What is hypnosis, anyway?
What is dissociation?
But I understood that it was some kind of ‘disorder’.
So would it be classified as a neurosis, or a mental
illness? Am I crazy?
What are the symptoms?
Are dissociative disorders treatable?
Are there testing procedures?
Must I take some kind of medication?
How long can therapy take?
Should the person be referred by his or her family
doctor?
Is hypnosis helpful in treating dissociative problems?
If I move to another city, can treatment be continued
with another therapist?
How do I tell people about ‘being in therapy’?
At what age can symptoms begin to show?
In the past, I have been told that I have Multiple
Personality Disorder. What’s the difference?
How did I get this ‘disorder’?
I don’t understand what ‘trauma’
means.
So it doesn’t have to be sexual abuse that
causes Dissociative Identity Disorder?
If I am classified as ‘dissociative’,
how should I feel about myself?
What qualifications should a therapist have?
Does medicare cover the cost of therapy?
Are there other problems which have dissociative
aspects?
What is
dissociation? 
In simple terms, it is a way of putting some distance between
yourself and what’s going on around you. We all do it
all the time; usually, we call it ‘daydreaming’.
But I understood
that it was some kind of ‘disorder’.
‘Dissociative Disorders’ refers to those situations
where the dissociative process interferes in one’s everyday
functioning. There are many kinds of dissociative disorders.
So would
it be classified as a neurosis, or a mental illness? Am I crazy?
You definitely are not crazy. It is neither a neurosis, nor
a mental illness; it is a way of adapting to an extremely difficult
situation in which the person, usually a child, has to find
an escape route (figuratively speaking) and survive, emotionally
and perhaps physically.
What are
the symptoms?
In general, people feel that somehow things are out of control,
or they find that they have done, or not done, various tasks,
or that time has slipped by in an unusual way, or that they
seem to have a part of themselves that ‘takes over’.
Sometimes, old memories from the far past become intrusive or
frightening. At other times, people feel like there are conversations
going on inside their heads.
Are dissociative
disorders treatable?
Yes. Good psychotherapy is very effective.
Are there
testing procedures?
There are several excellent diagnostic interviews which are
very reliable.
Must I take
some kind of medication?
Usually, medication is not particularly helpful. At times, it
can be detrimental. The basis treatment is good psychotherapy.
How long
can therapy take?
It varies, but frequently one is looking at an extended period
of time, perhaps two or three years.
Should the
person be referred by his or her family doctor?
Yes, definitely, or by their psychologist or psychiatrist if
that professional does not work
with dissociative patients. This protects the patient/client
and provides continuity of care.
Is hypnosis
helpful in treating dissociative problems?
It may be, but it is certainly not essential (although we used
to think that it was). If the
therapist uses hypnosis, he or she must have had training in
the clinical uses of that modality, from a fully professional
organization.
If I move
to another city, can treatment be continued with another therapist?
Yes. It is best if the records are available from the previous
therapist, with written consent
from the patient/client.
How do
I tell people about ‘being in therapy’?
If you feel you need to explain–which is usually not necessary
because it is your business and nobody else’s business–then
simply say that you are working with a knowledgeable professional
who is helping you to understand how you can make your life
more rewarding than it already is.
At what
age can symptoms begin to show?
At a very young age, if there is a knowledgeable person to observe
them; however, many people simply attribute the symptoms to
behaviourisms in the child. Generally it is the young adult
who presents for help because the symptoms have begun to intrude
into his/her life.
In the
past, I have been told that I have Multiple Personality Disorder.
What’s the difference?
Dissociative Identity Disorder is the new name for what used
to be called Multiple Personality Disorder. The new name is
much more accurate and much less melodramatic, and refers to
the way the personality is structured, which is in a compartmentalized
fashion. The ‘voices’ which some people describe,
are simply a means of inner communication. It is entirely different
from schizophrenia.
How did
I get this ‘disorder’?
By far the most common cause is some sort of trauma that goes
on for a very long time. Children who have grown up in a very
dysfunctional family are particularly vulnerable.
I don’t
understand what ‘trauma’ means.
‘Trauma’ refers to any situation which intrudes
upon a person emotionally, physically or sexually.
So it doesn’t
have to be sexual abuse that causes Dissociative Identity Disorder?
No, indeed. In fact, emotional abuse can be, and usually is,
far more devastating to a child than physical or sexual abuse.
If I am
classified as ‘dissociative’, how should I feel
about myself?
Feel very proud that, as a young child, you found a way to cope
with otherwise unmanageable situations. Now you need to learn
new ways of coping, that are appropriate for you as an adult.
That’s what therapy is all about.
What qualifications
should a therapist have?
He or she should be a member of an accredited professional organization,
such as the College of Psychologists in that province, or the
provincial College of Physicians and Surgeons, or be a Registered
Clinical Counselor. The therapist should also have experience
in the treatment of dissociative disorders and belong to a professional
organization such as CSSTD (Canadian Society for Studies in
Trauma and Dissociation) or ISSD (International Society for
the Study of Dissociation).
Does medicare
cover the cost of therapy?
In Canada, some provincial medical plans have a fee item for
what is known as
‘G.P Psychotherapy’, so that a family doctor who
is experienced in psychotherapy can offer those services to
his or her patient and the plan will cover the cost. Unfortunately,
some provinces do not have this option (e.g. British Columbia)
at this time, so the costs are covered only if the therapist
is a psychiatrist or the person is covered by an Extended Benefit
plan which will reimburse psychologists.
Are there
other problems which have dissociative aspects?
Yes. Many chronic disorders (chronic pain syndromes, chronic
fatigue syndrome,
fibromyalgia, irritable bowel syndrome, eating disorders and
many other chronic syndromes have a dissociative aspect which
needs to be addressed in order to achieve the best therapeutic
results.
Bibliography update (2001)
Siegel, D. (1999).
The Developing Mind: Towards a neurobiological approach.
New York: Guilford Press
Hunter, M.E. (1996).
Making Peace with Chronic Pain: A Whole-Life Strategy.
New York: Brunner/Mazel
Rivera, M. (1966).
More Alike Than Different: Treating Severely Dissociative
Trauma Survivors.
Toronto: University of Toronto
Press
Putnam, F.W. (1989)
Diagnosis and Treatment of Multiple Personality Disorder.
New York: Guilford Press
Herman, J. (1992)
Trauma and Recovery
New York: Basic Books.
Nijenhuis, E.R. (1999)
Somatoform Dissociation: Phenomena, Measurement and Theoretical
Issues.
Assen (The Netherlands); Van
Gorcum
|
