Martha Stout has written a cogent, eminently readable book on the wide range of dissociative reactions we have to different stimuli, providing meaningful insight into the behavior of ourselves and those around us. We are all a little bit crazy, she declares. This book was something of an eye opener for me, as I had never considered dissociation as a common condition in society. Dissociation is actually a natural survival mechanism that has helped man survive for thousands of years on this planet; in cases of extreme, disturbing stimuli, the human mind may be unable to handle what it is witnessing, so it compartmentalizes the trauma into self-contained groupings within it. The person may withdraw his/her own awareness from the situation at hand, and he/she may well have no conscious memory of it after the fact. The effects of significant trauma cannot be self-contained in such a way forever, though, and so eventually the individual begins having nightmares or flashbacks, begins to space out or lose himself/herself at different times, exhibits dramatic mood swings, etc. In the most serious cases, the person may well harm himself or someone else, transform into a completely new person, lose control of his own conscious self, or exhibit what used to be called multiple personalities. It has been my understanding for some time that the number of actual multiple personality cases is extremely small, but Stout points to a small but significant number of cases of dissociative identity disorder (DID), an unknown number of which go undiagnosed.
Pointing to vivid examples from her own case files as well as anecdotal accounts of nonprofessional acquaintances, Stout identifies the points along the dissociative spectrum. The most familiar and benign examples of detachment from self include daydreaming and losing oneself in a good book or movie. At the opposite end of the spectrum is full-fledged DID. In between lie such states as temporary phasing out, habitual dissociative reactions (phasing out whenever a remark or emotion suddenly triggers a trauma from early life), dissociation from feeling (feeling nothing during an event that should be emotional), intrusion of dissociated ego states (feeling strong, usually negative, emotions for no clearly discernible reason), demifugue (feeling adrift from both reality as well as your body), and fugue (losing significant periods of time wherein you unconsciously go about your daily life). In extreme cases, an individual may develop separate personalities of which he/she may or may not be consciously aware, as these separate personalities may or may not have identifiable names.
The source of all these dissociative states, Start argues, is childhood trauma. She is quick to point out that trauma does not necessarily result from a condition of personal harm, although it naturally does include physical abuse, incest, emotional abuse, and similar reprehensible acts. A child has a limited understanding of the world, so he/she may be traumatized in ways his/her parents never even discern; becoming lost, for example, even for a short period of time, can have a lasting, deleterious effect on a child. Years later, some word or sound or smell might trigger this buried trauma, thereby triggering a dissociative reaction in the individual; such root causes of dissociative behavior can be very hard to ferret out. The very process of remembering can be pure torture, but whatever dissociative behavior is negatively impacting the individual's life must be uncovered in order for that person to find healing and live as normal a life as possible. One cannot protect oneself (which is basically what dissociation consists of) and live life to the fullest at the same time. In the end, one's ability to withstand and/or recover from the dissociative effects of early traumas comes down to a conscious choice of personal responsibility.
I'm no psychologist, but Stout communicates her ideas in a way that makes very good sense to me; she even manages to sum up quite distinctly the difference between her techniques and those of psychoanalysis. Her case studies of dissociative identity disorder are of course fascinating, but the biggest thing I will take away from The Myth of Sanity is the insight I have gained into normal, everyday life.