Dissociative Identity Disorder
Richard P. Kluft
In his monumental work The Ego and the Id, Freud ( 1923/ 1961) took pains to emphasize that the ego (that coherent organization of mental processes to which consciousness is attached and which controls motility and the discharge of excitations into the external world in the form of decisions, behaviors and actions) develops as a consequence of the human organism's experience with the external world. The medium of this influence was described as perception-consciousness. Thus modified and informed, "The ego seeks to bring the influence of the external world to bear on the id and its tendencies, and endeavors to substitute the reality principle for the pleasure principle which reigns unrestrictedly in the id. For the ego, perception plays the part which in the id falls to instinct" (p. 25).
Along with perceptions from the special sensory organs, experiences registered by the body play an important role. The body, especially, the surface of the body, is a place from which both external and internal perceptions may spring. Furthermore, the role of pain in this process is potentially critical. Freud maintained that how we experience our bodies during periods of severe discomfort, such as painful illnesses, is one avenue by which we arrive at the idea of our body. Therefore, Freud wrote, "The ego is first and foremost a bodily ego; it is not merely a surface entity, but is itself the projection of a surface" (p. 26). Freud went on to state that although it is tempting to equate the ego with conscious mentation, there is "evidence that even subtle and difficult intellectual operations which ordinarily require strenuous reflection can