a
deconstruction of the addition by the DID proponents
of the concept “disorder” to dissociative identity. In
agreement with this, Hacking (1995) is also wary
about the term ‘disorder’. He purports that it is “loaded
with values and is code for a vision of the world that
ought to be orderly.” (p. 17). Such an addition of the
term ‘disorder’ contributes to discourses on
dissociative identity which are then disseminated by
subsequent generations of practitioners as the truth.
They inform how practitioners perceive clients with
multiplicity and shape a whole treatment approach.
The purpose of this paper is not to detract from the
valuable role played by prominent members of the DID
field in fostering a greater recognition of multiplicity.
Neither is the purpose to imply that such practitioners
have negative intent towards people who experience
multiplicity. Rather, the intention is to identify the
discourses of the DID proponents and to consider their
implications for working with people who experience
dissociative identity. In this paper, multiple self-states
are referred to not as ‘DID’ but rather as dissociative
identity or multiplicity, spelt without capitals. This is
done to avoid either automatically pigeonholing the
experience as inherently disordered or objectifying
those who experience it.
Method
The texts chosen are from three of the most well
known psychiatrists in the field of dissociative identity,
namely Richard Kluft, Frank Putnam, and Colin Ross.
Each has published recognised texts and numerous
articles on ‘DID’ and all contributed to the recognised
treatment guidelines of the International Society for the
Study of Dissociation (ISSD) (Barach, 1994). To explore
a counter position, a text by a more recent specialist in
multiplicity, Margo Rivera, is included. The texts
examined were:
Clinical Perspectives on Multiple Personality Disorder
(Kluft & Fine, 1993) and articles by Kluft (period of
1983-1996).
Diagnosis and Treatment of Multiple Personality
Disorder (Putnam, 1989).
Dissociative Identity Disorder: Diagnosis, Clinical
Features, and Treatment (Ross, 1989, 1997).
International Society for the Study of Dissociation (ISSD)
Treatment Guidelines (Barach, 1994).
More Alike than Dissociative: Treating Severely
Dissociative Trauma Survivors (Rivera, 1996).
To describe and analyse the power structures,
ideologies, images and messages within these texts, a
variety of qualitative analytical methods were applied as
part of a larger study which explores the clinical literature
more fully. As a precursor to a more thorough critical
discourse analysis or post modern critique, this paper
examines the texts from the point of view of content and
language, teasing out assumptions and attitudes
concerning DID and those who experience it. This paper
also offers a brief glimpse into how the identified
discourses construct individuals and diagnoses, and how
they inform and limit psychological theory and
therapeutic practice
Texts are segments of meaning reproduced in any form
that can be given an interpretive slant (Parker, 1992). A
discourse can be defined as “sets of statements that
construct objects and an array of subject positions”
(Parker, 1994, p. 245). “Discourse is a practice not just
of representing the world, but of signifying the world,
constituting and constructing the world in meaning”
(Fairclough 1992, p. 64). Fairclough (1992) argues that it
is important that this relationship is understood
dialectically. A dialectical perspective emphasises that
discourse is a way to study both explicit language and the
material anchoring of language.
Discourses can be found ‘performing’ in texts. This
paper sets in motion the process of exploring the
“connotations, allusions, and implications which the texts
evoke” (Parker, 1992, p.7). The questions that are posited
are “how are descriptions produced so that they will be
treated as factual?” and “how are these factual
descriptions put together in ways that allow them to
perform particular actions?” (Potter, 1996, p. 6).
Language is often a reflection of the attitudes and
assumptions of much of society at large. Critical analysis
of language used in the dissociative field, heightened
awareness of its implications, and considered choice of
new and different language to frame the experience of
those with DI, can have a major impact on the future
directions of therapy in this field.
Analysis and Discussion
From the many discourses discovered in the texts, two
central discourses were chosen for exploratory analysis.
These were:
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 11
1. ‘Single’ is necessary but not sufficient for health
2. Therapist knows best.
Exploring Discourse No. 1: ‘Single’ is Necessary…
but not Sufficient for Health.
Single’ is Necessary. …All the texts initially adopt an
egalitarian stance towards dissociative identity by
acknowledging and praising the functional aspects of
dissociation in helping individuals to cope with the
experiences of abuse. “Creating other children inside is
an excellent short-term solution to the abused child’s
problems” (Ross, 1989, p.128). “At one time, usually in
early childhood, dissociation was a highly adaptive
response to overwhelming trauma” (Putnam, 1989, p.
137).
Descriptions such as “excellent” and “highly adaptive”
express admiration for the processes involved. However
the implied praise is qualified: the solution is only “short-
term” (Ross, 1989, p. 128), the processes only adaptive
“at one time” (Putnam, 1989, p. 137). The assumption is
that a strategy that worked well in childhood is no longer
functional in adulthood.
All the texts, excluding Rivera’s, make much stronger
assertions that multiplicity for adults is dysfunctional,
maladaptive, and, in line with the Western medical
model, pathological: “The problem with adult DID is
that, like any survival strategy gone wrong, it creates
more problems than it solves” (Ross, 1997, p. viii). “The
person needs to be fixed so that he/she can be effective
rather than powerless in the face of the MPD
psychopathology and life events” (Kluft, 1993, p. 291).
“(Adults) require ‘symptom stabilisation’, ‘control’ of
their behaviour and ‘restoration of functioning’ (Barach,
1994, section II).
The implications of the ISSD Guidelines are twofold.
First, individuals with dissociative identity incur a
process of medicalisation, through which “non-medical
problems become defined and treated as medical
problems” (Conrad, 1992, p. 209). In this process the
concept of disease, for which a biological cause is
required is often misaligned with the concept of disorder.
Disorders do not have clear aetiologies, yet the practice
of psychiatry is still underpinned by the medical and
therefore disease model. Second, individuals with
multiple selves are further positioned as unstable, out of
control and dysfunctional respectively.
