Dissociative Disorders
What are the dissociative disorders?
These are Characterized by persistent, maladaptive disruptions in the integration of memory, consciousness and identity.
Person with a dissociative disorders may be
- Unable to remember many details about the past
- He or she may wander far from home and perhaps assume a new identity.
- Two or more personalities may coexist within the same person
· In the past Dissociative Disorders were viewed as expressions of hysteria.
Greek, hysteria means “uterus,” and the term hysteria reflects ancient speculation that these disorders were caused by frustrated sexual desires, particularly the desire to have a baby.
·
Janet and Freud were eager to
explain and treat hysteria.
What are the symptoms of Dissociative Disorders?
- Depersonalization is a form of dissociation wherein people feel detached from themselves or their social or physical environment
- Amnesia—the partial or complete loss of recall for particular events or for a particular period of time.
- Effected person feels he is disconnected from himself and the world around him.
- Effected person forget about certain time periods, events and personal information
- Effected person has multiple distinct identities or Personalities.
- Person feels little or no physical pain.
- Dissociative disorders typically involve disruption of identity, dissociative amnesia can involve loss of memory without loss of identity.
Diagnosis
of Dissociative Disorders
·
Descriptive approach to classification introduced in DSM-III
(1980) led to the
separation of dissociative and somatoform disorders into discrete diagnostic
categories.
The distinction is preserved in DSM-IV-TR (2000), because the symptoms of the two disorders
differ greatly.
Types of Dissociative
Disorders
There are generally five types of dissociative disorders.
- Dissociative amnesia
- Dissociative fugue
- Dissociative identity disorder
- Depersonalized disorder
- Derealization disorder
1- Dissociative Amnesia symptoms
Forgetfulness is not yet the same as memory loss
The person with memory loss is unable to recall important personal information too extensive to be viewed in terms of forgetfulness.
In dissociative (psychogenic)
amnesia, the memory system is not physically damage yet there is selective psychologically motivated
forgetting
Often, what has been forgotten is traumatic for the individual. It can sometimes be retrieved from memory
Types of dissociative amnesia
1-
Selective dissociative amnesia
Forgets some
but not of what happened during a certain period of time
2-
Generalized dissociative amnesia
Forgets one’s entire life history
Why do we forget? Theories of Forgetting
Forgetting happens as a routine part of life, and there are several explanations for why we forget.
Decay theory maintains that loss of memory is a result of disuse and the passage of time; if information is not used or rehearsed it fades over time.
Interference theory suggests that memory has a limited capacity; when its capacity is reached; you are susceptible to confusion and forgetting
Another theory suggests that forgetting occurs when there is failure in the process of retrieving information. The information is there, stored away, but it appears to have been forgotten because you cannot retrieve it.
Repression, then, is motivated forgetting, or the burying of unwanted memories in the unconscious where they stay largely unreachable.
2- Dissociative Fugue Symptoms
Fugue state involves physical retreat
During a fugue, the individual suddenly and unexpectedly departs
Two important features for diagnosing dissociative
(psychogenic) fugue
·
1- A sudden unexpected travel away from home
· 2- Work with an inability to recall one’s past, and confusion about personal identity
Marked confusion about personal identity interferes with routine daily activities, so, in an effort to adjust and relate to others, the person assumes a new identity
· Despite the new assumed identity,
characteristics of the “old self” are recognizable.
· Complicated behaviors are carried out
during the fugue such as:
· A victim may drive a long distance,
find a place to live, obtain employment, and begin a new life.
Who is affected with Dissociative Amnesia and Fugue?
Both dissociative amnesia and fugue
are rare.
Disorders can appear at any point in the life span,
though less among the elderly
Amnesia is most frequent among
adolescent and young women, but its incidence increases
slightly among men.
Treating Dissociative Amnesia and Fugue
A person in an amnesic or in a fugue state who is unaware of important facts about his or her own identity is often equally uninformed about the need for therapy
Dissociative amnesic and fugue patients do not seek treatment themselves rather, are referred to a therapist after an episode has occurred
The therapy itself often addresses clients’ need for more adaptive
ways to
manage personal distress and conflict.
Stress management programs, may be used to treat dissociative amnesia and fugue.
3- Dissociative Identity Disorder (DID)
· Also known as multiple personality
·
Existence of two or more distinct personalities in a single
individual.
·
At least two of these personalities repeatedly take control of the
person’s behavior
·
The original personality especially is likely to have amnesia for
subsequent personalities, which may
or may not be aware of the “alternates.”
· Example of dissociative personality disorder (DID)
The Three Faces of Eve, who describes a client,
whose three different personalities virtual opposites in terms of their
emotional and behavioral patterns. Eve White was the quiet, polite,
hard-working, and conservative mother of a young daughter; Eve Black was
seductive, impulsive, risk-taking, and adventure-seeking. Jane, the third
personality, was a confident and capable woman.
Who Is Affected with Dissociative Identity Disorder?
· Occur many time more often in women than in men (estimated rates
are three
to nine times higher in women).
· Because women are typically more exposed to sexual abuse, women
may handle their psychological traumas in “internal” ways and finally women
tend to seek help more than men do.
Treatment of dissociative personality disorder
·
Antidepressants and anti-anxiety drugs
· Typical treatment involves psychotherapy aimed at helping replace the patients’ internal division with a unity of personalities
4&5- Depersonalization/Derealization disorder
· Characterized by severe and persistent feelings of being detached from oneself.
Feeling as though you were in a dream or were floating above your
body and observing yourself acted.
· Occasional depersonalization experiences are normal and are
reported by about half of the population..
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