In this chapter we discuss a very basic issue: why does dissociation occur? Many people who deal with dissociative patients should be asking these questions to themselves all the time. However, as simple as these questions might sound, the answer should be very complicated and difficult.
Let us remember the circumstances in which dissociation was rediscovered in the late 1900s. “Dissociative Disorder”appeared in DSM-III in 1980 for the first time and later it was also adopted to ICD-10 in 1992. It is amazing that all the sudden new diagnostic category appeared in the American psychiatry and became widely known soon after. Nowadays, many books and articles on this topic are published and numerous academic meetings have been held all over the world. However, although dissociative disorder has been far better recognized and understood recently, the basic question that I mentioned above has not been addressed yet.
The forerunner of dissociative disorder, i.e., hysteria, was a very controversial and mystical condition, but at least“why does it occur?”was at least answered.: it is caused by the migration of the uterus. It was also explained by witchcraft in many different area of the world. In Japan, mental illness including hysterical was often interpreted as the possession of animals. Here is one of the historical data indicating these circumstances.
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| A patient turns offensive as senior people treat him irrationally. Tokyo NichiNichi Journal, 1875 People in a religious meeting challenge a syphilitic patient who is mumbling nonsense, trying to de-possess him. All the sudden the patient turns offensive and says “You guys are crazy! You must be possessed by foxes or raccoon dogs!”People get stunned and run away. (Japan Association of Mental Health. 2002.) |
Although dissociation is better understood than that period, there are so many questions to be answered. An authority Etzel Cardeña states that number of the way dissociation is explained is practically countless(Cardena, 1994).
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