These implications are broadened in most texts to a
conflation of multiplicity with undesirable behaviour and
disease:
The desire for intense dissociated states is built into
our DNA … such states are wonderful, desirable, and
healthy in their natural form … but there is nothing
wonderful about the chemical ecstasy of the heroin-
addicted ghetto prostitute. This is why there is
psychiatry of dissociation, the goal of which is to
substitute healthy, normal altered states for self-
destructive, painful ones (Ross, 1989, p. 187).
The emotive language in this extract implies an almost
inevitable link between dissociation, drug addiction and
prostitution. This is further developed by Ross:
MPD is directly linked to sexuality ... In our 236
cases, 19.1 percent had worked as prostitutes. Many
of these people would potentially stop prostituting if
they were diagnosed and treated for the MPD. The
connection between MPD, childhood sexual abuse,
prostitution, sexual promiscuity, and venereal
diseases including AIDS, makes MPD a major
unrecognised public health problem (Ross, 1989, p.
94).
Statistical data from one sample is used by Ross to
factualise a conflation of multiplicity, prostitution and
associated diseases such as AIDS and venereal diseases.
Although some individuals with multiplicity have these
health issues, the language used constructs ‘MPD’ as the
primary problem. However, it is disease that is a major
public health problem, not multiplicity. There is no doubt
that some people who experience multiple selves are
dysfunctional and/or live outside of society’s standards,
and in some cases a causal relationship could be
reasonably argued between multiplicity and
dysfunctionality. However, no evidence has been
published that dissociative identity inevitably causes
dysfunctional and socially unacceptable behaviour or
disease.
The assumption of automatic dysfunctionality in
dissociative identity is central in the DSM. “Diagnosis
can be made in the absence of significant objective
dysfunction” (Summerfield, 2001, p. 97). Other
diagnoses such as Schizophrenia, Major Depression and
Post-traumatic Stress Disorder include in their diagnostic
criteria that “the symptoms cause clinically significant
distress or impairment in social, occupational, or other
important areas of functioning” (APA, 1994, p. 327).
However, no such criteria are included for “Dissociative
Identity Disorder”. Whether or not there is distress or
impairment is irrelevant. Unlike other disorders,
dissociative identity is deemed a disorder and thereby
dysfunctional, purely on the basis that those who
experience it have a self that is not singular.
There may be in the general population a large
number of people with MPD who are high-
functioning, relatively free of overt psychopathology,
and no more in need of treatment than most of their
peers. They may not have abuse histories and may
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 12
have evolved a creative and adaptive multiplicity. If
these people exist, virtually nothing is known about
them. (Ross, 1989, p. 97)
The phrase “if these people exist” expresses some
doubt that there can be “high-functioning” individuals
with multiple selves, continuing the discourse of
dysfunction. However the phrase also highlights a gap in
the scientific research. Functional individuals who live
with multiplicity are most likely not documented because
of the very fact that they are functional and do not seek
therapy. At present, the only documented cases of
functional multiplicity are self-documented, for example
on internet pages. Although this is not persuasive
evidence for the scientific community, such data cannot
be summarily dismissed simply to hold to the dominant
discourse.
A construction of dissociative identity as inherently
disorderly and dysfunctional, in conjunction with many
therapists’ world view that a unitary self is normal and
best, leads to the assumption that multiplicity needs to be
cured: “The goal of treatment of MPD is not palliation. It
is cure” (Ross, 1997, p. 204). “Integration as an overall
treatment goal” (Barach, 1994, section IIIA). “It usually
becomes essential to replace dividedness with unity … for
any treatment to succeed” (Kluft, 1984a, p. 11).
The prescription for cure is integration to oneness as
accepted and unquestioned practice. According to this
view, multiple selves must be integrated into a unitary
identity. “My model of therapy is no more than this: the
patient has developed chronic trauma disorder with
MPD in response to childhood abuse. She needs to
integrate” (Ross, 1997, p.294). “This carries the seeds of
a prescriptive rigidity, one which might also serve to
confirm an illusion that it is possible to develop a set of
principles or codes which can be invariantly applied
irrespective of context” (Gergen, 1992, p.181). In
advocating integration, the texts support the traditional
understanding of the self as a unitary psychological
construct.
The unified, coherent self thereby becomes the
regulative norm. One of the ways in which a normative
prescription such as unitary oneness operates is through
the construction that dissociative identity is deviant.
“Those who lack ‘rightness’ help define what is ‘right’.
Some modes of living become accountable while others
remain unexceptional and taken for granted.” (Reynolds
& Wetherell, 2003, p. 490).
Alternatively, a position that constructs the self as
inherently plural and multiple in nature has the potential
to present a very different view of dissociative identity.
On first reading, Rivera’s text appears to do this, largely
due to the markedly positive language used throughout.
Multiplicity and dissociation are presented as not only
potentially functional, but also real strengths:
Multiplicity is not a problem; it is a wonderful
thing, individually, socially, and culturally. The
problems from which multiples suffer do not derive
from the existence of their personality states, their
many ways of being in the world. That is their
strength (Rivera, 1996, p. 41).
The different voices with different perspectives no
longer have to be silenced or devalued. The
individual who is now in a position to bear an
awareness of the depth, breadth, complexity and
contradictory nature of her life experience, can now
call all of those voices “I”, accepting none as the
whole story, but embracing them all. This is the
multiplicity at the heart of all of us. It transcends
categories (Rivera, 1996, p. 48).
However, a careful reading of the Rivera text reveals
that multiplicity is ultimately not equated with functional
living but instead is presented as a problem that needs to
be addressed. Rivera falls back on discursive resources
that situate dissociative identity within the Western
medical model:
You have a serious problem that used to be called
multiple personality and is now called dissociative
identity disorder. There is good news and bad news
about this condition. The good news is that is
treatable. Many people who have this problem get
completely better. The bad news is that the treatment
takes a long time and is very stressful (Rivera, 1996,
p. 79).
