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Paul Kiritsis, PsyD Clinical Psychology, DPhil., MA (History)

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The Concept of Dissociation: DSM and Ken Wilber

Paul Kiritsis - Sunday, July 21, 2013

In 1980, the DSM initiated changes to the phenomenological compartmentalization of psychiatric illnesses to reflect clinical and academic perceptions that had been wrought in the last few decades. Foremost was the grouping of somatoform manifestations of dissociation epitomized by conversion forms of hysterical neurosis under Somatoform Disorders. Lumped in with these were a host of new conditions that had never qualified for inclusion under the classical model of dissociation. There was also an impertinent shift from aetiological to symptomological concerns, or an emphasis of integrative dysfunction over and above dissociative causation. The diagnostic criterion utilized by surveys such as the DES and the MDI in appraising whether an individual is experiencing dissociation or not definitely substantiates this viewpoint. Both the DSM and the questionnaires work with the dissociation-association continuum in assessing whether affective, experiential, environmental, and developmental clinical and nonclinical phenomena might be considered dissociative or not, eschewing the phenomenological barrier between pathological and nonpathological forms of dissociation that had been erected in the nineteenth century by Janet.

In light of the historiographical analysis, should we interpret the gradual movement from a narrower categorization of dissociative phenomena with a causal singularity to a much broader one athwart variant psychological origins as evolution in understanding, or is it a theoretical drift? Whatever the case, it cannot be denied that the contemporary model has attracted to itself clinical and experimental ambiguities that must be clarified if it is to be advantageous in future research. Owing to their synonymous nature, certain terms utilized by researchers in the dissociative field like consciousness, alter ego, mind, identity, personality, state, and dissociation require sharper definitions within the dissociation-association continuum, a move that would allow clinical and nonclinical perception of how they all relate to one another to become blatantly clearer. There are also glitches in its developmental correlates, as transpersonal theorist Ken Wilber has pointed out; in the last century the incompetence of most Western schools of psychology in differentiating between personal and transpersonal levels of human development has fostered the erroneous belief that any experience involving the disintegration of ego frontiers is quintessentially pathological. Under such flawed logic transcendental experiences become infantile regressions, meditative states are reduced to noting but self-induced catatonia, and illumination or unio mystica with the divine is demoted to the regressive reliving of intrauterine stages. Wilber termed clinical blunders originating from confusion between the prepersonal and the transpersonal levels the pre-trans fallacy and pioneered an alternative model linking a spectrum of development stages and their respective pathological concerns with specific therapies and treatments in order to circumvent them.

Subsequent developments in these fields will not only clarify dissociation within its much broader contemporary conceptualization, but also exalt and pay homage to an insurmountable wealth of human experience emanating from the same fountainhead of consciousness.

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