Andrew Brown wrote:
>As
for multiple personalities, I’ve decide to proceed on the belief that
this is a psychotic disorder.
Medically, 'psychosis' is used to describe states broadly featuring:
* Delusions and hallucinations
* Disturbances of thought and behaviour
* Lack of insight, i.e. awareness that these delusions / disturbances
are abnormal
Both main diagnostic systems (the ICD-10 and DSM-IV) define psychosis
along these lines, and both have stopped using 'neurosis' at all. The
only instance of it I can find in my copy of Kumar & Clark's
"Clinical Medicine" is a passing reference which is illuminating as to
what the term used to mean and, unusually for a medical textbook,
slightly literary...
"Doctors have historically tended to diagnose 'stress' or
'psychosomatic disorders' in patients with symptoms that they cannot
explain. History is full of such disorders being reclassified as a
research clarifies the pathology. A recent example is writer's cramp
which most neurologists now agree is a dystonia rather than a
neurosis." (chapter 22-4, 6th edition).
As the above suggests, 'neurosis' was originally used to refer to
conditions which were thought to be due to "nerves", but it was adopted
most influentially by Sigmund Freud to refer to the results of
unconscious psychological conflict. As such, it can refer to states
which are within the normal spectrum of human experience, so that
something as simple as anxiety can be said to be a neurosis.
Multiple personality disorder is rather more common in literature than
in reality, and most textbooks would classify it as a dissociative
disorder rather than primarily a psychotic one. If pushed, though, I
suspect it would qualify as a psychosis simply because sufferers
classically are not aware of their other personalities, and so could be
said to lack insight.
Jansy wrote:
>What relationship is there between Freud's original theories ( the
ones VN might have read) and multiple personality disorder? Isn't
hysteria or psychosis enough >to describe delusions or "splits" ?
In Freudian terms, the "splits" would be a coping mechanism for
dissociating one's self from the outside world and distancing oneself
from the physical and emotional pain of a traumatic or
stressful experience. Generally this would be to enable to person to
maintain a relatively normal level of functioning.
Hope this helps,
Nick.