In some respects Rivera also prescribes integration to
oneness:
The more deeply parts of the individual connect
with the therapist; the more important it is for the
therapist to remember that the client is one person.
As the therapist does this, the individual aspects of
the system or personalties will gradually transform.
They will not be stuck in rigid and repetitive patterns,
and the early stages of a fluid responsive self will
begin to emerge (Rivera, 1996, p. 122).
“She can now call all of those voices ‘I’” (Rivera,
1996, p. 48). Rivera appears to fall back on the traditional
concept of encapsulating all parts into a single identity.
There has to be an “I”; she does not contemplate an
identity as ‘we’. She presents a mixed message: it is not
necessary for individuals with multiplicity to be directed
towards integration, but if they are left alone the parts
will integrate by themselves.
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 13
Although in some ways Rivera’s text tries to offer a
new approach, it really only removes itself to the margins
of the medical model. She takes issue with the position of
the DID proponents, but does not really establish a clear
alternative position of functionality as a “we”. If one
were to adopt such a position it would not only
acknowledge the possibility of a functional multiplicity
but also encompass a multi-faceted identity that could use
“we” as a description of “self”.
The plural self (we) is seen as being consistent with the
historical and social condition of pre-enlightenment and
post-modernity. The self is formed and performed
through interactions in specific and cultural contexts.
Hermans (1997) theorised the self as a constellation of
dialogically structured positions, each with their own
worldview and landscape, in relations of intersubjective
exchange and dominance. The “I” moves between
positions in an imaginal landscape, depending on time,
place and situation, resulting in a multi-voiced self. The
self as plural consists of a multiplicity of positions,
voices, states of mind, functions etc. (Rowan & Cooper,
1999). This self, therefore is never ultimately bound by a
set role but is constantly in the making; it is a self-in-
process (Ortega, 1991).
Although psychological discourse does not encourage
discussion about separate selves in ordinary speech
(Heinimaa, 2000) many people in today’s post-modern
world would describe themselves as having multiple
parts or senses of self, constantly changing and evolving.
They would see this as an appropriate response to the
multifaceted demands of contemporary society, in which
flexibility and horizontal integration are valued as
subjective qualities over stability and hierarchical
organisation (Rappoport, Baumgardner, & Boone,
1999). Our language also holds an underlying
‘multiplicity’. When describing individuals we use words
such as balanced and well-roundedness. We often use
phrases such as “part of me wanted to and part of me
didn’t” or “I didn’t feel like myself”. This “plurality in all
of us” Rivera believes, is experienced as a “unity”. “The
unmentioned or hidden ‘multiplicity’ in all of us
comprises the many distinct and separate facets of a
person’s personality, the many ways of being, which
make up the ‘whole’ individual called ‘I’.” (Rivera, 1996,
p. 48). Perhaps it is as Erdelyi (1994) describes, “when
the self-system is in disharmony, however, the multiplicity
of self-systems tends to be more obvious” (Rivera, 1996,
p.99).
It may also be that “fragmentation is a way of living
with differences without turning them into opposites, nor
trying to assimilate them out of insecurity” (Trinh, 1992,
p.156). Rather than focus on the issue of multiple self
“disorder”, an alternative approach could explore the
notion of functionality in conjunction with the
individual’s experience. This approach could explore
whether the individual experiences their inner and outer
world as safe, functional, happy, productive, and as an
acceptable way of being in the world. Similarly it could
explore whether the external world experiences the
person as safe, functional, happy, as productive, and
sufficiently consistent in presentation (in all guises) that
others can relate to the person. In this way the
“diagnosis” of disorder, if one was to be made at all,
would be linked with the individual’s views on multiple
aspects of both internal and external functioning.
Therapeutic goals would vary depending on which of
these different aspects of functionality were to be focused
on. One issue might be the degree of communication and
co-consciousness between parts thought necessary for
one’s definition of functional. While therapeutic work on
developing co-consciousness and communication has
frequently been promoted by DID therapists, this has
only been portrayed as a step along the way towards
integration (Kluft, 1993). Rivera’s stance (p. 41 & p.
122) moves towards seeing communication and co-
consciousness as a therapeutic end in itself, but still with
the goal of developing a functional “I”. If the goal is
functionality as “we”, two approaches are possible.
Either therapy works towards a co-ordinated internal
system, involving communication and co-consciousness
between parts, or the possibility could be explored that
functionality can be gained without all parts of the system
becoming aware of other parts and able to communicate
with them. In Bromberg’s (1993) view “Health is not
integration. Health is the ability to stand in the spaces
between realities without losing any of them” (p. 379).
Continuing Discourse No. 1: … But not Sufficient
for Health. Although the texts promote integration as
being the cure for dissociative identity, they then state
that more is needed to achieve health; that is, integration
is necessary but not sufficient for health: “Treatment does
not end with fusion/integration; it only enters a new
phase” (Putnam, 1989, p. 302). There is also the tacit
message that on this path to “true health” the “patient”
will develop further psychological problems: “The initial
euphoria that accompanies the achievement of unity
rapidly gives way to a profound depression” (Putnam,
1989, p. 318). “When you complete the multiple
personality part of the treatment and the person has
achieved integration, you are then dealing with a person
with single personality disorder” (Kluft, 1993, p. 89;
1994)
These problems may even be “untreatable”:
After the final alter personality has been
integrated, there is still a lot of work to do. Others
make a transition from MPD to PTSD in a single
personality. Such patients may have intense
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 14
flashbacks and continue to be suicidal, unstable in
their mood and self-destructive in their manner of
living for a long period of time post integration. For
some the outcome may be resolution of their MPD,
with an untreatable personality disorder (Ross, 1989,
p. 220).
