Dissociation (psychology)

The term describes dissociation in psychology, the separation of perception and memory contents, which are normally associated. This allows the integrative function of consciousness, memory, perception and identity are affected.

Explanation

In the brain, an experience track from a variety of impressions, namely generated visual, auditory, tactile, olfactory, gustatory, proprioceptive and kinesthetic signals. For this purpose, the arriving at different locations in the brain signals must be processed and integrated. The resulting experience track is ordered by time and space and stored in memory. Due to the high processing and integration capabilities of the human brain these different processes are experienced by the individual as a unit. In reality, however, many factors are necessary for contents of mental processes and can be connected to each other and thus these saw unit is maintained. If two or more mental processes or contents no longer linked together, although this is usually the case, one speaks of dissociation. This can happen in everyday life as a normal dissociative phenomenon, but also occur as a mental disorder and affect the viability of the individual considerably.

Examples of dissociative everyday phenomena:

  • A marathon runner displayed in a sort of trance of his pain.
  • A computer player is so deeply engrossed in the game that he temporarily loses track of the time elapsed.
  • A student suffers during a boring lecture a brief memory lapse because he does not focus his attention.

Examples of dissociative disorders:

  • In a trauma victim's recollection ability changed abnormally to the traumatic experience.
  • A man has to split even during a traumatic event feel in each one " active " and an " observational " person.
  • A rape victim for years to psychogenic pain in the abdomen, although the triggering event as a result of traumatic amnesia is not erinnerbar.

Diagnostics

The induced dissociation phenomena and symptoms point to an enormous breadth. While some sufferers describe a particular impairment of autobiographical memory or identity or experience of perception, the dissociation leads to other interested parties to movement disorders, pain disorders or seizures. It may resemble the observable symptoms of neurological disorders which ( epileptic seizures, dementia, etc.). Thus, there is a likelihood of confusion, because as an intra- psychic process dissociation to direct observation is available. The fact that symptoms are due to dissociation, must therefore be developed on the basis of typicity back of the symptoms as well as the autobiography of the person concerned by the exclusion of other possible explanations (eg, neurological disease) and.

Term accruals

Dissociation in the ICD -10

Dissociation in psychiatric and / or psychotherapeutic sense, as a defect of mental integration be understood in one or more areas of mental processes are separated from consciousness and independently run ( elimination of consciousness). In contrast, conversion includes somatic, ie, sensory and motor phenomena.

In contrast, in the ICD - 10 classification, the terms dissociative disorder and conversion disorder are used interchangeably. The general characteristics of dissociative or conversion disorders is then a partial or complete loss of the normal integration between memories of the past, awareness of identity, perception and immediate sensations, and control of bodily movements.

When dissociation is a multi-faceted disorder in which there is a partial or complete loss of mental functions such as the ability to remember, own feelings or sensations (pain, fear, hunger, thirst, ...), the perception of oneself and / or the environment and the control of body movements comes. The loss of these abilities may be pronounced differently from hour to hour.

History

The dissociation model has evolved in the 19th century from the association psychology and was initially applied to the interpretation of hysteria processes in hypnosis and of observations of duplications or multiplications of personalities. Theories about 1880 considered especially the trauma as a trigger for dissociation. So Pierre Janet described in 1889 amnesia and identity disorders as mental illnesses as a result of trauma. After it was significantly less current 1920-1970, the dissociation model was from 1970 again attention.

Dissociation means an interruption of the flow of consciousness, the elimination of feelings, body awareness and emotions, memory, identity and the perception of the environment.

According to recent research ( circa 2006 ) Psychosomatic disorder and conversion disorder are the preamble Somatoform dissociation fed and assigned to the dissociative disorders (as opposed to mental shape dissociation). Nijenhuis, Hart and Steele representing the concept supported by neurobiological findings of Structural Dissociation. Thereafter, the symptomatic sensations and behaviors permanently different personality shares ( ego states ) are in very severe and continuous Psychotraumatisierungen, especially in childhood, associated. The authors hypothesize that the corresponding behaviors, feelings and evaluations in later life, regardless of traumatic situations could hardly be avoided.

Patients with dissociative disorders often suffer from chronic body symptoms, which should be understood by a dentist but dissociations of his patients as well as a sign of the disintegration of the entire personality. The symptoms are the result here an instinctive survival reaction of the people, similar to that of animals, and produce excitation or incapacitating conditions. The consideration of the endorphin neurotransmitter at the biochemical level shows a new understanding of the dissociation at the behavioral level.

Dissociative disorders in medical nomenclature system ICD -10

In ICD -10 different dissociative disorders ( conversion disorders ) are described. A common feature is that no physical illness can be detected, which explains the symptoms, and that there is a temporal relation of symptoms to stressful events, problems or needs.

Dissociative amnesia

In dissociative amnesia ( F44.0 ) the person concerned being missing completely or partially memories of her past, v. a to stressful or traumatic events. The amnesia goes far beyond what the normal forgetfulness, that is lasts longer or is more pronounced. However, the extent of amnesia may fluctuate over time.

Dissociative Fugue

Under a dissociative fugue ( F44.1 ) (also psychogenic fugue ) is understood ( home, workplace ) the unexpected travel away from their usual environment. The trip is organized externally normal, self-sufficiency is largely maintained. There is a partial or complete amnesia for the entire past or parts thereof ( particularly for traumatic events). According to DSM - IV, a confusion is required about personal identity or assumption of a new identity as an additional criterion. However, the latter is rarely the case. If they do, then the new identity is usually characterized by more socializing and less restraint. The duration may be for several hours to several months.

