Research into Dissociation and Dissociative Disorders
Dissociative disorders, particularly complex dissociative disorders such as Dissociative Identity Disorder and Other Specified Dissociative Disorder (formerly DDNOS) are poorly understood by many in the general population, and by some professionals. Complex dissociative disorders have been the subject of an increasing amount of research in the two decades, including neuroscience, treatment studies and studies looking at the link between child abuse and different mental health disorders.
So, what causes of dissociative disorders? Could there by a biological or genetic cause to dissociative disorders, as there are in some other mental health conditions such as schizophrenia or psychosis? The research shows differences in the brains of people with dissociative identity disorder in particular, include decreased sizes of key parts of the brain.
Research has shown that the ability to dissociate (which we all have) may have a genetic or biological link, but the ability to dissociate alone cannot cause a dissociative disorder, nor can it cause persistent and traumatic memories. Dissociative identity disorder in particular is regarded as tertiary dissociation, rather than primary or secondary dissociation. as explained by the concept of Structural Dissociation we have blogged about before.
Whilst the brain alterations (show above) may seem to non-professionals to suggest a biological or genetic cause for DID, it actually parallels the changes in the brain also present in Posttraumatic Stress Disorder resulting from adult trauma. The consensus of research globally shows that dissociative disorders, especially DID, are extremely strongly associated with very early child abuse, and not genetic or biological factors.
Child Abuse and Mental Health
The link between complex dissociative disorders and child abuse goes back a long way, and is well documented in the history of psychiatry by well known figures such as Morton Prince (writing about Christine Beauchamp, 1906), Sigmund Freud, Pierre Janet and others.
The trauma theory of dissociation is first documented in 1889, but only in recent decades has society begun to acknowledge how common child abuse is, in particular child sexual abuse and incest. The shocking results from Adverse Childhood Experiences Study also reflect the fact that adverse childhood experiences including child abuse had a negative effect on people’s lives even decades afterwards. Furthermore, the brain changes resulting from trauma experiences are believed to be reversible, and it has been clearly shown in clinical research that both trauma and dissociative disorders can be healed.
Abusive Families, the Cycle of Abuse and the Need to Discredit Children
Today’s post was inspired by Darlene Ouimet’s post The Grooming Process of Discrediting Children and the Cycle of Abuse. Darlene is a life coach and mental health advocate who has previous struggled with severe depression, dissociative identity disorder and the legacy of child sexual abuse (more on this later).
Grooming a child to believe that the child is the problem and communicating that publically serves several purposes one of which is that it discredits the child to other family members and friends of the family way before the child ever tries to stand up to abusive treatment which serves to insure that the abuser will never be questioned by other people.
Her post reminded me of the history of Jennifer Freyd, Professor of Psychology at the University of Oregeon and a survivor of incest and a very dysfunctional family environment. Jennifer’s father, Peter Freyd, founded the false memory syndrome foundation with his wife and step-sister Pamela Freyd when he realized that his brother and even his own mother believed Jennifer’s reports of incest. Jennifer’s childhood journal revealed her distress, she wrote:
My parents oscillated between denying these symptoms and feelings…to using knowledge of these same symptoms and feelings to discredit me… My father told various people that I was brain damaged.
Jennifer also describes how her traumatic childhood experiences link to her development of PTSD as an adult, and the continuing impact of her dysfunctional parents on her career and adult life.
At times I am flabbergasted that my memory is considered “false,” Jennifer says, “and my alcoholic father’s memory is considered rational and sane.” She does not, after all, remember impossible abuses: “I remember incest in my father’s house…. My first memories came when I was at home a few hours after my second session with my therapist, a licensed clinical psychologist working within an established group in a large and respected medical clinic.
“During that second visit to my therapist’s office, I expressed great anxiety about the upcoming holiday visit from my parents. My therapist asked about half way into the session, whether I had ever been sexually abused. I was immediately thrown into a strange state. No one had ever asked me such a question. I responded, “no, but…”. I went home and within a few hours I was shaking uncontrollably, overwhelmed with intense and terrible flashbacks.” Jennifer asks herself why her parents are believed. “In the end, is it precisely because I was abused that I am to be discredited despite my personal and professional success?”
Another clear finding from the Adverse Childhood Experiences Study was that emotional abuse and a dysfunctional family life had a long lasting and significant link with poor adult health (both physical and mental). Jennifer’s experiences as an adult disclosing her childhood abuse led to her parents’ attempts to harm her career and publicly discredit her.
It is important for the controlling or abusive person to discredit the child in case the child ever tells or exposes the truth about the dysfunction in the family. Read more from Emerging from Broken…
Child sexual abuse (RAINN)
Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder (download, American Journal of Psychiatry)
PTSD is the amydala hijacking Joe’s brain (psychology today – explains neuroscience and that PTSD is the brain in survival mode rather than brain imjury)
Adverse childhood experiences and mental health (Mad in America, discussing psychosis and schizophrenia)
Child abuse and dissociative disorders (tellaboutabuse.com)
The war against the CHild’s and Victim’s Credibility and the Truth (Screams of a Childhood)
Brand, Bethany L. “What we know and what we need to learn about the treatment of dissociative disorders.” Journal of Trauma & Dissociation 13.4 (2012): 387-396.
Vermetten, E, Schmahl, C, Bremner, JD “Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder” American Journal of Psychiatry April 2006, issue 1634
Weniger, G., et al. “Amygdala and hippocampal volumes and cognition in adult survivors of childhood abuse with dissociative disorders.” Acta Psychiatrica Scandinavica 118.4 (2008): 281-290.
Felitti, M. D., et al. “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study.” American journal of preventive medicine 14.4 (1998): 245-258.