Chapter 5. Further Discussions on the “Relational stress” (6)

As for the participation of the parents for their daughter’s treatment, in twenty two cases (79%) they are very interested and involved in it. Among them, eleven patients (39%) are accompanied by their fathers in their treatment at least once during their treatment course. This last data might need some comments. They are conspicuous in indicating much smaller percentage of father’s sexual abuse found in the patients’ childhood history. Initially this data was perplexing to me and I wondered if there is any problem with my way of taking childhood abuse history. Although I asked systematically the patients and their family members about the history of physical and sexual abuse in their childhood and adolescence, I might not have been persistent enough. For some cases it might have been the case, as the history of abuse emerged in two out of 28 cases later on, more than two years into the treatment process.

However, it is more natural to think that there might be some essential difference between American cases and Japanese cases. Japanese patients’ fathers could be much less involved in sexual and physical abuse, and there is a circumstantial evidence. Fathers of Japanese DID patients’ attitude typically is much more collaborative and forthcoming in their daughters’ treatment. The fact that in 40% of cases father came to the treatment more than once might be indicating that the possibility that they were involved in abuse is very low. As I stated before, if fathers abused sexually and physically their daughters, typically they have left the family and are long gone by the time that their daughters get treatment.
As I discussed already, there are Japanese DID cases where overt abuse occurred while other cases did not involve any particular abuse history. How did these two groups of patients end up having the same dissociative pathology?