How about Passive to Active Tests?

• MPD and Freudian theory by Leigh , 2/26/98
  • A (pseudo)Freudian take on MPD by August Dolan-Henderson, 3/1/98
    
    

August, your efforts to reformulate and expand thinking on MPD/DID are thoughtful and, on behalf of myself, I thank you for sharing them with everyone. Inasmuch as I know almost nothing first-hand clinically about these conditions, I would be further grateful if you would continue to expound some more. In particular my attention was grabbed most when you began wondering about applications of control-mastery concepts to understanding this condition. You wrote:

"...from what I know of Control-Mastery Theory, I would say that the intense emotionality, and "seductiveness," of these persons were expressions of pathogenic beliefs, or adaptations...that the manipulations were "testing," or trying to meet their need for love and growth as human beings in ways that may have been adaptive in a traumatic early world, and checking on a therapist to see if they will recapitulate the responses of the traumatizers.."

As you probably already know, CMT makes reference to both transference tests and passive-to-active tests. If I understand your above statement correctly, you seem to be referring to transference tests. Would you agree?

Is the patient, that is, trying again to do what anyone might have done to get his or her needs met in relation to a caregiver? But because the patient feels altruistically unentitled to have these needs met, the purpose of the patient's trial effort to meet them (in relation to the therapist) is disguised. And apart from their disguise, the patient's needs may be otherwise rendered difficult for the would-be better caregiver to consider reasonable because of sundry extreme methods (i.e., symptoms) used by the patient to express these needs.

Seeking to have one's reasonable human needs met in disguised or extreme methods is what I think of as transference tests.

I am, however, also wondering if you may be able to understand any of the symptomatic behavior you observed among MPD/DID patients to be behavior representative of passive-to-active testing. In this kind of testing the patient is placing the therapist in the same interpersonal difficulties the patient was in when learning his or her adaptation that consists of feeling unentitled to affects or behaviors (goals) that are still needed but yet unattainable for a more satisfying life.

That is, could any of the symtomatic behaviors you observed be regarded as the patient's unconscious efforts to place the therapist is the interpersonal-position the patient was once in so that the patient may be able to learn from the therapist's example a better method of adaptation to this difficult interpersonal-position? Was the patient not "seduced," for instance, with extravagant displays of emotionality or chaoic confusion in his or her young life?

I am aware that somewhere in the CMT literature I read that when a therapist is not sure whether he or she is facing a transference or a passive-to-active test, it is usually safer to regard the patient as performing a transference test and proceed to understand the patient's need for understanding along these line. Interpretaions about passive-to-active testing are somewhat more risky to the extent that a patient may be insulted by such an interpretation, especially if the interpretation happens to be wrong or if it is delivered as somehow a criticism of the patient's worthy testing effort to overcome painful adaptations.

Would you care to comment on this matter, August, Jessica, or others?

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