NRNP 6665: PMHNP Across the Lifespan I: Controversy Associated With Dissociative Disorders

NRNP 6665: PMHNP Across the Lifespan I: Controversy Associated With Dissociative Disorders

NRNP 6665 PMHNP Across the Lifespan I Controversy Associated With Dissociative Disorders

Dissociative disorders manifest with an unconscious escape from reality whereby an individual experiences a disconnection in identity, thoughts, consciousness, and memory. Features of Dissociative disorders include marked memory loss of specific people, periods, and events. Besides, individuals report having out-of-body experiences and feeling disconnected from their emotions. The purpose of this assignment is to discuss the controversy surrounding Dissociative disorders.

Controversy That Surrounds Dissociative Disorders

Dissociative disorders have remained controversial, which hinders diagnosis and treatment. Reinders & Veltman (2021) explain that the controversy revolves around two opposing views, the trauma model and the fantasy model. The trauma model hypothesizes that DID Dissociative disorders are a serious form of post-traumatic stress disorder (PTSD) that stem from severe and chronic trauma in childhood. On the other hand, the fantasy model proposes that Dissociative disorders are primarily a product of suggestion and enactment and are fostered by a high degree of fantasy tendency and suggestibility (Reinders & Veltman, 2021). Clinicians have been fascinated by the fantasy model since Dissociative disorders are rooted in experimental research in non-clinical subjects and are not entirely founded on scientific research.

Professional Beliefs about Dissociative Disorders

My professional belief regarding dissociative disorders is that they usually result as a means of dealing with trauma. I believe dissociative disorders mainly develop in children that experience long-term physical, emotional, or sexual abuse. Dalenberg et al. (2020) found vital areas of consensus, including that exposure to trauma, are linked with depersonalization and, at times, memory errors. According to Krause-Utz (2022), psychological trauma is a major risk factor in the development of dissociation. Dissociation acts as a defense mechanism to deal with agonizing, overwhelming experiences of a traumatizing event. Furthermore, I believe that natural disasters and combat also contribute to the development of dissociative disorders. Loewenstein (2018) explain that dissociation lessens the effect of trauma by psychobiologically isolating the information about the trauma by protective activation of distorted states of consciousness.

Strategies for Maintaining the Therapeutic Relationship with a Client with a Dissociative Disorder

Clinicians should seek to maintain a therapeutic relationship (TR) with a patient with a dissociative disorder since it promotes a successful treatment process. The clinician should display empathy, compassion, and humility when interacting with the patient. The clinician should make things to be transparent, and they should be genuine and authentic (Graham Jr et al., 2018). In addition, the clinician should demonstrate unconditional positive regard irrespective of the patient being manipulative, aggressive, or inappropriate.

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Ethical and Legal Considerations Related To Dissociative Disorders

Ethical and legal factors that should be considered when dealing with patients with dissociative disorders revolve around

NRNP 6665 PMHNP Across the Lifespan I Controversy Associated With Dissociative Disorders

nonmaleficence and confidentiality. The practitioner should avoid causing harm (nonmaleficence) to the patient and should not put them in situations that may worsen their condition (Graham Jr et al., 2018). The practitioner should also maintain the confidentiality of the patient’s information and only share it after obtaining the patient’s consent or following a court order.

Conclusion

The controversy around dissociative disorders is rooted in their etiology, with the trauma and fantasy models having opposing views on the cause of the disease. I believe dissociative disorders’ symptoms initially develop as a response to a traumatic event, like abuse or military combat, to keep the distressful memories under control. Clinicians can maintain a TR with patients by showing empathy, compassion, humility, and unconditional positive regard.

NRNP 6665: PMHNP Across the Lifespan I: Controversy Associated With Dissociative Disorders References

Dalenberg, C. J., Brand, B. L., Loewenstein, R. J., Frewen, P. A., & Spiegel, D. (2020). Inviting Scientific Discourse on Traumatic Dissociation: Progress Made and Obstacles to Further Resolution. Psychological Injury and Law. doi:10.1007/s12207-020-09376-9

Graham Jr, J. M., Hundley, G., Zeligman, M. R., Bloom, Z. D., & Ayres, K. (2018). Counseling Clients with Dissociative Identity Disorder: Experts Share their Experiences. Journal of Counselor Practice, 9(1), 39–63.

Krause-Utz, A. (2022). Dissociation, trauma, and borderline personality disorder. Borderline personality disorder and emotion dysregulation, 9(1), 14. https://doi.org/10.1186/s40479-022-00184-y

Loewenstein, R. J. (2018). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein

Reinders, A. A., & Veltman, D. J. (2021). Dissociative identity disorder: out of the shadows at last?. The British Journal of Psychiatry, 219(2), 413-414. https://doi.org/10.1192/bjp.2020.168

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