Dissociative Disorders

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 Dissociative Identity Disorder
Dissociative identity disorder (DID), formerly called

multiple personality disorder, is an illness that is

characterized by the presence of at least two clear

personality states, called alters, which may have

different reactions and emotions.

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Alters may be created by people under conditions extreme stress, often
Dissociative disorders are characterized by an involuntary escape
from reality characterized by a disconnection between thoughts,
identity, consciousness and memory.

People from all age groups and racial, ethnic and socioeconomic
backgrounds can experience a dissociative disorder.

It is estimated that 2% of people experience dissociative disorders,

with women being more likely than men to be diagnosed.

Almost half of adults in the United States experience at least one

depersonalization/derealization episode in their lives, with only 2%
meeting the full criteria for chronic episodes.
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Most of us have experienced mild dissociation, which is like
daydreaming or getting lost in the moment while working on a project.

However, dissociative identity disorder is a severe form of

dissociation, a mental process which produces a lack of connection in
a person's thoughts, memories, feelings, actions, or sense of identity.

Dissociative identity disorder is thought to stem from a combination of

factors that may include trauma experienced by the person.

The dissociative aspect is thought to be a coping mechanism -- the

person literally dissociates himself from a situation or experience that's
too violent, traumatic, or painful to assimilate with his conscious self.
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The "alters" or different identities have their own age,
sex or race.

Each has his or her own postures, gestures, and

distinct way of behaving.

Sometimes the alters are imaginary people or animals.

As each personality reveals itself and controls the

person and reveals itself this is called switching. It can
take seconds or minutes or days.
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Symptoms and signs of dissociative disorders include:

Significant memory loss of specific times, people and events

Out-of-body experiences, such as feeling as though you are

watching a movie of yourself

Mental health problems such as depression, anxiety and

thoughts of suicide

A sense of detachment from your emotions, or emotional

numbness
A lack of a sense of self-identity

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 Along with the dissociation and multiple or split personalities,
people with dissociative disorders may experience a number of
other psychiatric problems, including the following symptoms:

Depression
Mood swings
Suicidal Tendencies
Sleep Disorders such as insomnia, night terrors, sleep walking
Anxiety, panic attacks; phobias (flashbacks, reactions to stimuli
or "triggers")
Alcohol and drug abuse
Compulsions and rituals
Psychotic-like symptoms (including auditory and visual
hallucinations)
Eating disorder
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How Does Dissociation Change the Way a Person
Experiences Life?

There are several main ways in which the psychological

processes of dissociative identity disorder change the way a
person experiences living, including the following:

Depersonalization. This is a sense of being detached from

one's body and is often referred to as an "out-of-body"
experience.

Derealization. This is the feeling that the world is not real.

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Amnesia. This is the failure to recall significant personal
information that is so extensive it cannot be blamed on ordinary
forgetfulness.

There can also be micro-amnesias where the discussion

engaged in is not remembered, or the content of a meaningful
conversation is forgotten from one second to the next.

Identity confusion or identity alteration. Both of these involve a

sense of confusion about who a person is.

An example of identity confusion is when a person has trouble

defining the things that interest them in life, or their political or
religious or social viewpoints, their sexual orientation or their
professional ambitions.
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Who Gets Dissociative Identity Disorder?

While the causes of dissociative identity disorder are still vague,

research indicates that it is likely a psychological response to
interpersonal and environmental stresses, particularly in early
childhood years when emotional neglect or abuse may interfere
with personality development.

As many as 99% of individuals who develop dissociative

disorders have recognized personal histories of recurring,
overpowering, and often life-threatening disturbances at a
sensitive developmental stage of childhood (before age 9)

Dissociation may also happen when there has been persistent

neglect or emotional abuse, even when there has been no overt
physical
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 Dissociative Fugue
Symptoms
Person suddenly moves away from home and assumes an
entirely new identity, with no memory of previous identity

Etiology
Fugue states usually occur in response to some stressor, but
because they are extremely rare, little is known about etiology

Treatment
Psychotherapy to help the person identify the stressors leading
to the fugue state and learn better coping skills

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 Dissociative Amnesia
Symptoms
Loss of memory due to psychological rather than
physiological causes. The memory loss is usually
confined to personal information only

Etiology
Typically occurs following traumatic events. May involve
motivated forgetting of events, poor storage of
information during events due to overarousal, or
avoidance of emotions experience during an event

Treatment
Help the individual remember traumatic events and
accept them

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 Depersonalization Disorder

• People with this disorder have frequent episodes in

which they feel detached from their own mental
processes or bodies, as if they are outside observers of
themselves.

• Occasional experiences of depersonalization are

common, especially when people are sleep deprived.

• Depersonalization Disorder is only diagnosed when

they are so frequent and distressing that they interfere
with an individual’s ability to function

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 Treatment Considerations
• While there's no "cure" for dissociative identity disorder,
long-term treatment can be helpful, if the patient stays
committed.

• Effective treatment includes talk therapy or

psychotherapy, hypnotherapy, and adjunctive therapies
such as art or movement therapy.

• There are no established medical treatments for

dissociative identity disorder, making psychologically
based approaches the mainstay of therapy
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 Dissociative Disorders
(Summary)

 Dissociative  Separate, multiple personalities in the

Identity Disorder same individual.

 Dissociative Fugue  The person moves away and assumes a

new identity, with amnesia for the previous
identity.
 Dissociative  The person loses memory of important
Amnesia personal facts, including personal identity,
for no apparent organic cause
 Depersonalization  Frequent episodes where individual feels
Disorder detached from his or her mental state or
body
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