The understanding of what constitutes ‘dissociation’ and how it might be defined has changed ample times over the last three centuries. Indubitably we could refer to it as one of the most elusive conceptual shape-shifters in the history of dynamic psychiatry, as volatile as liquid mercury coursing through our mercury-in-glass thermometers. An even greater mystery is human consciousness, the concept with which it is intimately bound. Ever since its inception the latter has been transposed with an agglomeration of other terms like ego, mind, psyche, and self; hence for the sake of conceptual clarity, I will utilize the terms ‘consciousness’ and ‘personality’ when referring to the stream of conscious awareness constellated by thought, memory, and a sense of self. Normally this state exhibits a fierce resistance to disintegration. This allows it to be categorized under an exclusive group comprising units of measurement that are fundamental in the natural world like quanta of energy; subatomic particles like electrons; and cells, the building blocks of life. Searle (1997) provides a most commanding expression of this quality in his description of consciousness:
“It is supposed to be frightfully difficult to define the term [consciousness]. But if we distinguished between analytical definitions, which aim to analyse the underlying essence of a phenomenon, and common-sense definitions, which just identify what we are talking about, it does not seem to me all difficult to give a common-sense definition of the term: ‘consciousness’ refers to these states of sentience and awareness that typically begin when we awake from a dreamless sleep and continue until we go to sleep again, or fall into a coma, or die, or otherwise become ‘unconscious’. Dreams are a form of consciousness, though of course quite different from full waking states (pg. 5).”
Before the eighteenth century the continuum of phenomena that comprise dissociation by contemporary standards was branded demoniacal possession by the Catholic Church. That perception gradually altered with the inauguration of animal magnetism under Franz Anton Mesmer (1734-1815) and the subsequent investigations into hypnosis executed by one of his most faithful disciples, Amand-Marie-Jacques de Chestenet, Marquis de Puységur (1751-1825). The term hypnosis wasn’t coined until 1843, however the alterations in consciousness witnessed whilst magnetizing patients convinced Puységur that the phenomenon in question revealed a fragmentation of sorts, a transitory bifurcation that caused an aspect of an otherwise unified stream to lapse into unconsciousness. Initially these curious changes to the inner psychic configuration were comprehensible only in terms of artificial somnambulism, a notion that inexorably imbued hypnotism with scientific credibility.
It was left to the great experimental psychologist Pierre Janet (1859-1947) to horde in the next evolutionary development by surmising that dissociation, or ‘desegregation’ as he called it, could be spawned both voluntarily and involuntarily. Janet posited that the unprompted variety were in fact subpersonalities composed of trauma-avoidant or trauma-fixated memories, emotions, and behaviors that had manifested under the immense duress of traumatic phenomena and of which the authentic personality remained unaware. Barring psychotherapeutic intervention, the trauma-induced, multi-streamed system of consciousness, or ‘split’ personality if you like, would continue operating until internal or external stressors effected a provisional alteration from one disenfranchised stream to another. Even though there was never unanimous agreement amongst Janet’s contemporaries regarding his philosophical grounding, nobody can deny the fact that the said model was succinct with phenomenological parameters that orientated dissociation stringently within a psychopathological milieu; from this perspective dissociation and its accompanying phenomena was a by-product of an atypical, unwarranted splitting of consciousness. Comprised wholly of somatoform and psychoform symptoms, the ‘pain’ repositories formed could be accessed voluntarily through hypnotic regression or alternatively witnessed through more noninvasive and subtle means, for instance lamentable lapses into hysterical neuroses. Originally, then, the term dissociation was utilized to describe rudimentary changes in the substructure of the unified personality and the posttraumatic occurant states that ensued as a result.
Three important developments heralded by the twentieth century wrought a modification of conceptual frontiers, enabling nonclinical breakdowns to enter a dissociative arena that had until then been exclusively reserved for pathological expressions. Firstly there was an experimental explosion into altered states of consciousness through hypnosis, psychedelic drugs, and meditative states where the latter came to be perceived as an exemplar par excellence of the dissociative state. Secondly the Diagnostic and Statistical Manuel of Mental Disorders (DSM) initiated changes to the phenomenological compartmentalization of psychiatric illnesses that resulted in an impertinent shift from aetiological to symptomological concerns, or am emphasis of integrative dysfunction over and above dissociative causation. The diagnostic criterion utilized by surveys such as the Diagnostic Experiences Scale (DES) and the Multiscale Dissociative Inventory (MDI) in appraising whether an individual is experiencing dissociation or not definitely substantiates this viewpoint. Thirdly the numinous, emergent school of Freudian psychoanalysis that inherited scientific positivism and Darwinism recast the entire phenomenon under a much less stringent framework, incidentally that of conscious repression where dissociative states corresponded to defence mechanisms set in motion by an ego vying to safeguard the individual from trauma. Together, these conceptual alterations allowed such a heterogeneous assortment of psychic phenomena like hypnotic trance states, daydreams, and pathological derivatives like posttraumatic personality substructures to be congregated under the same heading. Despite these dire impediments to theoretical lucidity, the broader conceptualization of the term remains in vogue within experimental and clinical circles today.