1. Dissociative Disorders

2. Dissociative Disorders
A category of psychological disorders in which extreme and frequent disruptions of awareness, memory, and personal identity impair the ability to function
What is dissociation?
literally a dis-association of memory
person suddenly becomes unaware of some aspect of their identity or history
unable to recall except under special circumstances (e.g., hypnosis)
Mild dissociative experiences are quite common and completely normal (daydreaming)
Keywords: definition of dissociation
Some psychologists use the term repression for dissociative amnesia
A problem is that we need to distinguish between normal forgetting and the extreme case of dissociative amnesia. Just because you can’t remember something from your past very well doesn’t mean you are dissociating.
Amnesia can also be caused by a head injury or by drugs. This isn’t considered dissociative amnesia
How can we tell other kinds of forgetting from dissociation?
Sudden onset, related to emotional trauma
absence of brain injury, drugs

4. Dissociative Amnesia Example
Margie and her brother were recently victims of a robbery. Margie was not injured, but her brother was killed when he resisted the robbers. Margie was unable to recall any details from the time of the accident until four days later.
Keywords: dissociative amnesia example

5. Dissociative Amnesia Also known as psychogenic amnesia
Memory loss the only symptom
Partial or total inability to recall important personal information.
Often selective loss surrounding traumatic events
person still knows identity and most of their past
Can also be global
loss of identity without replacement with a new one
Keywords: dissociative amnesia

6. Dissociative Fugue Example
• Jay, a high school physics teacher in New York City, disappeared three days after his wife unexpectedly left him for another man. Six months later, he was discovered tending bar in Miami Beach. Calling himself Martin, he claimed to have no recollection of his past life and insisted that he had never been married.
keywords: dissociative fugue example

7. Dissociative Fugue Also known as psychogenic fugue
Global amnesia with identity replacement
leaves home
develops a new identity
apparently no recollection of former life
called a ‘fugue state’
If fugue wears off
old identity recovers
new identity is totally forgotten
keywords: dissociative fugue

8. Dissociative Identity Disorder (DID) Example
Norma has frequent memory gaps and cannot account for her whereabouts during certain periods of time. While being interviewed by a clinical psychologist, she began speaking in a childlike voice. She claimed that her name was Donna and that she was only six years old. Moments later, she seemed to revert to her adult voice and had no recollection of speaking in a childlike voice or claiming that her name was Donna.
keywords: dissociative identity disorder example

9. Dissociative Identity Disorder
Originally known as “multiple personality disorder”
2 or more distinct personalities manifested by the same person at different times
VERY rare and controversial disorder
Examples include Sybil, Trudy Chase, Chris Sizemore (“Eve”)
Has been tried as a criminal defense
Hear the story of Herschel Walker (3 min).
Watch Tony go between his alters (4 min).
keywords: dissociative identity disorder, symptoms

10. DID Facts
Alternate personalities, often called alters, may be of widely varying ages and of different genders.
Alters are not really separate people; rather, they constitute a “system of mind.” At different times, different alters take over. Person’s primary personality often not aware of the alters.
Some researchers report physiological differences among the different personalities within a single individual
Symptoms of amnesia and memory problems are almost always present. People with DID typically have numerous other psychiatric and physical problems along with a chaotic personal history.

11. Dissociative Identity Disorder
Pattern typically starts prior to age 10 (childhood)
Most people with disorder are women
Most report recall of torture or sexual abuse as children and show symptoms of PTSD
keywords: dissociative identity disorder, characteristics

12. Causes of Dissociative Disorders?
Repeated, severe sexual or physical abuse
However, many abused people do not develop DID
Combine abuse with biological predisposition toward dissociation?
people with DID are easier to hypnotize than others
may begin as series of hypnotic trances to cope with abusive situations
keywords: causal theories of dissociative disorders

13. The DID Controversy Some curious statistics
1930–60: 2 cases per decade in USA
1980s: 20,000 cases reported
many more cases in US than elsewhere
varies by therapist—some see none, others see a lot
Is DID the result of suggestion by therapist and acting by patient?
keywords: dissociative identity disorder, controversy over
Spanos asked college students to pretend they were accused murderers being examined by a psychiatrist. When given hypnotic therapy the students often expressed a second personality which claimed to be the murderer.
This raises the question of whether DID might arise in some cases as a strategy or ploy by the patient, not just to avoid prosecution for crimes but perhaps to avoid other negative situations.
It is not suggested that all DID cases arise in this way, but perhaps the large increase in diagnosis can be accounted for in this way.
The increase in incidence in the 1980s was preceded by heightened awareness of the the stories of THE THREE FACES OF EVE and SYBIL which became known in the 1960’s

14. Is DID a real psychological disorder?
NO!
Some psychologists claim there is no such thing as DID and point to the dramatic increase in cases over the last two decades. They suggest that DID patients are consciously or unconsciously “faking” the symptoms, responding to a therapist’s suggestions, or mimicking the symptoms of cases portrayed in the media.
YES!
Defenders of the diagnosis note that many patients experience symptoms before entering treatment or learning about the disorder. They suggest the increase in cases is due to greater clinical awareness of the disorder, improved diagnostic description of DID symptoms, and increased screening for dissociative symptoms.

15. Dissociative Identity Disorder
In multiple personality disorder, also known as dissociative identity disorder, the person has two or more distinct identities that take turns controlling his or her behavior.
Some researchers regard this as a culturally created phenomenon, not a true psychological disorder. Multiple identities, they say, are just a more extreme version of the normal human tendency to vary how we present ourselves in different situations. Overeager clinicians can trigger an exaggeration of this phenomenon in some individuals.
Other researchers, such as Dr. Frank Putnam, see multiple personalities as a genuine psychological disorder, a protective response to childhood trauma.

16. Multiple Personality Disorder
Tony describes his life with multiple personalities, some of which we see emerging in a therapy session. Dr. Frank Putnam, at the National Institute of Mental Health, describes the results of testing on Tony and other individuals with multiple personality disorder.
Click HERE to view or on the box to the right.

17. Multiple Personality Disorder: Questions
Describe the tests done by Putnam and his colleagues using evoked potentials. What was the role of the control group in the tests?
What can you conclude from the results of these tests?