Dissociation and trauma
Current issue: Is dissociation on a continuum OR is it multidimensional?
Types of dissociative disorders
The self
The self relies on different factors to feel as though one exists .such as sensory and physical and cognitive control. How we feel we are experiencing these
emotional numbness
out-of-body experiences
Difficulty concentrating
You do not feel like yourself (loss of self/agency)
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what
why
Escape - the role of trauma
coping mechanism
seperating yourself, it is happening to someone else
Dissociative identity disorder
Affects personality and amnesia
ownership
agency and autonomy
Depersonalisation - derealisation
Affects empathy, social connections and the world
embodiment - have physical and sensory control
presence in yourself and the world
Theories about issues with the self
Explanations for depersonalisation
mutli-sensory processing
The brains process of integrating sensory information to perceive the world
process is thought to occur at multiple levels of the brain, from the primary sensory areas where the sensory input is first processed, to higher-order areas that integrate information from multiple senses and generate more abstract representations.
Explanations for dissociative personality
Cortico-limbic hypothesis
hippocampus was smaller (19%) and amygdala (32%) - Vermetten et al., 2006
abnormal = out of control, disconnected
normal functioning = agency and connected with the world
Predictive coding
The brain predicts sensory information about the environment.
normal perception = the brain is updating and improving predictions about the environment
abnormal perception // aberrant self = higher-level cognitive processes are not integrating the information / predictions do not integrate all the sensory information resulting in predictive error
Early life stress can cause structural changes in the hippocampus
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Anxiety, alertness 24/7 BUT suppressed responses to extreme circumstances
Continuum
multi-dimensional
out of body self- is not as severe, more temporary but is a type of dissociation
there are different disorders which are comorbid with other diagnoses
depends on how you consider dissociation, is it a normal human function which varies in extremity or is it considered as a completely abnerrant, leading to distinct mental differences
different tyoes associated with different traumas , amnesia (combat- related trauma) or depersonalisation (child-sexual absuse)
severity of dissociation can vary across different dimensions. For example, an individual with dissociative identity disorder may experience severe amnesia but have relatively mild depersonalization.
it means that it can be broken down into different dimensions or components. Each of these dimensions may be independent of each other and may have different properties or characteristics. For example, in the case of dissociation, it can be broken down into different types such as depersonalization, derealization, and amnesia.
it means that it is a spectrum of experiences or levels that range from one extreme to another. The continuum implies that there is a continuous gradation of the phenomenon, with no clear boundary between different levels. For example, if we think of dissociation as being on a continuum, it might mean that there are varying degrees of dissociation, from mild to severe, with no clear cut-off point.
derealisation and depersonalisation have been found to be distinct and not synonymous (Sierra & David, 2011)