Dissociation and the Dissociative Disorders: DSM-V and Beyond

Dissociation and the Dissociative Disorders: DSM-V and Beyond

Dissociation and the Dissociative Disorders: DSM-V and Beyond

Dissociation and the Dissociative Disorders: DSM-V and Beyond

Synopsis

This volume integrates recent scientific and conceptual foundations of dissociation and the dissociative disorders field, defines and establishes the boundaries of current knowledge in the field, identifies the field's current points of confusion, gaps in knowledge and conjectures and sets forth a research agenda for the future.

Excerpt

In this book, dissociation is introduced historically and conceptually (Part I); its origins in the early developmental phases of childhood are explored (Part II); its normal and exceptional expression is delineated (Part III); the circumstances of its acute manifestation are debated (Part IV); its manifestation, structure, and mechanisms, both acute (Part IV) and chronic (Part V) are discussed; and its neurobiology is explored (Part VI). The core DSM-IV Dissociative Disorders are finally dealt with in Part VII, followed by explorations of dissociation in other diagnostic groups, such as PTSD (Part VIII), Borderline Personality Disorder and Substance Dependence (Part IX), and psychosis (Part X). The forensic assessment of dissociation is updated (Part XI). Cutting across all diagnostic categories, various treatment approaches to dissociation are outlined (Part XII). Part XIII concludes by moving from the latest empirical delineation of pathological dissociation to the most pressing outstanding research that remains to be done, and culminates in an extended historical, conceptual, and empirical analysis of dissociation.

PART I. AN OVERVIEW

We begin with historical and philosophical introductions to the field, both of which make strong arguments in favor of particular points of view.

In chapter 1, “History of the Concept of Dissociation,” Onno van der Hart and Martin Dorahy analyze the various definitions and understandings of dissociation—from its origins in the eighteenth century to the current discussions of dissociation in the twenty-first century. Literature from the early years yields twenty-eight different terms or expressions that refer to what we now call dissociation. The story begins with the pioneer theorists, both French (Puységur, Moreau de Tours, Gros Jean, Taine, Charcot, Janet, Binet) and Anglo-American (F. Myers, James, Sidis, Prince), then moves on to discuss the era of World War I (C. S. Myers, Mitchell, McDougall). A step back is then taken to review the dissociative origins of Freud’s thinking, and his break with that tradition, as well as subsequent psychoanalysts who tried to heal the rift (Ferenczi, Fainbairn). The story then jumps forward to the 1970s (Tart, Ludwig, Ellenberger, Wilbur, Hilgard), after which the names become increasingly numerous and familiar. In conclusion, Drs. Van der Hart and Doherty argue that dissociation has tended to be conceptualized narrowly and broadly. They argue forcefully in favor of the narrow conceptualization: dissociation as a division of consciousness, which may be normal (hypnotically-induced) or pathological (trauma-induced). They argue forcefully against the broad conceptualization: dissociation as any breakdown in integrative functioning, regardless of origin.

In chapter 2, “The Conceptual Unity of Dissociation: A Philosophical Argument,” philosopher Stephen Braude extends the philosophical analysis of dissociation that he has been elaborating in his books and articles over the past many years. He opens with a welcome clarification . . .

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