Chapter 1. Dissociative Disorder in the Modern Era (2)

The emergence of schizophrenia had multiple implications for dissociative disorders in the 20th century. Many patients with dissociative disorders were obscured and hidden by the presence of schizophrenic patients: some dissociative patients were ignored or paid little attention, and others were misdiagnosed as having schizophrenia. In fact, 20th century psychiatry was characterized in one way with this gross confusion of dissociative and schizophrenic patients. One of the key men who contributed to this confusion was Eugen Bleuler himself, the very person who presented the notion of schizophrenia in 1911.

Colin Ross, a significant figure in the field of dissociation discusses the relationship between schizophrenia and dissociative disorder made these points, suggesting that Eugen Bleuler himself might have looked at dissociative disorder when he descried schizophrenia.

The Swiss psychiatrist, Eugen Bleuler (1911/ 1950), coined the term schizophrenia, which means split mind. In his classic text, translated into English in 1950, he described the phenomenology of schizophrenia and proposed that the fundamental process in schizophrenia is a splitting of mental contents. He said that his term splitting was snonymous with Pierre Janet's (1965, 1977) term dissociation：What Gross understands by his term, "fragmentation (or disintegration) of consciousness" corresponds to what we call "splitting" . . . [T]he term, "dissociation," has already been in use for a long time to designate similar observations and findings. (p. 363) throughout his text, Bleuler stated that various mental contents (e.g., affect, identity, movement, sensation, memory, volition, arousal, and appetite) can be split or dissociated from the main body of consciousness i n schizophrenia. He provided numerous clinical examples of such dissociative symptoms. These are consistent with the phenomenological meaning of dissociation; they also imply the activity of the defense mechanism of dissociation. Bleuler also described switches among personality states that have different names, genders, ages, voices, memories, and mannerisms. (Ross, 2009)

It is really amazing that the very concept of schizophrenia and its clinical presentation that we are so familiar with could have been, in fact, those of dissociative patients. (Perhaps even more amazing is that this fact has been paid so little attention by many psychiatrist even now.!)
There is another issue which is better shared among clinicians. This is the issue of Schneiderian first rank symptoms. They have been considered as the gold standard for the diagnosis of schizophrenia. Now studies have demonstrated that they are better applied for DID (Eliason, Ross, 1955).