Dissociative stupor

When dissociative stupor ( F44.2 ) voluntary movement, language, and the normal response to light, sound and touch are reduced or absent. The normal muscle tension, upright posture and breathing are obtained, however, the coordination of eye movements is often limited.

Trance and possession disorders

Hypnagogic state

Trance is the state in which a person is when a trance induction was carried out for example in the setting of psychotherapy. In common parlance, a distinction is made between:

  • Everyday trance and trance problem
  • Light trance
  • Deep trance
  • 3 phases of a trance Induction ( introduction)
  • Utilisation (Trance Content)
  • Reorientation (return)

An altered, relaxed state of consciousness is a state of consciousness in which the attention is focused so intensely on an object or a process that other perception is perceived hidden or restricted. A state of consciousness with increased permeability of psychosomatic and cognitive flexibility. It is based on a type of the non-dominant hemisphere.

In the representation of brain waves (EEG ) occur more alpha, delta, theta and gamma waves - in contrast to normal waking consciousness, occur predominantly beta waves in the.

Trance is an altered state of experience and behavior that is identical neither with the everyday wakefulness nor sleep. In Trance controlling the activity of consciousness is decreased, the independent functions of the unconscious are reinforced and more suggestible.

Trance can achieve different depth stages, from light daydream near the waking state to the hypnotic deep sleep, the one behind has no memory. Many studies prove that people respond to suggestions in a hypnotic sleep, even when consciousness " disappeared" and afterwards remember nothing more. Trance experiences are nothing exotic, which can experience only a select few after years of training or intensive, sophisticated influence. Everyone commonly experienced states of " everyday trance ", which are sometimes no less profound than the trances that are initiated by experienced hypnotists.

Light trance states occur during the day, such as: drive from A to B and is at its not fully aware of. The brain needs light trance states with alpha waves to regenerate. In this phase, messengers and nutrients are provided again for the brain. In the analogy of the computer world: the PC is shut down, in order to then download the programs again.

Clients describe the state of often very profound relaxation, very pleasant, a feeling of lightness or a pleasant heaviness. The sense of time in a trance is very often changed. In Trance is also the heartbeat, respiration, oxygen consumption, blood flow, skin temperature can change harmonizing. Other effects include endocrinology (stress hormones decrease ), immunologically ( Leukozytenmobilität increases, better wound healing), central nervous system ( Tonusveränderung ), vegetative ( calming, stabilizing conversion ), psychological (Trance logic, pictures, messages, tolerance of incongruity ), increased memory ability (childhood ), performance, attention, emotion and time perception. Trance strengthens and extends its resources.

Especially in periods of high mental and physical tension, it may be good to create a "mobile oasis of peace ". Through meditation, relaxation techniques or therapeutic trance people can improve their physical, mental and emotional well -being.

State of possession

In a state of possession sufferers are convinced to be dominated by a spirit, a power, a deity or another person.

Dissociative motor disorders

In dissociative (or psychogenic ) movement disorders ( F44.4 ), there is either

  • A loss or restriction of mobility ( voluntary motor, language) or
  • To incoordination, ataxia, or the inability to stand without assistance.

Dissociative motor disorders make from 2,6 to 25% of movement disorders in neurological departments. Of this, 32.8% fall on the psychogenic tremor, 25% in psychogenic dystonia, 25% of the psychogenic myoclonus, 6.1% to the psychogenic parkinsonism and 10.9% to the psychogenic gait disorder.

Dissociative convulsions

In dissociative seizures ( F44.5 ), there is sudden and unexpected spasmodic movements which may remind you of an epileptic seizure. However, it does not come to loss of consciousness and rarely a tongue bite, severe bruising, injuries due to a fall or urinary incontinence.

The dissociative seizures of classic Arc de cercle heard. Sigmund Freud has described a series of cases under the term hysteria.

Dissociative sensibility and sensory disturbances

In the dissociative sensibility and sensation disorders ( F44.6 ) is either a loss (partial or complete)

  • The normal skin sensations ( a body part or the entire body) or
  • Of visual, auditory or olfactory ago.

Other dissociative disorders

These include, for example,

  • The Ganser syndrome (also past answers Pseudodebilität, F44.80 ) and
  • The multiple personality disorder (also: dissociative identity disorder, F44.81 ). According to the DSM -IV ( the Diagnostic and Statistical Manual of Mental Disorders ) have two or more separate, completely different identities or personality states exist and determine the behavior of the person concerned in the exchange. This disorder does not belong to the group of schizophrenia, although this is not entirely clear in popular term fission insanity.

Diagnostic instruments

There are various instruments for the diagnosis of dissociation. These can be divided into questionnaires for self - and external assessment:

Self-assessment:

  • Dissociative Experience Scale ( DES) / questionnaire to dissociative symptoms ( FDS )
  • Impact of Event Scale ( IES ) - Measures intrusion, increased arousal and avoidance behavior after trauma

Foreign judgment:

  • Structured Clinical Interview for DSM -IV Dissociative Disorders (SCID -D)
  • Dissociative Disorders Interview Schedule ( DDIS )

Dissociation as a therapeutic technique

This ability of people to dissociation can be used therapeutically: In psychotherapy, the term refers to a consciously made ​​changing the perception away from fully identified Experience a " meta- position " (see also meta-level ), out of which the human being quasi " from outside " considered ( Heautoskopie ) to recognize his emotions or mental processes free valuation ( for example, as if one would look at a situation in which one is involved in a movie ). In the talk therapy and systemic therapy, the dissociation is an important element of the therapeutic work, as in the psychodynamic imaginative trauma therapy ( PITT ).

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