Grand angle : le concept de dissociation de Janet à aujourd’hui, dérive et écueil

Abstract

The studies of the ancient magnetisers had been reintegrated into medicine by Charcot, whose theory of hysteria was inspiring to Janet. At the end of the 19th century, Janet elaborates the first rigorous modelling of the dissociative trouble, with its traumatic origin (Janet, 1889). Janet indicates the aetiology, symptoms and some hints about the treatment, the most famous one being what he calls hypnosis. For Janet, the core notion of dissociative trouble is intimately twinned with a kind of amnesia. His model quickly earns international recognition. Soon it inspires new studies that are going to be prominent in the 20th century psychiatry, for instance the works on schizophrenia (Bleuler, 1911), those of Freud and Breuer, as well as the studies of Jung, who knew Janet personally. In spite of this promising beginning, the concept of dissociation gradually changed its original meaning. In particular, dissociation lost the properties that Janet regarded as central to its definition, amnesia being the main one. Within a few decades, dissociation changed into an alteration of consciousness on a continuum of normal–pathological states. This new conception of the dissociative trouble may cause some misleadings in the diagnostic and what is more in the patients’ treatment. Some clinicians (Van der Hart et al., 2010) are trying to give clarity back to the modern concept of dissociation, promoting the reading of Janet's works: the modelling of structural dissociation aims at this goal.