Dissociative Disorders

A Closer Look at Psychological Disorders

Dissociative Disorders

 Individuals with dissociative disorders have in some way

broken away from their sense of self

– from their memories, thoughts, or feelings.

 Symptoms:  Having a sense of being

unreal

 Being

separated

from the body  Watching yourself as if in a

movie

Dissociative Disorders

 Even though we may hear about them somewhat frequently, dissociative disorders are actually

quite rare

and usually represent a

response to overwhelming stress

.

 Three specific forms are: a  Amnesia  Fugue State  Dissociative Identity Disorder.

Dissociative Amnesia

    Remember that amnesia is memory loss.

Many things could cause amnesia – brain injury, drugs, etc.

Dissociative Amnesia:

amnesia that has _______

biological explanation

This type of amnesia is a reaction to a specific, stressful event – a traumatic incident – like  For example, witnessing a terrible accident, surviving a natural disaster, etc.

 If this gopher suddenly couldn’t remember who he was after a blow to the head, this would be plain old amnesia.

 Dissociative amnesia does

not

have a biological explanation.

Dissociative Amnesia (cont.)



Case studies:

 Combat soldiers may report losing their memories for hours or even days.

 An 18 year old man was on a sailing cruise with friends when a storm came up. He was the only one to put on a life vest and tie himself to the boat, and he watched all of his friends get swept overboard by high waves.  He spent days waiting to be rescued, but

remembered none of these events afterwards

.

Dissociative Amnesia (cont.)



Freud labeled this type of psychologically based amnesia

repression

.



Sometimes, as in some cases of abuse, what people have experienced becomes too difficult for them to handle, so they “forget.”

   

Dissociative Amnesia (cont.)

Localized amnesia time.

is present in an individual who has no memory of

specific events

that took place, usually traumatic. The loss of memory is

localized with a specific window of

 For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia.

Selective amnesia

happens when a person can recall

only small parts of events

that took place in a defined period of time.  For example, an abuse victim may recall only some parts of the series of events around the abuse.

Generalized amnesia

is diagnosed when a person's

amnesia encompasses his or her entire life

.

Systematized amnesia

is characterized by a loss of memory for a

specific category of information

.  A person with this disorder might, for example, be missing all memories about one specific family member.

Dissociative Fugue

   The word

fugue

fugitive.

comes from the same root as Dissociative fugue serves the same psychological function as dissociative amnesia –

escape from unbearable conflict or anxiety

.

Dissociative fugue also involves memory loss, but unlike dissociative amnesia, the memory loss is

also accompanied by travel to a new location and the adoption of a new identity

.

 People may forget who they are, travel to a new place, make new friends, get a new job, remarry, etc.  A fugue state may last for days or even decades.

Etiology of Dissociative Amnesia and Fugue States



Psychodynamic

: _________ of trauma or anxiety-producing memories



Behaviora

l:

 Operant conditioning: forgetting leads to relief, which is

reinforcing

 State-dependent learning: memories are not recalled during normal arousal states  Self-hypnosis

Depersonalization Disorder

    Marked by a

feeling of detachment or distance from one's own experience, body, or self

. One can easily relate to feeling as they are in a dream, or being "spaced out.” A person's experience with depersonalization can be so severe that he or she

believes the external world is unreal or distorted

. Etiology of Depersonalization Disorder:   Psychodynamic: more extreme defense; disturbed ego functioning Cognitive: difficulty attending to both internal and external events

   

Dissociative Identity Disorder

D.I.D.

was formerly known as

multiple personality disorder

.

With this disorder, a person is said to

exhibit two or more distinct and alternating personalities

. These sub-personalities can differ in age, sex, and self-perception of physical characteristics.  Some researches have even reported changes in brain function or handedness as a person switches from one personality to another.

Sometimes personalities seem to be aware of one another, and sometimes they do not.

Dissociative Identity Disorder (cont.)

