dissociative disorders. splitting off of thoughts, feelings, or behaviors ordinarily connected...
TRANSCRIPT
Dissociative Disorders
Dissociative Disorders
Splitting off of thoughts, feelings, or behaviors ordinarily connectedTemporary alteration in normally integrative functions of:
ConsciousnessIdentityMemory
Dissociation:
Historical DevelopmentPsychological DevelopmentInfluence of the timesSkepticism of MHPControversy
Historical Development
19 the CenturyHysterical Neurosis-Dissociative typeDerived from cultural factors of timeTheatricality, puritanical ethos which fostered repressionMechanism of defense/neurotic safeguard
Psychological Development
Janet: dissociation= split in consciousness
Result of of neuropsychological weakness
Freud: repression= unconscious thoughts used to ward off painful effects
Psychological over organic explanation
Psychological Development (cont’d)
Prince: different conscious states could co-exist without awareness
• Freud & Prince high influence on later researchers & theorists.
• Belief in split of conscious, not organic etiologies
• Disappearance explained by change in culture
Recent Trends
60’s: “me’ &“now” generation,shift to narcissistic ethos
Skepticism (confusion of lumping)DSM approach: diagnosis based on similarities of sign/symptoms rather than postulation
Core concept: Temporary disruption in memory, identity, or consciousness
May lead to amnesia, depersonalization or multiple personalities
Current Trends(last 20+ years)
Existence is rare Increase in # of cases
Resurgence of Interest: Inappropriate diagnosis
Split in MH Profession
Ex. I Never Promised You a Rose Garden
Normalcy of Disassociation
Not necessarily psychopathologyPhenomena may occur spontaneously
Can be soughtCan be induced for therapeutic purposes
Society supports & reinforces to some degreeRelated to phenomenon underlying hypnotizabilityContinuous rather than singular/discrete phenomenon
Commonplace Dissociative Events
DaydreamingAbsorption in reverieExamples:
Driving past one’s expressway exitNot hearing your name called by instructor3-yr old having imaginary playmate“Self” accepted by public; supported in literature & arts
Conflict, diversity, & disparity within self-structure is central to being human
As Pathological
When complex behavior takes place outside awareness of predominant consciousnessEtiologies usually functional or psychologicalCan be organic
Interferes with memory, identity, or consciousness
Etiologies
Periods of amnesia can be caused by
alcohol or substance intoxication
Head traumaTemporal lobe epilepsy/partial complex seizures
Synopsis of Dissociative DO
Dissociative AmnesiaOne or more episodes of inability to recall personal information.Traumatic or stressful nature, too extensive to be explained by ordinary forgetfulness.Extensive memory loss, but usually doesn’t travel from home.Transitional, usually no treatment.
Dissociative FugueSudden & unexpected (uncommon) travel from home or work; enabling recall of past, have confusion about personal identity, & may assume identity.“Exit” from personality, usually temporary.
Synopsis of Dissociative DO (cont’d)
Depersonalization DisorderRecurrent feelings of detachment from thoughts or body.Reality testing remains intact
Dissociative Disorder Not Otherwise Specified
Dissociative disoder present, but no specific criteria met
Dissociative Identity Disorder (DID)
Hallmark – failure to integrate identity, memory & consciousness2 or more distinct identities/personality states
with relatively enduring pattern of perceiving, relating to, & thinking a/O environment & self
Fluctuating clinical course tending toward chronicity & recurrence
Helpful Movies & Books
MoviesThree Faces of EveWhen Rabbits HowlsTrudy Chase StorySybil
BooksTry to Remember (Kotter)The First Sin of Ross Michael Carlson (Weissberg)SybilWhen Rabbit Howls