MODULE 10| DISSOCIATIVE DISORDERS o Prostitutes

o Gay males
I. NATURE OF DISSOCIATIVE DISORDERS o Lesbians

 Disruption or dissociation (“splitting off”) of the ALTERS: 

functions of identity, memory or consciousness
o A microcosm of conflicting urges and cultural
 COMPONENTS:  themes
o Themes of sexual ambivalence and shifting
o AMNESIA: Memory loss of certain time sexual orientation
periods, events, people, and personal o INTERPERSONALITY RIVALRY
information.
o DEREALIZATION: Perception of the people CONTROVERSIES LINKED WITH DID: N.
and things around you as distorted and unreal. SPANOS (1994): DID as a form of ROLE-
o DEPERSONALIZATION: Sense of PLAYING
detachment from oneself and one’s emotions
o IDENTITY CONFUSION: A blurred sense of 
identity o The person construes themselves as having
o IDENTITY ALTERATION: Having more multiple selves and acting in ways that are
than one distinct personality. consistent with their conception of the
disorder.
II. DISSOCIATIVE IDENTITY DISORDER o Role-playing becomes ingrained that it
becomes a REALITY for them.
 Formerly known as MULTIPLE o Impressionable people may have learned
PERSONALITY DISORDER OR SPLIT how to enact the role of persons with the
PERSONALITY disorder by watching others on TV and in
 Two or more personalities “occupy” the person the movies.
 Personality divides into 2 or more personalities, o The establishment of roles may
but each of them usually shows more integrated be SOCIALLY REINFORCED.
functioning on cognitive, affective, and
behavioral levels III. DISSOCIATIVE AMNESIA

 Amnesia: derived from the Greek words “a-”

(Not) and “mnasthia” (To remember).
 Formerly known as PSYCHOGENIC
AMNESIA.
 Inability to recall important personal
information, usually involving traumatic or
stressful experiences, in a way that cannot be
accounted for by simple forgetfulness.
 Forget events or periods of life that are
traumatic – that generated strong negative
emotions.
 Memory loss is NOT ATTRIBUTED TO A
CLINICAL FEATURES: PARTICULAR ORGANIC CAUSE.
 REVERSIBLE but may last for days, weeks, or
o The emergence of 2/ more distinct personalities even years.
that vie for control of the person.  Recall of memories may happen gradually but
o More common alter personalities: often occurs suddenly and spontaneously.
o Children of various ages
o Adolescents of the opposite gender
➢ DISTINCT TYPES OF MEMORY  The person is unable to recall past personal
PROBLEMS:  information and becomes confused about his or
her identity or assumes a new identity.
LOCALIZED AMNESIA  Not think about the past or may report a past
filled with false memories without recognizing
 Events occurring during a specific period of them as false.
time are lost to memory  Act more purposefully.
 A person could not recall events for a number of  The new identity is INCOMPLETE and
hours or days after a stressful or traumatic FLEETING, the FORMER SENSE OF SELF
incident RETURNS in a matter of hours or days.
 Assume an IDENTITY that is quite
SELECTIVE AMNESIA spontaneous and sociable as compared to their
former self
 People only forget only the disturbing  NOT CONSIDERED PSYCHOTIC
particulars that take place during a certain
period of time V. DEPERSONALIZATION/
DEREALIZATION DISORDER
GENERALIZED AMNESIA
 DEPERSONALIZATION
 People forget their entire lives- who they are, o Temporary loss or change in the usual sense
what they do, where they live, whom they live of our own reality
with, etc. o People feel detached from themselves and
 Very Rare form their surroundings
 Cannot recall personal information but retain o Feel as if they were dreaming or acting like
their skills, habits, and tastes a robot
o Feelings of depersonalization: COME ON
CONTINUOUS AMNESIA SUDDENLY and FADE GRADUALLY.
 The person forgets everything that occurred  
from a particular point in time up to and
including the present.  DEREALIZATION:
o Sense of unreality about the external world
SYSTEMATIZED AMNESIA involving odd changes in one’s perception
of the surroundings or the passage of time
 Memory loss is specific to a particular category o People or objects seem to change in size or
of information, such as memory about one’s shape and sounds may seem different
family or particular people in one’s life o Associated with feelings of anxiety,
including dizziness and fears of going
** MALINGERING: Faking symptoms or insane, or with depression
making false claims for personal gain**
IV. DISSOCIATIVE FUGUE

