In contrast, self-disturbance in schizophrenia has been studied and
discussed throughout the history of modern psychiatry. Recently it is often
discussed also in the context of“ipseity disturbance”
Sass, LA (2013)
self-disturbance and schizophrenia: structure, specificity, pathogenesis.
Association Recherches en psychanalyse 16;119-132.
The self-disturbances in
schizophrenia is far more distinct and severe. Take for example a schizophrenic
person, Mr. A who observes a man walking on a street, noticing another
pedestrian, a stranger approaching him from
a different direction.. Suddenly a voice in his head says “He is an enemy. He
will attack you!” Mr. A immediately takes an offense for that person as the voice
is his own thought. This type of hearing voice often referred to as “command
hallucination” characterizes the nature of the self-disturbance of schizophrenics,
where the individual experiences the voice of someone as though that someone is
almost seamlessly merged with himself. This condition might instantly meet the
criterial of the self-disturbance in four domains delineated by Jaspers.
Neurological basis of dissociative
symptoms
The difficult problem that we
are facing, as to whether we should understand personalities in DID as
independent individual or “partial” or “incomplete” might be easier to handle
if there is any neurological basis or “neural correlate” of these
personalities. If a personality A happens to be “located” in the right
hemisphere whereas the personality B resides in the left hemisphere, without
any overlapping area or communication between them, we could assume that they
are different and independent consciousnesses. However, no study has so far indicated
that each personality has its distinct localization. The author would still
make a case that so-called “split-brain experiment” (Gazzaniga,et al) , indicates
something akin to the multiplicity of the personalities in different location
in the brain, I will save this topic for any future opportunity for further
elaboration.)
In the past I approached this issue with the concept of
dynamic core model proposed by Edelman and Tononi.
In this article, I discuss
what I call ‘‘the problem of otherness’’ in dissociative identity disorder,
which addresses the extent to which we validate and recognize the perception of
otherness in each part of personality (PP) regarding other PPs. The general
trend is considered to not fully validate it, which seems to stem from the era
of the Freud–Janet controversy, partly due to the conceptual ambiguity of the
splitting of the mind in the sense of division vs. multiplication.
Consequently, we tend to consider dissociation as a defensive and intentional
act, at least when it was initiated, with an understanding that PPs are not
structurally separated from each other, but are rather internally and
dynamically connected to each other, and that a PP is somewhat causative to and
responsible for another PP’s thoughts and behaviors. Here, I consider the
hypothetical neuro-cognitive model that is based on the ‘‘dynamic core’’ model
proposed by G. Edelman, where the neurological correlate of dissociative
identity disorder is conceived as a simultaneous and multiple existence of a
‘‘dynamic core’’, which
represents each PP as a unique and wholesome existence in the conscious.
Okano (2019) Problem of ‘‘otherness’’ in dissociative
disorder European Journal of Trauma and Dissociation
