Chapter 1 Dissociative Disorders in the Modern Era (1)

In this chapter I will discuss some of the current hot topic regarding dissociative disorders.

Why are dissociative disorders a focus of attention?

Dissociative disorders are increasingly getting attention in the modern psychiatry. That trend has been obvious in European and North American countries already in 1970s, and the trend has been here in Japan for the past 10 years. Many psychiatric journals have put together special issues for dissociative disorders for the past several years.
A question should be asked here. "Why dissociations now ?" What does dissociation mean in modern psychiatry? A quick answer should be that the opportunities have ripened for dissociative disorders to be better researched and understood so we can learn more from them. In order to better respond to this question, we should go back to the history.
The concept which preceded dissociative disorders was the hysteria, but for a long time the notion has been pejorative and sarcastic. Even now in our daily life, if someone says "(S)He's hysteric", it merely means that that person lost his calm or got very emotional. In the long history of psychiatry, hysteria has worn so many connotations around it other than that of a disease concept. As Ellenberger (1977) eloquently discussed in his "discovery of Unconscious", hysteria has a history longer than any other psychiatric illnesses, perhaps longer than depression, and it has been changing its appearance throughout the history of human being.
Jean-Martin Charcot in 19th century was one of the major pioneers in the study of hysteria. Inspired by Charcot, Freud developed his theory of psychoanalysis. However, psychoanalysis never promoted the understanding of hysteria any further, unlike many people seem to believe. Hysteria conceptualized in psychoanalysis has too speculative and perhaps excessive unconscious meanings were attached to it. As a result, therapists were busy applying their theories to the patients, without really observing and understanding the patients themselves.
There is one event that prevented hysteria from being fully recognized and understood in 20th century psychiatry: The invention of the notion of schizophrenia.