In no other area of the DSM does the eradication of
one disorder inevitably lead to the diagnosis of another
disorder. This brings into question the validity of the
prescription for integration to oneness, and also reflects
the power of social expectations. Individuals must move
from socially unaccepted multiplicity to a socially
tolerated single disorder.
The texts go on to address the problems of integration:
“Even though the patient may be enormously distressed
after integration because they have lost their ability to
dissociate, this is still an ideal goal” (Putnam, 1989, p.
141). Kluft (1995) also notes that many multiples have
very unrealistic expectations about how good it feels to
be unified. “The patient may always be tempted to return
to the divided state and may even mourn the loss of the
alter selves. Vigilance is essential” (Putnam, 1992, p. 36).
These quotes attribute post-integration problems to the
client. The possibility that it is the treatment that is
problematic is not questioned and the fact that an
individual experiences ongoing distress is viewed as a
necessary sacrifice for the achievement of the therapist’s
ideal of a singleton self. “The multitude of voices are thus
reduced to a ‘systematically monologized whole”
(Bakhtin, 1997, p. 9).
Alternatively, if internal and external functionality as
“we” is the goal, then iatrogenic distress would be
avoided. The therapist’s task would be simply to explore
what each part of “we” needs in order to experience
health.
Exploring Discourse No. 2: Therapist Knows Best.
Representations of the relationship between therapist and
‘patient’ in the texts function to promote a further
discourse embedded in the dominant medical model: that
the therapist knows best. The texts initially advocate the
ideal collaborative nature of the therapeutic relationship
when dealing with dissociative identity, but quickly go
on to stress the importance of the power of the therapist:
“Treatment will be a collaboration but not democratic.
The patient is the patient and I am the doctor. We are not
friends, and I am the only one getting paid” (Ross, 1997,
p. 302).
This extract highlights that real collaboration is
impossible, stressing the chasm between the doctor as the
all-knowing professional and the patient as the unwell
one simply paying for the doctor’s expertise. The
therapeutic process therefore becomes one where the
dominant goals of the all-knowing professional are
imposed despite the client:
There is no need to be apologetic for commitment
to the goal of integration and the specific techniques
that help the patient get there. The patient will stall
and resist the work toward interpersonality
integration in countless ways (Ross, 1989, p. 245).
It is most important to decline to engage in
arguments over integration with the patient, because
this course of action almost inevitably heightens
narcissistic investment in the wish to avoid
integration and introduces an adversarial tension in
to an already difficult treatment. My personal style is
to encourage a wait-and-see attitude. Usually by the
time integration becomes an issue, it is in the process
of occurring and perceived as inevitable. The
argument is then irrelevant (Kluft, 1993, p. 109).
The word “argument” shapes the client as an adversary
and their desire to discuss the issue of integration before
committing to it as unreasonable and antagonistic. First,
the therapist is constructed as entitled to refuse to discuss
the issue of integration because he is right and knows
what is best for the client. Second, the text condones a
therapeutic approach of subterfuge that disguises, under
an apparently easy-going style of “wait-and-see”, the use
of a process that will lead to an “inevitable”
predetermined outcome. “I encourage their (the alters’)
communication and teamwork, all of which is in the
service of eroding narcissistic investments in uniqueness
and separateness and promoting integration.” (Kluft,
1993, p. 34)
Ironically, while a commitment to maintaining one’s
identity would be considered a normal and healthy life
force in a singleton, the selves (alters) of an individual
with dissociative identity are represented as having a
“narcissistic investment” when they attempt to preserve
their existence, rather than yielding to the therapist’s
demands.
“The medical field holds the power and it sets the
agenda” (Parker, 1995, p.2). The power of authoritative
knowledge is not that it is correct but that it counts
(Coates & Jordan, 1997). In the face of the expertise of
the medical fraternity, which is both sanctioned by and
informs society, the “patient” with multiplicity is
rendered powerless.
As part of this power asymmetry, the “patient” with
multiple selves is constructed as a child and the therapist
as a parent. In the role of “child”, the “patient” is
represented as unable to assess his/her own needs or
goals, incapable of equality with a professional person,
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 15
and requiring rules and discipline to manage out of
control behaviour:
Handling MPD patients is often like handling
misbehaving children. Limits, toughness, strict rules
and consistent enforcement are the kindest and most
effective treatment. Not everyone agrees with that
parenting approach, but the patients will eventually
teach it to most therapists who are committed to
effective efficient therapy (Ross, 1989, p. 224).
With this combination of a belief in the primacy of the
therapist’s knowledge, a minimising of the client’s wants,
and the adoption of a parent/child approach, it is only a
short step to justifying the use of coercion in therapy with
clients who experience multiplicity:
Initially, confrontation should be kind, firm, matter
of fact, and incorruptible. Once it is clear that the
patient understands what is required but behaves
inappropriately nonetheless, more forthright
confrontation may have a role. This may be
especially forceful if the issue concerns cooperation
with therapy (Kluft, 1993, p. 43).
A double standard is sanctioned: the therapist can
adopt an authoritarian approach involving force but the
client must exhibit “appropriate” behaviour and
democratic cooperation. Indeed, a state of siege initiated
by the therapist is prescribed:
The strategic integration therapist focuses more
specifically on undermining the dissociative defenses
that support the multiplicity; this erosion is ongoing
and relentless so that the dissociative structure
collapses from within (Fine, 1993, p. 137).
The easiest outcome of this war is for the client to
submit, to surrender. If not, more invasion is prescribed:
“Sodium amytal should be considered when other
techniques have failed or when temporary access to an
unavailable alter is required… it is a battering ram. It
gets you into the system” (Ross, 1997, p. 363).
