Chapter 15. Dissociation and the “Volcanic Model” (1)

In this last chapter, I will discuss what I call the “volcanic model” of dissociative disorder. Recently I often find myself using this model in explaining to the patients and their family members what is happening in the treatment process of dissociative disorder.
Dissociative phenomena, especially flashbacks and switching commonly occur in dissociative patients, and they are predictable to some extent, in terms of when and how they happen. If they happen on average a couple of times in a week, they will happen most certainly within a next month. However, in what day and at what time they occur is very hard to know, unless there are some very clear triggers. In that sense, dissociation is similar to natural phenomena, such as earthquake, hurricane, or volcanic activities.
In our mind, the memory of the Great East Japan Earthquake is still vivid. This incident might have left in the mind of many people the unpredictability of a disaster of this kind. We know that
earthquakes of that size occur semi-periodically, every hundreds of years or so in northern part of Japan. However, there is no way of knowing exactly what year and what month it certainly occurs, at least on the level of modern seismology in our country. In contrast, aferquakes are much easier to predict. They are likely to occur in proximity to the time and the area of the main shock. In the case of the Great East Japan Earthquake, they occurred in the most likelihood off the coast of Sanriku, and the sooner after the main shock, the more likely. However, if we earn predictability about some phenomenon on a certain level, we seek the higher level and eventually run up against unpredictability anyway.
Pathology of dissociation is similar to this. For example several different identities appear frequently for a period of time, and then they may become quiet for a while without any apparent reason. Even if there is some pattern found, such as seasonal, or that of the stress level, it would not allow us to foresee exactly what triggers the appearance of identity A, B, or C, etc., similar to most natural phenomenon.