rewrite must be original due 08/2/2022 at 11 am EST

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Dissociative Disorder

Monica Castelao

Walden University Dr Hopkins

Aug 1, 2022

Dissociative Disorder

Controversies that Surrounds the Disorder There are three primary controversies that are often attached to dissociative disorder. First, dissociative identity disorder (DID) attracts debate on whether it has iatrogenic influences. 1  However, the existing body of empirical evidences does not support such a conclusion, though iatrogenic influences may play a significant role in the presentation and manifestation of this mental health problem. The second controversy related to how sufficient its diagnostic criteria are. Many psychiatrists and psychologists hold the view that DSM-IV and V may elicit over diagnosis. As a consequence, there is a need for health care professionals to perform diagnoses using clinical interviews and assessments. 1  The third controversy emanates from the memory processes of DID patients.  In that respect, controversies over whether psychogenic amnesia for sexual abuse patients exist, or are the repressed memories of sexual abuse resent false memories that are unintentionally induced by an overzealous therapist.  2  More specifically, clinical data and experimental laboratory findings do not often cover this problem (Bailey et al., 2019).  1  The massive amnesia for traumatic events that are clinically reported in dissociative disorders have not yet been replicated in empirical and laboratory studies, while memory research indicate that false memories can be established in the laboratory.

My Professional Beliefs about the Disorder There are various professional beliefs that I hold about dissociative disorders. First, the problem occurs when people feel detached from themselves and the world around them. For instance, they may feel separated from their body as though the world around them is unreal (Bailey et al., 2019). 3  Dissociation is one of the ways in which the mind copes with too much stress, including the outcomes of a traumatic event, such as war or death of a loved one (Martinez et al., 2020). People who detach themselves from the real world for a long time may develop dissociative disorders. (Ganslev et al., 2020) Rather than the problem being something that one experiences for a short time, it may escalate into a far more common issue, and as such, is normally becomes the main way that people respond to stressful experiences.

Strategies of Maintaining Therapeutic Relationship with Patients The strategies of maintaining therapeutic relationship should be aimed at building a therapeutic alliance with patients. First, the therapist should develop an affective bond, which incorporates an agreement on the goals and tasks that should be accomplished between the therapist and the client (Ganslev et al., 2020). Additionally, it is important to show genuineness, flexibility, and capacity to truly listen to the patient. In that respect, such a process should strengthen alliance strength and be predictive of the strength of alliance at the end of the treatment. Individuals who undergo different forms of abuses are likely to have challenges in developing trusting relationships later in their lives. Thus, building trust should be the focus of a therapist since it goes a long way in alleviating symptoms as the patient’s state of the mind may not be easy to explore. As the treatment progresses, the therapist should examine the client’s unconscious conflicts that may be a cause of maladaptive functioning. This can help to reduce resistance, which emerges during the therapeutic procedure.

Ethical and Legal Considerations DID patients may pose many ethical and legal challenges to health professionals These problems stem from the capacity for medical decision-making. Since the patients present with different personality states, it would not be easy to determine their suitability to adhere to medications and the clarity of their judgment (Rocchio, 2020). In such a case, the ethical concept of patient self-determination should be weighed against their ability to make sound treatment decisions. Moreover, the patient may have shifting views, beliefs, and moral principles based on the changes in their mental states as they detach themselves from the real world (Rocchio, 2020). These problems can result in conflicting choices as to the appropriateness of the pharmacological interventions to be used.

References

Bailey, T. 4  D., Boyer, S.  M., & Brand, B. L. (2019). Dissociative disorders. In Diagnostic interviewing (pp. 401-424). 5  Springer, New York, NY.

Ganslev, C. 6  A., Storebø, O.  J., Callesen, H.  E., Ruddy, R., & Søgaard, U. (2020). 6  Psychosocial interventions for conversion and dissociative disorders in adults.  Cochrane Database of Systematic Reviews, (7).

Martinez, A. 7  P., Dorahy, M.  J., Nesbit, A., Palmer, R., & Middleton, W. (2020). 7  Delusional beliefs and their characteristics:  A comparative study between dissociative identity disorder and schizophrenia spectrum disorders.  Journal of Psychiatric Research, 131, 263-268.

Rocchio, L. M. (2020). 8  Ethical and professional considerations in the forensic assessment of complex trauma and dissociation.  9  Psychological injury and law, 13(2), 124-134.