The concept of ‘dissociation’ in psychiatry

Titolo Rivista RIVISTA SPERIMENTALE DI FRENIATRIA
Autori/Curatori German E. Berrios
Anno di pubblicazione 2018 Fascicolo 2018/1
Lingua Inglese Numero pagine 22 P. 29-50 Dimensione file 1763 KB
DOI 10.3280/RSF2018-001003
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‘Dissociation’ names an officialized psychiatric concept (as per DSM-5 and ICD-10) used to describe and explain certain forms of human behaviour and of mental disorder. Although the clinical literature on dissociation is large there is little on its historical epistemology, that is, on the structure, origins, meaning, evidential basis and explanatory power of ‘dissociation’. Started as a technical concept in physics and chemistry, ‘dissociation’ has since found a home in psychology and psychiatry where it offers a common referent to terms such as splitting, sejunction, disconnection, disharmony, discordance, separation, cleavage, etc. This terminological multiplicity reflects more historical rivalries between nations and needs for originality than nuanced theoretical distinctions. This paper explores some of the contextual and congener concepts into which ‘dissociation’ sinks its roots. It also identifies questions that need to be answered before it is decided that dissociation is a useful concept: 1) is the (horizontal or vertical) orientation of the plane of cleavage of the dissociation related to a type of mental disorder? 2) do disconnections consume energy? 3) what mechanisms set asunder what structures? 4) is dissociation a ‘normal’ mechanism? 5) Are there also coupling (healing) mechanisms, 6) what is the nature of the components (modules) that become disconnected, etc., etc. Without this information claims that, for example, ‘depersonalization’ or ‘multiple personality’ etc. are ‘caused’ by ‘dissociation’ have little or no meaning.

Il termine ‘dissociazione’ denota un concetto psichiatrico ufficiale (per esempio nel DSM-5 e ICD-10) usato per descrivere e spiegare talune forme di comportamento umano e di disturbo mentale. Sebbene la letteratura clinica sulla dissociazione sia vasta, si trova poco materiale sulla sua epistemologia storica, cioè sulla struttura, origini, significato, evidenze e potere esplicativo della ‘dissociazione’. Originatosi come concetto tecnico in fisica e chimica, la ‘dissociazione’ ha da allora trovato casa in psicologia e psichiatria dove offre un referente comune a termini come scissione, disgiunzione, disconnessione, disarmonia, discordanza, separazione, clivaggio, ecc. Questa molteplicità terminologica è più il riflesso di rivalità storiche tra nazioni e del bisogno di originalità che di sfumate differenze teoriche. Questo articolo esplora alcuni dei concetti contestuali e congeneri in cui la ‘dissociazione’ affonda le sue radici. Inoltre individua domande a cui si deve dare risposta prima di giungere alla conclusione che la dissociazione sia un concetto utile: 1) l’orientamento (orizzontale o verticale) del piano di scissione della dissociazione è correlato ad un tipo di disturbo mentale? 2) le disconnessioni consumano energia? 3) quali meccanismi compartimentano quali strutture? 4) la dissociazione è un meccanismo ‘normale’? 5) esistono anche dei meccanismi (di guarigione) di associazione? 6) quale è la natura dei componenti (moduli) che si disconnettono, e così via. Senza queste informazioni l’affermazione che, per esempio, la ‘depersonalizzazione’ o ‘la personalità multipla’ siano ‘causate’ dalla ‘dissociazione’ ha poco o nullo significato.

Keywords:Psichiatria, psicologia, dissociazione, splitting, discordanza, disarmonia, disgiunzione, epistemologia storica, meccanismo, concetto

  1. Spitzer C, Barnow S, Freyberger HJ, Grabe HJ. Recent Developments in the theory of dissociation. World Psychiatry 2006; 5: 82-86.
  2. Augusto LM. Lost in dissociation: the main paradigms in unconscious cognition. Consciousness and Cognition 2016; 42: 293-310.
