Dissociation and Dissociative Disorders

Dissociation is the feeling of being detached from oneself, of being able to watch oneself as though from a distance; several different psychological disorders have long-term periods of such feelings.

Dissociation, the feeling of being detached from one's body, can be categorized into two types: depersonalization and derealization. Depersonalization is the uncomfortable feeling that individuals do not know who they are, or of questioning longstanding beliefs about who they are. During derealization, people perceive reality in a distorted way. They may not feel that their hand is their hand or may suddenly feel that their family is unfamiliar. Psychologists have identified several types of disorders based on these feelings. Many of the disorders include anxiety. Dissociative disorders include depersonalization-derealization disorder, dissociative amnesia, dissociative trance disorder, and dissociative identity disorder (once known as multiple personality syndrome). In Diagnostic and Statistic Manual of Mental Disorders (DSM-5), there are significant changes to these disorders. Derealization is included in the name of what previously was called depersonalization disorder. Dissociative fugue is subsumed as part of dissociative amnesia, rather than as an independent diagnosis.

Depersonalization is a condition marked by a persistent feeling of not being real. The symptoms, according to the DSM-5, are “persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).” While many people have experienced this feeling briefly, those who actually have this disorder are so overwhelmed by these feelings they are unable to function normally. In order to receive this diagnosis, the person's symptoms cannot be caused by drug use or by one specific event. Both the symptoms of depersonalization and derealization are often seen in more common disorders, such as acute stress disorder and panic attacks.

Dissociative fugue is a strange phenomenon, usually caused by a traumatic event, in which people experience sudden memory loss that prompts them to flee their familiar surroundings. People with this disorder find themselves in a new location, hundreds or even thousands of miles from their homes, with no memories of the weeks, months, or years that have elapsed since their flight. Incidence of dissociative fugue rarely appear until after adolescence and usually before the age of 50. Once a person has fallen into the behavior, however, it is more likely that it will recur.

Dissociative amnesia describes the condition of suddenly losing large chunks of memory. There are two types of this disorder: generalized amnesia, during which individuals cannot remember anything about their lives, and localized amnesia, during which individuals forget pieces of their history but retain an overall understanding of who they are. Dissociative amnesia is generally caused by a traumatic event, such as natural disaster, violent crime, or war. In these instances, amnesia is largely an adaptive mechanism that allows individuals to continue their life without a horrific memory.

See also Abnormal psychology ; Diagnostic and Statistical Manual of Mental Disorder (DSM-5); Post-traumatic stress disorder (PTSD) .

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5, 5th ed. Washington, DC: Author, 2013.

Biever, John A., and Maryann Karinch. The Wandering Mind: Understanding Dissociation, from Daydreams to Disorders. Lanham, MD: Rowman & Littlefield, 2012.

Horowitz, Mardi Jon. Stress Response Syndromes: PTSD, Grief, Adjustment, and Dissociative Disorders. Lanham, MD: Jason Aronson, 2011.

Sar, Vedat, et al. Global Perspectives on Dissociative Disorders: Individual and Societal Oppression. London: Routledge, 2014.

PERIODICALS

Goleman, Daniel. “Those Who Stay Calm in Disasters May Face Psychological Risk.” New York Times (17 April 1994): 12.

Mukerjee, Madhursee. “Hidden Scars: Sexual and Other Abuse May Alter Brain Region.” Scientific American (October 1995): 14.

WEBSITES

Mayo Clinic. “Dissociative Disorders.” http://www.mayoclinic.org/diseases-conditions/dissociative-disorders/basics/definition/con-20031012 (accessed September 17, 2015).

National Health Service. “Dissociative Disorders.” http://www.ncbi.nlm.nih.gov/pubmed/17716088 (accessed September 17, 2015).

National Institutes of Health. “Dissociative Disorders.” (accessed September 17, 2015).