Thursday, 3 November 2016

On Dissociative Identity Disorder: an Interview with Michelle Maiese

In this post, Magdalena Antrobus, PhD student on Project PERFECT, interviews Michelle Maiese (pictured above), Associate Professor of Philosophy at Emmanuel College, whose recent work centres on dissociative identity disorder.

MA: How would you describe Dissociative Identity Disorder (DID)?

MM: It formerly was known as multiple personality disorder. Although theorists sometimes describe DID as a case in which two or more subjects inhabit a single body, I find it more plausible to suppose that it involves a single individual who suffers from delusions surrounding identity.

Young children who develop DID experience extreme conflict that seems incapable of resolution and which concerns emotional needs to which they feel deeply attached. Suppose that Sue endures some sort of abuse at the hands of her mother. She develops strong feelings of anger or hatred toward her mother, but also loves her mother and wants to have a close relationship with her. Consistency demands that she modifies or abandons at least one of these stances.

But suppose that Sue is five years old. Because she is so young, she does not yet have a stable sense of self, nor has she developed an ability to manage inner conflict. It is possible that Sue will begin to dissociate and will hand off some of her mental states to different alter-personalities as a way to cope with inner discord. Suppose that over time, dissociation becomes Sue’s habitual coping mechanism and whole chunks of experience become split off from her conscious awareness. This ultimately leads to delusions of disownership: Sue ascribes some of her own mental states to a separate alter-personality, whom she regards as a separate person.

MA: What cognitive processes are involved in the formation of dissociated identity?

MM: Dissociation is central to this disorder. There is a disruption to the usual integration of mental states and processes and certain mental states are blocked from the subject’s self-reflective awareness. The sort of dissociation found in DID can be understood in terms of compartmentalization: there is an attempt to establish boundaries between various aspects of self, so that some mental states are detached from the subject’s psychological history.

Dissociation actually is quite common, and even ordinary subjects use it as a way to cope with their surroundings, e.g., in the form of behaviors they can perform without thinking or paying attention to them. Most of us also compartmentalize on a regular basis. For example, I have a fight with my partner in the morning, but then I have to go to campus and teach my classes. While I’m teaching, I set aside the memory of the argument I and the negative feelings it evoked. Like other defense mechanisms, this kind of compartmentalization can be understood as a way to avoid facing up to a particular subject matter. The difference is that in my case, these mental states remain easily accessible. When classes are over, I likely will start thinking about the argument again. But in cases of DID, the barriers that are erected are much more pronounced. The subject ascribes these mental states to separate selves as a way to hide her ambivalence from herself.

Tuesday, 1 November 2016

Project PERFECT Year 3: Magdalena

My research focuses on epistemic and pragmatic benefits of depression. More specifically I investigate whether experiences related to depressive illness such as low mood, negativity bias or delusions might have implicit or explicit beneficial outcomes for the subject.

It is widespread news that depression constitutes a modern epidemic. It relates to individual suffering, distorts one’s cognitive, emotional and behavioural processes, and sometimes leads to suicide. However, the results of more recent psychological studies indicate that the experience of depression might be linked to particular benefits for the subject as well as to pain and despair.

I spent my first two years on PERFECT researching epistemic and psychological benefits of low mood and depressive delusions. Low mood occurring in mild and moderate forms of depression is linked to more accurate judgements about the self and self-related circumstances. In the view of trade-off accounts this means that the epistemic benefit of more realistic judgements is achieved at the price of well-being: something has got to give. However, according to empirical research, it is possible for the subject to be psychologically better-off despite other psychological costs. For example, the phenomenon of defensive pessimism, understood as using own anxiety in order to improve performance, seems to be more effective in people suffering from low mood rather than in controls. The experiences such as low mood are linked to psychological suffering, but at the same time they have the potential to make us psychologically better.

The other topic I have been working on relates to depressive delusions. Are there any delusions in depression? If so, how are they different or similar to those occurring in schizophrenia? What role may they play in a personal life story? Are depressive delusions adaptive? Do they carry potential for any other benefits for the subject? These are some of the questions that I address in my research.