How we see the world, depend on our categories
Dissociation is a complex theory that is based on basic research and knowledge gathered from philosophers and theories from different disciplines. Sometimes we forget that everything we experience in the world, is a construct created by ourselves. I can give a little example of this from my personal experiences. Before I had my own car (a little opel corsa) I did often not “see” other cars as anything else than a vehicle who takes me from A to B. After I bought the car, I suddenly started to notice new things: I saw many other cars of the same type, and it almost seemed like the world was filled with little corsas. This does not mean that it was more Corsa`s there after I bought my car, just that I did not attend to the fact before. The “outer” world is still the same, but my world has suddenly changed.
Understanding in psychiatry
We also experience this in psychiatry. Where a doctor might see bipolar disorder, a psychiatrist might see the same symptoms as AD/HD, and therefore notice other things than the doctor might do. This will also shape how one tries to “treat” the same patient. Where one doctor might give them lithium for bipolar disorder, a psychiatrist who interpret it as AD/HD will maybe prescribe Ritalin. In fact, this happens all the time. Some patients have been given every diagnosis possible, but still not feel better. When I work, I feel that no matter if a person has bipolar disorder, AD/HD, dissociation they still need much of the same: The need to be whatever they are. I find one of psychoterapists main goal must be to help patients to live more in accordance with their impulses. In fact, many schizophrenic patients, still live with voices in their heads even on medicine, but they don`t feel bothered by it anymore. The same thing happens (hears voices), but since it is “okay” it doesn`t evoke a feeling of guilt and shame when it occurs.
The dissociation model as a tool in psychiatry
For me the dissociation-model has been meaningful in my work. I often see dissociation where others might see bipolar disorder or AD/HD. I am not against medicine, since I think it can be an important supplement IF the person taking them, believe it is necessary. Right now I am on a two-day course with Ellert Nijenhuis, who has written “the haunted self”. This book was one of the first dissociation books I read, and I immidiately found the theory meaningful. To sit here and actually hear him talk about his theories is very interesting. Right now he is talking about the background for the theory, and I will focus on some of those thoughts in the following paragraph
Aristoteles four causes as a background for understanding dissociation
- A change or movement’s material cause is the aspect of the change or movement which is determined by the material which the moving or changing things are made of. For a table, that might be wood; for a statue, that might be bronze or marble. Where the organization IS
- A change or movement’s formal cause is a change or movement caused by the arrangement, shape or appearance of the thing changing or moving. Aristotle says for example that the ratio 2:1, and number in general, is the cause of the octave. The structural dissociation of the personality, what we need to know about is there
- A change or movement’s efficient or moving cause refers to things apart from the thing being changed or moved, which interact so as to be an agency of the change or movement. For example, the efficient cause of a table is a carpenter, or a person working as one, and according to Aristotle the efficient cause of a boy is a father. It needs to be organized
- An event’s final cause is the aim or purpose being served by it. That for the sake of which a thing is what it is. For a seed, it might be an adult plant. For a sailboat, it might be sailing. For a ball at the top of a ramp, it might be coming to rest at the bottom. The most important, that explains the reason for the structural dissocation? The “I want” part. Spinoza: Everything that exist, wants to continue to exist. Why? We don`t know. It can be very frightening to think there is NO reason for living, and it can be easier to think that there must be something more, like a God. In the tv-show “All in the family” there is a episode where “Archie” sees God, as a negro Woman. He is shocked and in Awe. He says “I am sorry, I did not know that”. He did not really believe in God, but since he had no other way to regulate his feelings of uncertainty at that time, to keep his self-esteem alive, he sought something “outerwordly” that might give meaning.
- Nietzche thoughts about consciousness and it`s relation to dissociation
Nietzche talked about our inner “needs”. One of those were the will to power. We have an inner need to control. He thought this underlying need was unconscious, that means that we did not always register that we had to feel in control. This is meaningful for every person who has at one time or another not understood WHY it is so important for them to not “loose” an argument. Have you ever experienced to have a argument with somebody you know, and finding yourself protesting against things you are not really against? Afterwards you might think: Why did I do that? I did not really mean to say those things. Why do we not want to be the first person that says “I`m sorry”, even when we as grown-ups see that it would be better to lay down the sword? In fact, this can sometimes lead to unneccessary powerstruggles in the outer world. The Cuba Crisis was one example of this. Being the first person to withdraw, left you vulnerable for attack. If it withdrawing first hadn`t been done by USA, the outcome might have been very different.
Neuroscience and dissociaiton
Panksepp, an neuroscientist interested in the unconscious mind, has studied the brain, and found that there are truly active areas in the brain, that we do not “register” in consciousness even if some other part of the brain has done so. The vagus nerve is the part of our nervous system that mediates the parasympathic and sympathic nerve-system. The ventral part of the vagus-nerve has become specialized in regulation social relationships. Those systems are complex, and will be written about elsewhere, but the point is that neuroscience can explain why we do certain things: Like defend ourselves. Normally we approach people close to us, but when a person has experiences trauma, confusion often develops, between the system that wants to approach (like our natural system would) and the system who wants to escape or “fight” to survive. To manage this confusion, a solution can be to dissociation these systems from each other. It keeps the conflict “away” so that the person can “appear normal (ANP: Apparent normal personality).
- Sidran: Help for Post Traumatic Stress (PTSD) and dissociation.
- Affective Neuroscience