DSM-5-TR SELF REFLECTION: FINAL ASSIGNMENT
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DSM- 5 Dissociative Disorders
Samantha Deenihan
School of Clinical Mental Health Counseling, Liberty University
DSM-5- TR Self Reflection
Dissociative Disorders
Dissociative disorders involve problems with memory, identity, emotion, perception,
behavior and sense of self. Dissociative symptoms can potentially disrupt every area of mental
functioning. Examples of dissociative symptoms include the experience of detachment or feeling
as if one is outside one’s body, and loss of memory or amnesia. Dissociative disorders are
frequently associated with previous experience of trauma.
DSM-5-TR SELF REFLECTION: FINAL ASSIGNMENT
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Worldview
From my worldview, I believe that dissociative identity disorder (DID) develops primarily
as a coping mechanism in response to severe and chronic trauma, particularly early childhood
trauma such as physical or sexual abuse. I have worked with a couple of children that have
presented with this disorder and most of the time they are coming with a type of abuse. My
belief is influenced by psychological theories that focus on the mind's ability to dissociate as a
protective mechanism when a person experiences overwhelming emotional pain or trauma
(Putnam, 1989). When individuals face unbearable stress, especially during critical periods of
development, their psyche may fragment to compartmentalize the trauma and protect the self
from emotional collapse (Van der Kolk, 2014). The experience of dissociation can become so
deep-rooted that it eventually results in the formation of distinct identities or personality states
as a means of dealing with different aspects of the trauma (Dell, 2009). In this context, DID can
be seen as an adaptive, response to extreme psychological stress. From what I have witnessed a
lot of the time someone is suffering from this diagnosis; they are trying to exit themselves and
wanting to become someone else. They dislike themselves and want to block out the abuse or
trauma that they want to leave their bodies for good, so they make other identities.
Bias
I recognize that one potential bias is the tendency to question the legitimacy of DID,
especially given its controversial nature and frequent portrayal in the media. There is often
skepticism about whether the disorder is real or simply a product of suggestion or misdiagnosis,
which may influence how I initially perceive a client’s experiences (Lynn et al., 2007). This
disorder has been portrayed “crazy” especially in movies. Additionally, I may unintentionally
associate the diagnosis with a higher level of complexity and difficulty in treatment, leading me
to feel uncertain or overwhelmed. To mitigate these biases, I will focus on evidence-based
practices and continuously educate myself on the current research regarding DID and its
DSM-5-TR SELF REFLECTION: FINAL ASSIGNMENT
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treatment (Dell, 2009). There is so much to learn about DID and it is more then what we need in
TV shows and the movies, most of the time it is not like that so gaining more knowledge is th
best tool. I will approach each client with an open mind, acknowledging that their lived
experience is valid, regardless of my prior assumptions. I will also consult with colleagues or
supervisors and participate in ongoing professional development to address any biases that may
arise, ensuring that I maintain an empathetic, nonjudgmental stance.
ACA Code
A relevant code from the ACA Code of Ethics is A.1.a. Primary Responsibility, which
emphasizes that the counselor’s primary responsibility is to respect the dignity and promote the
welfare of clients. This is especially valid when working with individuals diagnosed with DID, as
the disorder is often linked to complex trauma, which can lead to a high level of vulnerability. A
counselor must approach such clients with empathy, respect, and sensitivity, ensuring that their
treatment is supportive of their emotional and psychological well-being. You want to make sure
you are giving your client a safe space so they feel they can trust you and open up. Given the
potential for clients with DID to experience significant distress and confusion about their
identities, counselors must be committed to providing a safe, nonjudgmental environment
where clients can process their trauma and work toward integration and healing (Herman,
1992).
Disposition
One disposition I plan to cultivate is Social Responsibility. The complexity of DID and the
trauma that often underlies it necessitate a deep understanding of the client’s emotional world.
Empathy will allow me to connect with clients who may feel misunderstood or stigmatized due
to their diagnosis. Will also help me connect with them and to get them to trust me so they can
open up and we have a therapeutic relationship. It is essential for building trust and creating a
therapeutic relationship in which the client feels safe enough to explore the fragmented parts of
themselves. I will strive to put myself in the client's shoes, acknowledging their emotional pain
DSM-5-TR SELF REFLECTION: FINAL ASSIGNMENT
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and helping them make sense of their experiences in a supportive and understanding way
(Rogers, 1961).
ASERVIC Competency
One competency I would like to cultivate is Competency 3: Understanding the Role of
Spirituality in Mental Health. Spirituality can play a significant role in the lives of individuals with
DID, especially in terms of finding meaning, coping, and healing. Some spiritual practices, like
meditation or connecting with a higher power, can help individuals with DID access and
integrate different "alter" personalities, promoting a sense of wholeness. It is important to
explore and respect these beliefs, whether they use spirituality as a source of strength or
struggle with reconciling their experiences within their religious framework. By being open to
incorporating spiritual perspectives into counseling, I can offer a more holistic approach to
treatment, acknowledging that healing may involve addressing the spiritual dimension of the
self as well as the psychological (Sperry & Shafranske, 2005). Also important to remember that
you may not also believe what they believe, but you cannot put your own beliefs on them. They
are allowed to believe and incorporate their own beliefs in their healing practices.
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References
American Counseling Association. (2014). ACA Code of Ethics.
Dell, P. F. (2009). The prevalence of dissociative identity disorder in the general population: A
critical review of the evidence. Journal of Trauma & Dissociation, 10(1), 17-41.
https://doi.org/10.1080/15299730802582965
Herman, J. L. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to
political terror. Basic Books.
Lynn, S. J., Kirsch, I., & Hallquist, M. N. (2007). Dissociation and the dissociative disorders:
DSM-V and beyond. Routledge.
Putnam, F. W. (1989). The development of dissociative disorders: A clinical perspective. In P. F.
Dell (Ed.), Dissociation and the dissociative disorders (pp. 12-35). Brunner/Mazel.
Rogers, C. R. (1961). On becoming a person: A therapist's view of psychotherapy. Houghton
Mifflin.
Sperry, L., & Shafranske, E. P. (2005). Spirituality in clinical practice: Incorporating spiritual
and religious beliefs in mental health care. American Psychological Association.
Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of
trauma. Viking.
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