A dissociative identity disorder usually develops during childhood as a result of traumatic experiences.
Most conversion disorders occur acutely and temporarily and remit (subside) quickly. They can therefore appear suddenly and disappear just as suddenly after a few weeks or months. If they persist for more than two years, the untreated course is often chronic.
Those affected often suffer from other disorders at the same time. These include personality disorders or somatoform disorders in particular.
Patients are often regarded as physically ill and treated somatically (on the body) for years. For this reason, the frequency of dissociative disorders cannot be precisely estimated. Overall, between 0.5 and 4.5 percent of all people can be affected, women three times as often as men.
In dissociative disorders
- Memory contents,
- body perceptions or
- movements
from normal consciousness and are no longer under the control of the person affected. This can manifest itself in physical functions in the form of paralysis or convulsions. There are no organic abnormalities.
Dissociative amnesia: Recurrent (recurring) or one-off gaps in memory of certain life events or phases of life. The amnesia often relates to other traumatic, stressful or conflictual life situations.
Dissociative fugue (pathological wandering instinct): Sudden and unexpected removal from familiar surroundings. Amnesia for the past and the personal life situation during this state.
Dissociative stupor (dissociative paralysis): A state of torpor with lack of movement and cessation of movement as well as
- mutistic states,
- inactivity and
- non-response to environmental and pain stimuli,
- Refusal of food and fluid intake.
Depersonalization and derealization syndromes: The self is altered, alienated, perceived as unreal (depersonalization). Thoughts, feelings and actions are experienced as no longer belonging to the self (like a robot). Other sensory perceptions (hearing, sight, etc.) and general bodily sensations (hunger, thirst, appetite, etc.) can also be disturbed.
Dissociative seizures: Paroxysmal (seizure-like), involuntary behavioral patterns that mimic epileptic seizures. No seizure activity can be detected in the brain. Also characterized by a sudden, temporary disturbance in the control of motor, sensory, autonomic, cognitive and emotional behavioural patterns.
Dissociative identity disorder: This syndrome (also known as multiple personality disorder) is the most severe of the dissociative disorders of consciousness. How frequently this form occurs is relatively unclear.
The central feature is the presence of at least two distinguishable partial identities or personality states. They each take control of the affected person's behavior. At the same time, there is amnesia towards the other identity.
These are dissociated aspects of the overall personality, each of which manifests itself in
- specific abilities,
- age,
- gender,
- state of affect, etc.
can differ. The change of states can be caused by various, often trauma-associated triggers. In addition, all symptoms of other dissociative disorders of consciousness (amnesia, fugue, etc.) may be present.
Extremely severe childhood trauma is thought to be responsible for the development of these dissociative disorders. There has been little scientific research into this disorder.
Dissociative disorders can be treated with psychotherapy © Photographee.eu | AdobeStock
Dissociative disorders should be treated with psychotherapy. The aim of the treatment is for the patient to understand the psychological nature of their suffering and to look for psychological or social solutions. This is often difficult because those affected are firmly convinced that they are suffering from a physical illness. If they are referred for psychotherapeutic treatment, they are labeled as malingerers by their practitioners.
Depending on the severity, short-term psychodynamic therapy or longer-term psychodynamic treatment is required. The latter should also take place on an inpatient basis if necessary and be supplemented by specific forms of trauma therapy. These include imaginative trauma therapy or EMDR therapy.
Medical therapy is also indicated in the case of accompanying illnesses, e.g. depression.