The medieval war image of the battering ram has
echoes of rape and thus could be seen as highly
insensitive in light of evidence that a history of prior
abuse is common in multiplicity (Kluft, 1990; Ross,
1989). Nowhere within these texts is there an
acknowledgement of the possibility that these breaking-
down processes may replicate and perpetuate abuse
dynamics, further harming the client. It is possibly
because of the invasive forcefulness advocated in such
therapy that client resistance becomes an issue.
Again and again the patient must be educated and
reminded of his or her role and duties in the therapy.
… Unless the therapist takes such steps he or she will
find it difficult to confront the MPD patient who is
resistant and/or noncompliant. Confrontation will be
met with protestations of helplessness and wounded
innocence (Kluft, 1993, p. 33).
Resistance to invasion is portrayed as troublesome and
constructed as a manipulative overreaction. Critics of this
traditional view point out that resistance has been, and in
some cases still is, seen as an obstacle that must be
circumvented or overcome (Rowe, 1996) and arises
from a patronising position that clients “just don’t know
what is in their own best interests” (Amundson, Stewart,
& Valentine, 1993, online version).
An alternative view is that resistance is a positive
instinct. “Resistance to violence and oppression is both a
symptom of health and health inducing” (Wade, 1997, p.
24). From this perspective, clients could be seen as
exhibiting a healthy response to the invasion of the
therapist. Such resistance is not unexpected, given that
multiplicity is itself a: “Creative and courageous
resistance, the refusal by women and children to be
destroyed” (Rivera, 1996, p. 18).
Perhaps the therapeutic goal for people who are
experiencing dysfunctional multiplicity should be to
recognise the creative instinct to resist past abuse, to
develop resistance to the legacies of previous and current
abuse, including invasions by traditional therapists.
Instead, the majority of the texts examined depict
therapy as a site of conflict. The therapist’s role is seen as
the holder of knowledge, “the expert who diagnoses the
client’s problem and applies treatment” (Bohart, 2000, p.
143), with an entitlement to use force in order to change
the patient. These power relations between therapist and
patient “grant powers to some and delimit the powers of
others, enable some to judge and some to be judged,
some to cure and some to be cured, some to speak truth
and others to acknowledge its authority and embrace it,
aspire to it, or submit to it” (Rose, 1996, p. 175).
Rivera’s text acknowledges the importance of a more
collaborative relationship between therapist and client as
a more effective basis for growth and change:
Although the therapist has the training and the
experience that give her more responsibility for the
effectiveness of the treatment, it is crucial that the
client not lose control over this part of her life.
Therapy is always a partnership, and unless both
partners respect the roles and responsibilities of both
themselves and the other, the relationship is likely to
undermine the client’s strengths rather than
contribute to her growth (Rivera, 1996, p. 82).
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 16
Although Rivera emphasises the notion of
“partnership” the growth is still portrayed as occurring on
one side only. Perhaps a more equal collaborative client
therapist relationship would demonstrate and
acknowledge that often the therapeutic relationship is a
mutual process of growth and learning.
General Discussion
This analysis does not purport to be a thorough
discourse analysis or the only possible interpretation of
the texts explored. It is important to note that what we
accept as possible interpretations of a text are determined
by our “horizons of understanding” (Gadamer, 1975, p.
273) and as such these texts are open to other readings,
other possible interpretations. Indeed there are as many
possible interpretations as there are readers of the texts.
However this brief exploration offers a glimpse into the
ambiguities, contradictions and complexities involved in
the language used to describe dissociative identity. It also
demonstrates the need for further qualitative research into
the area of dissociative identity.
The present analysis raises many issues, some of which
will be discussed here. A prominent issue which has been
long recognised in the psychological literature is that of
defining self. The literature on ‘the self’ is huge and there
is no claim here to cover the numerous ways in which the
term has been used in modern and postmodern writings.
However when looking at how the authors of the five
examined texts viewed the self within the dissociative
identity context, the majority proposed the unitary self as
the goal of therapy. However when one looks beyond the
five texts, there is an acceptance of multiplicity, the
multiple self and polypsychism within the psychological
literature (see Hermans, Rappoport, Ross, Shotter, &
Watkins in Rowan & Cooper, 1999). Mair (1977)
proposed the mind to be a ‘community of selves’ while
Stone (1998) states that the belief that only one “I” could
belong to one body, or even that only one “I” could be
present at one time, was: “a kind of a story we told each
other” (p.85). “For the post-modern practitioner a
multiplicity of self-accounts is invited, but a commitment
to none” (Gergen, 1992, p.180).
Within the views that embrace multiplicity, however,
there appear to be varying degrees of acceptance of
multiplicity. Ross (1999) takes the position that, while
MPD is a psychiatric pathology or psychiatric
polypsychism, polypsychism is the “normal state of the
human mind.” (Rowan & Cooper, 1999, p. 193). Ross
defines polypsychism (rarely obtained) as “a degree of
healthy, fluid integration of sub-selves” (p. 194) and that
MPD and polypsychism are distinguished, he explains by
“the difference in the degree of personification of the ego
states, the delusion of literal separateness of the
personality states, the conflict, and the degree of
information blockage in the system”(p.193). Although
polypsychism may be an ideal, Ross states that what “we
call normal in our culture is actually pathological
pseudounity” (p. 194). He states that “DID is a
psychiatric disorder while pathological pseudounity is a
cultural sickness” (p. 195). “The integrated DID patient
is better off having no DID, even though he or she may
now exhibit pathological pseudounity” (p. 195)
So, is the requirement for oneness necessarily healthy
and helping the client? The texts explored indicated that
this may not always be so. In general integration was
expected to result in further problems (eg. Putnam,
1989). The possibility that the treatment is problematic is
not questioned within the texts. Instead the problems
resulting from treatment are individualised to the client
and at best are seen as a sacrifice that the client has to
pay. This highlights issues of power, responsibility,
control and agency which will be covered in a further
paper.
