Dissociative disorders (DD) are mental diseases distinguished by an inability to connect and coordinate between thoughts, memories, surroundings, behaviors, and identity. Patients with dissociative disorders detach from reality involuntarily and destructively, challenging everyday functioning. Dissociative disorders often arise as a response to trauma and aid in suppressing painful memories. The symptoms experienced may range from amnesia to other identities, partly determined by the kind of dissociative disorder patients have. Stress might temporarily increase symptoms, rendering them more visible. Controversy significantly surrounds this field due to the lack of conclusive literature. Therefore, medical officials need to devise creative means to enhance a therapeutical connection that is legal and follows ethical rules.
Controversy Associated with Dissociative Disorders
The scarcity of scholarly literature on DD, despite data showing a significant association between Dissociative Disorders and trauma, sparks controversy. According to research, a contentious discussion centres on whether dissociations are the product of psychological trauma, things that a person composes with their confabulated trauma experiences, or if it is medically induced (Lynn et al., 2022). A study on dissociation concluded that everyone experiences dissociation as a natural and adaptable process in stressful circumstances. However, further studies on psychoanalysis conducted in the 1900s found flows in her research. Therefore, despite the availability of research, the lack of conclusive empirical findings and variations in different studies result in a lack of knowledge in this field, hence the controversy.
Professional Beliefs on Dissociative Disorders
Some individuals may feign dissociation for selfish reasons; however, all patients should not be stereotyped since there are valid cases. My professional opinion is that dissociative illnesses should be accorded equal attention to psychiatric diseases in the DSM-5 clinical guidelines (Lynn et al., 2022). This ensures that individuals exhibiting dissociation get a thorough examination, evaluation, and treatment rather than being rejected as feigning their symptoms. Critics of dissociation have raised concerns about the relationship connecting dissociation to trauma based on the prevalent posttraumatic paradigm (Nester et al., 2022). However, growing data supports the posttraumatic theory by demonstrating a probable relationship between dissociation disorder and the historical background of trauma, such as the function of particular brain processes. Therefore, I would also devote significant resources to educating healthcare practitioners about trauma-related illnesses, particularly dissociative disorders.
Strategies for Maintaining Therapeutic Relationships
Treating clients with the dissociative disorder is demanding since these patients often suffer from trust difficulties. The initial step in providing care to clients with dissociative disorder is to have professional expertise in the conditions and form a therapeutic relationship with the patient. The preferred treatment includes trauma-based behavioral therapy, one of the recommended psychotherapy techniques for individuals who have experienced trauma (TF-CBT) (Lynn et al., 2022). When responding to client changes, it is critical to regularly review the therapeutic relationship, watch for minor changes in the patient, and be conscious of one’s emotions.
Ethical and Legal Considerations
Because of the issues surrounding dissociative illnesses, there are a variety of ethical and legal ramifications. Various incidents of dissociative disorder pose a central ethical quandary that contradicts the responsibility to disclose and the fiduciary duty (Nester et al., 2022). Mental health providers have an ethical obligation to safeguard patients from self-harm while offering comprehensive treatment. The clinician must decide whether to denounce a recalcitrant patient or maintain personalized therapy access. Such a scenario raises concerns about secrecy, beneficence, and justice. The clinician’s task is to undertake a full mental examination to determine the suicide risk or homicide. The assessment improves risk management and early action.
References
Lynn, S. J., Polizzi, C., Merckelbach, H., Chiu, C. D., Maxwell, R., van Heugten, D., & Lilienfeld, S. O. (2022). Dissociation and dissociative disorders reconsidered: Beyond sociocognitive and trauma models toward a transtheoretical framework. Annual Review of Clinical Psychology, 18.
Nester, M. S., Brand, B. L., Schielke, H. J., & Kumar, S. (2022). An examination of the relations between emotion dysregulation, dissociation, and self-injury among dissociative disorder patients. European journal of psychotraumatology, 13(1), 2031592.