Question

B. Define and describe the concept of dissociation. Discuss the variations of dissociation, describing it in terms of how mild, moderate, and severe presentations of dissociation may appear. Select one of the dissociative disorders and describe in detail, including a detailed treatment strategy (treatment strategy should show understanding of the complexity of the disorder selected).

Answer 1

Dissociation can be defined as disruptions in aspect of consciousness, memory, identity, physical actions or the environment. The concept of dissociation refers to the human mind's capacity to mediate complex mental activity in channels split off from, or independent of, conscious awareness.

Mild dissociative symptoms are seen when we daydream or lose he awareness of what is going on in the present environment, when we drive miles beyond our destination without realizing how far we have got or when we miss a part of the conversation we are engaged in.

Much of normal individual's mental life involves non conscious processes that are to a large extent autonomous with respect to deliberate, self aware monitoring and direction. However in dissociative disorders, this normally well integrated and coordinated human cognition becomes less coordinated and the affected person may be unable to access information that is normally in the forefront of consciousness, showing moderate to severe presentation of dissociations.

According to DSM-1V-TR, dissociative identity disorder (DID), earlier known as multiple personality disorder is a dramatic dissociative disorder in which a person shows two or more distinct identities that alternate in some way taking control of behaviour.

According to DSM-1V-TR, Criteria for dissociative identity disorder (DID):

A. Presence of two or more distinct identities, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.

B. At least two of the identities recurrently take control of the person's behaviour.

C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

In most cases of DID, one identity that is most frequently encountered and carries person’s real name is the host identity, which is often not the original identity. The alter identities may differ in gender, age, handedness, handwriting, sexual orientation, foreign languages spoken, general knowledge.

TREATMENT FOR DID

For DID patients, the therapeutic approaches are based on the assumption of post-traumatic theory that the disorder was caused by abuse. Most therapists set integration of the previously separate alters, together with their collective merging into the host personality, as the ultimate goal of treatment.

The treatment is mostly psychodynamic and insight oriented, focused on uncovering and working through the trauma and other conflicts that are thought to led to the disorder.

Hypnosis is often used with DID patients to be able to recover past unconscious and frequently traumatic memories from the childhood.