Controversy Associates with Dissociative Disorder

Controversy Associates with Dissociative Disorder

Controversy Associates with Dissociative Disorder

The controversy that surrounds dissociative disorders

Dissociative disorders (DD) have been the subject of debate ever since the development of contemporary psychiatry and psychology. Even among professionals, DD views are frequently not supported by the scientific literature. Multiple lines of research point to a strong connection between psychological trauma, particularly cumulative and early-life trauma, and DD (Loewenstein, 2019). The argument presented by skeptics is that DDs are artifactual states caused by iatrogenic or sociocultural influences and dissociation causes trauma fantasies. However, almost no clinical or research data lend weight to this assertion.

Dissociative identity disorder (DID) is the most common and controversial DD. It is founded on the argument that the development of existing diagnostic measures renders first-person claims of dissociation based on those scales unreliable (Loewenstein, 2019). According to the argument, how these scales are made causes more false positives. The misinterpretation of other conditions, poor patient care, and insufficient treatment of depression have all been attributed to DID diagnoses (Loewenstein, 2019). Even when DID is treated with the best of intentions, psychotherapy may have unintended negative effects, and some patients report worsening symptoms and declining functionality. On understanding if DID is fake, some medical professionals question whether those who advocate the diagnosis of dissociative identity disorder have any financial or other conflicts of interest. According to Loewenstein (2019), physicians or organizations can generate an income of up to $20,000 per patient from the long-term intensive psychotherapy care that people with DID typically get, giving doctors a strong incentive to identify DID. It implies that doctors can continue to wrongfully diagnose people with DID because its treatment is a significant revenue stream.

My professional beliefs about dissociative disorders

Besides the controversy, I believe dissociative disorders are real and impact a significant part of the population. In most cases, the disease is misdiagnosed as schizophrenia due to the unjustified belief that the individual might be delusional (Mitra & Jain, 2021). Dissociative disorders are widespread in both general and clinical populations, and they constitute a significant underserved group with a high risk of self-harm and suicide (Pietkiewicz et al., 2021). Serious DD patients’ symptoms, including suicidal and self-destructive tendencies, significantly improved after treatment, according to prospective studies of treatment outcomes (Loewenstein, 2019). A significant public health initiative is required to promote understanding of dissociation/DD, including educational initiatives in all programs for mental health professionals and more financing for research.

(Controversy Associates with Dissociative Disorder)

Strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder

Building rapport and fostering trust in the therapeutic process are the main goals of the initial phase of treatment. The therapist tells the client that they will not be required to confront any topics that they do not feel comfortable facing and emphasizes that symptoms are a byproduct of identified factors during the assessment (Thayyil & Rani, 2020). The therapist empowers the client’s capacity for self-regulation and willingness to effect change within themselves while establishing a strong therapeutic alliance and retaining professional neutrality. The therapeutic relationship is reinforced by establishing and maintaining clear boundaries, developing reliable strategies to deal with emotions during therapy, establishing appropriate ways to assert oneself and deal with interpersonal conflict, acting mindfully, acknowledging changes, and appreciating the significance of the client’s efforts towards change and recovery.

Ethical and legal considerations related to dissociative disorders that should be brought to practice and why they are important

There are more than nine parts of lore and less than one part of the law in the entire legal situation pertaining to dissociation and pathological dissociation. In regards to all facets of the putative “special status” that dissociation phenomena, whether normal or sick in nature, purportedly deserve, there is a great deal more communal (and contradictory) tradition than statutory or judicial law (Kabene et al., 2022). The objective of the present examination is to determine if a person with DID is legally accountable for the offence they committed and whether they are capable of facing trial. There is no agreement within the legal system as to whether DID patients should be held accountable for their conduct, despite the fact that the disease is fundamentally defined by dissociative amnesia and that the host personality may only have minimal or no contact with the alters. Additionally, courts typically reject the accusations of insanity made by DID sufferers (Kabene et al., 2022). The excessive dependence on secondary data requires people to accept the inferences that have already been formed, and there is no chance to independently confirm those results, hence it is recommended that additional studies in the field integrate primary data into this study.

References

Kabene, S. M., Neftci, N. B., & Papatzikis, E. (2022). Dissociative Identity Disorder and the Law: Guilty or Not Guilty?. Frontiers in Psychology, 13.

Loewenstein R. J. (2019). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2019.20.3/rloewenstein

Mitra, P., & Jain, A. (2021). Dissociative identity disorder. Statpearls [Internet].

Pietkiewicz, I. J., Bańbura-Nowak, A., Tomalski, R., & Boon, S. (2021). Revisiting false-positive and imitated dissociative identity disorder. Frontiers in psychology, 12, 637929.

Thayyil, M. M., & Rani, A. (2020). Structural Family Therapy with a Client Diagnosed with Dissociative Disorder. Indian Journal of Psychological Medicine, 43(6), 549-554.

Controversy Associates with Dissociative Disorder