Psychological Disorders Dissociative Disorders

What is dissociation? A split in the mind in which there can be two independent streams of consciousness occurring at the same time, allowing some thoughts and behaviors to occur simultaneously with others.

Dissociation Continuum ________________________________________________ Normal Dissociative DID Polyfragmented Amnesia or Fugue DID Normal: Daydreaming, highway hypnosis, “getting lost” in a book Dissociative Amnesia: Loss of memory (no physical cause) Dissociative Fugue: Loss of memory with flight (leave home) DID: DSM IV definition Polyfragmented DID: Over 100 personality states

Dissociative Amnesia 1 or more episodes or inability to recall important personal information, usually of a traumatic nature. Example: Marcie “Marcie…was found by the police…wandering in the street. She could not remember her name, did not know where she lived, and did not recognize the…identification papers that she was carrying. She was examined [at a local hospital] and had no serious injuries….” “The following day the medical staff was able to contact Marcie’s parents. They rushed to the hospital. Marcie did not recognize them…Her parents told the staff that Marcie had been involved in an automobile accident 2 days before on her way to work with her cousin…Her cousin…was not wearing a seat belt and was severely injured…The accident was not Marcie’s fault but she seemed to blame herself. She became withdrawn and later disappeared from her apartment. The family had been trying to locate her since then.”

Dissociative Fugue Individuals suddenly and unexpectedly travel away from their home. Unable to recall their past, have confusion over their identity, and may assume a new identity. Example: Douglas “Douglas and his wife have had long-term marital problems…his wife accused him of being inattentive to her…and spending all of his time on his hobby, taxidermy. After a serious argument, his wife threw out all of the stuffed birds she could find…When he “When he returned home he has enraged. The next day Douglas left for work and disappeared…Three weeks later Douglas awoke in a hotel room several hundred miles away form home. He had no idea how he had gotten there and no memory for the time since he left home…[He] reconstructed the events…The day after Douglas arrived in the city he went to the Museum of Natural History and volunteered…He seemed knowledgeable, especially about birds…he met a woman who he asked out. His work at the museum and relationship with the woman continued until he awoke in his hotel room.”

Dissociative Identity Disorder Two or more distinct personalities* At least 2 of these identities recurrently take control of the person’s behavior During these periods, the individual is often unable to recall important personal information *Average # is 15 personalities

DID Why? Psychologically escape from trauma; a coping mechanism More women than men (ratio 9 – 1) Onset early childhood, median 4-years-old

DID: Treatment No drug therapies “treat” different personalities, but can be treated with drugs for other issues (for example, SSRI’s for depression) INTEGRATION is the goal of “talk therapies.” Long-term treatment Emotionally painful (remembering & reclaiming the dissociated traumatic experience)

DID Controversial diagnosis Scientific evidence? (brain wave patterns) Increase in number of cases (“induced” by therapists?) Cultural differences (“culture bound”) Example: Kim Noble (20 main, many fragments) http://www.oprah.com/oprahshow/Introduction-to-Kim-Nobles-Multiple-Personalities-Video (5:20) Art work: http://kimnoble.com/virtual_galleries.htm