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Dissociation: a valid concept?

Published online by Cambridge University Press:  02 January 2018

Remy Aquarone
Remy Aquarone*
Affiliation:
European Society for Trauma and Dissociation. Email: [email protected]
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Abstract

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The British Journal of Psychiatry , Volume 200 , Issue 2 , February 2012 , pp. 163 - 164
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Copyright © 2012 The Royal College of Psychiatrists 

I was saddened by Harold Merskey's review of the second edition of Attachment, Trauma and Multiplicity: Working with Dissociative Identity Disorder (edited by Valerie Sinason). Reference Mersky1 My sadness was not primarily caused by his critical assessment of some of the material presented, but by his inference that dissociative identity disorder and dissociative disorders in general do not exist. Anyone unfamiliar with dissociative disorders reading his comments would be forgiven for being persuaded of this. Dissociative disorders have been recognised in both DSM-IV and ICD-10 for some 25 years now. Yet among psychiatrists in particular, they continue to be denied or misdiagnosed, causing serious re-traumatisation for a significant number of patients.

Merskey writes of the absence of ‘critical statement[s] by a professional society’, but fails to cite the acknowledged leaders in the field, the International Society for the Study of Trauma and Dissociation (ISSTD; www.isst-d.org) and the European Society for Trauma and Dissociation (ESTD; www.estd.org). The ISSTD includes among its members a number of eminent psychiatrists and psychologists and it has produced extensive online guidelines on treatment. The charity First Person Plural, in association with the ESTD and Cheshire & Wirral Partnership NHS Foundation Trust, has produced a training and information DVD. 2

Furthermore, the National Institute for Health and Clinical Excellence's guidelines accept the existence of dissociative disorders. It has not yet produced a treatment protocol for this condition and recommends that clinicians follow the guidelines of the best informed organisation (www.isst-d.org/education/treatmentguidelines-index.htm).

It should be noted that many psychiatric services and community mental health teams across the country are now implementing treatment protocols for dissociative identity disorder and dissociative disorders that are not only effecting significant changes for patients but are also bringing about cost savings for services. Reference Lloyd3

Footnotes

Declaration of interest

R.A. is President of the European Society for Trauma and Dissociation.

References

1 Mersky, H. Book review: Attachment, Trauma and Multiplicity: Working with Dissociative Identity Disorder . Br J Psychiatry 2011; 199: 347–8.Google Scholar
2 First Person Plural. A Logical Way of Being: The Reality of Dissociative Identity Disorder and Other Complex Dissociative Conditions (DVD). FPP (http://www.firstpersonplural.org.uk).Google Scholar
3 Lloyd, M. How investing in therapeutic services provides a clinical cost saving in the long term. Health Serv J 2011; 1 Sept.Google Scholar
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