Dissociative disorders disrupt memory, awareness, and identity, often triggered by trauma or extreme stress. These conditions can profoundly impact daily life, causing disconnection between thoughts and consciousness. They range from memory loss to feeling detached from oneself or surroundings.

Types include dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder (DID). While causes are linked to severe childhood trauma, DID remains controversial. Some question its validity, worry about misdiagnosis, and debate treatment approaches.

Dissociative Disorders

Core Features

• Disruption or breakdown of memory, awareness, identity, or perception
• Disconnection between thoughts, identity, consciousness, and memory
• Triggered as a way of coping with trauma or overwhelming stress (childhood abuse, natural disasters, war)
• Symptoms can be short-term or long-term significantly impacting daily functioning (relationships, work, self-care)

Types

• Dissociative amnesia
  • Inability to recall important autobiographical information usually of a traumatic or stressful nature (sexual abuse, combat experiences)
  • Memory loss more extensive than normal forgetfulness not attributed to other medical conditions (head injury, substance abuse)
  • Localized (event-specific), selective (partial memory loss), or generalized (complete loss of identity and life history)
• Depersonalization/derealization disorder
  • Persistent or recurrent experiences of feeling detached from one's mental processes or body (feeling like an outside observer, emotional numbness)
  • Persistent or recurrent experiences of unreality of surroundings (world feels dreamlike, artificial, or distorted)
  • Reality testing remains intact individual aware experiences are not real
  • Causes significant distress or impairment in social, occupational, or other important areas of functioning
• Dissociative identity disorder (DID)
  • Presence of two or more distinct personality states or identities (alters)
  • Each identity may have its own name, personal history, and characteristics including differences in voice, gender, mannerisms, and physical qualities
  • Identities recurrently take control of the individual's behavior accompanied by inability to recall important personal information
  • Causes significant distress or impairment in social, occupational, or other important areas of functioning

Causes and Controversies of DID

• Potential causes
  • Severe and prolonged childhood trauma (physical abuse, sexual abuse, emotional abuse)
  • Traumatic experiences may lead to fragmentation of identity as a coping mechanism
  • Genetic and biological factors may contribute to an individual's vulnerability to developing DID
• Controversies
  • Validity of diagnosis questioned by some mental health professionals
  • Concerns about over-diagnosis or misdiagnosis particularly when suggestive therapeutic techniques used
  • Debate about accuracy of recovered memories of trauma in individuals with DID
  • Some argue DID is a culturally-bound syndrome with higher rates of diagnosis in North America
  • Disagreement about effectiveness of various treatment approaches for DID (psychotherapy, medication, hypnosis)