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Discussion 7.1: Dissociative Disorders 

Institutional Affiliation

Author’s Name

Date
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Discussion 7.1: Dissociative Disorders

As a Psychiatric-Mental Health Nurse Practitioner diagnosing a patient with dissociative

disorders whose life has been characterized by traumatic experiences caused by mistrust of

authority figures, my role would be to help the patient reflect upon and narrate experiences that

have been dissociated since they evoke strong, negative, and contradictory emotions. To achieve

this, I would have to be patient with them and take time to establish a collaborative relationship

built on increased trust levels, data from diagnostic interviews, and self-report measures (Sharma

et al., 2021). Other barriers to diagnosing dissociative disorders among traumatized patients

include differential diagnosis, misdiagnosis of dissociative disorders, denial, and disavowal.

Differential diagnosis and misdiagnosis are evident in false negative and false positive diagnoses

where the patient’s symptoms are likely to be confused with other mental disorders with similar

symptoms (Subramanyam et al., 2020). Additionally, patients with dissociative disorders also

often do not realize that their internal experiences are not identical to those of others, thus using

dissociation as resistance against uncomfortable realities.

As a result, I would employ therapeutic alliance in administering the most effective

therapeutic interventions in dealing with patients with dissociative disorders. I intend to achieve

an alliance and positive relationship with such patients by creating an affective bond, agreeing on

the goals of the selected therapy, and jointly developing tasks with the patient. Consequently, the

therapeutic alliance would result in helping the patient stabilize the symptoms related to the

dissociative disorder, decrease suicidal and self-destructive behaviors, achieve tolerance and

regulation, establish awareness and cooperation with dissociated self-states, process and resolve

uncomfortable traumatic experiences, and develop a sense of internal wholeness (Subramanyam

et al., 2020). Even though there are no specifically recognized medications in treating co-
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occurring and distressing symptoms among such patients, antidepressants, antipsychotics, or

anti-anxiety medications could be used on patients with dissociative disorders (Hoskins et al.,

2021). Examples of such pharmacotherapy interventions include sertraline, fluoxetine,

venlafaxine, and citalopram.

 
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References

Hoskins, M. D., Bridges, J., Sinnerton, R., Nakamura, A., Underwood, J. F., Slater, A., ... &

Bisson, J. I. (2021). Pharmacological therapy for post-traumatic stress disorder: A

systematic review and meta-analysis of monotherapy, augmentation and head-to-head

approaches. European Journal of Psychotraumatology, 12(1), 1802920.

Sharma, R., Satapathy, S., Choudhary, V., & Sagar, R. (2021). Childhood Trauma and Clinical

Correlates of Dissociative Disorders among Adolescents: An Exploratory Study. Journal

of Indian Association for Child and Adolescent Mental Health-ISSN 0973-1342, 17(3),

92-111.

Subramanyam, A. A., Somaiya, M., Shankar, S., Nasirabadi, M., Shah, H. R., Paul, I., &

Ghildiyal, R. (2020). Psychological Interventions for Dissociative disorders. Indian

journal of psychiatry, 62(Suppl 2), S280.