Dissociative Disorders Some part of a person's personality or memory is separated from the rest. May be genetic link

The Curious Experiences Survey Here are some experiences that people have in their daily lives. We are interested in how often you have these experiences (when you are not under the influence of alcohol or drugs). Please use the following scale for your responses. 1 = This never happens to me. 2 = This occasionally happens to me. 3 = This sometimes happens to me. 4 = This frequently happens to me. 5 = This is almost always happening to me. 1. Had the experience of feeling as though I was standing next to myself, or watching myself as if I were look at a different person. 2. Had the experience of looking in a mirror and not recognizing myself. 3. Had the experience of feeling that other people, objects, and the world around me were not real. 4. Had the experience of feeling that my body did not belong to me. 5. Had the experience of remembering a past event so vividly that it felt like I was reliving that event.

1 = This never happens to me. 2 = This occasionally happens to me 1 = This never happens to me. 2 = This occasionally happens to me. 3 = This sometimes happens to me. 4 = This frequently happens to me. 5 = This is almost always happening to me. 6. Had the experience of not being sure whether things I remember happening really did happen or whether I just dreamed them. 7. Had the experience of being in a familiar place but finding it strange and unfamiliar. 8. Feeling that I became so involved in a fantasy or daydream that it felt like it was really happening to me. 9. Find that I sometimes sit staring off in space, thinking of nothing, and am not aware of the passage of time. 10. Find that in one situation I act so differently from when I’m in another situation that I felt almost as if I were two different people. 11. Find that in certain situations I am able to do things with amazing ease and spontaneity that would usually be difficult for me.

16. Felt like I was dreaming when I was awake. 1 = This never happens to me. 2 = This occasionally happens to me. 3 = This sometimes happens to me. 4 = This frequently happens to me. 5 = This is almost always happening to me. 12. Found that I could not remember whether I had done something or had just thought about doing that thing. 13. Found evidence that I had done things that I did not remember doing. 14. Found that I hear voices inside my head that told me to do things or that commented on things that I was doing. 15. Felt as though I was looking at the world through a fog so that people or objects appeared far away or unclear. 16. Felt like I was dreaming when I was awake. 17. Felt like I was disconnected from my body. Source: Goldberg, L. R. (1999). The Curious Experiences Survey, a revised version of the Dissociative Experiences Scale: Factor structure, reliability, and relations to demographic and personality variables. Psychological Assessment, 11, 134–145. (Scale items appear on p. 145.) Copyright © 1999 by the American Psychological Association. Reprinted by permission.

Dissociation as a Spectrum Disorder Poly-Fragmented Dissociation Complex DID Fugue Dissociation Normal Poly-Fragmented DID Several Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htm Amnesia Partial DID

Dissociative Amnesia Sudden loss of memory for past events without organic cause. Generalized (forget all) Localized (time period) Selective (parts of period of time) Continuous (from specific time to present) Systemized (particular category) May result from an intolerable experience (overwhelming stress) Rare More common in women

Dissociative Amnesia Treatment Goals: Methods: relieve symptoms control problem behavior safely express & process painful memories develop new coping & life skills restore functioning improve relationships Methods: Psychotherapy, cognitive therapy, meds, family therapy

Dissociative Fugue Fugue = “flight” “Amnesia on the run” Involves: Sudden, unexpected travel from home/work Loss of memory of identify, personal info Confusion about or possible assumption of a new identity Can last for less than a day to years Usually ends abruptly Fugue = “flight” “Amnesia on the run”

Dissociative Fugue Causes: Severe stress Traumatic events—war, abuse, accidents, disasters, extreme violence Rare (0.2%) More common in men More frequent during stressful or traumatic periods

Dissociative Fugue Treatment: Goal = deal with stress or trauma that triggered the fugue & develop coping methods to prevent future episodes Methods Psychotherapy to communicate conflicts and increase insight into problems Cognitive therapy, meds, family therapy

Depersonalization Temporary loss or change in usual sense of own reality Feel detached from self & surroundings Like dreaming or like robot Feel like observing self 80-90% have dissociative experiences; only disorder if persistent, recurrent, or causes distress

Dissociative Identity Disorder Formerly Multiple Personality Disorder The presence of 2 or more distinct identities or personality states (“alters”) that recurrently take control of behavior. Each personality has its own memories, behavior patterns and social relations IS NOT schizophrenia http://www.oprah.com/oprahshow/Introduction-to-Kim-Nobles-Multiple-Personalities-Video http://www.youtube.com/watch?v=7iHJfIH20TY (Tony)

Dissociative Identity Disorder The Nature of Dissociative Identity Disorder Central Features Host Identity One Who Asks for Treatment Attempt to Hold Alters Together Several Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htm A Switch Abrupt Change in Personalities Usually Instantaneous

Dissociative Identity Disorder The Nature of Dissociative Identity Disorder Facts and Statistics Average Number of Alters? 15 (F); 8 (M) Several Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htm Females > Males (9:1) BUT # of males increasing Chronic

Dissociative Identity Disorder The Nature of Dissociative Identity Disorder Causes Severe Childhood Abuse or Trauma 97% of Cases before age 9 DID as a Means of Coping? Escape Into Fantasy World Become Someone Else Do What It Takes to Survive Several Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htm

Dissociative Identity Disorder IDENTITIES (“ALTERS”) MAY: have contrasting personalities emerge in certain circumstances/serve specific function differ in reported age and gender, vocabulary use, general attitude and predominant affect. Time to switch between identities is usually only a matter of seconds and often accompanied by visible changes. Treatment goal = INTEGRATION or fusion of personalities Mostly psychoanalysis

A Self-Test Some people have the experience of driving a car and suddenly realizing that they don’t remember what happened during all or part of the trip. 0% 100%

A Self-Test Some people find that sometimes they are listening to someone talk and they suddenly realize that they did not hear part or all of what was just said. 0% 100%

A Self-Test Some people find that they have no memory for some important events in their lives (e.g. a wedding or graduation). 0% 100%

A Self-Test Some people have the experience of finding themselves dressed in clothes that they don’t remember putting on. 0% 100%

A Self-Test Some people sometimes have the experience of feeling that other people, objects, and the world around them are not real. 0% 100%