 “Amnesia on the run”

 Derived from the Latin word, fugere (flight)
 A person may travel suddenly and unexpectedly
from his or her home or place of work.
 Travels may either be purposeful, leading to a
particular location, or involve bewildered
wandering.
  Dysfunction in BRAIN METABOLIC
ACTIVITY: possible dysfunction in areas of
the brain involved with body perception.

 Disruption in NORMAL SLEEP-WAKE

CYCLE: Dissociative experiences i.e., being
detached from the body.

B. PSYCHODYNAMIC PERSPECTIVE

 The massive use of repression results in the

splitting off from consciousness of unacceptable
impulses and painful memories, typically
 Maintain contact with reality involving parental abuse.
 Distinguish reality from unreality
 Memories are intact and they know where they  DISSOCIATIVE IDENTITY
are DISORDER: Express unacceptable impulses
 DIAGNOSIS: through the development of alternate
o Experiences become persistent or recurrent personalities.
o Cause significant distress or impairment in
daily functioning  DISSOCIATIVE AMNESIA: Adaptive
o Become chronic or a long-lasting problem function of disconnecting or dissociating one’s
conscious self from awareness of traumatic
VI. CULTURE-BOUND SYNDROMES experiences or other sources of psychological
pain.
AMOK 
 EGO DEFENSE against anxiety.
 Southeast Asia and Pacific Islands
 Trance-like state where a person suddenly  DEPERSONALIZATION: People stand
becomes highly excited and violently attacks outside themselves safely distanced from the
other people or destroys objects emotional turmoil within
 People who run amuck: claim to have no
memory of the episode or recall feeling as if C. SOCIAL-COGNITIVE THEORY
they were acting like a robot
DISSOCIATION AS A LEARNED RESPONSE
 ZAR
 Psychologically distancing the self from
 North Africa and the Middle East disturbing memories or emotions.
 Spirit possession in people who experience  NEGATIVELY REINFORCED by relief
dissociative states from anxiety or removal of feelings of shame
 Individuals engage in unusual behavior, ranging and guilt.
from shouting to banging their heads against the
wall D. DIATHESIS-STRESS MODEL

VII. THEORETICAL PERSPECTIVE  People who are prone to fantasize:

 Highly hypnotizable and are open to altered
A. BIOLOGICAL PERSPECTIVE states of consciousness.
 Increase the risk that people who experience
 Structural differences in areas of the brain severe trauma will develop a dissociative
associated with emotions and memory. phenomenon as a survival mechanism.

VIII. TREATMENT
A. REINTEGRATION OF THE
PERSONALITY

 Integrating the altered personalities into a

cohesive personality structure
 Seek to help patients uncover and work through
memories of early childhood trauma

B. COGNITIVE-BEHAVIORAL THERAPY

 Help change the negative thinking and behavior

associated with depression
 GOAL: Recognize negative thoughts and teach
coping strategies

C. DIALECTICAL-BEHAVIOR THERAPY

 Focus on teaching coping skills to combat

destructive urges, regulate emotions, and
improve relationships while adding validation.
 Encourages MINDFULNESS techniques such
as meditation, regulated breathing, and self-
soothing. 

D. EYE-MOVEMENT DESENSITIZATION
AND REPROCESSING (EMDR)

 Alleviate distress associated with traumatic

memories.

 Combines CBT techniques of re-learning

thought patterns with visual stimulation
exercises to access traumatic memories to
replace negative beliefs with positive ones.