Week 9 Dissociative Disorders Sample Paper

Week 9 Dissociative Disorders Sample Paper

Dissociative disorders are a group of mental disorders characterized by the fragmentation of personality. Personality disruptions in dissociative disorder are seen as a discontinuity in memory, consciousness, identity, perception, cognition, and sensorimotor functions. The DSM-5 recognizes dissociative disorders and classifies them into three related disorders: dissociative identity disorder (DID), dissociative amnesia, depersonalization, derealization disorder, and unspecified type of dissociative disorder. According to Dr. Todd Grande (2018), more controversy is seen towards DID than other types of dissociative disorders (Grande, 2018). The controversy and criticism around the result from different schools of thought around the diagnosis of DID. This paper described the controversy in DID and personal professional opinions about dissociative disorders.

Week 9 Dissociative Disorders Sample Paper

The Controversy in Dissociation Disorders

The controversy in dissociative identity disorder arises from the presentation of distinct personalities in one individual. DID is usually associated with childhood abuse and trauma that leads to brain adaptation to cope with this unusual environment. This theory believes that in the process of this adaptation, the personality of the individual fragments thus multiple personalities (Grande, 2018). The first school of thought believes that this condition is real and the diagnosis is genuine. These proponents of this disorder argue that the brain personalities are compartmentalized such that they do not communicate or have access to each other thus the distinct personality presentations (Wild Pages Press, 2018 Week 9 Dissociative Disorders Sample Paper). This theory is also called the trauma (dynamic/developmental) model and is the most widely accepted and used.

The opponents of the diagnosis of dissociative disorders argue that these disorders are unreal and sometimes enthusiastically over-diagnosed by clinicians. There are sometimes mixed thoughts about these disorders among the opponents of their diagnosis. Some clinicians believe that this disorder is real and the diagnosis may be misplaced. They believe that the symptom presented by the individuals ‘ labeled’ to have these disorders are actual symptoms but are seen in other disorders such as schizophrenia borderline personality disorder (Grande, 2018). The fantasy, also known as the socio-cognitive model is used by the opponents of dissociative disorders (Wild Pages Press, 2018). This model explains that dissociative symptoms are social constructs thus the made-up or learned symptoms. clinicians suggesting these symptoms objectively to the patients makes them aware of alternative personalities that they can act up. Therefore, factors such as underlying vulnerability, social conditioning, and clinical suggestions are responsible for the presentation of dissociative symptoms.

Professional Belief about Dissociative Disorders

The presence of the symptoms cannot be denied. However, I believe that overdiagnosis can be possible. I cannot deny the existence of these symptoms of some patients. The DSM-5 sets out clear criteria for the diagnosis of dissociative disorders (American Psychiatric Association, 2013) but leaves loopholes for overdiagnosis. I believe that dissociative disorders are real and may coexist with other mental health issues. The dynamic model suggests relatable outcomes of trauma and has been seen in other sequelae of trauma. trauma in childhood has various mental health consequences that do not necessarily present as a posttraumatic stress disorder. According to Peterson (2018) through the National Child Traumatic Stress Network (NCTSN), childhood trauma leads to varied outcomes in emotion, memory, identity, and consciousness because they lack a developed pattern in these domains of mental health. Therefore, a fragmentation change in personality may arise because of the developmental modifications to fit in these settings. Albin et al. (2020) acknowledge that physical trauma can cause physical outcomes but there is a need to watch out for the emotional and psychological outcomes in children that warrant counseling and other psychiatric interventions. Therefore, my stance in this debate is that dissociative disorders are real but there is a need to take care when making these diagnoses because of their resemblance with other mental illnesses.

Maintaining Therapeutic Relationship in Patients with Dissociative Disorders

The therapeutic relationship is important in promoting successful outcomes psychotherapy for every mental illness. In dissociative disorders, the therapist’s honesty, genuineness, and empathy are important in ensuring a positive therapeutic relationship. Strategies for maintaining a therapeutic relationship in a patient that may have the dissociative disorder may include keeping the trust, ensuring congruence and respect (Firestone, 2018). These patients may present symptoms that they may not disclose to other relatives because of their personal fears. Therefore, keeping this trust and ensuring respect for their information can keep the therapeutic relationship.

Ethical and Legal Considerations

The skepticism around dissociative disorders presents a difficult ethical dilemma and legal outcomes in the patient’s care. According to the DSM-5, culture plays a vital role in the patient’s understanding of their illnesses. Associating dissociative disorders with cultural entities such as spiritual possession, mythical figures, and religious deities makes psychoeducation about these disorders difficult, and the need to respect patient autonomy may override the need for psychiatric attention. Firestone (2018) associated dissociative disorders and high suicidal risks. Missing these suicidal tendencies during diagnosis may remotely be interpreted as medical negligence thus legal implications may follow. I feel the need to ensure these ethical, cultural, and legal considerations when managing patients with suspected dissociative disorders.

Conclusion

Despite the controversy and skepticism around dissociative disorders, their diagnosis is valid. I believe that their diagnosis is a volatile one and can be confused with other illnesses. The risk of suicide cultural determination of the patient’s beliefs around their presentations can cause dilemmatic situations when managing these patients. therefore, I will keep the patient’s trust respect their autonomy, and give my honest professional opinion during the management to maintain a good therapeutic relationship.

Week 9 Dissociative Disorders Sample Paper References