PSY 215 Module Five Milestone Template

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Dec 6, 2023

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PSY 215 Module Five Milestone Template  Distress: Describe the extent to which the selected behavior causes distress as characterized by mental or emotional imbalance. Disassociation is classified as a disruption of normal integration of one or more psychological aspects of functioning including memory, identity, perception, consciousness or motor control (Hooley et al., 2019). It is linked to trauma, emotional memory, and a disintegrated sense of self. In the same way that individuals avoid things to reduce their anxiety, those who disassociate do so to avoid emotional feelings or thought about painful experiences. Dissociation is present in both depersonalization, derealization, and dissociative fugues. In depersonalization, dissociation causes a detachment to one’s self, and an emotional or psychical numbness, whereas in derealization, a person experiences detachment from reality (Hooley et al., Ch. 8.7). These feeling of disconnectedness can create anxiety and stress in an individual as they are unable to fully trust themselves and their surroundings. In extreme cases, a person may begin to exhibit early symptoms of psychosis. “People experiencing dissociative amnesia are typically faced with extremely unpleasant situations from which they see no acceptable way to escape” (Hooley et al., 2019, Ch. 8.8, para. 6). In addition to creating unpleasant sensations and feelings of anxiety, dissociation may create anticipatory anxiety that reinforces a person to dissociate again (Vancappel et al., 2023). For example, if a person had dissociated in the past to avoid the temper of a volatile boss and it reduced their anxiety, a cycle may emerge in which the person continues to dissociate in order to avoid the unpleasant of their boss’s behavior. In addition, dissociation can cause distress if attached to a neutral stimulus that reminds the person of the original trigger that caused them to dissociate in the first place.  Dysfunction: Describe the extent to which the selected behavior causes dysfunction by interfering with adaptive daily functioning. There is nothing dysfunctional about dissociation inherently. Everyone is subject to daydream, or misses a piece of a conversation from time to time. Pathological dissociation, however, invokes frequent memory loss of needed information, and disrupts the sense of self (Hooley et al., 2019). “In people with dissociative disorders, {the} normally integrated and well-coordinated multichannel of human cognition becomes much less coordinated and integrated” (Hooley et al., 2019, Ch. 8.6, para. 5). To screen for dissociative symptoms, often dissociative experiences scale, DES, is provided, asking how frequently a person has experiences such as arriving at a place and having no knowledge of how or when they got there. The more experiences a person has, the more likely they have a disorder. A variety of disorders may develop if a person has persistent dissociative symptoms, including depersonalization, derealization, dissociative amnesia and dissociative identity disorder. To diagnose a person with depersonalization or derealization 1

disorders, symptoms of unreality to the self or the outside world must be reoccurring, and while having symptoms, their reality must stay intact. Dysfunction related to dissociative amnesia must include an inability to recall autobiographical information of an event or several events, usually traumatic or stressful in nature. Finally, in dissociative identity disorder, a person will exhibit the same gaps in information recall, while also being disrupted by two distinct personalities. These alternations in self may affect consciousness, behavior, sensory motor skills, and more. As with all dissociative disorders, DID may develop as a protective measure. The dysfunction of dissociative is associated with escaping a sense of powerlessness.  Danger: Describe the extent to which the selected behavior presents as a danger to self or others. The long-term sustainment of dissociative symptoms can be very dangerous to an individual. In chronic disassociation, the continuous inability to recall information can impact a person’s interpersonal relationships, and lead to job loss. The distressing feelings of detachment from oneself or reality may lead to sexual problems, depression, anxiety, and even self-harm or suicide. For many, dissociation is a protective strategy to keep safe from harm. It is commonly linked to individuals with a history of sexual trauma, higher PTSD severity, and psychiatric disorders (Lathan et al., 2023). In addition, individuals who tend to feel guilt, shame, or blame themsleves are linked with dissociative behaviors. The real danger arises when a person recalls what they were disassociating from, which perhaps may return in the form of a horrifying image or fragments of a memory. In contrast, not being able to remember an event at all can be equally as distressing. This behavior may also impact those close to the individual with this behavior if unresponsive when needed, or appearing emotionally cold and uncommunicative. Joe, an individual with depersonalization/ derealization disorder spoke about his condition stating that he felt like a danger to himself because as he’d grown older his disorder has only grown worse. Dissociation is often misunderstood in the mental health community and improper treatments from providers and improper therapy has left Joe wondering if there is any hope for him. “The condition is hell but the grind of dealing with the mental health services is often worse” (Rethink Mental Illness, 2022, 1:30).  Deviance: Describe the extent to which the selected behavior deviates from normality. Dissociation makes for a distorted view of the world that deviates from what the rest of the world sees. Zoning out in the middle of a conversation is a normal behavior that happens to most from time to time, yet with dissociation, the act of zoning might also include derealization where the individual feels that the conversation they’re having with a friend isn’t real, or they might experience depersonalization, where they feel as if they’re watching themselves have the conversation. This behavior deviates from the norm both internally, where the individual feels unsure of themselves or their surroundings, and externally appears different to others. This behavior also deviates from normal emotional behavior. Dissociation makes a person have difficulty handeling emotions and may feel compelled to behave in a certain way in order to avoid mood shifts. Dissociation is a protective response used by the brain to turn down the pain when there are no other options. This behavior deviates from protective behavior to abnormal 2

behavior when it’s present in situations without danger present. For example, a person may have been in a car accident and smelled burning gasoline during the crash. Now, whenever they’re in a car they think they smell gasoline. This behavior deviates from how a person would normally act in a car when unencumbered by trauma or fear of feeling pain. References: Hooley, J. M., Nock, K., & Butcher, N. (2019). Abnormal Psychology (18th ed.). Pearson Education. https://mbsdirect.vitalsource.com/#/ Lathan, E. C., Sheikh, I. S., Guelfo, A., Choucair, K. C., Fulton, T., Julian, J., Mekawi, Y., Currier, J. M., Powers, A., & Fani, N. (2023). Moral injury appraisals and dissociation: Associations in a sample of trauma-exposed community members. Journal of Trauma & Dissociation, 24(5), 692–711. https://doi-org.ezproxy.snhu.edu/10.1080/15299732.2023.2231010 Rethink Mental Illness. (2022, May 11). Living with dissociation- Joe’s Story . [Video]. YouTube. https://www.youtube.com/watch?v=ZcGLkisSmyk . Vancappel, A., Tapia, G., Clarys, D., Raysseguier, C., & El-Hage, W. (2023). Association between cognitive impairments and dissociation: A PRISMA systematic review. European Journal of Trauma & Dissociation, 7(3). https://doi- org.ezproxy.snhu.edu/10.1016/j.ejtd.2023.100341 3

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