討論の部分の推敲をしていて、いろいろ気になることがある。
Discussion
In this article, I take
a second look at how personalities in DID are conceptualized in modern
psychiatric diagnostic criteria such as DSM-5 and ICD-11 and delineated current
trend of regarding the identities in DID as partial and fragmentary.
Presumably, DID is
characterized as having a disruption of identity (DSM-5,
ICD-11), which is cogently expressed in the name of the “dissociative identity
disorder”, a diagnostic nomenclature which seems to have gained its citizenship
well enough after its first appearance in 1994 (DSM-IV, American Psychiatric
Association). If we trace the way
the diagnostic naming is switched from MPD(multiple personality disorder) to
DID, the rationale for the change was to remind clinicians that personalities
are not whole ones, but parts as result of the failure of integration.
David Spiegel, who
chaired the committee for dissociative disorder spoke the rationale with a
pejorative tone, as follows: “People with this disorder do not have more than one personality
but rather less than one personality. (The name was changed recently from
‘multiple personality disorder’ to ‘dissociative identity disorder.’) “
Spiegel, D expert
Q&A: dissociative disorders American Psychiatric Association https://www.psychiatry.org/patients-families/dissociative-disorders/expert-q-and-a
改めて思うことだが、1994年に発表されたDSM-IVで、MPDからDIDに変わった時、実は大きな意識の変化があったのだが、このことを今日まで十分把握していなかった。つまり多重人格障害（MPD）に示唆された「人格が沢山ある」という表現は誤解を招くという。DSMの解離部会の委員長だったDavid Spiegel はこんなことを言っていた。私はこれまでシュピーゲル先生を尊敬していたが、これはひどすぎる。
「彼らはたくさんの人格を持つことが問題ではない。一つも【正常な】人格を持てないことだ。」
私はこれに断固反対したい。これほどDIDの患者さんを誤解した文章はないだろう。
I proposed that this
view is not altogether consistent with their clinical manifestations and
proposed an alternative way of looking at these personalities has having their
sense of self on their own, furnished with all its component delineated by
Japers.