If treatment is problematic and yet remains
unquestioned by the therapist, then does the therapist
really know best? This was the second discourse
explored within the texts. It was found that the texts
placed the client in a subservient role; he or she was
required to comply with the therapist or be labelled
recalcitrant or possibly not treatable. This type of
therapeutic paradigm requires the client to take on board
the therapist’s world view and become how the therapist
thinks he or she should be, rather than how he or she
would choose to be. This also raises an issue of what
Hacking (1999) calls “false consciousness” (p. 266). The
fear concerning false consciousness is the sense that the
end product of therapy is a thoroughly crafted person.
Not a person with self knowledge, but a person who is
worse for having a glib patter that
simulates an understanding of herself (Hacking, 1999)
Towards a More Open Stance. I have selected
extreme extracts because these may highlight the
underlying beliefs that inform the texts. But the texts
themselves are not extremes. Indeed these are the most
common and widely used texts practitioners read to learn
about and inform their practice relating to dissociative
identity. These texts both reproduce and produce the
discourses that construct dissociative identity at the
present time.
Discourses can inform or misinform understanding of
multiplicity and therefore enhance or hamper
understanding of self/selves. Some beliefs about the self
which are most widely shared are the least easy to see;
this is because they are shared and therefore go
unquestioned. By failing to question these beliefs we are
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 17
complicit in promoting them: “there is a tacit and almost
heedless allegiance. We influence that which we observe,
as much as we are influenced by it” (Radden, 1996, p. 8).
Wearing (1994) determined that there is a professional
dominance of psychiatry and nosographic language of
medical discourse used to classify and treat illness and
syndromes within the health system. However there are,
in contrast to this, many therapists who use and promote
alternative “therapies of resistance” (Guilfoyle, 2005, p.
101) such as narrative approaches. These approaches not
only privilege the client rather than expert accounts, but
also bring to the fore the situation of their client and their
problems in respect of societal domination or
marginalisation. (e.g. Albee, 2000; Ali, 2002; Gilligan,
Rogers, & Tolman, 1991; Kaye, 1999). Nevertheless
many health professionals are still required to adhere to
the rigid and objectified set of categories of illness found
within the DSM. The DSM becomes professional
knowledge and diagnosis, the language of psychiatry, the
“social representation of psychiatric knowledge, as well
as the psychiatric profession’s presentation of self”
(Brown, 1990, p. 389). Moreover, Parker (1995) states
“When the categories from the DSM-IV are used, they
become charged with an emotional force which has far-
reaching consequences for those who are labelled” (p.2).
It is important to recognise that “discursive practices
are ways of talking, thinking, feeling and acting that,
when enacted, serve to reinforce, reproduce or support a
given discourse and at the same time deny, disqualify or
silence that which does not fit the discourse” (Law, 1999,
p. 119). The texts explored here indicated both symbolic
and real violence towards those who experience
dissociative identity. Through the setting down of
ideological boundaries and inclusion/exclusion of
single/multiple and healthy/not healthy, those with
dissociative identity who do not conform to the expected
way of being (by completing treatment) are marginalised.
The limitations of the mainstream approaches towards
dissociative identity become apparent when the
assumptions and norms implicit in these approaches are
uncovered: that the self is ideally unitary, that the
experience of multiple selves is pathological, and the
professional has the authority to impose goals and
processes on the client, to define any signs of resistance
as a problem and to over-power such resistance.
This analysis of traditional psychotherapeutic discourse
in relation to dissociative identity raises some important
questions. Does the traditional view of dissociative
identity empower the client or does it individualise
oppression and pathologise their experiences? Does the
therapy offer space for clients to develop new forms of
subjectivity or does it confirm them within their current
restrictive positions and castigate them for their
resistance? How are the power relations embodied in
certain specific kinds of techniques, for example the use
of a metaphorical battering ram?
If we recognise that personal constructions are shaped
and constrained by culture or by the “shared language
and meaning systems that develop, persist, and evolve
over time” (Lyddon, 1995, pp. 69-92), and that
knowledges, discourses, and power are interrelated, and
that some discourses are legitimated as proper
knowledges while others are subjugated (Foucault, 1980,
1983), then how do individuals experiencing a “we”
identity negotiate the expectations of the majority? Do
they adopt or resist the different discourses? How does
the “we” find their voice when faced with powerful
traditional professions such as psychiatry and
psychology? How is the “we” identity constituted in
relation to the dominant discourses of the DID group and
the psychological community?
The analysis undertaken indicates that a resistant
reading of the texts is possible. It could be that other
practitioners and theorists can also be resistant to these
texts. The texts themselves do not necessarily indicate
what actually goes on in practice. The relation between
texts and the practices that might be informed by them
needs to be explored.
Although it is not possible at the present time to
answer all the questions and issues raised in this paper,
further research exploring these issues and the
phenomenology, the lived experience, of dissociative
identity from the client’s point of view is being
undertaken by this writer. This may aid in creating a
space for individuals with dissociative identity to speak
with their own voices and their own discourses.
It is likely that there will be some resistance to the
adoption of more open discourses on dissociative identity
into the mainstream. This is because by its very nature
dissociative identity challenges and disrupts the dominant
views held by the psychological community and society
at large. Adopting a more open view of multiplicity
depends on and informs a major shift in notions of the
self, therapeutic research and practice, and social
attitudes in general. Adopting this view may well cause
considerable discomfort in the mainstream
psychiatry/psychological communities. However it is
perhaps this discomfort that has blocked more open
views on dissociative identity, rather than anything
inherent in multiplicity itself.
Adopting a different therapeutic stance that embraces
the possibility of a functional multiplicity in relation to
dissociative identity might allow new discourses to
develop. Instead of the notion that single is necessary
but not sufficient for health, a dissociative identity
therapist could also convey the message that
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 18
multiplicity is an alternative, valid and potentially
highly functional way of being, but internal
communication might be necessary for health. Rather
than promoting the concept that the therapist knows
best, dissociative identity therapy could be underpinned
by the idea that therapist and client work best together,
with transparency, honesty and mutual learning being
paramount, and with “resistance” valued as a healthy
survival instinct.
