Brenner I
Philadelphia Psychoanalytic Institute.
J Am Psychoanal Assoc. 1994;42(3):819-46. doi: 10.1177/000306519404200307.
The author has interviewed and reviewed the cases of over 100 patients with a suspected diagnosis of multiple personality disorder (MPD). He finds it clinically useful to think of a continuum of character pathology in which dissociative and defensive altered states predominate. At one end of this continuum is MPD, which he considers a lower-level dissociative character. He redefines dissociation as a defensive altered state, due to autohypnosis, which augments repression or splitting. Depending on the degree of integration of the ego, it may result in a broad range of disturbances of alertness, awareness, memory, and identity. Four vignettes are presented which illustrate a transient hypnoid state, "characterological" dissociation in an upper-level dissociative character, and two cases of MPD, including one emerging in analysis.
作者访谈并回顾了100多名疑似多重人格障碍（MPD）患者的病例。他发现在临床上，将性格病理视为一个连续体很有用，其中解离性和防御性改变状态占主导。在这个连续体的一端是MPD，他认为这是一种较低层次的解离性人格。他将解离重新定义为一种由于自我催眠导致的防御性改变状态，这种状态会增强压抑或分裂。根据自我的整合程度，它可能会导致广泛的警觉、意识、记忆和身份障碍。文中呈现了四个案例，分别说明了一种短暂的类催眠状态、一种高层解离性人格中的“性格学”解离，以及两例MPD病例，其中一例是在分析过程中出现的。
