Transcript Psychological Disorders: Part 2

Dissociative
Disorders
A Closer Look at Psychological
Disorders
Dissociative Disorders

Individuals with dissociative
disorders have in some way
broken away from their sense
of self – from their memories,
thoughts, or feelings.
 Symptoms:
Having a sense of being unreal
 Being separated from the body
 Watching yourself as if in a
movie

Dissociative Disorders

Even though we may hear about
them somewhat frequently,
dissociative disorders are
actually quite rare and usually
represent a response to
overwhelming stress.
 Three specific forms are: a
Amnesia
 Fugue State
 Dissociative Identity Disorder.

Dissociative Amnesia




Remember that amnesia is
memory loss.
Many things could cause
amnesia – brain injury, drugs,
etc.
Dissociative Amnesia:
amnesia that has _______
biological explanation
This type of amnesia is a reaction to
a specific, stressful event – a
traumatic incident – like
 For example, witnessing a
terrible accident, surviving a
natural disaster, etc.
 If this gopher
suddenly couldn’t
remember who he
was after a blow to
the head, this would
be plain old amnesia.
 Dissociative amnesia
does not have a
biological explanation.
Dissociative Amnesia (cont.)

Case studies:

Combat soldiers may report losing their memories
for hours or even days.
An 18 year old man was on a sailing cruise with
friends when a storm came up. He was the only
one to put on a life vest and tie himself to the boat,
and he watched all of his friends get swept
overboard by high waves.
 He spent days waiting to be rescued, but
remembered none of these events afterwards.

Dissociative Amnesia (cont.)
Freud labeled this type of
psychologically based
amnesia repression.
 Sometimes, as in some
cases of abuse, what
people have experienced
becomes too difficult for
them to handle, so they
“forget.”

Dissociative Amnesia (cont.)

Localized amnesia is present in an individual who has no
memory of specific events that took place, usually traumatic.
The loss of memory is localized with a specific window of
time.


Selective amnesia happens when a person can recall only
small parts of events that took place in a defined period of
time.



For example, a survivor of a car wreck who has no memory of
the experience until two days later is experiencing localized
amnesia.
For example, an abuse victim may recall only some parts of the
series of events around the abuse.
Generalized amnesia is diagnosed when a person's
amnesia encompasses his or her entire life.
Systematized amnesia is characterized by a loss of memory
for a specific category of information.

A person with this disorder might, for example, be missing all
memories about one specific family member.
Dissociative Fugue



The word fugue comes from the same root as
fugitive.
Dissociative fugue serves the same
psychological function as dissociative amnesia –
escape from unbearable conflict or anxiety.
Dissociative fugue also involves memory loss,
but unlike dissociative amnesia, the memory
loss is also accompanied by travel to a new
location and the adoption of a new identity.
 People
may forget who they are, travel to a new
place, make new friends, get a new job, remarry, etc.
 A fugue state may last for days or even decades.
Etiology of Dissociative Amnesia and
Fugue States
Psychodynamic: _________ of trauma or
anxiety-producing memories
 Behavioral:

 Operant
conditioning: forgetting leads to relief,
which is reinforcing
 State-dependent learning: memories are not
recalled during normal arousal states
 Self-hypnosis
Depersonalization
Disorder




Marked by a feeling of detachment or
distance from one's own experience,
body, or self.
One can easily relate to feeling as they
are in a dream, or being "spaced out.”
A person's experience with
depersonalization can be so severe
that he or she believes the external
world is unreal or distorted.
Etiology of Depersonalization Disorder:


Psychodynamic: more extreme defense;
disturbed ego functioning
Cognitive: difficulty attending to both
internal and external events
Dissociative Identity Disorder



D.I.D. was formerly known as multiple
personality disorder.
With this disorder, a person is said to
exhibit two or more distinct and
alternating personalities.
These sub-personalities can differ in
age, sex, and self-perception of physical
characteristics.


Some researches have even reported
changes in brain function or handedness as a
person switches from one personality to
another.
Sometimes personalities seem to be
aware of one another, and sometimes
they do not.
Dissociative Identity Disorder (cont.)

