Dissociative Disorders Dissociation…the human minds capacity to mediate complex mental activity in channels split off from or independent of conscious awareness A way of managing anxiety and stress… – Dissociative Identity Disorder Amnesia & Fugue – Psychogenic/Dissociative Amnesia & Fugue – Depersonalization disorder

Coexisting Diagnoses or Misdiagnoses Major depression Generalized anxiety disorder Bipolar disorder Attention deficit hyperactivity disorder Obsessive compulsive disorder Eating disorders Substance abuse disorders Sleep disorders Impulse control disorders

Dissociative Identity Disorder Multiple Personality Disorder Previously known as Multiple Personality Disorder Individual manifests at least two or more distinct systems of identity Individual manifests at least two or more distinct systems of identity Host personality + Alter identities (~ ) Associated with childhood abuse Rare disorder Popular in media Can be faked or influenced by therapist

Mary Kendall DSM-IV casebook: Mary Kendall, a 35 yr old caseworker. Not much social life--devoted to helping others. Extensive medical history, including chronic pain in her right hand and forearm, led her to meet with a psychiatrist. Displayed many characteristics common w/ DID ~ability to be easily hypnotized ~frequent gaps in her memory +especially childhood memories

Frequent gaps in memory Noticed gas tank often almost full when returned from work, but almost empty in a.m. Kept track of odometer: miles overnight, but could not remember driving anywhere. (Marian) Hypnosis session: one of the hostile personalities (Marian) emerged. Marian Marian described rides that she often took at night in an attempt to work out her problems.

Marian Mary Alter personality, Marian, displayed strong contempt for Mary. Marian Mary Marian felt Mary was very pathetic and that it was a waste of time to always be concerned about others. In therapy ~ 6 personalities emerged- in conflict. Childhood memories emerged: abuse (physical and sexual) committed by father guilt over not protecting siblings. Psychotherapy, in cases of DID not a rapid process. 4 yrs before gradual integration of personality states evident. Some personalities: no integration.

Dissociative Amnesia PSYCHOGENIC AMNESIA – Inability to recall certain personal information, which is still know at the unconscious level – Loss in episodic memory, not procedural or semantic

Dissociative Fugue PSYCHOGENIC FUGUE – Loss of memory accompanied by an actual flight from ones present life situation to a new environment – May take on a new identity

Depersonalization disorder Characterized by a sudden sense of being outside yourself, Observing your actions from a distance as though watching a movie. May be accompanied by a perceived distortion of the size and shape of your body or of other people and objects around you. Time may seem to slow down, and the world may seem unreal. Symptoms may last only a few moments or may come and go over many years