A comparison between the six cases and previously reported cases of amnesia exposed the general characteristics of this disorder. Three of the patients believed they had names of other persons; and the two of the recalled personal histories completely different from their own (Seishin Shinkeigaku Zasshi: 1989; 91(4):260-93).
In a continuous amnesia, the amnesia covers the entire period without interruption from a traumatic event in the past to the present. The individual has no memory for events beginning from a certain point in the past continuing up to the present.
The significant distress within the individual is caused by the malfunction of his or her consciousness, memory, identity, or perception. This disorder is characterized by gaps related to traumatic or stressful events which are too extreme to be accounted for by normal forgetting. A traumatic event is typically a precursor to this disorder and memory is often restored. Typically, the memory returns by the help of therapy, although it is not always needed. Therapy is only administered when the individual develops excessive fears or worries, or the memory loss has a drastic effect on their everyday functioning.
When the person shows a loss of autobiographical memory and a flight to a new locale, that person has a Dissociative Fugue. A person temporarily loses his or her sense of personal identity and travels to another location where the person acquires a new identity. This includes a new name, profession, and other personal details. Again, this type of disorder represents an illness where an individual has experienced an extreme stress or traumatic event. An example of a traumatic event include wartime or after a natural disaster. Aside from the inability of the person to recall their past or personal information, patients with dissociative fugue do not behave strangely or appear disturbed to others. Note, however, this disorder is very rare and typically runs its course within a month.
The Depersonalization Disorder is a disturbance in which the patient's primary symptom is the sense of detachment from his or her "self.' Take note that depersonalization is a symptom, and not a disorder. It is triggered by an acute stressor and is common in college-age population. It is divided into two segments: the Depersonalization and the Derealization. The former refers to the stage where the patient reaches the feeling that he or she is "unreal" and that his or her body does not belong to him or to her. The person may also feel that he or she is in a dreamlike state.
On the other hand, the latter refers to the stage where the person may feel that other things around him or her, including other people, are unreal or alien. It is often associated with sleep deprivation or 'recreational' drug use. This has been termed 'derealization' because objects in an environment appear altered. Patients characterized themselves as feeling like a robot or watching themselves from the outside. Other patients involve feelings of numbness. The disorder will typically dissipate on its own after a period of time. To strengthen the coping skills, a therapy will be of great help.
The Dissociative Identity Disorder (DID) is also known as Multiple Personality Disorder or MPD. In the book, Interviewing Children and Adolescents, it was mentioned that dissociation as a term has originated 400 years ago, but only during the 20th century has it been applied to thought (2001: 390). The disorder is considered as the most severe dissociative disorder. This disorder involves all of the major dissociative symptoms. There are two or more distinct personalities residing within an individual's consciousness. These separate personalities vary and take control of the individual at different intervals, thus, creating a gap in memory between memories.
In other word, there is an "altering" memory in between the two personalities. The shifts between personalities are abrupt and spontaneous and only one personality dominates consciousness at one time. Each personality appears to function as an autonomous individual with different traits, talents, capacities, different social networks, and different physical responses. The individual personalities are clustered into core personalities, alter personalities, and intermediary personalities.
This type of disorder is quite uncommon and is associated with severe psychological stress in childhood and a significant trauma such as extended sexual abuse and the chance to witness a violent death of another are usually the precursor. There is no biological explanation for this type of disorder, but only mere responses to stress. However, people with dissociative identity disorder usually have close relatives who have also had similar experiences....
The symptoms usually appear in childhood and adolescence stage.
As mentioned by Vitkus (1993) in his Casebook in abnormal psychology, in treating DID, the patient must be assisted to recognize and control dissociations. The use of hypnosis will help the patient to remember the abuse and express old rages and fears directly. Patients can also be taught to set limits on self-destructive behavior.
The treatment of DID is difficult for a variety of reasons, which include the confidentiality of the patient's personality, which makes him or her unwilling to seek help, and the complexity involved in diagnosing the disorder.
On the average, this type of disorder is longstanding and it can be very difficult to treat. Most of the time, individuals have several 'ups' and 'downs' in treatment. When the patient agrees to be cured, the therapist assists the patient to remember. There should be a focus on relationship between the patients and therapist. It is also best to consider that because of the patient's traumatic experience, developing real trust in another person is difficult for him or her.
The use of therapeutic relationship will help the person to distinguish people in the present from tormentors of the past. Helping the patient to integrate personalities and teaching him or her to value the hostile, disruptive aspects of himself or herself that he or she has displaced onto others are important aspects to be considered in the therapy process. Social skills training will help the patient 'make up for lost time' with interpersonal relationships. Given these extensive works with an experienced therapist, the treatment process can be greatly improved.
Dissociative disorders treatment also encompasses several methods. Aside from psychotherapy, some doctors prescribe medications such as tranquilizers or antidepressants for the anxiety. The negative part on this type of treatment lies on the patient's risk of becoming dependent on the medications. Hypnosis is another method that is frequently recommended by practitioners to patients with dissociative disorders. This treatment process is viewed as a controlled form of dissociation and is used as a vehicle to gain confidence in the patient. As stated in an article about DID, Merck Manuals Online Medical Library states that "hypnosis is often used to explore traumatic memories and diffuse their effect. Hypnosis may also help with accessing the identities, facilitating communication between them, and stabilizing and interpreting them."
Axis II pertains to the Developmental Disorders and Personality Disorders. Developmental disorders include disorders that are typically first evident in childhood. This disorder is evident to persons with DID. On the other hand, personality disorders are clinical syndromes which have more long lasting symptoms and encompass the individual's way of interacting with the world. They include Paranoid, Antisocial, and Borderline Personality Disorders. The symptoms are partly seen in persons with dissociative disorders, but they are not greatly related to the disorder.
Under Axis III, Physical Conditions lay a role in the development, continuance, or exacerbation of Axis I and II Disorders. Here, physical conditions such as brain injury or HIV / AIDS that can result in symptoms of mental illness are included. The role of a neuroscientist is very important in this assessment because from here, the patient's condition will be examined physically. Other causes of the symptoms can be identified and will be given appropriate attention.
Axis IV refers to the Severity of Psychosocial Stressors This axis lists and rates the events in a person's life, such as death of a loved one, starting a new job, college, unemployment, and even marriage because these can impact the disorders listed in Axis I and II. These stressors can also provide the degree of the traumatic damage the patient has encountered.
The final axis, Axis V, pertains to the Highest Level of Functioning. Here, the clinician rates the person's level of functioning at the present time and the highest level within the previous year. This helps the clinician understand how the above four axes are affecting the person and what type of changes could be expected. This will also determine the degree of the person's chance to recover from the disorder.
In as much as the human brain is wonderfully made, with the complexity of its functions and connectivity with the other parts of our body; and so is the study of psychopathology as it requires diligent understanding of the many behaviors and experiences that are associated with the disorders of the consciousness and other mental illness.
References
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