Dissociative Disorders 1

Dissociative Experience Scale: Items indicating dissociative experiences include:
- Not remembering all or part of a car or bus trip.
- Missing parts of a conversation while listening.
- Finding oneself in a familiar place with no memory of arriving.
- Discovering new items among personal belongings without memory of their purchase.
- Wearing clothes without recollection of putting them on.
- Being approached by strangers claiming to know you.
- Experiencing oneself as an observer, watching oneself interact with another person.
- Lacking memory for significant personal events.
- Staring into space with no thoughts and losing track of time.
- Having evidence of actions performed but possessing no memory of doing them.
- Viewing people and objects as distant or unclear, akin to seeing through a fog.

Dissociation fractures and fragments memory, often as a response to trauma.
The healing process involves reconnection and integration of these fragmented memories.
Common triggers include significant adverse experiences and traumas.
It serves as an unconscious defense mechanism, protecting against overwhelming anxiety by creating emotional separation.
This can lead to disturbances in memory, consciousness, self-identity, and perception.

Depersonalization: Focus on self, where an individual feels detached from their mental processes or body.
Derealization: Focus on the external world, characterized by a feeling of detachment from the environment, where one’s surroundings feel unreal.
- Symptoms may include feelings reminiscent of being in a fog or dream-like state.
- Visual distortions: blurriness, changes in visual field (widened/narrowed), and size distortion of objects.
- Auditory distortions: alteration in sound perception (muting or enhancing).

Defines as an inability to recall important personal information, usually related to trauma or stressful events.
Dissociative Fugue: A subtype marked by sudden, unexpected travel and an inability to remember one’s identity during that time.

Characterized by the presence of two or more distinct personality states (referred to as "alters"). Each alter possesses its own:
- Perception and relationship patterns regarding self and environment.
- Memorable experiences, behaviors, and interaction styles.
- Alters may exhibit varying sexes, races, or religions.
Transitioning to an alter often occurs during stressful situations.

Historical Context: Approximately 90% of individuals with DID have a history of childhood abuse or neglect.
Impact Assessment:
- Significant implications for the individual and their families.
- Elevated suicide risk, with about 70% of affected individuals having attempted suicide.
Assessment Techniques:
- Simply asking a patient to state their name may not be adequate to assess identity perception.
- Behavioral cues indicating presence of an alter may include changes in:
- Behavior
- Voice
- Dress
- Verbal indicators, such as referring to oneself by another name, using third-person pronouns, or the collective pronoun "we" instead of "I."

Phase 1: Establishing safety, stabilizing the patient, and reducing symptoms.
Phase 2: Confronting, working through, and integrating traumatic memories.
Phase 3: Integration of identity and rehabilitation to support recovery.