In the split personality two identities arise which contradict each other. One is based upon the ego image; the other upon the body. Several methods are available to elucidate these identities. The history of the patient and the meaning of his activities tell us something about his ego identity. An examination of the appearance and movement of his body tells us about his body identity. Figure drawings and other projective techniques supply important information about who the person is. Finally, every patient will reveal in his thoughts and feelings his opposing views of himself.
I shall present two case histories to illustrate the ideas set forth above. The first case is that of a young woman who stated that her problem was one of anomie. She had picked up this term from reading an article in Esquire and from reading Betty Friedan's book The Feminine Mystique. Friedan defines anomie as “that bored, diffuse feeling of purposelessness, nonexistence, non-involvement with the world that can be called anomie, or loss of identity, or merely felt as the problem that has no name.”3 Anomie is a sociological term which means normlessness or, as I prefer, formlessness. My patient, whom I will call Barbara, described her condition as:
…a feeling of disorientation and emptiness, essentially a blankness. I saw no reason to do anything. I had no motivation to move. I wasn't actually aware of it until lately. It struck me strongly when I returned from my summer vacation. During the summer I was responsible for my children and the home, but afterward, the maid took over. I felt that the things I do at home were like nervous tics—you know, unnecessary actions.
Barbara was thirty-five years old, married, and the mother of four children. Her activities at home could hardly be described as unnecessary. Even with a maid, she was busy all day with important tasks. One of her immediate difficulties stemmed from her relation to the maid. She wanted to discharge the maid, who was inefficient, but she couldn't bring herself to do it. All her life she suffered from an inability to say No to other people, and it made her feel inadequate as a person. When a conflict became too intense, as in the situation with the maid, she collapsed and gave up. The result was the loss of the sense of self and a feeling of emptiness. Barbara knew this from a previous analysis. She even knew the origin of her difficulty in her childhood relations with her parents. What Barbara didn't know was that she also collapsed physically whenever the stress increased. This physical collapse made her feel helpless.
What caused this physical collapse? She was a woman of average height, with a small head and dainty, regular features. Her eyes were soft, their expression, apprehensive. Her voice came out hesitantly, with frequent pauses between phrases. Her neck was thin and constricted, which partly accounted for her difficulty in speaking. Her shoulders were pulled up in a frightened attitude. Her body was toneless: her superficial muscles were extremely flabby. However, the deep muscles along the backbone, around the shoulder girdle, in the neck and thorax were tightly contracted. Her breathing was very shallow, which added to her difficulty in speaking and accounted also for her poor skin color. Any attempt on her part to breathe more deeply lasted a minute; then her effort collapsed as the upper half of her body sagged downward and she folded up in the middle. Many of her physical functions were depressed: her appetite was poor, her sexual drive was reduced, and she had trouble sleeping. It was easy to see why she felt so unalive, so empty.
Barbara couldn't see any connection between her physical state and her psychological attitude. When I pointed out this connection, she would answer, “If you say so.” She explained that she had no choice but to accept my analysis of her problem. She didn't like her body and unconsciously she denied it. On some other level, she sensed the connection, for during the physical therapy, she made an effort to breathe more fully and to mobilize her muscles through movement. When the effort became painful, she would cry for a short time, despite her reluctance to do so. She remarked that she had suffered too much pain in her life and she saw no need to experience more. But she also realized that she was ashamed to show her feelings, and consequently fought them. She became aware that the crying made her feel better since it made her feel more alive, and gradually, she gave in more and more to body sensation and feeling. She even tried to express her negation vocally by saying out loud, “No, I won't!”
Slowly, Barbara improved. She could maintain an activity longer and breathe more easily. The tendency to collapse diminished. She discharged her maid. Her eyes brightened perceptibly and she smiled at me. She no longer complained of anomie. She understood that she had to restore feeling in her body to recover her sense of self and identity. This improvement in Barbara's condition stemmed partly from her feeling that she had found someone who could help her, someone who seemed to understand her difficulty. Such an improvement, however, should be regarded as temporary. The conflicts which engendered her disturbance were alluded to but had not yet been resolved. Some idea of these conflicts can be obtained from figure drawings which Barbara made and from her comments about them.
Figures 1 and 2 are two successive drawings of the female. Of Figure 1, Barbara said, “She looks silly. Her shoulders are too broad. She looks Mephistophelian. She looks demure in a diabolic way.” Figure 2 struck Barbara as “unalive, a mannequin whose face is a death mask.” Figure 3, that of a male, strikes one as having a demonic or diabolic quality. We see certain similarities between Figure 1 and Figure 3 which indicate Barbara's identification with the male.
The accentuation of the body outline in Figure 2 should be interpreted as revealing a deficiency or weakness in the perception of her body's periphery. It is an attempt to impose a form upon what is felt to be formless. The loss of muscular tone in Barbara's body gave it an amorphous quality, for which she compensated by drawing heavy body lines.
Who was Barbara? Was she the corpse of Figure 2, portrayed as a wax figure, or was she the diabolic, demure maiden shown in Figure 1?
Looking at Barbara one would have considerable difficulty detecting a perverse side to her nature. Her expression was demure, shy, and apprehensive. But she recognized the demonic aspect of her personality and admitted it.
FIG. 1
FIG. 2
I felt most alive when I felt most perverse. At college, sleeping with boys had a perverse quality. I slept with a boyfriend of one of my girl friends, and I was proud of it. I bragged about it because I had done something perverse. Another time, I slept with a man, fat and ugly, who paid me for it. I was very proud. I felt I had the ability to do something different.
In terms of her body, toneless and amorphous, Barbara saw herself as an object (unalive, a mannequin) to be sacrificed to the demonic sexual demands of the male. In terms of her ego, expressed by the head and hands, Barbara identified with the demon who demanded this sacrifice and she derived some strange satisfaction from her debasement.
Barbara's mother had also regarded herself as a victim or martyr and her body was similarly shapeless and formless. Barbara obviously identified with her mother on the body level, while on the ego level she was repelled by her mother's body and humiliated by her mother's role as a sexual object. To give her own life a more positive meaning, she dissociated from her femininity and identified