Chapter 1. Dissociative Disorder in the Modern Era (3)

Psychiatrists who had their training in the sixties or seventies might remember well that the term dissociation was nowhere in their textbooks, except as a subcategory of hysteria, such as dissociative type and conversion type of hysteria. In early 1980s when I had my training of psychiatry in Japan, case conferences that I attended never dealt with any cases that had hysteria as their primary diagnosis. When the term hysteria practically disappeared and dissociation emerged instead in DSM-III in 1980, the trend took a turn and dissociative disorders appeared to be formally accepted as a decent disease entity. I would call this phenomenon the “detoxication” of hysteria that DSM made possible.

The widespread acceptance of dissociative disorders was exemplified by the ever increasing activity of ISSTD (International Society for the Study of Trauma and Dissociation) and the publication of its journal (Journal of Trauma and Dissociation). The size of the meeting seems to be steadily increasing. The activities of the organization in European countries seem to be marked whereas that of Asian countries does not seem to be as much. In Japan activities of the component group of ISSTD have started in 2007.
It appears that recognition of dissociative disorders has been finally occurring, but is it just a temporary fad, somewhat similar to the one that we saw a century ago? Or is it rather an irreversible trend which really gives dissociative disorder its due attention? We never really know which is true. One thing that I am convinced is that still clinicians who are well enough versed in dissociative disorder is very limited and many patients with this disorder are not given enough attention and treatment. Recognition of dissociative disorder should be even more promoted in the future.