Acknowledgments
I would like to thank Fran, Doris, Daf, Alison, and
Sue for their thoughts on this paper. I would also like to
thank the anonymous reviewers for their helpful
comments.
References
Albee, G.W. (2000). A critique of psychotherapy in
American society. In C.R. Snyder & R.E. Ingram
(Eds.), Handbook of psychological change:
Psychotherapy processes and practices for the 21st
Century (pp. 609–706). New York: Wiley.
Ali, A. (2002). The convergence of Foucault and
feminist psychiatry: Exploring emancipatory
knowledge-building. Journal of Gender Studies, 11,
233–242.
American Psychiatric Association. (1994). Diagnostic
and statistical manual of psychiatric disorders, fourth
edition (DSM-IV). Washington DC: American
Psychiatric Association.
Amundson, J., Stewart, K. & Valentine, L. (1993).
Temptations of power and certainty. Journal of Marital
and Family Therapy, 19, 111-123. Online:
http://www.kennethstewart.com/temptations.htm
Anzaldúa, Gloria. (1987). Borderlands/la frontera: The
new mestiza. San Francisco: Aunt Lute Books.
Bakhtin, M. (1997). Problems of Dostoevsky’s poetics.
Minneapolis: University of Minnesota Press.
Barach, P. (1994). ISSD Guidelines for treating
dissociative identity disorder (multiple personality
disorder) in adults (1994). Skokie, IL: The
International Society for the Study of Dissociation.
Bohart, A. C., (2000). The client is the most important
common factor: Clients’ self-healing capacities and
psychotherapy. Journal of psychotherapy Integration,
10, 127-149.
Bromberg, P. M. (1993) Shadow and substance: A
relational perspective on clinical process. In P. M.
Bromberg, Standing in the Spaces: Essays on Clinical
Process Trauma and Dissociation, (pp. 379-406).
Analytic Press Incorporated.
Bromberg, P. M. (1993). Shadow and substance: A
relational perspective on clinical process. Psychoanalytic
Psychology 10, 147–168.
Coates, J. & Jordan. M., E. (1997). Que(e)rying
friendship: Discourses of resistance and the
construction of gendered subjectivity. Queerly phrased:
Language, gender, and sexuality, ed. by Anna Livia
and Kira Hall, 214-232. Oxford: Oxford University
Press.
Conrad, P. (1992). Medicalization and social control.
Annual Review of Sociology, 18, 209-232.
Fairclough, N. (1992). Discourse and Social Change.
Cambridge: Polity Press.
Fairclough, N. (1995). Critical discourse analysis: the
critical study of language. London: Longman.
Fine, C. G. (1993). A tactical integrationalist perspective
on the treatment of multiple personality disorder. In R.
P. Kluft & C. G. Fine (Eds.), Clinical Perspectives on
Multiple Personality Disorder, (pp. 135-54).
Washington: American Psychiatric Press.
Foucault, M. (1980). Power/knowledge: Selected
Interviews and Other Writings, 1972-1977 (C. Gordon,
Trans. & Ed.). New York: Pantheon.
Foucault, M. (1983). The subject and power. In H.
Dreyfus & P. Rabinow, Michael Foucault: Beyond
Structuralism and Hermeneutics (pp. 208-226).
Chicago: University of Chicago.
Gadamer, H. (1975). Truth and method. 2nd ed. New
York: Crossroads, 1984.
Gergen, K. J. (1992). Beyond Narrative in the
Negotiation of Therapeutic Meaning. In Sheila
McNamee and Kenneth J. Gergen (Eds). Therapy as
Social Construction. (pp.166-185). London: Sage.
Gilligan, C., Rogers, A.G., & Tolman, D.L. (Eds.).
(1991). Women, girls and psychotherapy: Reframing
resistance. New York: Harrington Park Press.
Graham, L. (1994). Critical Biography without subjects
and objects: An Encounter With Dr. Lillian Moller
Gilbreth. The Sociological Quarterly, 35,
Guilfoyle, M. (2005). From Therapeutic Power to
Resistance? Therapy and Cultural Hegemony.
Theory & Psychology, 15, 101–124.
Hacking, I. (1995). Rewriting the Soul: multiple
personality and the sciences of memory. Princeton U.P.
Harre, R., & Gillett, G. (1994). The discursive mind.
Thousand Oaks, CA: Sage Publications
Heinimaa, M. (2000). Ambiguities in the Psychiatric Use
of the Concepts of the Person: An Analysis.
Philosophy, Psychiatry, & Psychology, 7, 125-136.
Kaye, J. (1999). Toward a non-regulative praxis. In I.
Parker (Ed.), Deconstructing psychotherapy, (pp. 19–
38). London: Sage.
Kluft, R. P. (1984a). Treatment of multiple personality
disorder: A case study of 33 cases. Psychiatric Clinics
of North America, 7, 9-29.
Kluft, R. P. (1993). Basic principles in conducting the
psychotherapy of multiple personality disorder. In R. P.
Kluft & C. G. Fine (Eds.), Clinical Perspectives on
Multiple Personality Disorder, (pp. 19-50).
Washington: American Psychiatric Press.
Kluft, R. P. (1993). Clinical approaches to the integration
of personalties. In R. P. Kluft & C. G. Fine (Eds.),
Clinical Perspectives on Multiple Personality Disorder,
(pp. 101-133). Washington: American Psychiatric
Press.
Kluft, R. P. (1995a). Dissociative identity disorder, part
I: Definition, description, and diagnosis. Directions in
Psychiatry, 15, 23, 1-8.
