Controversy Associated with Dissociative Disorders Discussion Paper
Mental illnesses like dissociative identity disorder (DID), derealization/depolarization disorder, and dissociative amnesia constitute dissociative disorders (DD). With dissociative disorders, one or more mental functions, such as motor activity, awareness, perception, identity, and memory are disrupted (Sadock, Sadock, & Ruiz, 2015). When treating someone with DD, practitioners should consider numerous controversies, beliefs, and ethical concerns. This paper seeks to delve into particular DD controversies, professional beliefs and therapeutic relationship strategies, and ethical and legal concerns in the treatment of DD patients Controversy Associated with Dissociative Disorders Discussion Paper.
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Controversy that Surrounds Dissociative Disorders
The link between dissociative disorders (DD) and psychological trauma particularly early childhood and cumulative trauma disorder, is well established in research. It is possible to believe that dissociation causes trauma illusions, and that dissociative disorders (DD) are artefactual states caused by socio-cultural variables and iatrogenesis (Loewenstein, 2018). Another controversy is based on the anxiety generated by the disturbing symptomology observed in DD, which may be comparable to certain doctors’ emotional responses to individuals in mental emergency departments (psychiatric emergencies). There is also controversy about the interpretation of identified DD symptoms, and whether they are a distinct and elusive array of fundamental symptoms and behaviors that some healthcare professionals miss when they are right in front of them, or a deliberate indolent cause of symptoms generated by other healthcare professionals who believe something is there when is really not (Loewenstein, 2018) Controversy Associated with Dissociative Disorders Discussion Paper.
Professional Beliefs about Dissociative Disorders
Numerous misconceptions and myths regarding dissociative disorders have yet to be dispelled, such as the notion that they are a passing trend and that they are uncommon. Other than trauma, it is also thought that dissociative disorders are iatrogenic and that the therapy is detrimental to individuals with DD (Brand et al., 2016). Nevertheless, the evidence basis for DD is increasing, according to studies, and patients are being discovered in inpatient, outpatient, and public settings all around the globe as a result of this increasing scientific evidence (Brand et al., 2016) Controversy Associated with Dissociative Disorders Discussion Paper.
I believe that there is a strong link between dissociative disorders and Borderline Personality Disorder (BPD) and that they often co-exist. About 25% of individuals with Borderline personality disorder report health problems that indicate potential dissociated identity experiences, and around 18% of patients who satisfy BPD diagnostic criteria also match DID diagnostic criteria (Brand et al., 2016). Individuals with DD, on the other hand, had a higher capability for self-reflection, insight, emotional modulation, sense of happiness, clear observation rational thought, and the capacity to perceive others as possibly cooperative (Sar et al., 2017). DD patients have also been found to have higher levels of introspection and traumatic invasions, as well as a proclivity to partake in intricate pondering regarding the meaning of occurrences (Ringrose, 2018). Additionally, they continuously employ a thought-based problem-solving strategy, in contrast to individuals who have BPD, demonstrating a statistically substantial difference between DD and BPD in this regard (Sar et al., 2017).
Strategies for Maintaining the Therapeutic Relationship
Psychotherapy is the gold standard of care for those suffering from Dissociative Disorders. As such, choosing the right psychotherapist is critical in establishing a therapeutic relationship (Subramanyam et al., 2020). There are a couple of additional methods in which the practitioner may build a therapeutic connection with the patient. One approach is to have a thorough understanding of this disorder, especially symptom severity, psychodynamic elements, and professional expertise in the disorder to be capable of identifying the kind of DD and begin therapy as soon as possible with the most suitable course of treatment (Subramanyam et al., 2020). An emotional connection, consensus on objectives, responsibilities between the client and therapist, and the significance of sincerity, adaptability, and capacity to give a listening ear to a client are important elements in sustaining a therapeutic relationship (Cronin et al., 2014). A further result of this study is that early patient perceptions of relationship level reflect the degree of the relationship at the completion of therapy indicating that the relationship is rather stable across the course of treatment (Cronin et al., 2014) Controversy Associated with Dissociative Disorders Discussion Paper.
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Legal and Ethical Considerations
When managing individuals suffering from dissociative disorders, there are a number of ethical and legal issues that should be taken into account. Key considerations should include the safety of the patient as well as of the provider (Ducharme, 2017). This requires the doctor to have clinical expertise in the field and to keep up with the latest research findings. There are a few additional problems including transference and countertransference that will more than probably emerge during the examination of an individual with dissociative disorder, and thus guidance or monitoring will be an essential aspect to consider while examining a person with this disorder (Ducharme, 2017). Our professional capacity should be understood as clinicians, and therefore we should recognize the necessity to offer services, educate, and undertake studies with communities and in domains that are strictly within our professional capacity bounds (Ducharme, 2017) Controversy Associated with Dissociative Disorders Discussion Paper.
Conclusion
Conclusively, dissociative disorders impair mental ability and, if not addressed promptly and effectively, may result in long-term suffering and physical impairment. It is important to recognize and address DD beliefs and controversies because they may contribute to the increase in the economic impact of DD as a result of inadequate diagnoses and management. There are a variety of methods that may be used to sustain a therapeutic connection and a partnership throughout the course of therapy. When it comes to ethical and legal concerns, the most essential consideration ought to be the safety of not only the client but also the professional Controversy Associated with Dissociative Disorders Discussion Paper.
References
Brand, B. L., Sar, V., Stavropoulos, P., Krüger, C., Korzekwa, M., Martínez-Taboas, A., & Middleton, W. (2016). Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder. Harvard review of psychiatry, 24(4), 257– 270. https://doi.org/10.1097/HRP.0000000000000100
Cronin, E., Brand, B. L., & Mattanah, J. F. (2014). The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders. European Journal of Psychotraumatology, 5(1), 22676. https://doi.org/10.3402/ejpt.v5.22676
Ducharme, E. L. (2017). Best practices in working with complex trauma and dissociative identity disorder. Practice Innovations, 2(3), 150-161. https://doi.org/10.1037/pri0000050
Loewenstein R. J. (2018). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/dcns.2018.20.3/rloewenstein
Ringrose, J. L. (2018). The dissociative disorders and the presentation of dissociative identity disorder (DID), or multiple personality disorder (MPD). Understanding and Treating Dissociative Identity Disorder (or Multiple Personality Disorder), 1-10. https://doi.org/10.4324/9780429484483-1
Şar, V., Alioğlu, F., Akyuz, G., Tayakısı, E., Öğülmüş, E. F., & Sönmez, D. (2016). Awareness of identity alteration and diagnostic preference between borderline personality disorder and dissociative disorders. Journal of Trauma & Dissociation, 18(5), 693-709. https://doi.org/10.1080/15299732.2016.1267684
Subramanyam, A., Somaiya, M., Shankar, S., Nasirabadi, M., Shah, H., Paul, I., & Ghildiyal, R. (2020). Psychological interventions for dissociative disorders. Indian Journal of Psychiatry, 62(8), 280. https://doi.org/10.4103/psychiatry.indianjpsychiatry_777_19
The Assignment Explain the controversy that surrounds dissociative disorders. Explain your professional beliefs about dissociative disorders, supporting your rationale with five scholarly references from the literature. Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important. Include an introduction with a clear statement of purpose, and a conclusion Controversy Associated with Dissociative Disorders Discussion Paper