When disorder formation is discussed, it is important that disorder formation is clearly separated from symptom formation. Some might be surprised to know that many groups of disorders, which belong to conventional psychiatry (psychoanalysis), are included into symptom clusters　in my new theory. Here, it should be understood that there is a distinct principle related to disorder formation. In other words, disorder formation is the presence of undifferentiated diapleasing factors and the direction of pathological identification based on temperaments.

  First, various groups of disorders are classified into psychoses, pathological states (pathological states of the aggressive system and pathological states of the fragile system) and defensive states (defensive states of the aggressive system and defensive states of the fragile system), by the presence of  undifferentiated displeasing factors (see Type Ⅰ~Ⅳ of basic model in figure 1: The basic model of mental structure). 

  Next, psychoses are classified into schizophrenia and manic-depressive disorders by the defensive fluidity based on temperaments. Pathological states of the aggressive system is classified into borderline, histrionic, antisocial, and obsessive-abortive personality disorders. Pathological states of the fragile system is classified into schizoid, schizotypal, paranoid, and passive-aggressive personality disorders. Both pathological subtypes are classified by the defensive fluidity and the direction of pathological identification. Defensive states are classified by the direction of pathological identification rather than by the type of conflict. Defensive states of the aggressive system is classified into irritable, obsessive-compulsive, avoidant, and hysterical personality disorders. Defensive states of the fragile system is classified into narcissistic and dependent personality disorders. These comprise the whole of the groups of disorders.

  The cause and the radical treatment for each group of disorders will be discussed and summarized. There is content with a few differences, among the groups of disorders, which are classified into a specific category based on the diagnostic criterion mentioned above. This classification allows us to better understand what is similar or different concerning aspects researched regarding conventional groups of disorders. Therefore, even if aspects within certain groups of disorders are classified based on new criteria and their causes and treatments are quite similar, they will be presented repeatedly without omission. Consequently, it is possile to understand subtle differences among groups
of disorders.


                                                                                Disorder Formation (Ⅰ)

  I have discussed the causes of psychoses in several parts of this book. Psychoses have been referred to as "insanity," and patients with psychoses have been called the "insane," until recently. Hereafter, I will express psychoses as the "defect of forgiveness and help," and patients with psychoses as the "people suffering from the defect of emotional control." Causes and systematized radical treatments of psychoses will be introduced separately. Here, I will mention a little about how I could elucidate psychoses.

  When I became psychiatrist, I thought that the mental affliction of an individual originated in the poor management of displeasing emotions (affects). After gaining clinical experiences, I gained confidence in asserting that our displeasing emotions could be clarified into two categories. Although I had struggled with treatments for borderline cases, I found that the relationships to forgive and to be forgiven was formed very distinctly when examining the therapeutic relationships within cases showing improvement. Within these relationships, patients and I commonly experienced anger while apologizing. This discovery is referred to as the "double identification." This discovery is composed of rebellion and apology through analyzing this double identification in detail, and I began to elucidate the psychodynamics of forgiveness.

  There was another theme that I felt incompletion even though I had developed the elucidation of forgiveness. This related to research on narcissism. I had generally studied Kohut's theory, but I could not understand the practicality of his theory. I continued to think that there might be some problems with his theory, because I was filled with the feeling of imperfection whenever I used it. However, my feeling of imperfection was wiped out by silence observed with severe withdrawal patients and their responses to my embarrassment. In other words, I noticed a strange treatment development, filled with silence when I did not waver but progressed when I was confused. This led to the "discovery of the weak object." Afterwards, I elucidated the psycho-dynamics of expectation and became aware of limitations in Kohut's theory. This also helped me elucidate the psychodynamics of help.

  These two discoveries brought with them two new developments. One was a comparison with brain research. I found out that the opinion on constancy in self stimulating behaviors (in the brain) and the neural transmissions models coincided with characteristics of psychodynamics in forgiveness and help. Another development was the discovery concerning the inevitability of the following combination: two kinds of displeasing emotions (which I had already identified) and two kinds of regulation systems (forgiveness and help which are placed as regulation). The displeasing factors, which have the traits of diffusion to others and the traits of convergence to self, indicate the double contrast characteristics of their traits). I noticed that views of cognition and recognition on two kinds of displeasing emotions were the boundary of normality and abnormality of mind. I proceeded to elucidate the causes of psychoses based on this typology.


                                                                               Disorder formation (Ⅰ)
 
 

  I mentioned frankly my observations during my clinical experiences in the paragraph titled, "The pain in the interruption of treatments," in Part 3: Case study, The Integration Theory of Psychoanalysis. I had elucidated the causes of psychoses, but I still experienced interruption of treatment. I was occasionally frustrated, wondering, "Why? What's wrong?" I was under the assumption that patients' families would take part in, and cooperate with my radical treatments. It took more than ten years before I discovered that the premise of my treatment was unreasonable. When I realized that the source of interruption of treatments was within the avoidance and conceit of patients' families, I gradually came to the conclusion that I could not cure patients by myself. Some patients had also suggested this. When I thought that two therapists should treat a single patient simultaneously and separately, I had already finished two works, "The formulation of the radical treatments of psychoses" and "The concrete formulation of the radical treatments of psychoses."  Looking back upon my clinical experiences, I confronted my limitations when I discovered the weak object. I also confronted the situation, "I could not do," when I enabled this formulation. I thought that I was not rewarded even if I had made unimaginable efforts. Such thought provided great truth.


                                                                                 Disorder formation (Ⅰ)