Dissociative Disorders

Dissociative Disorders

Dr. C. George Boeree

In dissociative disorders, one aspect of a person’s psychological makeup is dissociated (separated) from others. A commonality among most people diagnosed with these disorders is their susceptibility to trance states, hypnosis, and suggestibility. Hans Eysenck's research suggests as well that these are more likely to be nervous extraverts.

Dissocative amnesia is the “inability to recall important personal information, usually of a traumatic or stressful nature,” (DSM IV) but more than what we would characterize as ordinary forgetfulness. It is not due, of course, to a physical trauma, drug use, or a medical condition. Instead, it is due to the ability that these people have to focus away from certain memories that disturb them.

It has been increasingly common for people to report having forgotten childhood traumas, especially sexual abuse, while in the care of certain therapists. Recent researchers now believe that the “recovered memories” that these patients report are actually implanted in the minds of these very suggestable people by their over-enthusiastic therapists. It is still not known whether all recovered memories should be suspect or not, although memory research suggests that trauma is more typically remembered well, not poorly.

Fugue is amnesia accompanied by sudden travel away from a person’s usual haunts. Time away can range from a few hours to months. When these people return to normal, they often don’t remember what happened while they were away. A few adopt an entirely new identity while “on the road.”

Dissociative identity disorder -- formerly known as multiple personality -- involves someone developing two or more seperate “identities” that take over the person’s behavior from time to time. The "usual" personality doesn't remember what happens when an alternate personality takes over. Dissociative identity disorder is not the same as schizophrenia, but does have some similarities. In schizophrenia, voices and impulses are seen as coming from outside oneself, while in dissociative identity disorder, they are seen as coming from within, in the form of these alternate personalities.

One of the first cases to reach the public was the story of Eve White. Eve White (a pseudonym, of course), was a mild mannered woman with a domineering husband. She found herself waking up with garish makeup, hangovers, and other signs that she had been out carousing during the night. This alternate personality that took over occasionally was called Eve Black. Eventually, the two personalities were brought together, and Eve's story was made into a movie with actress Joanne Woodward called "The Three Faces of Eve." A second movie was much more popular: "Sybil." This was the true story of a woman who had been severely abused by her schizophrenic mother, and developed (supposedly) 26 personalities.

People with multiple personalities are usually easily hypnotized, making it likely that this disorder may be caused or at least aggravated by therapists, intentionally or unintentionally, much like recovered memories. It is looked upon with skepticism by many psychologists.

On the other hand, it may also be understood as a modern version of a fairly common occurance in the nonwestern, premodern world: Spirit possession. In cultures where the powers of gods, ghosts, and demons are taken for granted, people sometimes feel possessed by these outside personalities. In more modern societies, lacking the possession explanation, people assume that the alternate personality is internal.

Depersonalization is the “persistent or recurrent feeling of being detached from one’s mental processes or body....” (DSM IV) Often the world seems odd as well, which is called derealization. Physical objects may seem distorted and other people may seem mechanical. Again, these people may be particularly easy to hypnotize, and the feeling can be induced even in normal people under hypnosis. Half of all adults may have experienced a brief episode of depersonalization or derealization in their lifetime, but it is most common in people who have suffered from abuse, the loss of a loved one, or have seen combat. It is also common under the influence of hallucinogens like LSD.

Dissociative trance disorder is an unofficial category often referred to by psychologists and psychiatrists working in premodern, nonwestern societies. Trance is a narrowing of one's attention so that some things (such as sight, movement, or even outer reality) are placed outside awareness. Cross-cultural therapist Richard Castillo, in his book Culture and Mental Illness, says that trance is "an adaptation with great individual and species survival value." It is not far from such non-pathological states as hypnosis and meditation.

Castillo gives numerous examples:

Amok is found in Malaysia and Indonesia. The word comes from the Sanskrit for "no freedom." It involves a person losing their sense of self, grabbing a weapon such as a machete, and running through the village slashing at people. Afterwards, they have no memory of what they have done and are typically excused from any damage, even if their actions resulted in someone's death!

Grisi siknis is found among teenage girls and yound women of the Miskito indians in Nicaragua. They also run wild with machetes, occasionally assaulting people or mutilating themselves. They have no memory of their actions.

Pibloktoq or arctic hysteria is found among polar eskimos. For anywhere from a few minutes to an hour, a person takes off their clothing and runs screaming through the snow and ice, as a response to a sudden fright.

Latah (in Malaysia) involves violent body movements, taking unusual postures, trance dancing, mimicking other people, throwing things, and so on.

"Falling out" (in the Bahamas) involves falling to the ground, apparently comatose, but hearing and understanding what is going on around you.

"Indisposition" (in Haiti) is a possession trance understood as a response to fear.

"Fits" (in India) is a seizure-like response by some women to family stress, curable by exorcism or by simply telling her husband to protect her from her inlaws!

In the west, these kinds of behaviors are often classified as impulse control disorders, along with trichotillomania, compulsive gambling, pyromania, and kleptomania (discussed with anxiety disorders). One of these - intermittent explosive disorder - is basically the same as running amok, and is commonly known as "going postal."