  3. Morselli GE. Sulla Dissociazione mentale. Rivista Sperimentale di Freniatria 1930; 53: 209-322.
  4. Cardeña E: Dissociative Disorders. In Ramachandran VS (ed) Encyclopedia of Human Behavior. Second Edition. Amsterdam: Elsevier; 2012, pp. 710-715.
  5. Nijenhuis ERS. La Dissociation dans le DSM-5. European Journal of Trauma and Dissociation 2017; 1: 205-209.
  6. Sar V: Epidemiology of Dissociative Disorders. Epidemiology Research International 2011: 1-8. [https://www.hindawi.com/journals/eri/2011/404538/].
  7. Dell PF, O’Neil JA (eds.). Dissociation and Dissociative Disorders. London: Routledge, 2011.
  8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.
  9. World Health Organization. Dissociative disorders. In: ICD-11 Beta Draft, available at: https://icd.who.int/dev11/f/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f108180424
  10. Beaney M. Analysis. In: Zalta EN (ed.), The Stanford Encyclopedia of Philosophy (Winter 2017 Edition) https://plato.stanford.edu/archives/win2017/entries/analysis/.
  11. Dijksterhius EJ. The Mechanization of the World Picture. Oxford: Oxford University Press; 1961.
  12. Coleman D, Fraser H. Minds, Bodies and Machines 1770-1930. New York: Palgrave; 2011.
  13. Chapuis A, Gélis E. Le Monde des automates: étude historique et technique, Volume 1. Paris: Slatkine; 1928.
  14. de Condillac EBA: Traité des sensations. 2 Vols. Paris: Chez de Bure; 1909.
  15. de La Mettrie JG. L’homme machine. Paris: Henry; 1865.
  16. Bichat X. Recherches physiologiques sur la vie et la mort. 3rd edition. Paris: Brosson; 1805.
  17. Ackerknecht E. Medicine at the Paris Hospital 1794-1848, Baltimore: Johns Hopkins Press; 1967.
  18. Corradini A, O’Conner T (eds.). Emergence in Science and Philosophy. London: Routledge; 2010.
  19. von Hartmann. Philosophy of the Unconscious. 3 Vols. Second Edition. London: Kagan Paul; 1893.
  20. Utaker A. Psychoanalysis and Hermeneutics. Annals of Theoretical Psychology 1986; 4: 99-115.
  21. Berríos GE. Psiquiatría y sus objetos. Revista de Psiquiatría y Salud Mental (Barcelona) 2011; 4:179-82.
  22. Bouchut E. Étude sur le Vitalisme. Orleans: Colas; 1864.
  23. Normandin S, Wolfe CT. Vitalism and the Scientific Image in Post-Enlightenment Life Science 1800-2010. Berlin: Springer; 2013.
  24. Reed ES. From Soul to Mind. New Haven: Yale University Press; 1997.
  25. Heinämaa S, Reuter M (eds.). Psychology and Philosophy: Inquiries into the Soul from Late Scholasticism to Contemporary Thought. Berlin: Springer; 2009.
  26. Berrios GE. Convergences that are no more. History of Psychiatry 2011; 22: 133-136.
  27. Oxford English Dictionary, Oxford: Oxford University Press; 1992.
  28. Bloch O, Warburg W. Dictionnaire étymologique de la langue française. Paris: Presses Universitaires de France; 1950.
  29. Rey A. Dictionnaire Historique de la langue française. Paris: Le Robert; 2010.
  30. Grimm J, Grimm W. Deutsches Wörterbuch, Leipzig: Hirzel; 1854-1961.
  31. Muret-Sanders. Großwörterbuch Englisch-Deutsch. München: Langenscheidt; 2018.
  32. Glare PGW. Oxford Latin Dictionary. Oxford: Clarendon Press; 1968.
  33. Gilbert NW. Renaissance Concepts of Method. New York: Columbia University Press; 1960.
  34. Cooper JM. Phaedrus in Plato: Complete Works. Indianapolis: Hackett; 1997.
  35. Bleuler E. Die Prognose der Dementia praecox (Schizophreniegruppe). Allgemeine Zeitschrift für Psychiatrie und psychisch-gerichtliche Medizin 1908; 31:436–464.
