Types of dissociative disorders

[David Baxter PhD]

Dissociative Disorders (NAMI)

Dissociative disorders are so-called because they are marked by a dissociation from or interruption of a person's fundamental aspects of waking consciousness (such as one's personal identity, one's personal history, etc.). Dissociative disorders come in many forms, the most famous of which is dissociative identity disorder (formerly known as multiple personality disorder). All of the dissociative disorders are thought to stem from trauma experienced by the individual with this disorder. The dissociative aspect is thought to be a coping mechanism -- the person literally dissociates himself from a situation or experience too traumatic to integrate with his conscious self. Symptoms of these disorders, or even one or more of the disorders themselves, are also seen in a number of other mental illnesses, including post-traumatic stress disorder, panic disorder, and obsessive compulsive disorder.

Dissociative amnesia
This disorder is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature. Dissociative amnesia, unlike other types of amnesia, does not result from other medical trauma (e.g. a blow to the head). Dissociative amnesia has several subtypes:

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. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia.

Selective amnesia happens when a person can recall only small parts of events that took place in a defined period of time. 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 is a rare disorder. An individual with dissociative fugue suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some kind. These journeys can last hours, or even several days or months. Individuals experiencing a dissociative fugue have traveled over thousands of miles. An individual in a fugue state is unaware of or confused about his identity, and in some cases will assume a new identity (although this is the exception).

Dissociative identity disorder (DID), which has been known as multiple personality disorder, is the most famous of the dissociative disorders. An individual suffering from DID has more than one distinct identity or personality state that surfaces in the individual on a recurring basis. This disorder is also marked by differences in memory which vary with the individual's "alters," or other personalities. For more information on this, see the NAMI factsheet on dissociative identity disorder.

Depersonalization disorder is marked by a feeling of detachment or distance from one's own experience, body, or self. These feelings of depersonalization are recurrent. Of the dissociative disorders, depersonalization is the one most easily identified with by the general public; one can easily relate to feeling as they in a dream, or being "spaced out." Feeling out of control of one's actions and movements is something that people describe when intoxicated. An individual with depersonalization disorder has this experience so frequently and so severely that it interrupts his or her functioning and experience. A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.

Treatment
Since dissociative disorders seem to be triggered as a response to trauma or abuse, treatment for individuals with such a disorder may stress psychotherapy, although a combination of psychopharmacological and psychosocial treatments is often used. Many of the symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, and can be controlled by the same drugs used to treat those disorders. A person in treatment for a dissociative disorder might benefit from antidepressants or antianxiety medication.

 

[Ash]

Selective amnesia

Interesting. I have spots in my memory like that. For example... When I was younger, I was walking up the stairs to my room one day. My dad called my name and (I don't know why) I ignored him. Wow did he get mad. I was scared and ended up locking myself in my room and hiding under the bed. I vaguely remember him getting into my room and after that, it's all a blank. There aren't as many episodes where I recall parts of the situation so well but not all of it.

Depersonalization

One of my best friends is a social worker and after I explain what I go through, she brought this up. I don't do it very often but there are times when I'm triggered and overwhelmed to the point where I don't feel that I'm there. I suppose I should say it isn't SEVERE very often.

I understand what's going on around me but everything's different and nothing matters. I'm completely unresponsive. It's so hard to explain. Sometimes it scares me afterwards but other times I don't mind so much because it takes me away. I think that's determined by the severity of the episode.

Hope that I'm not chiming in too much!

 

[David Baxter PhD]

Hope that I'm not chiming in too much!

Certainly not... we don't even call it "chiming in" here... we call it "a conversation" )

 

[Ash]

Hope that I'm not chiming in too much!

Certainly not... we don't even call it "chiming in" here... we call it "a conversation" )

LOL Well, thanks!! I hate sounding like I only talk about me, me, me but I can really only speak for myself! And my kids. ;-)

 

[stargazer]

I met someone in a psych ward who focused really well when she was doing some editing work for me, but when not focused on her work she began to believe that she was an angelic being, or a good witch, or the Holy Spirit. They weren't permitted to tell me her diagnosis. Might that have been dissociative?

