The continuity of experience, memory, and identity is an accomplishment. The complexity of mental processing requires that most of it occur out of consciousness, making it possible if not probable that certain perceptions and memories may seem dis-integrated. The phenomena of dissociation have themselves been dissociated from the mainstream of psychiatry and psychiatric theory despite origins at the heart of early psychiatric and psychological thought. William James, Boris Sidis, Morton Prince, Joseph Breuer, Sigmund Freud, and Pierre Janet based their diverse but influential theories of psychological functioning in large measure on their observations of dissociation and its effects. Despite this history, the phenomenon has been viewed as something of an oddity in psychiatry, causing many to doubt the validity of the disorders.
Dissociation is here to stay.
The chapters that follow indicate that there is a growing body of clinical observation and research documenting the prevalence, phenomenology, psychophysiology, and treatment of dissociation. Dr. Putnam reviews the phenomenology of dissociation, underscoring the fact that dissociation is a normal as well as a pathological phenomenon. Dr. Kluft skillfully reviews the rapidly growing literature on multiple personality disorder, distilling what is known about the etiology of this rare and intriguing disorder in summarizing the principles of treatment, with emphasis on using various techniques to access and integrate these dissociated mental states in the context of working through traumatic memories. Dr. Lowenstein systematically reviews the literature on psychogenic fugue and amnesia, examining the combination of memory loss for specific episodes with evidence of availability of such memories that is at the heart of the dissociative process. Dr. Steinberg provides a review of new work in the systematic assessment of depersonalization.