1. To Get:
Guided notes
Your seat
To Do:
Opener
Dissociative and Somatoform Disorders
Viewing Examples
Application: personal anxiety
Agenda – Day 3
No hall passes until after lecture material has been covered! 
Big Idea – Identifying, Symptoms, and Classifying Dissociative and Somatoform Disorders
Guiding Question – How does a person use dissociation to escape reality? How does psychological trauma manifest in physical form?
I can…
Understand causes and symptoms
of dissociative and somatoform disorders and explanations for why they exist.

2. Opener – Anxiety Review -write the letter next to the correct term.
A. Anxiety represents the “leakage” of primitive aggressive or sexual ideas or urges that were repressed during childhood. B. Excessive or unrealistic worry that appears to be present nearly all the time. C. A persistent, excessive or irrational fear of an object or a situation. Acrophobia is a fear of heights; claustrophobia is a fear of enclosed places. Fear of public speaking is an example of a social phobia. D. Intense, persistent feelings of anxiety that follow traumatic events. PTSD may be accompanied by flashbacks, nightmares, and avoidance of stimuli connected with the traumatic event. E. Phobias are conditioned, or learned in childhood, either through direct experience or observing others. People avoid threatening situations to reduce anxiety. F. People exaggerate threats and believe they are helpless to deal with them. G. Unwanted thoughts or ideas; impulses that are difficult or impossible to resist, such as repeated hand washing connected with the idea that one’s hands remain unclean. H. Anxiety disorders tend to run in families, suggesting a role for genetic factors. Anxiety disorders may be exaggerated descendants of adaptive fears. I. Recurring, unexpected panic attacks characterized by rapid heart rate. Agoraphobia is a panic disorder in which people fear being caught in crowded, public places when they have an attack.

3. Check your answers… 1. C 2. I 3. B 4. D 5. G 1. A 2. E 3. F 4. H Types
Explanations
1. C 2. I 3. B 4. D 5. G
1. A 2. E 3. F 4. H

4. Anxiety Activity – student style…20 points
Requirements:
-Imagine you are actually this person.
Something that causes me high levels of stress…
I prepare myself for mentally and physically for stressful situations by…
One way I calm myself down is to…
-Be respectful; these are someone’s thoughts and feelings – either from B3 or B4!
-We are not trying to comment on, criticize or diagnose, we are just sharing so we realize that EVERYONE has anxiety at some point about similar or very specific things, objects or situations.
Answer in your guided notes as people present:
1. Name two things that you do that you hear other people do, to calm themselves in stressful situations.
2. Name one thing you never thought of, from the presentations, that might work to calm you down in stressful situations.

5. Dissociative Disorders
Dissociation – separation of certain personality components or mental processes from conscious thought.
Can be NORMAL at times.
Ex. Deeply involved in a book, movie or video game and you don’t hear someone calling your name.
Ex. Day dreaming
Becomes a disorder when dissociation is used to avoid stressful events or feelings.
People with this disorder can forget certain events or, in extreme cases, their own identity.
Can be brought on by extreme stress
Mentally removing self from stress lessens anxiety

6. Types of Dissociative Disorders
1. Dissociative Amnesia
Characterized by sudden loss of memory following a stressful or traumatic event
Typically cannot remember events that occurred before, during, and after a traumatic event
In extreme cases a person might forget ALL prior experiences and be unable to remember his or her name, recognize friends and family or recall important personal information
Can last for a few hours or even years
Memory can return as suddenly as it was lost
Amnesia rarely returns
Psychogenic – meaning it cannot be explained biologically (like a head injury)
Cases increase following war and natural disasters
Doc Martin S5 Ep. 5 – 9:00-14:00 then 40:00

7. Types of Dissociative Disorders
2. Dissociative Fugue
Characterized by forgetting personal information and past events but includes taking on a new identity.
Follows traumatic events like war and natural disasters
May travel away from home/work and take on a new name, residence and occupation
Do not appear to be ill in any way
When a fugue ends there is no conscious memory of what took place during the fugue

8. Types of Dissociative Disorders
3. Dissociative Identity Disorder
Formally labeled multiple personality disorder
Existence of two or more personalities within a single individual
Personalities may or may not be aware of each other
At least two personalities take turns controlling a person’s behavior
Typically a result of severe child abuse – physical/sexual/psychological
Personalities are typically different in:
Voice, facial expressions, handedness, perceived age, gender and physical characteristics. Even allergies and eye glass prescription may vary!
Gollum clip -

9. Types of Dissociative Disorders
4. Depersonalization Disorder
Feelings of detachment from one’s mental processes or body
Described as feeling “outside” your body or observing yourself from a distance
Common symptom of other disorders
Most common disorder following depression and anxiety
Preceded by a stressful event

10. Explaining Dissociative Disorders
Explained mainly via psychological views, not biological
Psychoanalytic theory suggests people dissociate to repress unacceptable urges
In cases of amnesia and fugue a person forgets the urges
In cases of identity disorder, the person expresses urges via other personalities
In depersonalization the person separates themselves from the turmoil within
Learning theory suggests people learn not to think about disturbing events to avoid feelings of guilt, shame, or pain
Truly “selective” memory
No cognitive or biological theories exist to explain dissociative disorders

11. Somatoform Disorders
Somatization – Greek for “body,” is psychological distress manifested in physical form.
Ex. Depression (psychological) causing paralysis (physical).
It is NOT malingering – a conscious attempt to fake an illness to avoid work, school or other responsibilities.
People honestly feel pain or cannot move limbs (even though no physical cause can be identified.)
Many diagnosis are incorrect when an illness is discovered
Many cases go undiagnosed as the focus is on the physical, rather than the psychological symptoms.

12. Types of Somatoform Disorders
1. Conversion Disorder
Change, or loss of physical functioning, in a major part of the body for which there is no medical explanation
Ex. Sudden inability to see at night or inability to walk with no medical reason
Symptoms are not “faked” or intentionally produced
Sufferers show little concern about their symptoms; which is one part of a successful diagnosis
CBS This Morning Clip -

13. Types of Somatoform Disorders
2. Hypochondriasis
Unrealistic preoccupation with having an illness
Person becomes absorbed by minor physical sensations that indicate serious medical illness
Maintain belief despite doctors reassurance they are fine
May visit many doctors to find a physical cause to illness
Woody Allen Clip - Hannah and Her Sisters

14. Explaining Somatoform Disorders
Primarily psychological in nature
Psychoanalytic theory suggests somatoform disorders occur when individuals repress emotions associated with forbidden urges which then get expressed physically.
Seen as a compromise between the unconscious need to express feelings and the fear of actually expressing them
Recently psychologists have argued that people “convert” psychological stress into actual medical problems
Ex. A fighter pilot who looses the ability to see at night due to anxiety over nighttime bombing missions
Ex. Someone who suffers leg paralysis after NEARLY getting hit by a car
Behavioral theory suggests somatoform disorders serve as reinforcement if they allow a person to escape from anxiety.
Biological AND genetic factors are believed to play a role in somatoform disorders

15. Opener Review 1. Name the four types of Dissociative Disorder.
2. What is the main difference between amnesia and fugue?
3. Depersonalization disorder is defined as feelings of detachment from one’s __________________________________.
4. In a person with DID, what traits can be different?
5. There are no ______________ or ____________ theories to explain dissociative disorders, meaning that it is primarily what?