What is Dissociation?
Dissociation is a disconnect between a person’s thoughts, feelings, memories, actions, identity or a sense of who they are. Mild dissociation such as daydreaming or losing yourself in a book is common, but dissociative disorders are more debilitating and can potentially lead to a disruption in all areas of functioning. During traumatic events, a person may dissociate the memory or feelings associated with the situation, enabling them to tolerate what they would otherwise be unable to bear. Dissociative disorders are associated with previous experiences of trauma.
Depersonalisation/Derealization (DPDR)
Depersonalization is the experience of unreality or detachment from the experience of self, such as mind, body, memories and inner experience. People that struggle with depersonalization sometimes feel as if they are outside their body and watching events happening to them. Derealisation includes the experience of unreality or detachment from one’s surroundings, leaving the individual feeling as if the world is not real, or is somehow distorted. DPDR can be highly distressing for those that experience these alterations but may also be acute and not questioned as out of the ordinary.
Dissociative Amnesia
Involves not being able to recall information about oneself and is associated with traumatic events as opposed to normal forgetting. This amnesia may be localised (unable to remember an event or time period), selective (unable to remember a specific aspect of an event) or generalised (complete loss of identity and life history). Dissociative amnesia is particularly associated with experiences of emotional abuse and neglect.
Dissociative Identity Disorder (DID)
DID was previously known as multiple personality disorder (MPD) and is associated with overwhelming traumatic events that occurred in childhood. Symptom needed for a diagnosis include the following: the existence of two or more distinct identity states (alters/parts) that take over the functioning of the body and are accompanied by changes in identity, memory and beliefs. These changes may be reported by the individual in question or observed by other people. A second determining factor is gaps in memory associated with everyday events, personal information and past traumatic events. For a diagnosis, these symptoms need to cause significant distress and problems in functioning. Those that live with DID describe feeling as though they are observing someone else in control of their body, they may describe alters/parts that are male, childlike or characters from fairy tales. The alters/parts are described as having their own way of thinking and remembering the experiences of life. Although these parts are manifestations of the whole unintegrated individual, the person with DID (due to the dissociative disconnect) will not experience these parts of self as them.
DDNOS/OSSD1a/1b
DDNOS is the terminology that may be used when a person does not fit the tight criteria for one of the other dissociative disorders and OSDD1a and 1b help us to understand the experiences of those who don’t quite fit the criteria for DID. OSDD1a might be understood as people experience themselves as having parts, but these parts may not be as distinct as what we see in DID. OSDD1b refers to people that have distinct parts but no memory loss between the parts.
