How many types of Dissociation do you know?

Dissociation takes many different forms, some effect everyday life or affect people every now and then, and other forms of dissociation can lead to distress and/or problems in everyday life. If these other forms of dissociative experiences happen several times – or once, but for an extended period of time – then they become problematic (pathological).

Dissociation can be seen as a spectrum, or more recently tends to be categorized as Normal/Normative, or Pathological Dissociation (i.e., the diagnosable/problematic kind).

How many types of Dissociation do you know? Which are types of normal Dissociation? Which are types of problematic Dissociation?

Types of Normal Dissociation
– Day dreaming
– Spacing out (briefly)
– Absorption (e.g., in a book)
– Highway hypnosis (expected travel with gaps in memory)

Types of Pathological Dissociation
– Numbing (emotional and/or physical) – a symptom of PTSD, Depression and others
Freeze Response – a symptom of PTSD and DID and others, common during trauma
– Out of Body Experiences (form of Depersonalization) – common during trauma, sometimes happens during near-death experiences, may also happen in BPD, and DID
– ‘Wall staring’ (spacing out, common in Depression)
– Trance states (e.g., Dissociative Trance Disorder in the ICD-10 manual, can happen in other disorders)
– Maladaptive day dreaming*
Derealization (either you/the world doesn’t feel real) – a separate diagnosis but also a symptom of BPD, Dissociative PTSD, and DID
Depersonalization (part of all of you doesn’t seem like you) – also symptom of BPD, Dissociative PTSD, and DID
Amnesia (without a physical cause) -a separate diagnosis but also a symptom of PTSD and DID
Fugue states (unexpected travel, sometimes with loss of or change in identity)
– Identity alterations/switching – a symptom of Dissociative Identity Disorder, and OSDD
– Catatonia (can be present in Schizophrenia)
Pseudo Seizures/Psychogenic Non-Epileptic Seizures – dissociative reactions to stressors
Dissociative movement or sensation problems – also known as Functional Neurological Symptom Disorder (FND), or Conversion Disorder
* not currently a diagnosis

Problematic types of dissociation are recognized as mental health problems – and can be either a Dissociative Disorder or a common symptom/experience involved in another kind of mental health problem, such as depression.
Can you think of any which are missing? Leave a comment if you can.

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If the Abuse is Ongoing

Breaking the chains of abuse – parallels between domestic violence and ritual abuse.

The strong attachment bonds, psychological and emotional abuse, often combined with trauma bonding, can be understood and undone. Healing is possible.

If you think about studies on domestic violence, you will recall that the abused person often returns to the abuser, perhaps because they are too afraid not to, perhaps because they hope against hope that this time it will be different. The abuser may turn regretful and apologetic and things may be better for a short period of time. But the abuse inevitably returns, and often is more violent. The sweet talk is the carrot, the stick is the threat of dire consequences for disobedience. It’s the same with cults. - Jean http://ritualabuse.wordpress.com

This article may be triggering.

Ritual Abuse

There is a blog entry on Labor Day at https://ritualabuse.wordpress.com/2013/08/20/labor-day/

I haven’t ever blogged about this, at least that I can remember. The closest I have come is writing about how to handle harassing phone calls, which, after all, are cues to show up for more abuse.

I wonder why. I think it is because it breaks my heart that some of us think we have escaped, but haven’t. When a friend has unexplained bruises or little burns in strange places, I get really upset. Or when they start remembering recent abuse, perhaps after a long stretch of safety.

I’d like to believe that each and every one of us has broken with our perpetrators, worked through all the cues and programming, and disarmed all the triggers once and for all. That would mean we never could be hurt in this way again, we never could be abducted and reprogrammed…

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DDNOS1 and Dissociative Identity Disorder – Do you know the differences?

