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Understanding Dissociation Part I

Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories, or sense of identity. This can be a coping mechanism in response to trauma or overwhelming stress. While it’s common for people to experience mild dissociation (like daydreaming or losing track of time), more severe and persistent forms can lead to dissociative disorders. These disorders can significantly impact a person’s daily life, and understanding them is crucial for those affected and their loved ones. Here, we explore three key types of dissociative disorders: Dissociative Identity Disorder (DID) (note: this used to be termed Multiple Personality Disorder), Dissociative Amnesia, and Otherwise Specified Dissociative Disorder (OSDD).




One particularly intriguing aspect of Dissociative Identity Disorder (DID) is the phenomenon of differential physiological responses among different personality states. Research by Putnam et al. (1986) found that 26% of DID patients exhibited varying allergic responses depending on the active personality state, with some being allergic to substances such as orange juice while others were not. Additionally, 46% of these patients demonstrated different responses to medication, and 35% had varying reactions to food across different personality states. These differences extend beyond allergies and medication reactions; DID patients have also shown distinct cardiovascular responses, such as variations in heart rate and blood pressure, as well as differing patterns of cerebral activation and subjective reactions when exposed to trauma-related memory stimuli. These findings highlight the complex interplay between psychological and physiological processes in individuals with DID


Dissociative Identity Disorder (DID)

Formerly known as multiple personality disorder, Dissociative Identity Disorder (DID) is characterized by the presence of two or more distinct personality states or identities within a single individual. Each identity may have its own name, age, gender, and mannerisms. People with DID often experience amnesia or memory gaps, which can lead to confusion about events and information. The different identities, sometimes called "alters," may take control of the person’s behavior at different times.

DID usually develops as a response to severe trauma during early childhood, such as physical, emotional, or sexual abuse. The mind's way of coping with extreme stress is to compartmentalize or split into different identities. This dissociation serves as a protective mechanism, allowing the individual to endure and function despite the trauma. DID can be challenging to diagnose because its symptoms overlap with those of other mental health conditions, such as depression, anxiety, and PTSD. Effective treatment often involves long-term psychotherapy aimed at integrating the different identities and addressing the traumatic experiences at the root of the disorder.


Dissociative Amnesia

Dissociative Amnesia is characterized by an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. This memory loss can last for hours, days, weeks, or even longer. It can occur with or without dissociative fugue, where an individual may travel or wander away from their usual surroundings and assume a new identity, with no memory of their previous one.


Unlike other types of amnesia caused by medical conditions, dissociative amnesia is purely psychological. It is often triggered by a traumatic event or extreme stress, where the mind essentially "blocks out" the memory to protect the person from the emotional pain associated with the trauma. We see this often in practice as a client may say "I don't remember my childhood."


Treatment for dissociative amnesia usually involves psychotherapy, which can help individuals gradually recover lost memories, understand the context of their trauma, and integrate these parts.


Otherwise Specified Dissociative Disorder (OSDD)

Otherwise Specified Dissociative Disorder (OSDD) is a category for dissociative disorders that do not fit the criteria for DID or dissociative amnesia but still cause significant distress or impairment. OSDD can include conditions where an individual may have dissociative symptoms but does not meet all the criteria for DID, such as experiencing different identities without complete amnesia between them. OSDD is relatively common and can vary widely in its presentation.

People with OSDD may experience identity disturbance with less distinct shifts compared to DID, meaning they might feel different parts of their personality coming forward without the complete switch seen in DID. Treatment for OSDD is typically tailored to the individual's specific symptoms and often involves psychotherapy aimed at improving awareness, managing dissociative symptoms, and processing trauma.


Conclusion

Dissociative disorders are complex and often misunderstood mental health conditions. They highlight the profound ways in which the human mind can protect itself from trauma and stress. Recognizing and understanding dissociation is crucial for effective treatment and healing. If you or someone you know is experiencing symptoms of dissociation, seeking help from a mental health professional with experience in trauma and dissociation is essential. Therapy can provide a safe space to explore these experiences and work towards greater self-awareness and healing.

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