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Ch.6 Dissociative Disorders section includes: Dissociative amnesia (Localized, Selective, Generalized, Systemized, Continuous) Dissociative Fugue Depersonalization disorder Dissociative Identity Disorder (DID) Common factors in DID Merskey’s explana

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Kathy Foxall

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Dissociative Disorders
Includes Amnesia, Fugue, DID, Depersonalization Disorder
Dissociative amnesia
5 types
vary in extent – severity
episodic memory loss – events involving one’s experience
the partial or total loss of important personal information
most common – forget all details of an event
events that happened recently enough that you would be expected to remember
cannot remember certain significant details of an event
about 70% of criminals claiming this for a criminal action are probably lying
cannot remember any details of past life
able to process what is currently going on
cannot recall any information about a person, or about several people
alert, but has forgotten events going back to a certain time in the past, and forgets
each new event after it happens
Dissociative Fugue
confused about identity
lose episodic memory
in dissociative amnesia, both the source and the content of the amnesia are
recovery from fugue state is often abrupt and complete, although the gradual
return of bits of information may also occur
assume new identity, or partially new identity, and travel away from home
usually short lasting
E.F., 12-15 episodes in 5 years, British man
oOccurs under periods of great stress
oLegal, financial, marital problems
oPlaced on drugs that keep him in heightened state of awareness
Depersonalization disorder
the self and the environment feel unreal
may feel like are living out a dream
only diagnosed when the feelings cause significant impairment in occupational or
social functioning
condition tends to be chronic
usually begins during adolescence, associated with anxiety and depression
may be caused by emotional and sexual abuse
theorized that it is developed as a coping method
“I feel like I was dropped into this body and life from outer space. It is like I was
suddenly inserted into this life. It’s like I woke up from a deep sleep to find
myself in this life. I’m here, and I’m startled to be here, but then if I’m not me
and here where else would I be? My mind goes round and round and the more I
think about it the more confusing it becomes. “
Dissociative Identity Disorder (DID)
aka MPD (multiple personality disorder)
2 or more personalities exist in one person
some personalities may be aware of one or more of the other personalities
usually there are one or more that are not aware of the other personalities
supposedly occurs in early childhood/adolescence and is a result of severe abuse
very controversial
only one personality is evident at any one time, and the alternation of personalities
usually produces periods of amnesia in the personality that has been displaced
conversion symptoms – loss of physical or sensory function with no physical
basis, depression, and anxiety are common in people with the disorder
rarely diagnosed in Britain
prevalence unknown
many people believe it is iatrogenic
highly hypnotizable, suggestible
some therapists see it in suspiciously large number of their clients
fashionable, in 70’s after movie Sybil
more common in women, except in Switzerland
associated with conversion disorders as well
studies using physiological measures EEG’s, brain blood flow, GSR, etc.
contradictory findings
many outrageous claims made, e.g. hair colour changes during personality change
eyes rolling, head lolling, etc. easily faked
Possibly a real disorder but rare?
many think it is a variant of borderline personality disorder
6,000/year reported
before the movie Sybil in the 1970s, fewer than 200 cases reported
iatrogenic factors – unintended effects of some action by the therapist
Common factors in DID
hx of sexual and/or physical abuse in up to 80% of cases
begins by age 12 in most cases
highly hypnotizable
high incidence of substance abuse, sleepwalking
child overwhelmed by trauma and uses dissociation as a coping method
memories become compartmentalized due to state dependent learning, and
ultimately there is a memory barrier
a memory barrier develops between parts of the self
everyone has different facets to personality, some more integrated than others
DID, not integrated
big divisions, discontinuities
e.g., child, opposite sex, usually have a very angry person, wild person, shy
Merskey’s explanations for DID
what we are really seeing are differences in mood, memory, or attention
different personalities are developed through expectation, suggestion, social
reinforcement by the therapist
some therapists wrongly interpret depersonalization experiences as multiple
personality disorder
Etiology of Dissociative Disorders
Psychodynamic perspective
a result of the person’s use of repression to block from consciousness unpleasant
or traumatic events
the split in personality may develop because of traumatic early experiences
combined with an inability to escape them
4 factors necessary in the development of multiple personalities:
the capacity to dissociate
exposure to overwhelming stress
encapsulating or walling off the experience
developing different memory systems