Dissociative Disorders

Dissociative disorders involve a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The key idea is a loss of the normal integration of memories, identity, and consciousness — the person feels disconnected from themselves or their surroundings in a fundamental way.

The disorders are not due to the direct effects of a substance or a general medical condition. They are understood as a psychological response to overwhelming stress or trauma, where the mind "dissociates" or splits off parts of experience to protect itself.

Types of Dissociative Disorders

The textbook describes several specific types, each with a distinct pattern of symptoms.

• Dissociative Amnesia: This is the most common dissociative disorder. The person experiences an inability to recall important personal information, usually of a traumatic or stressful nature. This memory loss is too extensive to be explained by ordinary forgetfulness. It can be:

  • Localized: Inability to recall events during a specific period of time (e.g., the hours surrounding a traumatic accident).
  • Selective: Remembering some, but not all, events during a specific period.
  • Generalized: Complete loss of memory for one's entire life history (this is rare).
  • Continuous: Forgetting each new event as it occurs.
  • A specific form is Dissociative Fugue, which involves sudden, unexpected travel away from home or one's place of work, along with an inability to recall one's past. The person may be confused about their identity or even assume a new identity.

• Dissociative Identity Disorder (DID): This is the most severe and chronic dissociative disorder. It is characterized by the presence of two or more distinct personality states (often called "alters") that recurrently take control of the person's behavior. There is an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. Each personality state may have its own name, age, history, and characteristics. The transition between states is often sudden and triggered by stress.

• Depersonalization/Derealization Disorder: This involves persistent or recurrent experiences of depersonalization, derealization, or both.

  • Depersonalization is the experience of feeling detached from one's own mental processes or body, as if one is an outside observer of oneself (e.g., feeling like you are in a dream or that your body is not your own).
  • Derealization is the experience of feeling that the external world is unreal, dreamlike, distorted, or foggy (e.g., people seem like actors on a stage, or the world looks flat and artificial). During these experiences, reality testing remains intact — the person knows that their perception is distorted, which can be very distressing.

Why Do Dissociative Disorders Occur? …