Amity Institute of Psychology and Allied Sciences

Dissociative Disorders
Module 3
 Amity Institute of Psychology and Allied Sciences

Dissociative Disorders
• The key to our identity – the sense of who we are and where we fit in our
environment – is memory
– Our recall of past experiences helps us to react to present events and guides us in
making decisions about the future
– People sometimes experience a major disruption of their memory
• Dissociative disorders are mental illnesses that involve disruptions or breakdowns of
memory, consciousness, awareness, identity, and/or perception.
• When one or more of these functions is disrupted, symptoms can result.
• These symptoms can interfere with a person's general functioning, including social
and work activities, and relationships.
• The dissociative disorders we will look at include dissociative amnesia, dissociative
fugue and dissociative identity disorder. 2
 Amity Institute of Psychology and Allied Sciences

Dissociative Disorders
• Dissociative disorders are a group of conditions involving
disruptions in a person’s normally integrated functions of
consciousness, memory, identity, or perception.
• The term dissociation refers to the human mind’s capacity to engage
in complex mental activity in channels split off from or independent
of, conscious awareness.
 Amity Institute of Psychology and Allied Sciences

Dissociative Disorders
 There are several kinds of dissociative disorders, including:
 Dissociative amnesia
 Dissociative identity disorder (multiple personality disorder)
 Depersonalization-derealization disorder
 These disorders are often memorably portrayed in books,
movies, and television programs

4
 Amity Institute of Psychology and Allied Sciences

Dissociative Amnesia
• Retrograde amnesia is the partial or total inability to recall or identify
previously acquired information or past experiences; by contrast, anterograde
amnesia is the partial or total inability to retain new information
• dissociative amnesia is usually limited to a failure to recall previously stored
personal information (retrograde amnesia) when that failure cannot be accounted
for by ordinary forgetting.
• The gaps in memory most often occur following intolerably stressful
circumstances—wartime combat conditions, for example, or catastrophic events
such as serious car accidents, suicide attempts, or violent outbursts
• n typical dissociative amnesic reactions, individuals cannot remember certain
aspects of their personal life history or important facts about their identity. Yet
their basic habit patterns—such as their abilities to read, talk, perform skilled
work, and so on—remain intact
Amity Institute of Psychology and Allied Sciences
 Amity Institute of Psychology and Allied Sciences

Symptoms
• The primary symptom of dissociative amnesia is the sudden
inability to remember past experiences or personal
information.
• Some people with this disorder also might appear confused
and suffer from depression and/or anxiety.
 Amity Institute of Psychology and Allied Sciences

Causes
• Dissociative amnesia has been linked to overwhelming stress, which might be the
result of traumatic events
– such as war, abuse, accidents, or disasters
– that the person has experienced or witnessed.
• There also might be a genetic link to the development of dissociative disorders,
including dissociative amnesia, because people with these disorders sometimes
have close relatives who have had similar conditions.
 Amity Institute of Psychology and Allied Sciences

Dissociative Amnesia
 Dissociative amnesia may be:
 Localized – most common type; loss of all memory of events
occurring within a limited period
 Selective – loss of memory for some, but not all, events occurring
within a period
 Generalized – loss of memory beginning with an event, but
extending back in time; may lose sense of identity; may fail to
recognize family and friends
 Continuous – forgetting continues into the future; quite rare in
cases of dissociative amnesia
9
 Amity Institute of Psychology and Allied Sciences

Dissociative Fugue
• The word fugue comes from the Latin word for "flight." People with
dissociative fugue temporarily lose their sense of personal identity
and impulsively wander or travel away from their homes or places of
work.
• They often become confused about who they are and might even
create new identities.
• Outwardly, people with this disorder show no signs of illness, such as
a strange appearance or odd behaviour.
 Amity Institute of Psychology and Allied Sciences

Dissociative Fugue
 Dissociative fugue is a sub part of Dissociative Amnesia
 People with dissociative fugue not only forget their personal
identities and details of their past, but also flee to an entirely
different location
 For some, the fugue is brief – a matter of hours or days – and ends
suddenly
 For others, the fugue is more severe: people may travel far from
home, take a new name and establish new relationships, and even a
new line of work; some display new personality characteristics
11
 Amity Institute of Psychology and Allied Sciences

Dissociative Fugue
 0.2% of the population experience dissociative fugue
 It usually follows a severely stressful event
 Fugues tend to end abruptly
 When people are found before their fugue has ended, therapists
may find it necessary to continually remind them of their own
identity
 The majority of people regain most or all of their memories and
never have a recurrence

