Conventional thoughts on dissociation

  The conventional concept of dissociation, which is widely known, differs  from my definition (as you have already noticed). Several experts might think that the conventional concept is correct because it is familiar and that my definition is difficult to understand and wrong. However, I would argue that my definition has great utility and might be easier to understand. Moreover, it is possible to locate not only dissociation but also dissociative disorders according to my concept. I will briefly discuss my thoughts on conventional dissociation and provide an outline of my theoretical constitution.

  The meaning of dissociation is generally expressed as the "defense of trauma." Trauma here refers to psychic trauma. What is the range of this trauma? If this psychic trauma indicates "all trauma," it can range from disastrous incidents, which someone will rarely encounter, to minor incidents due to calumny or slander frequently occurring within ordinary personal relationships. Even if we refer to this wide range of incidents as traumatic, we meet a problem of the individual level as to whether someone will accept an incident as traumatic. Some might not accept their circumstances as traumatic, even if they encounter severe accidents; some might accept others' trifling words as traumatic. There are multiple levels of trauma, and their meanings are ambiguous.

  Freud elucidated the psychodynamics of defense. He abandoned traumatic theory and presented the anxiety-defense model. Conventional definitions mentioned above seem to reflect the trauma-defense model. This gives me the impression that researchers assessing dissociation reclaimed an idea that Freud has abandoned, and they replaced anxiety with trauma. This impression suggests to me an undisguised takeover against Freud's theory. They also seem to deal with defense in segments. For instance, the defense of anxiety is dealt with as repression, and the defense of trauma is dealt with as dissociation. Nevertheless, an undisguised expression as defined above cannot be found in the psychiatry textbooks. For example, in H.I. Kaplan and B.J. Sadock's Synopsis of Psychiatry, dissociation is defined as "temporarily but drastically modifying a person's character or one's sense of personal identity to avoid emotional distress." This definition does not use the words "trauma" or "defense." However, dissociation is expressed as defense of trauma within one word.


                                                                             Theory of dissociation

My thoughts on dissociation

  According to the definition of dissociation in the textbook mentioned above,  I wonder if it is more suitable for dissociative disorders rather than for dissociation. Dissociative disorders have their origin in dissociation, but many other psychic phenomena also have originated in dissociation. Dissociative disorders are just one group. The concept of dissociation has a wide range. Dissociative disorders are a cluster of specific symptoms. I think that there is a big gulf betwen dissociation and dissociative disorders. I will introduce my idea on dissociation, here.

  I consulted Koujien, which is a dictionary well known in Japan, for the definition of dissociation. According to this source, dissociation refers to the action of unfastening and separating. However, I understand that dissociation means "to tear off" and "to be torn off." What will happen when defense is torn off? For example, when a certain external stimulus penetrates into someone who has withdrawn to him/herself, we can assume that an adult will get angry, and a child will cry. Each of these reactions is "affective incontinence." An individual's personality, which has kept calm, changes into a personality that gets angry or begins to cry in response to the external stimulus. Affective incontinence is also attended with a change in personality. Some might seldom use this concept of affective incontinence, even if they find dissociation difficult to define. However, affective incontinence is just a psychic phenomenon that most people hold in common, because most have naturally experienced affective incontinence during childhood. Only tearing off a defense generates a change of personality. Therefore, it is doubtful whether an exaggerated definition of dissociation mentioned above is appropriate. The importance of affective incontinence is mentioned in The Integration Theory of Psychoanalysis through the psychodynamics of a "drinker's eccentricity," (i.e., a vicious drinker or a maudlin drinker).

  I once again consulted the dictionary for the definition of dissociation. I found a scientific analogy: one molecule is separated into its elemental atoms, an atomic group or another molecule, and its resolution is reversible. The "reversible" part is the point. From this viewpoint, I'm afraid that the definition mentioned above shows only one-way of passing "defense←trauma." Some might be set against this idea by showing the phenomenon (i.e., flashback), and suggest that the converse is also present. However, a flashback is not always generated. In my opinion, this is a farfetched explanation. I think that it is quite easier for us to understand the psychodynamics due to the following explanation: "defense⇔affective incontinence" or "defense⇔dissociation." My thoughts originate in "affective incontinence=dissociation." I defined dissociation in this way (at my own discretion) and went ahead with my study of dissociative disorders. This help us better understand dissociation. It might be hard for you to understand my ideas because I have presented various phenomena without providing sufficient background. Precisely speaking, affective incontinence is generated through stimulating the motor system by the self-displeasing factors. The emotional experience that manifests right before stimulating the motor system is what I argue as dissociation. However, I provided "dissociation=affective incontinence" for clearer understanding.


                                                                        Theory of dissociation

Location of dissociative disorders

  When dissociation is defined as "affective incontinence=dissociation" or "defense⇔dissociation," we observe that several psychic phenomena occur based on dissociation, and dissociation does not always form the following pathway, "dissociation→dissociative disorders." This idea is more practical than the conventional definition of dissociation for dealing with clinical cases. I present psychic phenomena occurring based on dissociation into following five groups.

  ① No symptoms
  Even if dissociation occurs, an individual does not present with symptoms when dissociation can be promptly defended or regulated.

  ② A cluster of symptoms centering on anxiety
  Dissociation lies behind a series of symptoms belonging to neurosis, which contains anxiety, hypochondria, somatization involving hysteria, phobia, etc. I have already mentioned that "anxiety is nothing more than dissociation." Many readers might not quickly understand this concept. You might consider these symptoms as the premonitory states of affective incontinence. If dissociation occurs, an individual presents with symptoms centering on anxiety when dissociation can be partially defended or regulated.

