Transcript Dissociative Disorders

Dissociative Disorders
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)
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 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 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 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 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.
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).
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
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
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–
–
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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?
Is DID a real psychological disorder?
NO!
YES!
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.
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.
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.
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.
Multiple Personality Disorder:
Questions
1.
Describe the tests done by Putnam and his colleagues using
evoked potentials. What was the role of the control group in
the tests?
2.
What can you conclude from the results of these tests?