Quote from: I like vanilla on September 25, 2015, 03:29:06 AM
Recently, I read an article by a therapist whose client was all flustered and 'overreacting' to a particular situation. The client was fully conscious of where she was and had a discussion with the T about her response to the situation. The T noted the client was 'dissociating' because she was responding to internalized emotional cues rather than the situation at hand. The T reported that the client agreed with that assessment. I do occasionally do that but never thought of it as 'dissociation'.
If that is true, then being human is a dissociative state. If this is where dissociation starts per definition in psychology and psychiatry, psychology and psychiatry are overshooting the mark. I won't be surprised, but I will still think it's ridiculous. Because, regardless of our mental state, we all do that. We all react to events against the backdrop of our previous experience. So we could call all human reaction dissociative, or we could stay reasonable and not call a reaction dissociative if it is proportional to that person's previous experiences with that or similar situations.
Surely people must realise that, if they disagree, then what constitutes dissociation - an internal state - becomes incidental and dependent on external and even coincidental circumstances. Schrödinger's dissociation.
Example, in hopes of triggering as few people as possible:
Let's say you've been in the middle of a natural disaster and experienced the fear and destruction and loss that come with it. It could be anything: a tsunami, a heavy earthquake, a [fill in the blank]. You remember the moments before disaster struck and the warning signs. Let's pick the earthquake. I've never been in one, so I must apologise for a. possible triggers and b. my simplistic concept.
I've heard earthquakes sound like really loud freight trains, excluding for the moment any additional ambient noise from the destruction, like things falling over or buildings collapsing. So, with that experience in your past, you're sitting somewhere and suddenly hear an approaching freight train in the background, one that is running on a rail line that you aren't aware is closeby. You start to react in a way that prepares for the worst: an earthquake. If you're wrong - no harm done. If you're right - so much the better you got out from under that parapet.
Possibility a: It was an earthquake and you reacted quickly and appropriately and survived. No one is going to call you dissociative because of it, but they may thank you later for having reacted to so quickly and warned them through your actions.
Possibility b: It was a freight train and you are seen to have 'overreacted'. Select mental health professionals may choose to call you dissociative.
All other things being equal, there is no shift in the person's mental state between possibility a and possibility b.
To define dissociation without the need for incidental externalities to validate it - or to invalidate the person (ostensibly) experiencing it - I think we will have to use criteria that are not dependent on an incidental outcome.
Are all the people who dislike some thing or other because they mentally connect it with a negative experience dissociating? Dear Flying Spaghetti Monster - all of humanity is dissociative then!! You've disliked chocolate icecream ever since your parents sat you down with a bowl and broke the news to you that your dog had died. You've given up on oil pastels because of the upsetting experience of giving your all to a picture that ended up the star of an exhibition but earned you a failing grade in class and a gratuitous verbal bashing by the teacher in front of everybody.
The icecream, the crayons - most people have at least one of these types of experiences and certain aversions because of them. Those would now have to be considered dissociative, i.e. pathological, if the definition above were correct. That's a bit out there. Contrary to the earthquake example, they're not as rational at first sight: it's unlikely that having chocolate icecream again will result in news of another pet's demise. However, they are indeed connected to that negative experience in the mind, and because they evoke the feelings from that experience, they are avoided in order to avoid the bad feeling. That's actually quite rational, if there's no good reason to relive that feeling at that time.
I'm not convinced, at this time, that defining exactly where dissociation begins and ends has any particular value in recovery. I try to stay or become aware of what I'm doing, internally and externally, and why I'm doing it, but whether it's given a particular name or currently considered pathological or not doesn't really interest me that much if I'm not harming anyone - not least because what's considered pathological can change quite a bit, so I'm not going to put much stock in what side of the mental health barrier this phenomenon or that is currently on.
I do know that definitions are helpful in order to validate personal experiences, sometimes. That's usually when troubles are rationalised away by unsympathetic people around you or society in general. But, in my opinion, psychology and psychiatry have a tendency to pathologise when they're trying to define clearcut boundaries to where good-enough mental health ends and mental illness and disorders begin. Calling conditions what they are isn't so much trouble if you're not so close to the borderline, but with the part I quoted, they're really pushing the envelope. In that context, it's also worth remembering that extending the definition of what constitutes pathology carries financial incentive for health professionals.