  ③ Withdrawal
  Even if dissociation occurs, an individual returns to a state of withdrawal when dissociation is exhaustively defended. When some people experience displeasure (they are hurt) in ordinary, daily life, they can rest after going home and withdraw into themselves. They can pass the next day as if nothing has happened. We find that several people can live their lives without changing their personalities or individualities. Several neural transmissions (already introduced) begin with withdrawal (defense) as the origin.

  ④ Dissociative disorders
  The main symptoms of dissociative disorders are dissociative identity disorder (i.e., multiple personality disorder). Amnesia,fugue, harming self or object, and criminal activities are partial symptoms. Depersonalization does not belong to dissociative disorders. The "dissociative type of self-consciousness" characterizes dissociative disorders. This self-consciousness is generated in conformity with the "dissociative cycle." This will be mentioned later.

  ⑤ Affective incontinence
  Dissociation occurs, and nothing corresponds to cases ① to ④ mentioned above; this leads to the occurrence of affective incontinence. Affective incontinence is observed most prominently in children, and it is easily generated in schizophrenia. Therapists usually observe affective incontinence in schizophrenia. Affective incontinence hardly occurs in manic-depressive disorders because the self-defensive factor (the ideal self) has immense power in manic-depressive disorders. The concept of "defensive fluidity" is shown in The Integration Theory of Psychoanalysis. This concept was derived from the observation of affective incontinence in psychoses.


                                                                            Theory of dissociation

My theory on dissociation and dissociative disorders

  I developed my original dissociation theory based on the origins mentioned above. Readers would find it hard to accept my theory outlined in the Integration Theory of Psychoanalysis if they accepted the conventional definition of dissociation. When a textbook (psychiatry) definition of dissociation is used, dissociation is linked directly with dissociative disorders. However, according to this definition, only a part of dissociation represents dissociation. Dissociation is a psychic phenomenon that has much more breadth. This leads to a situation that a psychic phenomenon referred to as dissociation is deprived of its freedom. Thus, we have to generate the trauma-defense model, which opposes and matches the anxiety-defense model. It is doubtful that a mere Freudian definition can survive this weeding-out process over many years. The establishment of new psychiatry and new psychoanalysis, including both the anxiety-defense model and trauma-defense model is highly important. Therefore, I outline the psychodynamics on defense and regulation, including the breadth of dissociation.

  I presented an abstract of important areas related to dissociation in the Integration Theory of Psychoanalysis. I selected five items. Each item indicates that dissociation forms the core of the Integration Theory of Psychoanalysis.

  ① Two kinds of self-displeasing factors
  Two kinds of self-displeasing factors are the bad self and weak self. The control of the two (by the object-regulatory factors) is key during radical treatment of any disorder (functional mental disorders). Several patients experience (more or less) affective incontinence prior to the advent of emotional control. A cure might be close at hand when a patient's affective incontinence is under control.

  ② The equality of defense and dissociation
  Emotional control within humans works based on two kinds of pleasure-displeasure principles. These principles' neural transmissions are expressed as follows: "defensive factor←displeasing factor," and "defensive factor→displeasing factor→regulatory factor." The combination of both is expressed as "defensive factor⇔displeasing factor→regulatory factor." It is possible to rewrite this transmission as follows: "defense⇔dissociation→regulation."

  ③ Self-dissociation and object-dissociation
  Dissociation occurs not only within the self (representation) but also within the object (representation). Self-dissociation produces the fragmented self, and object-dissociation produces the divided object. Affective incontinence is generated in self-dissociation, and affective incontinence corresponds to the fragmented self. Affective incontinence, which is caused by repeated psychic trauma, leads to the fragmented selves. The accumulation of these experiences forms the origin of multiple personality disorder (dissociative identity disorders).

  ④ Natural leakage and forced leakage
  The concept of psychic trauma usually impoverishes a consideration of dissociation. The more I examined the nature of psychic trauma, the more I was bothered with its frequency or intensity. This concept defied pigeonholing and threw me into a chaotic process where other concepts also defied easy categorization. I finally discovered the concepts of "natural leakage" and "forced leakage." The content (especially intensity) of psychic trauma is important; it is also important to what extent an individual can control psychic trauma. Natural leakage and forced leakage are concepts that include and categorize both of these points. Leaving the details to The Integration Theory of Psychoanalysis, the case where dissociation (self-dissociation) is natural leakage leads to the occurrence of symptoms centering on anxiety (because the displeasure-regulation system works inefficiently). The case where dissociation (self-dissociation) is forced leakage leads to the occurrence of affective incontinence and dissociative disorders (because the displeasure-regulation system is nearly ineffective).

  ⑤ The dissociative type of self-consciousness
  The dissociative type of self-consciousness characterizes dissociative disorders. In order to grasp the dissociative type of self-consciousness, it is necessary to first understand the relation between consciousness and self-consciousness, and then the regulatory type of self-consciousness and the defensive type of self-consciousness. Regarding the dissociative type of self-consciousness, the fundamental rule, which is shuttle movements between the regulatory type of self-consciousness and the defensive type of self-consciousness, is observed as follows: the regulatory type of self-consciousness changes into the defensive type of self-consciousness and the defensive type of self-consciousness changes into the regulatory type of self-consciousness. This enables the formation of mechanisms related to a series of symptoms that are observed in dissociative disorders. See The Integration Theory of Psychoanalysis for further details.


                                                                         Theory of dissociation
 

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