  36. Maatz A, Hoff P. The birth of schizophrenia or a very modern Bleuler: a close reading of Eugen Bleuler’s ‘Die Prognose der Dementia praecox’ and a reconsideration of his contribution to psychiatry. History of Psychiatry 2014; 25: 431-440.
  37. Chaslin P. Eléments de Sémiologie et de Clinique Mentale. Paris: Asselin et Houzeau; 1912.
  38. Stransky E. Lehrbuch der allgemeinen und speziellen Psychiatrie. Leipzig: FCW Vogel; 1914.
  39. J. Berze. “Über das Wesen der psychischen Aktivität (Versuch einer energetischen Deutung)”. In: Die primäre Insuffizienz der psychischen Aktivität. Leipzig: Deuticke; 1914.
  40. Gross O. Dementia sejunctiva. Neurologisches Centralblatt 1904; 23: 1144-1146.
  41. Wernicke C. Grundriss der Psychiatrie in klinischen Vorlesungen. Leipzig: Thieme; 1900.
  42. Fischer B. Vitalismus und Pathologie. Berlin: Springer; 1924.
  43. Hoffmann HF. Die Schichttheorie: Eine Anschauung von Natur und Leben. Stuttgart: Enke; 1935.
  44. Berrios GE. The Factors on Insanities and JH Jackson. History of Psychiatry 2001; 12: 353-373.
  45. MacKinnon FI. The Meaning of ‘Emergent’ in Lloyd Morgan’s ‘Emergent Evolution. Mind 1924; 33: 311-315.
  46. Goldstein K. Human Nature in the Light of Psychopathology. New York: Schocken Books; 1940.
  47. Conrad K. Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns. Stuttgart: Thieme; 1958.
  48. Coopersmith J. Energy, the subtle concept. Oxford: Oxford University Press; 2010.
  49. Helmholtz H. Über die Erhaltung der Kraft. Leipzig: Engelman; 1915.
  50. Jammer M. Energy. In: Edwards P (ed.) The Encyclopedia of Philosophy Vol. 2. London: McMillan; 1967.
  51. Exner S. Entwurf zu einer Physiologischen Erklärung der Psychischen Erscheinungen. Leipzig: Deuticke; 1894.
  52. Berrios GE. Historical epistemology of the body-mind interaction in psychiatry. Dialogues in Clinical Neuroscience 2018; 20: 5-12.
  53. Yolton JW. A Locke Dictionary. Oxford: Blackwell; 1993.
  54. Hilgard ER. The Trilogy of Mind: Cognition, Affection and Conation. Journal of the History of the Behavioral Sciences 1980; 16: 107-117.
  55. Brooks GP. The Faculty Psychology of Thomas Reid. Journal of the History of the Behavioral Sciences 1976; 12: 65-77.
  56. Cooter RJ. Phrenology and British Alienists, c.1825-1845. Medical History 1979; 20: 1-21; 135-151.
  57. Spoerl HD. Faculties versus Traits. Gall’s Solution. Character and Personality 1936; 4: 360-363.
  58. Berrios GE. History of Mental Symptoms. Cambridge: Cambridge University Press; 1996.
  59. Hoeldtke R. The History of Associationism and British Medical Psychology. Medical History 1967; 11: 46-64.
  60. Science l970; 6: 36-40.
  61. Fodor JA The Modularity of the Mind. Bradford: MIT Press; 1983.
  62. Cooter R. The cultural meaning of popular science. Phrenology and the organization of consent in nineteenth century Britain. Cambridge: Cambridge University Press; 1984.
