Psychoeducation Psychoeducation is an inevitable aspect in the management of dissociative disorder. Psychoeducation should focus on normalizing and acknowledging patient's symptoms and relating them with dysfunction in daily life.
In certain cases of dissociative disorder with complex psychopathology, an entire treatment team maybe required, comprising of clinicians, therapists, family therapists, specialists in eye movement desensitization and reprocessing etc.
The role of traditional group therapy in the treatment of dissociative disorders is limited.
Dissociation is a mechanism that allows the mind to compartmentalize certain memories or thoughts from normal consciousness. These split-off mental contents are available and may return to consciousness either by an event or spontaneously. Broadly, dissociative disorders may be viewed as shown in Table 1. Table 1 Types of dissociative disorders
Treatment of dissociative disorders usually consists of psychotherapy, with the goal of helping the person integrate different identities, and to gain control over the dissociative process and symptoms.
Psychotherapy. Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional.
My coping strategies for living with DIDEnd the blame and the shame. It's important to tell yourself that this illness is not your fault. ... Build your knowledge. ... Find calm and relaxation. ... Start planning and organising. ... Develop emergency strategies. ... Form a support network. ... Communicate.
Dissociation can be a withdrawal inside or a complete withdrawal somewhere else. Clients who dissociate might have difficulty with sensory awareness, or their perceptions of senses might change. Familiar things might start to feel unfamiliar, or the client may experience an altered sense of reality (derealisation).
Treatment for DID consists primarily of individual psychotherapy and can last for an average of five to seven years in adults.
Dissociative disorders involve problems with memory, identity, emotion, perception, behavior and sense of self. Dissociative symptoms can potentially disrupt every area of mental functioning.
Dissociative identity disorder. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices. People with DID will experience gaps in memory of every day events, personal information and trauma.
Psychotherapy is the cornerstone of treatment for dissociative disorders and hence choosing the right therapist is of paramount importance. The following section enumerates the characteristics of a therapist ideally suited to engage in therapy for dissociative disorders.
A formal training in psychotherapy is desirable before the therapist attempts to undertake therapy for dissociative disorders. Patients with dissociative disorders may need to be approached from a psychodynamic perspective to gain a better understanding of the role of past trauma in the manifestation of their current symptoms and unless the therapist is well versed in the nuances of psychodynamic approach and trained formally in psychotherapy, only crisis intervention and supportive therapy will be done, which will partially ameliorate the patient's symptoms. Ideally, an experienced therapist should be able to incorporate eclectic therapeutic techniques, psychoeducation and skills development flexibly within an overall psychodynamic framework and undertake therapy.
Dissociative disorders as described by ICD 10 include a range of disorders and combine what are conversion disorders (assumed under somatoform disorders in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and the cluster of dissociative disorders. The mutual idea shared by these disorders is a partial or complete loss of usual integration between memories, cognizance of identity, and immediate sensations and voluntary control of body movements. Conversion occurs when there are clinical symptoms representing alteration of functioning of motor or sensory systems and which do not follow a pattern of a known neurological or medical disease. Dissociation is a mechanism that allows the mind to compartmentalize certain memories or thoughts from normal consciousness. These split-off mental contents are available and may return to consciousness either by an event or spontaneously.
Dissociation is a mechanism that allows the mind to compartmentalize certain memories or thoughts from normal consciousness. These split-off mental contents are available and may return to consciousness either by an event or spontaneously. Broadly, dissociative disorders may be viewed as shown in Table 1. Table 1.
The process of desensitization involves: Therapist guided lateral eye movements and substitute activities in the patient, in order to process the target picture, emotion, physical symptoms, and cognitions. Once the process of desensitization is achieved a positive/healthier cognition is paired with eye movement.
To summarize, there has to be an amalgamation of theoretical expertise, specific therapeutic knowledge and human skills encompassing a broader context on the part of the therapist for the development of an ideal therapeutic alliance.
As therapy progresses, the therapist explores the patient's unconscious conflicts which may be a cause of maladaptive functioning. Also, resistance emerges and the therapist may experience counter transference. The therapist should be experienced enough to recognize counter transference which can provide valuable information about the original trauma by its re-enactment within the therapeutic context and to manage it sensitively so that trust in the therapeutic alliance is maintained