 

[David Baxter PhD]

Probably not, minstrelite. It's hard to say what that was but it sounds more delusional than dissociative to me.

 

[stargazer]

Just curious: when you say "delusional" is that a specific disorder; i.e., delusional disorder? I don't know much about this, of course, but I was taken by the fact that when she was focused on a work-oriented task she seemed perfectly fine, but in casual conversation she tended to drift into that delusion, usually thinking she was an Angel.

 

[David Baxter PhD]

It may have been a delusional disorder, paranoid disorder, bipolar disorder, schizophrenia, or something else along those lines -- it's difficult to say based on the information given but my guess is that is was only partially or incompletely controlled so that without a concrete task or object to focus on her attention wandered and reverted to delusional thoughts.

 

[stargazer]

That makes sense, given my memory of her. Thanks.

 

[eekline]

I've heard of selective amnesia before, but could someone give him/herself selective amnesia on purpose? It seems as though if the mind were capable of unconsiously blocking out a traumatic event, then it would also be capable of consciously doing it. Any thoughts? I'd really like to do this.

 

[eekline]

I've heard of selective amnesia before, but could someone give him/herself selective amnesia on purpose? It seems as though if the mind were capable of unconsiously blocking out a traumatic event, then it would also be capable of consciously doing it. Any thoughts? I'd really like to do this.

 

[David Baxter PhD]

If by "on purpose" you mean "consciously", I have my doubts but I'll admit I've never asked or been asked that question before...

I think the problem is that while you can push a thought / memory away consciously, you're doing so because that thought bothers you and such thoughts tend to return because they are unwanted, intrusive thoughts.

I'm not a huge proponent of hypnosis although it does seem to work for some people in some circumstances - I wonder if a form of "self-hypnosis" might work...

 

[Cat Dancer]

Depersonalization disorder is marked by a feeling of detachment or distance from one's own experience, body, or self. These feelings of depersonalization are recurrent. Of the dissociative disorders, depersonalization is the one most easily identified with by the general public; one can easily relate to feeling as they in a dream, or being "spaced out." Feeling out of control of one's actions and movements is something that people describe when intoxicated. An individual with depersonalization disorder has this experience so frequently and so severely that it interrupts his or her functioning and experience. A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.

Can this happen in sexual abuse survivors a lot?

 

[David Baxter PhD]

Yes. Various forms of dissociation are not uncommon in victims of repetitive sexual abuse.

 

[Cat Dancer]

Depersonalization disorder is marked by a feeling of detachment or distance from one's own experience, body, or self. These feelings of depersonalization are recurrent. Of the dissociative disorders, depersonalization is the one most easily identified with by the general public; one can easily relate to feeling as they in a dream, or being "spaced out." Feeling out of control of one's actions and movements is something that people describe when intoxicated. An individual with depersonalization disorder has this experience so frequently and so severely that it interrupts his or her functioning and experience. A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.

When I first came to Psychlinks, I thought I wasn't real. I really believed it. I had almost no contact with reality. I can't really explain it, but it was an awful feeling. I could talk and no one could hear me. Or so I thought.

Then people started talking to me here and I felt heard. Someone was listening to me, hearing me, talking back to me. I was real again. I will forever be grateful to this forum (the people here) for that and for being here. Always.

Sometimes in my real world I still feel this way, this sense of depersonalization, but I know now that there are kind people who will listen and respond with warmth and care and it makes all the difference in the world.

 

[ladylore]

:agree:

 

[amastie]

I've wanted a chance to explain Dissociative Identity from the perspective of someone who has it.

I don't experience being unreal on the whole - maybe a long time ago. Rather, my experience of having different people inside is all quite "real" in a sense.