  63. Wigan AL. The Duality of the Mind. London: Longman, Brown, Green and Longmans; 1844.
  64. Clarke B. Arthur Wigan and the Duality of the mind. Monograph Supplement 11. Psychological Medicine; 1987.
  65. Quen JM (ed). Split Minds Split Brains. New York: New York University Press; 1986.
  66. Zaidel E, Iacoboni M, Zaidel DW, Bogen JE. The callosal syndromes. In Heilman KM & Valenstein E (Eds.), Clinical Neuropsychology. New York: Oxford University Press; 2003.
  67. Schiefele H. Schichtenlehre in der Psychiatrie un Psychologie. In: Ritter J (ed) Historische Wörterbuch der Philosophie. Vol 8. Darmstadt: Wissenschaftliche Buchgesellschaft; 1992.
  68. Rothacker E. Die Schichten der Personlichkeit. Bonn: H. Bouvier; 1948.
  69. Cossa P. Organogenèse ou psychogenèse des troubles mentaux? Bulletin de L’Académie Nationale de Médicine 1969; 133: 345-348.
  70. Fountopoulos A. La Psychogénèse. Paris: Gamber; 1924.
  71. Monakow C, Mourgue R. Introduction Biologique a l’Étude de la Neurologie et de la Psychopathologie. Paris: Alcan; 1928.
  72. Smith R. Inhibition. Berkeley: University of California Press; 1992.
  73. Berrios GE, Luque R, Villagran JM. Schizophrenia: a conceptual history. International Journal of Psychology and Psychological Therapy 2003; 3: 111-140.
  74. Bleuler E. Consciousness and Association. In Jung CG (ed) Studies in Word Association. New York: Moffatt; 1919.
  75. Liddell HG, Scott R. A Greek-English Lexicon. Oxford: Clarendon Press; 1996.
  76. Long AA. Greek Models of Mind and Self. Cambridge: Harvard University Press; 2015.
  77. Ostenfeld E. Ancient Greek Psychology. Aarhus: Aarhus University Press; 1987.
  78. Snell B. The Discovery of the Mind. The Greek Origins of European Thought. Cambridge: Harvard University Press; 1953.
  79. Waddington-Kastus C. De la Psychologie d’Aristote. Paris: Joubert; 1848.
  80. Liddell HG, Scott R. A Greek-English Lexicon. Oxford: Clarendon Press; 1996.
  81. Moskowitz A, Heim G. Eugen Bleuler’s dementia praecox. Schizophrenia Bulletin 2011; 37: 471-479.
  82. Jung CG. The Psychology of Dementia Praecox. New York: The Journal of Nervous and Mental Disease Pub. Co.; 1909.
  83. Pruyser PW. What splits in “splitting”. Bulletin of the Menninger Clinic 1975; 39:1-46.
  84. Bleuler E. The Theory of Schizophrenic Negativism. New York: The Journal of Nervous and Mental Disease Pub. Co.; 1912.
  85. Lanteri-Laura G, Gros M. Essai sur la discordance dans la Psychiatrie Contemporaine. Paris: EPEL; 1992.
  86. Haustgen T. Philippe Chaslin (1857-1923) À propos du centenaire des Éléments de sémiologie et de la discordance (1912). Annales Médico-Psychologiques 2012; 170: 601-608.
  87. Abély P, Delaville M. Nouvelles Recherches cliniques and biologiques sur le syndrome discordant. Paris: Masson; 1960.
  88. Porot A. Discordance, Folies discordantes. In: Porot A (ed.) Manuel Alphabétique de Psychiatrie. Paris: Presses Universitaires de France; 1975.
  89. Canguilhem G. La formation du concept de réflexe aux XVIIe et XVIIIe siècles. Paris: Presses Universitaires de France; 1955.
  90. Willis T. Two discourses concerning the soul of brutes. London: Thomas Dring; 1683.
  91. Fearing F. René Descartes. A study in the history of the theories of reflex action. Psychological Review 1929; 36: 375-388.
