atelierJAK

Medical report Dec. 30, 2010

​

Dr. med. Julia Ehmer

Doctor, psychiatric assessor

​

Synopsis:

JAK came for the first  exploration dialogue in November 2010, which was followed by further consultations. These  conversations with JAK were used for exact case history investigation and diagnosis. No projective tests or neorological and somatic 

 

examinations have been undertaken. 

At the beginning of the second sitting with JAK, it was noticed that his habitus, his mimic and gesture and his verbal expressions were quite altered. Upon enquiry, he admitted that  he  came from Korea. He spoke with an accent and his verbal expressions were not so fluent  as in the first sitting. He had during the second sitting , altered preferences and behaviour, although the same age and the same gender  as the personality of the first sitting. Strikingly, he also narrated a totally different life history.

 

In the third sitting, he narrated again another different story of origin, named different preferences and displayed a totally different attitude. His mimic and gestures were  absolutely different and he spoke with a different accent. His speech was very stagnant. This time he declared  he came from Lithuania.

 

In the following sessions with JAK, these three appearances repeated themselves.

Till then atleast three states of personality could be differentiated. But it cannot be ruled out that Jak can manifest more  partial identities.

 

All the personalities had a relatively long term cognition pattern in relation to their thoughts about the environment and about themselves and a corresponding mannerism. Their identities, their lifestories, their introductions and accordingly  their extraversions and  and their association  with emotions differentiate the three split personalities clearly from each other.

All the three personalities can be allocated  different characteristic properties. For example, one personality exhibits a very critical voice, challenges and scrutinizes everything and his actions as well as his personal works  fold in a  stark test of reality.

Another  identifiable condition  in JAK  deals with intution and spontaenity  and  it seems that he plans his actions  only for a relatively  short time span  where his goals are clearly identified.

This JAK admits that he has only the next 2-3 months in focus. A well defined childhood does not allow this partial identity to be investigated. The future also seems unclear. To it can be added another identity, that can express itself fluently, is verbally strong and also ‚headstrong’ that can think and act.

Through the clear identification of these three partial identities or personalities, that repeatedly takes control over  the behaviour of Jak leads itself  to a suspicious diagnosis: dissociative  split personality.

 

The term dissociate means to seperate or to disintigrate. Dissociation decribes here the process, in which  a part of the experiences with regards to content  tears  apart from one another  when the person suffers from an excess of fear, pain or grief.

 

Characteristically , a deep trauma suffered in early childhood  forms the basis of or as the case may be  the posible trigger for the beginning of the  sickness. In JAK this trauma has not been spotted till date. Although in one of the split personalities, it is highly remarkable , that it can not recall its experiences before puberty. This could be a clue to the cause of dissociation, but it remains speculative.

 

The moment of early traumatization in the childhood accounts for the beginning of the splitting up of the  different personalities. The person concerned developed a mechanism to escape the pain: he seperates the real events from his consciousness and try to think himself out of the situation. This process happens unconsciously and does not let it be controlled. In order to overcome the repeated traumatization, the person splits himself in two or more identities: each identity overtakes particular funtions in the respective situations and can surface in a similar situation . A system of split personalities developes where each has its defined function.

 

The  different persons can serve the purpose of adjusting itself to contrasting environmental and survival conditions. Often the split personalities with distinct functions   can be categorised  as someone who guards, someone who governs and someone who carries out the casual day-to-day tasks.  The dissociative person can enjoy things that are tabooed or  repressed. They can in relation to origin, age, gender, sexual orientation etc exhibit  totally opposite characteristics  as that of  the original personality.

 

How the system of split personalities functions in JAK is not clear. Also a  clear prime personality  could also not be identified. In their appearance  together, it reminds one of the till date explored system  of the Freudian  model with Id,Ego, Superego in which  JAK’s intuitive, unconscious and spontaneous  parts are meant. Also head-heart-stomach and control-voice could be a plausible model. Every model  appears till now  too simple and carries the cultural differences as well as  the mutualities and the expression through art .....

 

It is noteworthy,  that till now no comorbidities like depression, fear, coersion or self-destructive behaviour could be diagonized. Also the dissociation does not lead back to alchohol or drug consumption.

 

 Recommended  therapy

 It could not be adequately  ascertained  whether JAK is constrained in his daily life and in his work  due to his dissociative split personality. Also not enough psychological strain  has been detected  for which a therapy would be required.

A possible therapy, so long that JAK would like to get engaged in, would be to the slowly  familiarize  all the split identities and get them to cooperate together. It appears partly  that the  split identities already know each other and also seem to cooperate with one another,although time wise there appears to be a split in the personalities , without the existence of mutual exchange.

 

 

Aim of the therapy

Amalgamation and integration of all the identities.