Examples of handwriting samples from a D.I.D. patient:
Dissociative Identity Disorder (cont.)





One of the most famous cases of D.I.D. is Eve
White, the basis of the film The Three Faces of
Eve.
Eve sought psychiatric treatment for severe
headaches and blackouts. She was a
conscientious, self-controlled, and shy person.
However, during one of her therapy sessions,
her expression – and her personality – suddenly
changed. Eve White had become Eve Black –
childlike, irresponsible, and fun-loving – the
opposite of Eve White.
Eve Black was conscience of Eve White’s
existence but considered her a separate person.
Eve White did not know about Eve Black,
however, nor did she know about Jane, a third
personality that emerged during the course of
therapy.
Eve White’s real name is Chris Costner
Sizemore, and she released her story many
years later when she published a book titled I’m
Eve.
In her book, Sizemore** admits she ultimately
had 22 separate personalities.
Chris Sizemore (DID)
The Controversy Over DID



The diagnosis of this disorder is very controversial –
many psychologists doubt it even exists.
In a recent survey, only ¼ of American psychiatrists in
the sample indicated that they felt there was solid
evidence for the scientific validity of DID.
Why?




Diagnosed cases of D.I.D. have increased dramatically in recent
years. Prior to the 1970s, fewer than 100 cases had ever been
reported. Then, in the 1980s alone, reports of more than 20,000
cases appeared, almost all of them in the U.S.
The average number of sub-personalities has also increased – from
3 to 12. In some cases, dozens or even 100 personalities have
been reported.
One famous sufferer of D.I.D., Sybil Dorsett, is now believed to
have been inappropriately influenced by her psychiatrist.
After the death of Sybil’s psychiatrist and the release of her records,
experts have come to believe that by giving names to Sybil’s
emotional states and asking her to take on these roles as part of the
therapeutic process, the psychiatrist could have led Sybil to believe
that she possessed multiple personalities.
Recent Controversial Cases

In 2001, former NFL football star
Herschel Walker was diagnosed
with D.I.D. by his psychiatrist.
Watch these videos:
 http://www.youtube.com/watch?v=YX
uG2zI39yA (Part 1)
 and
http://www.youtube.com/watch?v=6Xl
KOC-WnZo&feature=related (Part 2)
 or
http://www.youtube.com/watch?v=bX
3F-CkTaFU

What do you think?
Etiology of Dissociative Identity
Disorder


Some people believe that DID is simply an
exaggeration of normal human tendencies. For
example, everyone is capable of behaving in different
ways depending on the circumstances (rowdy in a bar,
quiet in a museum). This variation may become so
extreme that that a person feels, or is perceived by
others, as a “different person.”
Behavioral

Operant conditioning: forgetting leads to relief, which is
reinforcing



Sudden memory loss or unusual behavior may be rewarded by
providing escape from unpleasant situations, responsibilities, or
punishment for misbehavior.
State-dependent learning: different arousal states associated
with different identities
Self-hypnosis
Etiology of Dissociative Identity
Disorder, (cont.)

Sociocognitive: due to clinician’s influence (iatrogenic –
caused by the diagnosis, manner, or treatment of a
physician)


Some theorists believe that people with DID are engaging in
intentional role playing to use an exotic mental illness as a facesaving excuse for their personal failings and that therapists may
play a role in their development of this pattern of behavior, others
argue to the contrary.
Psychodynamic:

person disowns or denies unacceptable impulses, which are
projected or displaced onto other identities


Massive repression of unwanted impulses or memories may be the
basis for creating a “new person” who acts out otherwise
unacceptable impulses or recalls otherwise unbearable memories.
DID is related to severe emotional trauma that occurred in
childhood, although this link is not unique to DID, as a history of
child abuse elevates the likelihood of many disorders, especially
among females.
Recap
Dissociative
Disorders:
Loss of Self
Dissociative
Amnesia:
Loss of memory of
a traumatic event
Dissociative
Fugue:
Loss of identity and
travel to a new
location
Depersonalization
Disorder:
Dissociative
Identity
Disorder:
Feeling detached
from oneself
Two or more distinct
personalities