  92. Fearing F. Reflex action: a study in the history of physiological psychology. New York: Williams and Wilkins; 1930.
  93. Liddell EGT. The Discovery of Reflexes. Oxford: Oxford University Press; 1960.
  94. Laycock T. On the reflex action of brain. The British and Foreign Medical Review 1845; 19: 298-311.
  95. Geschwind N. Disconnexion syndromes in animals and man. Brain 1965; 88: 237–294.
  96. Burns J. The Descent of Madness (see chapter 8). London: Routledge; 2007.
  97. Carpenter WB. Principles of Mental Physiology, London: C. Kegan Paul and Co.; 1879.
  98. Berrios GE. Positive and Negative Symptoms and Jackson. Archives of General Psychiatry 1985; 42: 95-97.
  99. Myers FWH. Human Personality. Vol 1. London: Longmans, Green and Co.; 1903.
  100. Janet P. L’Automatisme Psychologique. Paris: Alcan; 1889.
  101. Lantéri-Laura G, Daumézon G. La signification sémiologique de l’automatisme mental de Clérambault. Recherches sur les maladies mentales 1961; 61-91.
  102. Ey H. La notion d’automatisme en psychiatrie. L’Evolution Psychiatrique 1932; 3: 11-35.
  103. Crabtree A. “Automatism” and the emergence of dynamic psychiatry. Journal of the History of the Behavioural Sciences 2003; 39: 51-70.
  104. Ganser SM. Über einen eigenartigen hysterichen Dämmerzustand. Archiv für Psychiatrie und Nervenkrankheiten 1898; 30: 633-640.
  105. Allen DF, Postel J. For SJM Ganser of Dresden. A much mis-represented man. History of Psychiatry 1994; 5: 289-319.
  106. Marx O. Morton Prince and the dissociation of a personality. Journal of the History of the Behavioral Sciences 1970; 6: 120–130.
  107. Rieber RW. The Bifurcation of the Self. The History and Theory of Dissociation and its Disorders. Berlin: Springer; 2006.
  108. Bourneville DM. Preface. In: La Possession de Jeanne Fery (1584). Paris: A Delahaye et Lecrosnier; 1886.
  109. Berrios GE. European views on personality disorders: a conceptual history. Comprehensive Psychiatry 1993; 34: 14-30.
  110. Brown E. Pierre Janet and Félida Artificielle: multiple personality in a nineteenth-century guise. Journal of the History of Behavioral Sciences 2003; 39: 279-288.
  111. Rieber RW. The duality of the brain and the multiplicity of minds: can you have it both ways? History of Psychiatry 2002; 13: 3-17.
  112. Breuer J, Freud S: Studies on Hysteria. New York: Basic Books; 1955.
  113. Janet P. La Tension Psychologique, ses degrés, ses oscillations. The British Journal of Psychology 1920; 1:1-15.
  114. Zepf S. Libido and psychic energy. International Forum of Psychoanalysis 2010; 19: 3-14.
  115. Exner S. Entwurf zu einer Physiologischen Erklärung der Psychischen Erscheinungen. Leipzig: Deuticke; 1894.
  116. Denis P. Psychic Energy. In: Mijolla S (ed.) International Dictionary of Psychoanalysis, Vol 2. Detroit: Thomson, Gale; 2005.
  117. McLaughlin BP, Rorty AO (eds) Perspectives on Self Deception. Berkeley: University of California Press; 1988.
  118. Mele AR. Self-Deception unmasked. Princeton: Princeton University Press; 2001.
  119. Erwin E. Psychoanalysis and self-deception. In: McLaughlin BP and Rorty AO (eds) Perspectives on Self Deception. Berkeley: University of California Press; 1988.

German E. Berrios, The concept of ‘dissociation’ in psychiatry in "RIVISTA SPERIMENTALE DI FRENIATRIA" 1/2018, pp 29-50, DOI: 10.3280/RSF2018-001003