Dissociative Disorder Not Otherwise Specified (DDNOS) and Other Specified Dissociative Disorder (OSDD)

Dissociative Disorder Not Otherwise Specified was the most commonly diagnosed Dissociative Disorder in the DSM-IV diagnostic manual.[1] DDNOS is a complex dissociative disorder which includes many different groups of dissociative symptoms. The most common presentations of DDNOS are numbered, for example DDNOS1, DDNOS2, etc. The DSM-5 changed the name of DDNOS to Other Specified Dissociative Disorder (OSDD); DDNOS-1 was renamed to OSDD-1.

DDNOS-1 and Other Specified Dissociative Disorder

Dissociative Disorder Not Otherwise Specified (DDNOS) and DID. DDNOS is any significant mix of dissociative symptoms that don't fully fit another Dissociative Disorder - It was renamed to Other Specified Dissociative Disorder in the DSM-5 - DDNOS-1 (DDNOS presentation 1) is very similar to DID. DDNOS 1 is either DDNOS-1a - identity disturbance with less distinct parts than in DID (alter personalities may exist but can't physically take control of the person's body, but strongly influence the person's thoughts and actions and amnesia is present), or DDNOS-1b - distinct dissociative parts (alters identities) exist and can take executive control, but without amnesia, less common - DDNOS may be diagnosed if symptoms are not quite clear enough for DID criteria but are similar - the amnesia needed for DID in the DSM5 has been broadened to "recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting", meaning amnesia for past trauma alone is enough - symptoms (including alters and amnesia) can be self-reported in the DSM5. height=

DDNOS1 and Dissociative Identity Disorder differences explained and DSM-5 changes to DID.
Information taken from DSM-5 (APA, 2013) and Dissociative Disorders: The DSM-V and beyond (2011).

DDNOS-1 is the most common form of DDNOS, and can be thought of as “partial DID”. [1] The improved wording of the Dissociative Identity Disorder criteria in the DSM-5 will help those incorrectly diagnosed as DDNOS, for instance because of not obviously switching to an alter identity in front of the psychiatrist, be correctly classed as Dissociative Identity Disorder. [1, 2]

References

  1. Dell, P. F., & O’Neil, J. A. (Eds.). (2010).Dissociation and the dissociative disorders: DSM-V and beyond. Routledge. ISBN 1135906033.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association. ISBN 0890425574.

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The Crowded Room and Misunderstanding Dissociative Identity Disorder

The Crowded Room starring Leonardo de Caprio looks set to focus the spotlight on Dissociative Identity Disorder (Multiple Personality Disorder). It is based on the story of Billy Milligan, a murderer rapist who was later diagnosed with Dissociative Identity Disorder.

An excellent article by Kirstin Fawcett of US News was published this week and should help improve understanding of Dissociative Identity Disorder by addressing several key misconceptions.

The Crowded Room: Dissociative Identity Disorder. Did you know... With DID patients, if they feel hostility or aggression they take it out on themselves with self-harm... They’re self-destructive and repeatedly suicidal, more so than any other psychological disorder. So that's what's typical - not this wild aggression, or stalking women [or robbery]. Dr Bethany Brand, psychologist

The Crowded Room: Dissociative Identity Disorder. Did you know…

With DID patients, if they feel hostility or aggression they take it out on themselves with self-harm… They’re self-destructive and repeatedly suicidal, more so than any other psychological disorder. So that’s what’s typical – not this wild aggression, or stalking women [or robbery].
– Dr Bethany Brand, psychologist

What is Dissociative Identity Disorder (Multiple Personality Disorder)?

What is Dissociative Identity Disorder (Multiple Personality Disorder)?

Another misconception is that “alter” states in DID are as defined and separate as, say, Toni Collette’s in “The U.S. of Tara.” Although a small subset of patients experience what clinicians call a “florid presentation,” a majority of people with DID experience much more subtle transitions between their various identity states.
– Kirstin Fawcett, US News

Read the article http://tinyurl.com/crowdedroom
Short link to this post http://tinyurl.com/thecrowdedroom

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