Dissociative Disorders Notes

Hypnosis and Dissociation

  • Hypnosis is mentioned in introduction. Alex Tsander, a 21st-century hypnotist, is referenced.

Dissociative Disorders

  • Overview of dissociative disorders based on DSM-5.
  • Characterized by a disturbance causing significant distress or functional impairment.
  • Not better explained by other medical or mental disorders.

Types of Dissociative Disorders:

  • Depersonalisation/Derealisation Disorder
  • Dissociative Amnesia (may include dissociative fugue)
  • Dissociative Identity Disorder

Depersonalisation Disorder

  • Persistent feeling of detachment from oneself.

Derealisation Disorder

  • Experiencing surroundings as unreal.

Dissociative Amnesia

  • Loss of memory for significant personal information.
  • May involve a fugue state: travel away from home or work with inability to recall the past.

Dissociative Identity Disorder (DID)

  • Presence of two or more distinct identities or personality states that recurrently take control of behavior.
  • Individuals also experience:
    • Other dissociative phenomena
    • Posttraumatic stress symptoms
    • Auditory hallucinations
  • Popular culture references DID, but it's sometimes overused.

Iatrogenesis of Dissociative Identity Disorder

  • Iatrogenesis: Creation of an illness through medical intervention.
  • DID is suggested by some to be an iatrogenic illness.
  • Influenced by:
    • Therapist expectancies
    • Patient/client expectancies
    • Suggestibility of patient/clients

Aetiology of Dissociative Disorders

  • Most dissociative disorders are believed to be stress/trauma-related.
  • Depersonalisation/derealisation disorder:
    • Associated with childhood abuse.
    • Common precipitants: extreme stress, depression, anxiety, and substance abuse.
  • Dissociative Amnesia:
    • Biological explanations: effects of stress on brain systems.
    • Psychological explanations: motivations for forgetting.

Treatment of Dissociative Disorders

  • Depersonalisation/derealisation disorder:
    • Partial support for medication and cognitive behavior therapy.
  • Dissociative Amnesia:
    • Most cases spontaneously remit.
  • Dissociative Identity Disorder:
    • Support for teaching coping skills.
    • Exposure-based techniques.
    • Integrating different identities.