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)

Clayton: Critiquing the Requirement of Oneness Over Multiplicity. 19
Kluft, R. P. (1999). An overview of the psychotherapy of
dissociative identity disorder. American Journal of
Psychotherapy, 53, 3, 289-317.
Law, I. (1999). A discursive approach to therapy with
men. In I. Parker (Ed.). Deconstructing psychotherapy
(pp. 115-131). Thousand Oaks, CA: Sage.
Lester, D. (1994). On the disunity of the self: a systems
theory of personality. Current Psychology, 12, 312-
325.
Lyddon, W. (1995). Forms and facets of constructivist
psychology. In R. A. Neimeyer & M. J. Mahoney
(Eds.), Constructivism in Psychotherapy (pp. 69-92).
Washington, DC: American Psychological Press.
Mair, J. M. M. (1977). The community of self. In D.
Bannister (Ed.), New perspectives in personal construct
theory (pp. 125-149). New York: Academic
Neimeyer, R. A., & Raskin, J. D. (2000). On practicing
postmodern therapy in modern times. In R. A.
Neimeyer & J. D. Raskin (Eds.), Constructions of
Disorder: Meaning-making Frameworks for
Psychotherapy (pp. 1-14). Washington, DC: American
Psychological Association Press.
O’Connor, K. P., & Hallam, R. S. (2000). Sorcery of the
self: the magic of you. Theory and Psychology, 10,
238-264.
Ortega, M. (2001). "New Mestizas," "'World'-Travelers,"
and "Dasein": Phenomenology and the Multi-Voiced,
Multi-Cultural Self. Hypatia, Online
http://muse.jhu.edu/journals/hypatia/toc/hyp16.3.html
Parker, I. (1992). Discourse Dynamics: Critical Analysis
for Social and Individual Psychology. London:
Routledge.
Parker, I. (1994). Reflexive research and the grounding
of analysis: Social psychology and the psy-complex.
Journal of Community & Applied Social Psychology, 4,
239-252.
Parker, I. (1995). In I. Parker; M. Stowell-Smith; E.
Georgaca; D. Harper; & T. Mclaughlin, Deconstructing
Psychopathology, (pp. 1-167). Sage Publications.
Potter. J. (1996). Representing reality: Discourse,
rhetoric and social construction. Thousand Oaks, CA:
Sage Publications.
Putnam, F. W. (1989). Diagnosis and Treatment of
Multiple Personality Disorder. New York: Guilford
Publications Inc.
Putnam, F. W. (1992). Discussion: Are alter personalities
fragments or figments? Psychoanalytic Inquiry, 12, 95-
111.
Radden, J. (1996). Relational individualism and feminist
therapy. Hypatia, 11, 71-96.
Rappoport, L., Baumgardner, S., & Boone, G. (1999).
Postmodern culture and the plural self. In J. Rowan and
M. Cooper (Eds), The Plural Self. London: Sage, 93-
106.
Reynolds, J. & Wetherell, M. (2003). The discursive
climate of singleness: the consequences for women’s
negotiation of a single identity. Feminism &
Psychology, 13, 489-510.
Rivera, M. (1996). More Alike Than Different: Treating
Severely Dissociative Trauma Survivors. Toronto:
University of Toronto Press.
Rose, N. (1996). Inventing Our Selves: Psychology,
Power and Personhood. Cambridge, UK: Cambridge
University Press.
Ross, C. A. (1989). Multiple Personality Disorder:
Diagnosis, Clinical Features, and Treatment. Canada:
John Wiley & Sons, Inc.
Ross, C. A. (1997). Dissociative Identity Disorder:
Diagnosis, Clinical Features, and Treatment. (2nd
Ed.). Canada: John Wiley & Sons, Inc.
Ross, C. A. (1999). Subpersonalities and multiple
personalities: A dissociative continuum. In Rowan, J. &
Cooper, M. (Eds.), The plural self: multiplicity in
everyday life. (pp. 183-197). London: Sage
Publications.
Rowan, J., & Cooper, M. (1999). The plural self:
multiplicity in everyday life. London: Sage
Publications.
Spanos, N. (1994). Multiple identity enactments and
multiple personality disorder: A sociocognitive
perspective. Psychological Bulletin, 116, 143-165.
Stam, H.J. (2004). The dialogical self, meaning and
theory: Making the subject. In W.E. Smythe & A.
Baydala (Eds.), Studies of how the mind publicly
enfolds into being (pp. 3–28). Lewiston, NY: Edwin
Mellen.
Summerfield, D. (2001). The invention of post-traumatic
stress disorder and the social usefulness of a psychiatric
category. British Medical Journal, 332, 95-98.
Trinh, T. (1992). Framer framed. New York: Routledge.
Wade, A. (1997). Small acts of living: Everyday
resistance to violence and other forms of oppression.
Contemporary Family Therapy, 19, 23-29.
Wearing, M. (1994). The health professions, psychiatric
discourse, and the classification of mental illness.
Australian Journal of Communication, 21, 53-73.
Yardley L. (Ed.) (1997). Material Discourses on Health
and Illness. Routledge: London.
Correspondence to: Kymbra Clayton, Department of
Psychology, Macquarie University, North Ryde,
Sydney, 2109, Australia. email:
kclayton@psy.mq.edu.au
Research Profile
Kymbra Clayton is a registered psychologist who is
currently completing a PhD exploring dissociative
identity. She is the cofacilitator of Dissociation
Australia. Her areas of interest are trauma,
dissociation, eating disorders, self development,
relationships and emotions. She also enjoys
researching how the internet aids those with stigmatised
illnesses, and exploring how animals aid in human
healing and therapy. Kymbra has run workshops on
dissociation and trauma, and presented at numerous
conferences. She currently tutors on a variety of
courses in the psychology department at Macquarie
University, NSW, Australia
E-Journal of Applied Psychology: Clinical Section. 1(2): 9-19 (2005)