A Fractured Mind

I have a difficult time knowing where to begin with my thoughts and reactions to A Fractured Mind by Robert B. Oxnam. That task is further complicated by a need to carefully edit what I should and should not say in a public forum. But I found this a powerful book and I want to encourage others to read it, so I’ll do my best to walk that particular razor’s edge.

Robert B. Oxnam is, by most measures we tend to use, a highly successful and accomplished man. Ivy League education. Scholar and academic in Asian studies from a time when that was less common than it is today. Head of the prestigious Asia Society for nearly a decade. Appearances on the Today Show and other media outlets. His curriculum vitae is quite impressive.

Robert B. Oxnam also discovered late in life, as everything crumbled around him, that he suffers from dissociative identity disorder or DID. That’s the clinical DSM-IV name for the disorder formerly (and still popularly) known as multiple personality disorder or MPD. This autobiographical book captures the story of that journey in an unique manner. Robert records the experience of his discovery of the disorder and his journey through treatment from the various perspectives of each personality. It’s a glimpse into the inner world of those who have a disorder which is difficult to understand from the outside.

The book also includes an excellent epilogue by Robert’s therapist, Dr. Jeffery Smith. If you read the book, don’t skip the epilogue. Dr. Smith provides an excellent overview of DID as well as a description of what he was trying to accomplish in the various stages of therapy and how he approached Robert’s disorder and his various personalities.

Dissociative identity disorder is not as bizarre or strange as people often consider it. Rather, all of the elements which together create it are normal pieces of the way our brains function and protect themselves. It’s just that in DID, each of those pieces is pushed somewhere close to its maximum extent. I want to take a moment to examine the primary two components.

First there is our capacity to, in effect, function as different people in different situations and settings. We all do this to one degree or another. Personally, when I’m focused on solving technical computer design or programming problems I tend to enter into a place where my mind is working at a level of abstraction that renders me less verbal. If you try to communicate with me while I am in that place, you are likely to get a blank stare initially if you get any response at all. It’s not that my ears didn’t hear the sounds you made, it’s that my brain is not engaged and operating in a way that allows me to immediately interpret those sounds as language. Now, I can fairly readily switch gears from that state into one that’s better able to communicate, but those around me can observe the shift. When I’m in the office, I find my coworkers understand that shift (most of them experience something like it themselves) and when they need to talk to me will wait for a moment to be sure I’m engaged with them. When I’m working from home, my family is less familiar with that process and they have a tendency to start telling me something before I’m ready to absorb it. I find I often have to tell them to stop and backup a bit when they need to talk to me while I’m working. They don’t experience that when I’m in the office because they have to call me and the process of hearing and responding to a ringing phone provides me all the time I need to shift gears.

However, while that’s the first example that comes to my mind, it’s hardly the only one. We all tend to present different aspects of ourselves in professional settings, in casual social settings, with more intimate friends, and with those who are closest to us. It’s so easy and natural that we hardly even think about it unless the “face” we are compelled to portray in a particular context feels so alien to us that it becomes a “mask”. Even then, we don’t have any particular problem pulling off the required masquerade. It just feels unnatural. But for every “mask” we notice, we likely have a hundred “faces” that we don’t. So even though we all feel like a single, unified person, the reality is that we are constantly and largely unconsciously rearranging the elements of our personality to meet the demands of particular settings and circumstances.

Dissociative identity disorder is a disorder because this natural function of the mind becomes cast in iron as distinct and divided personalities rather than more fluid “faces”. Those walls between the personalities are built through dissociation. But dissociation itself is a very common defense mechanism. It’s one of the ways our minds protect themselves from trauma.

One of the dissociative disorders that people are pretty familiar with today is post-traumatic stress disorder. While dissociation is hardly the only feature of PTSD, it is a significant piece of it. The dissociation can take the form of a total amnesiac block of the traumatic memory. You will still suffer to some degree from the trauma, even without the specific memory, but it seems to lessen the overall impact and allows the person to continue to function, even if in a diminished capacity. In other cases the dissociation can take the form of some sort of detachment, where you can recall the traumatic event, but it’s almost as though it’s from a third-person perspective.

My father is a Vietnam veteran and by the confluence of a number of events, he served in a particularly dangerous role. I remember a time when the sound of a breaking glass suddenly placed him back in a memory from the war from which he had dissociated until that moment. Dissociation helps us keep functioning in the face of trauma, but it’s not necessarily permanent. The traumatic memory isn’t actually gone. We just don’t have full access to it. (In fact, traumatic memories, by their nature, are the memories least likely to fade. They are seared into our psyche.)

If you’ve been fortunate enough to have never yet experienced trauma of this sort, consider yourself blessed. Try to remember that many of the people with whom you interact each day have not been as fortunate.

While I’m not inclined to share details, I will say that my earliest memories are like the shattered shards of a mirror. I see bits and pieces of scenes, but they are in confusing disorder and slide from one to another without connection or transition. There are also other periods across my childhood where I can see evidence in my mind of dissociation. I will give one example to illustrate my point.

I remember a number of nights at a young age (no older than 7, though I can’t place my exact age or place) when I would lie in bed and imagine that my life was a very realistic dream. I would pick a point in the past where a younger me was asleep and dreaming and I would try to convince myself that everything since that point in time was just a dream and soon the younger me would awake and the dream (or perhaps nightmare) would fade. As an adult, I can recognize that that is not exactly a typical train of thought for a young child. But I can’t remember why I wanted some significant portion of my life at that time to be a dream. Nothing. That part of my memory is simply gone.

And if I’m speaking truthfully, given the nature of much that I do remember, I’m not certain I really want those memories. That’s the sword of Damocles hanging ominously within dissociation. If the memories were not traumatic, there would be no need to dissociate. As a result, at least speaking for myself, there is a reluctance to try to pierce the veil and something of a fear that the veil might one day drop on its own.

So the various elements of dissociative identity disorder are either part of our normal, everyday mental capacity or  pretty common defense mechanisms. But in this disorder, they are ratcheted up to the Nth degree. Typically it’s the result of severe abuse at a very young age with no hope of escape. And it’s often the result of such abuse over an extended period of time. The traumatic memories are divided up between personalities to hold them. Some element of the ethos of the abusers tends to be encapsulated in other personalities. And finally, personalities that do not have any of those memories are created to function in the outside world. It’s a survival response in the face of an otherwise unbearable onslaught. Dissociation forms the walls between the personalities or identities. In order to survive, the whole person shatters.

Usually, the dominant personality or personalities are not aware of each other or of the inner selves who protect the secret. And since the entire construct of personalities were created in the face of severe trauma and typically exist to protect secrets, they are masters at hiding. As such, it’s a notoriously difficult disorder to diagnose.

And that’s the case in this book for Robert B. Oxnam. As “Bob” he functioned in the real world for decades without any awareness of the world within him. He achieved high degrees of success, even if he also suffered a host of chronic problems. It was only as “Bob” burned out and began to collapse that he reached a point where another personality revealed himself in the context of a therapy session. The book records his journey of discovery and healing from that point onward.

This book does an excellent job of taking us into the inner world of a disorder we have a hard time understanding and which, unfortunately, is the subject of much skepticism and humor. Take the time to read it. You won’t regret the experience.