Dissociative Disorders

Module 69

Dissociative Disorders

• A category of psychological disorders in which extreme and frequent disruptions of awareness, memory, and personal identity during times of stress 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)
• Usually occurs when a person faces extreme stress or trauma
• Mild dissociative experiences are quite common and completely normal (daydreaming)

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

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.

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

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.

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).

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.

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.

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

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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

The DID Controversy

• Some curious statistics
• 1930–60: 2 cases per decade in USA
• 1980s: 20,000 cases reported
• Average number of personalities per case went up from 3 to 12
• 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?

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.

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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.

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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.

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Multiple Personality Disorder

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