 Examples of handwriting samples from a D.I.D. patient:

    

Dissociative Identity Disorder (cont.)

One of the most famous cases of D.I.D. is

Eve White

, the basis of the film

The Three Faces of Eve.

Eve sought psychiatric treatment for severe headaches and blackouts. She was a conscientious, self-controlled, and shy person. However, during one of her therapy sessions, her expression – and her personality – suddenly changed. Eve White had become Eve Black – childlike, irresponsible, and fun-loving – the opposite of Eve White.

Eve Black was conscience of Eve White’s existence but considered her a separate person. Eve White did not know about Eve Black, however, nor did she know about Jane, a third personality that emerged during the course of therapy.

Eve White’s real name is Chris Costner Sizemore, and she released her story many years later when she published a book titled

I’m Eve.

In her book, Sizemore ** admits she ultimately had 22 separate personalities.

Chris Sizemore (DID)

The Controversy Over DID

   The diagnosis of this disorder is very controversial – many psychologists doubt it even exists. In a recent survey, only ¼ of American psychiatrists in the sample indicated that they felt there was solid evidence for the scientific validity of DID.

Why?

    Diagnosed cases of D.I.D. have

increased dramatically

in recent years. Prior to the 1970s, fewer than 100 cases had ever been reported. Then, in the 1980s alone, reports of more than 20,000 cases appeared, almost all of them in the U.S. The average number of sub-personalities has also increased been reported.

– from 3 to 12. In some cases, dozens or even 100 personalities have One famous sufferer of D.I.D., Sybil Dorsett, is now

believed to have been inappropriately influenced by her psychiatrist

. After the death of Sybil’s psychiatrist and the release of her records, experts have come to believe that by giving names to Sybil’s emotional states and asking her to take on these roles as part of the therapeutic process, the psychiatrist could have led Sybil to believe that she possessed multiple personalities.

Recent Controversial Cases

  In 2001, former NFL football star Herschel Walker was diagnosed with D.I.D. by his psychiatrist. Watch these videos:  http://www.youtube.com/watch?v=YX uG2zI39yA (Part 1)  and http://www.youtube.com/watch?v=6Xl KOC-WnZo&feature=related (Part 2)  or http://www.youtube.com/watch?v=bX 3F-CkTaFU What do

you

think?

Etiology of Dissociative Identity Disorder

  Some people believe that DID is

simply an exaggeration of normal human tendencies

. For example, everyone is capable of behaving in different ways depending on the circumstances (rowdy in a bar, quiet in a museum). This variation may become so extreme that that a person feels, or is perceived by others, as a “different person.” Behavioral    Operant conditioning: forgetting leads to relief, which is reinforcing  Sudden memory loss or unusual behavior may be rewarded by providing escape from unpleasant situations, responsibilities, or punishment for misbehavior.

State-dependent learning: different arousal states associated with different identities Self-hypnosis

Etiology of Dissociative Identity Disorder, (cont.)

  Sociocognitive: due to clinician’s influence (iatrogenic – caused by the diagnosis, manner, or treatment of a physician)  Some theorists believe that people with DID are engaging in intentional role playing to use an exotic mental illness as a face saving excuse for their personal failings and that therapists may play a role in their development of this pattern of behavior, others argue to the contrary.

Psychodynamic:   person disowns or denies unacceptable impulses, which are projected or displaced onto other identities  Massive repression of unwanted impulses or memories may be the basis for creating a “new person” who acts out otherwise unacceptable impulses or recalls otherwise unbearable memories.

DID is related to severe emotional trauma that occurred in childhood, although this link is not unique to DID, as a history of child abuse elevates the likelihood of many disorders, especially among females.

Recap

Dissociative Disorders:

Loss of Self

Dissociative Amnesia:

Loss of memory of a traumatic event

Dissociative Fugue:

Loss of identity and travel to a new location

Depersonal ization Disorder:

Feeling detached from oneself

Dissociative Identity Disorder:

Two or more distinct personalities