Primitive Mental Processes: Psychoanalysis and the Ethics of Integration

Abstract

A person in two minds has to make choices. General ethics would accept that people can be influenced in their decisions both ethically and unethically. Divisions of the human mind occur in varying degrees: from ordinary conflict, to repression, to splitting. This paper describes these levels, as encountered in psychoanalytic observation. The primitive defense mechanisms of splitting, projection and introjection result in phenomena in which one person can perform the function of part of another person’s mind. The interpersonal situation as found in the psychoanalytic setting can exemplify the diminishing of an individual’s autonomy, not only in the practice of psychoanalysis but in the wider interpersonal social field. If external, interpersonal relations represent internal conflicts and splits, that person suffers significant depletion. If the missing part of the mind actually becomes another person, this dissolved personal identity leads to the question: the autonomy of which part of the mind? Such odd manifestations give rise to profound problems for standard professional ethics. Because observation of these occurrences can be replicated in ordinary everyday social relationships, there are equally profound implications for ethics in general.

Autonomy and the principle of rationality are problematic, from this point of view, and in their stead a principle of integration can be usefully substituted. The principle of integration concerns the way in which people attempt to operate upon their own minds and exploit those of others, either to cause greater relocation of parts of personalities, or to diminish such relocations. The “principle of integration” can thus distinguish between benign intentions to promote a mental integration in oneself and others, or a malignant one that inhibits mental integration.

In a previous paper (1995), I showed that observations by psychoanalysts suggest strongly that personal identity is divisible. It is not an atomic singularity. On the contrary aspects of a person’s identity (in particular personal attributes and mental functions) may disappear, or become “split off” from consciousness, sometimes for a brief moment, sometimes for an extended period, or even permanently. Such personal attributes and mental functions, moreover, can re-appear in the personalities of other people with whom the subject is in some social relationship: they may be “projected” onto someone else by the subject; or even actually “introjected,” or experienced, by the other person on a temporary or permanent basis. This disjoined subjectivity, arising within the interpersonal network of relationships, conflicts with the (widely assumed) notion of a coherent individualistic and consistent personal identity.

In my previous paper I described these processes (splitting, projection, and introjection) with detailed illustrations from psychoanalytic practice (see endnote ¹). I also showed that the picture of personal identity as interpersonally disjointed, and in some sense shared with the analyst, is not confined to the psychoanalytic setting, but in fact occurs in everyday life away from all treatment settings.

In the present paper, I examine the implications of these phenomena for ethics, both in psychoanalytic practice and generally. I argue that they raise doubts about the validity of the notion of autonomy as usually understood (Lindley 1986). Autonomy implies choices, choosing between alternatives, including alternative treatments, or the choice of having treatment or not. Such choices are at the root of standard medical ethics as systematically described by Gillon (1986), for instance. Such a standard ethical code is somewhat unthinkingly adopted by psychoanalysts (see endnote ²). But if a person’s mind can be split into parts with separate intentions, and in addition some parts can be represented by the mind of someone else, then whose autonomy should be respected?

This and similar problems posed for standard medical ethics by psychoanalytic observations on personal identity suggest a revision in professional ethics is necessary. I will look at some of these problems posed for standard professional ethics that are raised by psychoanalysis. Repression and rationalization demonstrated by psychoanalysis prompt severe questions, but even greater problems arise when patients dismantle their minds by rendering it into separate parts through a sequence of more primitive processes of splitting, projection, and introjection.

I shall conclude that a notion of integration...