Dissociative Disorders

Separation of self. Forgetting who you are. Unable to remember who your family is.

This is a scary scenario. Unfortunately, it is a reality for those who suffer from a dissociative disorder. Those who suffer from this disorder have experienced trauma and as a result, they completely separate mentally from themselves.

• What is a dissociative disorder?
• What are symptoms of dissociative disorders?
• What are the types of dissociative disorders?
• How are dissociative disorders treated?

What is a Dissociative Disorder in Psychology?

Dissociation is a common response from our psyche so that emotions can be processed. However, a massive separation from self is considered a dissociative disorder.

separation of self, flaticon.com

Dissociative Disorder Symptoms

Those affected usually have two very distinct personalities, each with its own behaviorism and voice. Most often, individuals with dissociative identity disorder are not violent individuals, but society and depictions in news and popular culture have shaped this disorder into one that seems unpredictable and dark.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has distinct diagnostic criteria for dissociative disorders. These criteria involve the inclusion of what seems to be two or more personalities. These personalities have their behaviors, genders, memories, perceptions, and cognition.

The person who may be affected reports large or frequent gaps in memory. It is likely that the unremembered events involve a traumatic episode or series of events that the patient experienced. These symptoms will also cause a ripple effect into the personal, work, and social lives of the person who may present these symptoms. Also, the DSM-5 mentions that these symptoms are not brought on by drug or substance abuse, or from a medical condition such as seizures.

As with most psychological disorders, there are possible factors that may make them difficult to diagnose. With dissociative disorder, there are cultural implications that should be considered. In some religions, for example, the fragmentation of personalities could be considered an effect of possession by deities, spirits, or mythical creatures. The question of what is "normal" or "culturally accepted" comes to question when making a diagnosis of dissociative disorder.

Examples of Dissociative Disorder in Psychology

A famous case of DID was that of Kenneth Bianchi. Nicknamed the "Hillside Strangler", he raped and murdered 10 women in California. After his arrest, a psychologist named John Watkins performed a therapy session involving hypnosis. Watkins uncovered a hidden personality within Bianchi named Steve, who would respond to Watkins' questioning. "Steve" admitted to the murders and mentioned that Kenneth knew nothing of the happenings and was innocent. These findings posed many questions to the public, and the psychology world.

Was this a ruse to keep Kenneth from being persecuted? Is a split in personality something that could affect another individual?

Causes of Dissociative Identity Disorder

We have already mentioned that a very stressful and impactful event is the usual cause of dissociative identity disorder. But what happens after the stressful event? How does it manifest into DID?

Research claims to have found a connection within the body and brain that supports a differentiation in personalities. Studies have shown that eye-muscle balance shifts as the patient's personalities shift. The same can be said of handedness; a patient who is usually right-handed switched to being left-handed when his other personality was in "control". Most surprisingly, those who were diagnosed with DID showed brain activity in the part of the brain that is associated with control and inhibition of traumatic memories (Myers, 2014).

Why did this happen?

Abuse, sexual abuse, war trauma, natural disasters: These are some of the traumas associated with a dissociative identity disorder. The emotional and psychological toll from these traumas is so great that a separation in cognitive awareness becomes a way to cope. This energy has no outlet for the individual; therefore, the person's mind creates a persona that can act out impulses brought on by high anxiety.

The Four Types of Dissociative Disorders

There have been four identified dissociative disorders; dissociative fugue, dissociative amnesia, dissociative identity disorder, and depersonalization disorder. Each of these has its own set of symptoms and effects on the person who is diagnosed.

Dissociative Fugue

This type of dissociative disorder seems to manifest without warning. The person is unable to remember who they are and has no memory of the past. The person who is experiencing this also has no clue that it is happening. The person's mind creates a new identity as the lapse is happening. Once the episode passes, the person will have no memory of the new identity or of the events that occurred.

Dissociative Amnesia

This type is different in that the person affected is unable to remember the traumatic event leading up to their dissociative amnesia episode (and is aware that they can not remember the traumatic episode). Also, this episode can last for a few days or up to many years. There are four subcategories of dissociative amnesia; generalized amnesia, localized amnesia, selective amnesia, and systemized amnesia.

Dissociative Identity Disorder (DID)

Previously called multiple personality disorder, DID is shrouded in controversy. There is usually a manifestation of two separate personalities, neither of which is aware of the other personality and their behaviors. It is when under severe stress that there is a sudden switch in personality. Also, this other personality often manifests with a different set of behaviors, voice tones, or memories.

Depersonalization Disorder

Those with depersonalization disorder often feel separate from their feelings, thoughts, and overall life. They feel so separated from their lives, it is as if they are watching their lives in a movie. An individual with this disorder will also have difficulty recognizing themselves in a mirror.

Treating Dissociative Disorders

There is a lack of knowledge of dissociative disorders and how they manifest; the same can be said about treatment approaches. The choice in treatment is most often based on individual case studies. The most evident approach to help is psychotherapy. Psychoanalysis and cognitive therapies are long-term counseling options. In these counseling sessions, stress management is applied so that possible triggers can be avoided. Pharmacologically speaking, barbiturates are used to help calm the immense amount of anxiety typical of individuals with DID.

Psychological Functions of Dissociative Disorders

Dissociative disorders serve as a coping mechanism. Those who have suffered great trauma in life often have the potential to be diagnosed with these disorders. They are ways for a person to cope with the anxieties and deep feelings associated with those traumas. Essentially, they are an outlet.

Psychodynamic theorists see these disorders as a defense mechanism against sudden impulsive behaviors brought on by traumatic stress.