12
 Amity Institute of Psychology and Allied Sciences

Dissociative identity disorder (DID)

• Dissociative identity disorder (DID), formerly known as multiple
personality disorder is a
– dramatic dissociative disorder in which a patient manifests two or
more distinct identities that alternate in some way in taking control
of behavior.
• Each identity may appear to have a different personal history, self-
image, and name, although there are some identities that are only
partially distinct and independent from other identities.
Amity Institute of Psychology and Allied Sciences
 Amity Institute of Psychology and Allied Sciences

DID Causes
• It is seen by both psychoanalytic and learning perspectives that DID develops as
a way for the mind to deal with anxiety.
• Psychoanalysts view it as a defense against the anxiety caused by the eruption of
unacceptable impulses, while learning theorists see it as more of a learned
behavior because of the anxiety reduction.
• Others view DID as a post-traumatic disorder, since 11 out of 12 were subject to
severe childhood abuse.
• Overall, multiple personalities appear to be the desperate efforts of the
traumatized to detach from a horrific existence.
 Amity Institute of Psychology and Allied Sciences

Prevalence
• DID usually starts in childhood, although most patients are
in their teens, 20s, or 30s at the time of diagnosis .
• Approximately three to nine times more females than males
are diagnosed as having the disorder, and females tend to
have a larger number of alters than do males
 Amity Institute of Psychology and Allied Sciences

Depersonalization/Derealization Disorder
• Derealization one’s sense of the reality of the outside world is
temporarily lost, and in Depersonalization one’s sense of one’s own
self and one’s own reality is temporarily lost.
• In this disorder, people have persistent or recurrent experiences of
feeling detached from (and like an outside observer of) their own
bodies and mental processes. They may even feel they are, for a time,
floating above their physical bodies, which may
suddenly feel very different—as if drastically changed or unreal.
Amity Institute of Psychology and Allied Sciences
 Amity Institute of Psychology and Allied Sciences

Prevalence
• The lifetime prevalence of depersonalization/derealisation disorder is
unknown but has been estimated at 1 to 2 percent of the population
(Reutens et al., 2010).
• Moreover, occasional depersonalization/derealization symptoms are
not uncommon in a variety of other disorders such as schizophrenia,
borderline personality disorder, panic disorder,
 Amity Institute of Psychology and Allied Sciences

How Do Theorists Explain Dissociative

Disorders?
• The psychodynamic view
– Psychodynamic theorists believe that dissociative disorders are
caused by repression, the most basic ego defense mechanism
• People fight off anxiety by unconsciously preventing painful memories,
thoughts, or impulses from reaching awareness

20
 Amity Institute of Psychology and Allied Sciences

How Do Theorists Explain Dissociative

Disorders?
 The behavioral view
 Behaviorists believe that dissociation grows from normal memory
processes and is a response learned through operant conditioning:
 Momentary forgetting of trauma leads to a drop in anxiety, which increases
the likelihood of future forgetting
 Like psychodynamic theorists, behaviorists see dissociation as escape
behavior
 Also like psychodynamic theorists, behaviorists rely largely on
case histories to support their view of dissociative disorders
 Moreover, these explanations fail to explain all aspects of these disorders
21
 Amity Institute of Psychology and Allied Sciences

Treatment
• The first goal of treatment for dissociative amnesia is to relieve
symptoms and control any problem behaviour.
• Treatment then aims to help the person safely express and process
painful memories, develop new coping and life skills, restore
functioning, and improve relationships.
• The best treatment approach depends on the individual and the severity
of his or her symptoms. Treatments may include the following:
• Psychotherapy: designed to encourage communication of conflicts and
increase insight into problems.
• Cognitive therapy: focuses on changing dysfunctional thinking
patterns and the resulting feelings and behaviours.
 Amity Institute of Psychology and Allied Sciences

Treatment cont’d…
• Medication: antidepressants used to treat depression.
• Family therapy: helps to teach the family about the disorder and its causes, as
well as to help family members recognize symptoms of a recurrence.
• Creative therapies (art therapy, music therapy): allow the patient to explore
and express his or her thoughts and feelings in a safe and creative way.
• Clinical hypnosis: uses intense relaxation, concentration, and focused attention
to achieve an altered state of consciousness (awareness), allowing people to
explore thoughts, feelings, and memories they may have hidden from their
conscious minds. The use of hypnosis for treating dissociative disorders is
controversial due to the risk of creating false memories.