All people struggle at times with self-sabotage or resistance to achieving our daily plans. I'm not aware of other people inside me thwarting my plans until I resist *not* being sabotaged and *then* they come through and I am engaged in an internal verbal exchange with someone else. Not with myself but someone else - someone who, if strong enough, would manifest though my body in order to hurt me. So far, they've never been that strong. The closest my "alters" have come to physically hurting me is to raise my arm up to hit me. But of course the most prevalent influence is on my thinking (they intrude in my thoughts, sometimes less consciously than at other times) and also on my eating and relating to others. Perhaps I do experience a degree of derealisation because I know that I can keep eating without any sense of connection to that activity. But, at other times, I can feel the internal "people" demanding that I eat, just like they demand that I do things that bring out about other negative response to me, such as being late for an appointment. Knowing this, I put into place strategies to thwart their involvement. I picture myself having to be at an appointment at an earlier time - and often it works!

They get pleasure from my being found to have done something wrong. it devastates me to do so. I've looked at the difference between being masochistic at those times and being dissociative, and I'm clear that I get *no* pleasure from being brought low. As well, their pleasure is possible to unravel and be helped to see that it does not serve to protect me at all - although I've yet to help them sustain such an understanding.

Most people with DID, I have found, have names for these internal people. I don't - just "man", "child" etc. I don't want to give them more power by naming them.) but it is true that these other people do have a personality of their own, with their own tastes and personas.

I am Spiritualist by belief and that belief opens up avenues for dealing with the personalities - using a different modality of healing. I'm fortunate that my psychiatrist, who knows me very well, has supported me in finding different ways to engage with the personalities in ways that are helpful.

Why I am not free of them after so many years is a question that does not bewilder me. I can see reasons for it, but it does sadden me enormously.

No matter how good the therapist, resolving a long-held mental/emotional issue holds no guarantee. One keeps taking one day at a time.

I may not be free of my challenges, but I've certainly learned a lot on account of them I need no sympathy. I don't deserve it. When I look at how courageously others pursue their life challenges, mine is, to me a much easier one. I see that very often.

I've explained as well as I can what it means for me to be dissociative, but I'm aware that others, further along the dissociative spectrum than me, *do* lose time and that there lives are much more fractured as a result - but the gist is the same. Other people take over our thoughts and awareness - just to different degrees.

I really did just want to add to this discussion to help explain what it is to actually be dissociative.

Thanks

 

[forgetmenot]

with my dr he is drawing out memories from my past that i totally blanked out i cannot remember names say of a certain doll i had but can remember every name of the people who caused harm i keep telling this dr that this person he is making me remember abt is not me it is someone else that does not exist anymore she was left behind along time ago he doesn't get it it is not me i am a different person with a different name now i am not her and never willbe again so why bring her back

 

[Jazzey]

Hi Mary,

Sometimes, delving into our pasts, into our childhoods, helps us to understand who we are today. It's difficult and painful. Especially when we've erased much of it. But there is a purpose in going back to that time.

I don't particularly feel like the child that I once was either. But there is also some comfort in understanding why I'm am who I am today. And while I don't totally understand dissociation, I can't help but feel hopeful that in reconstructing my past, I'll find the bits and pieces that are missing so that I can *feel* like I understand how I came to be who I am today...

 

[amastie]

mary :hug: :support:
I have concern that your doctor is "making" you remember - though I also think I can understand why he might want you to remember if he feels that the part of you who is "forgotten" is keeping you in pain now. Many therapists believe that only by integrating all the alters/people we are/have been can we be healed. That could be why he is trying to get you to remember. I've seen others live quite well withoiut integrating. There are people who dissociate fully and who choose to live with the alters as they are rather than go back and recover memories or even, as you say, reclaim some forgotten "other" person who they once were. It not a matter of remembering or not, but functioning here and now, and being free of pain. Every therapist works in their own way. If you remain unhappy with yours, certainly discuss it with him, Mine has never pursued past memories. You might be able to resolve it with him by discussing your concerns, especially if he knows that you feel coerced into remembering. You might also want to consider seeing someone else even if only for a second opinion.