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The Toronto group continues to focus on traumatic and depressive syndromes, applying psychoanalytic and neuroscientific knowledge with the goal of an integrated understanding of the patient. The past few meetings have involved presentations by members of the group focusing on qualitative research, anthropology, and clinical work.
Wendy Tevins presented on “Enigmatic Illness and the Wounded Self: A Qualitative Study of Women with Fibromyalgia and Chronic Fatigue Syndrome.” The effect of economic and social factors in a situation of prolonged stress and trauma threatens the maintenance of self-coherence and meaning. Descriptive diagnostic categories, such as the DSM, do not do justice to the psychological or putative biological concomitants. Multiple etiologies are suggested, including viral infection, reduction of signal to noise, problems with prefrontal gating, loss of useful function, and “falling out of culture.” The life-history approach underlined the alienation and devastating loss. Several case studies were presented. Similarities to multi-infarct dementia and to shamanism, among other phenomena, were noted. It was also commented that there is a lack of in-depth psychoanalytic literature in this area.
Paul Antze presented “An Anthropological Perspective on Multiple Personality Disorder/DID.” He had been asked to lead a group of patients with these diagnoses and had brought his anthropological skills to addressing the arbitrary divisions among biological, social, and cultural descriptive categories. Various cultures were contrasted in terms of the degree of individuality and idioms of distress and illness. Ranges between emotional outburst and extremes of self-control as the norm were contrasted with the special status (including suffering) of the person who dissociates. Diagnostic trends were traced in terms of economic, legal, and political forces.
The group consisted of high-functioning women with careers, many of them the mothers of small children. An integra