Psychologist Nancy Shaffer, Ph.D. -- D.C. Dept. Mental Health -- Letter 10/4/2000

TO: Nancy Shaffer, Ph.D.
FROM: Gary Freedman
DATE: October 4, 2000
RE: Clinical Interpretations
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I recently came across a discussion of Dissociative Identity Disorder in the "Merck Manual of Medical Information" (Merck Research Lab, 1997). The disorder was formerly known as "Multiple Personality Disorder."

While I do not have this disorder, I believe that dissociation is a significant psychiatric symotom in my case. (The cited publication states that "dissociation" is the third most common psychiatric symptom, and ranks right behind depression and anxiety.)

What struck my attention is that a particular childhood experience is considered to be an important causative factor in dissociative identity disorder (and presumably also in the psychiatric symptom of dissociation): namely, insufficient protection.

I recall that a few months ago, I mentioned that I have fantasies concerning idealized protectors. You responded: "Don't you think you've reached a point where you can dispense with that?"

I then became agitated and angry. I now feel vindicated in my anger.

I believe that your interpretation is typical of a distortion in your clinical interpretations generally.

You routinely fail to distinguish between the following:

1. Disturbances in adult function that relate back to a failure in childhood to achieve a developmental milestone;

2. Disturbances in adult functioning that relate back to a failure of the developmental environment to satisfy the child's age-appropriate needs.

Persons suffering from dissociative disorder, for example, are not people who have simply failed to develop; they are persons whose adult functioning is structured around deficits and aggressions in the child environment. You will never see that--which seems consistent with a need to preserve the image of the parents as idealized.

(Incidentally, the "Merck Manual of Medical Information" contains an endorsement from the former Secretary of the Department of Health and Human Services, Joseph Califano, Jr. -- a friend of Bob Strauss.)