2020年8月12日水曜日

ミラーニューロンと解離 18

Disturbance of the sense of self in DID reconsidered

Do personalities of DID have any serious disturbance of the sense of self? Let us take a flesh look at this issue from a standpoint of psychiatric symptomatically.

Jaspers, K., Hoenig, J., & Hamilton, M. W. (1997). trans. General psychopathology. London: John Hopkins University Press.

 Karl Jaspers, Hoenig, & Hamilton (1997/1913) delineated the basic sense of self into four domains; living as a self-present, single, temporally persistent, and bodily and demarcated (bounded) subject of experience and action. Jaspers indicated that, in schizophrenia, there are serious disturbances among these domains. In contrast, each PP in individuals with DID would not manifest disturbances among any of them.

Consider the clinical example discussed above. In reference to the sense of self-presence, it is certain that A and B are going through their own experiences without any sense of intrusion. It is because of her intact sense of agency that A feels vexed with complaint of B who resents A’s behavior. Their sense of agency enables A and B to assert herself/himself and attempt to protect her and his own interest around the third party C. As for their sense of singleness, certainly, A and B feel that they are on their own and C feels that she needs to treat A and B separately and independently. As regards to their sense of temporal continuity, A would still claim that, even if she is amnestic about events that occurred while B is out and active, she could provide an ‘‘alibi’’ for herself, such as that she was gone or asleep and therefore she has nothing to do with B’s deeds. B himself would maintain his own temporal continuity, stating that he was “there” watching the interaction between A and C “from inside” at least during the time that he is not “asleep”. The sense of demarcation of A and B certainly exists although B himself has a peculiarly distorted sense of his own body as he is not aware that he is “very big” as a five year old boy and tries to snuggle up to C’s lap, each time literally knocking her away with his adult body size. Although A does not feel that B is inside or out side of her body or anywhere else, B feels that he is outside of A and C interacting each other and observe them with frustration and resentment.