PSYC 360 L12 Dissociation

dissociation

separation/compartmentalization of mental process that under usual conditions is well integrated. thoughts, memories, sensations split off from conscious awareness which helps person being overwhelmed by trauma

normative dissociation

daydreaming, white line fever, highway hypnosis, media absorption, self hypnosis

• in these cases dissociation helps people focus attention/mentally escape boredom and mild stress 

the role of conversion disorders in modern conceptualization of dissociation

• freuds view: unresolved conflict converted into physical symptoms without medical cause

• the connection: conversion disorers reflect a split between conscious awareness and physical experience. freud says repressed mental energy is convertes to bodily symptoms and the mind dissociates awareness from underlying conflict

conversion disorder

what freud called hysteria and is a functional neurological symptom disorder

key features:

• loss of functioning in motor systems without medical cause

• sudden onset following extreme stressor

• no detectable neurological damage yet symptoms distressing to individual

• physical symptoms are psychological escape to emotional conflict

somatic symptom disorder

excessive concern and anxiety of distressing physical symptom without clear medical cause

features:

• at least 1 physical symptom causes distress

• individuals thoughts, feelings, behaviors are disproportionately focused on the symptom 

• excessive worry - symptoms may be real to person but not medically reliable

• formerly hypochondriasis in dsm III

Illness anxiety disorder

anxiety about developing serious illness despite minimal or no physical syptoms

features

• persistent fear of illness like cancer

• medical reassurance does not ease anxiety

somatic symptom disorder and illness anxiety disorder are examples of how

psychological distress manifests as physical symptoms

dissociative identity disorder

• characterized by 2 alters and was multiple personality disorder but changed to emphasize the fragmenting of identity and not creation of multiple personalities

• is treatable but often requires long term psychotherapy

• treatment focused on integrating parts of self and resolving underlying trauma

key features of DID 

alters

• not full personaltiies but distinct identity states limited to set of attributes organized around a theme 

• role only capable of being agressive

• # of alters directly proportionat to level of trauma experienced 

• switches: process by which one alter becomes dominant aand can be cued/uncued and accompanied by rapid changes in eeg

Dissociative divide

• the psychic barrier between alters 

• flow of info can be bi directional

• alter a may have access to alter b but alter b unaware of a 

amnesia

• must have some form of amnesia partly due to dissociative divide and can be bidirectional 

likely to have comorbid features including psychotic symptoms like delusions, hallucinations, mood disorder, substance abuse 

psychodynamic perspectives on did

hypnotizability

• presumed to be normally distributed trait

• individuals easily able to achieve altered state are talented

• not sign of weakness but suggestibility can be more capable of dissociating

psychodynamic explanation

• develops as defense mechanism

• split from consciousness to protect ego from horror of reality especially in childhood w sexual abuse

• altered state crystallized permanently in other state

perspective on did: nick Spanos and the sociocultural perspective

• individuals learn dissociative behaviors that are valued by culture as a means of gaining and acquiring status

• socially learned and culturally reinforced (like shaman is admired and state reinforced)

• true altered states of consciousness do not occur and says hypnotizability is not talent just high suggestibility from a person of higher authority

evidence

• nature of symptoms change overtime

• cultural differences in manifestation of dissociation (possession v multiple id imply learning context)

• can easily stimulate psychological correlates in lab

counter

• ideas not developed by actual psychiatric patients

• simulating in lab is not the same as examining real patients

dissociative amnesia

inability to recall important info due to traumatic nature, not due to injury, drugs, PTSD, emotional overload

dissociative fugue

subtype of amnesia associated with unexpected travel over extended distance. may assume new id and forget old one

depersonalization disorders

feeling detached from one’s body with de-realization that outside world is unreal