How To Identify Severe Dissociative Disorders After Trauma

Tom was stunned. The last he remembered he was at home enjoying a cold Sunday winter morning with his family. And now… well, he found himself at a biker’s bar. Instead of his fashionable trousers and shirt, he was wearing leather chaps and jacket. To his shock, he was holding a cigarette in one hand and a beer in the other. He hated both.

A woman, whom he didn’t recognize, called to him, addressing him as John. She wanted to know if he wanted to join everyone for a ride on the bikes to the mountains. Tom did not know how to answer. John, whoever he was, certainly was not him! Tom had no interests in bikes nor had he ever rode one; he liked driving his BMW if he wanted to go into the mountains with wine, not beer, in the trunk. Something was terribly wrong and he was terrified.

Tom’s experience is not uncommon for those who experience severe dissociative disorders- those experiences, which are not induced by use of drugs, that severely disrupt our memory, identity, perceptions and our ability to function in our daily lives.

DISSOCIATION: FROM MILD TO SEVERE

In a previous article entitled, “ Has Dissociation After a Trauma Left You Feeling Spacey?” I described how dissociation helps us cope with overwhelming threats. Dissociation- the experience of feeling spacey, having time go in slow motion, or a sense of floating outside of your body- can range from mild to severe. In mild cases, the symptoms are transient; after the threat passes, we return to feeling and acting like ourselves. Some people, however, live their lives in a dissociated state long after the threatening events, which are usually related to prolonged and severe childhood abuse, have passed. By knowing what to look for to help identify severe dissociation, you can better choose the care you need to recover from severe trauma.

5 Questions To Ask To Help You Identify Severe Dissociation

1. Do you experience severe memory loss?
As in the example above, you cannot remember significant things about yourself. These can include: how you arrived at a strange place, your address or other important identifying information, skills you learned as a child or what season it is.

2. Does your physical body or emotions seem unfamiliar?
When this happens, you may feel invisible to others or as though you are viewing yourself as someone in a strange movie. Your mind can become cloudy so that you lose the ability to respond to danger appropriately.

3. Does your environment and all that is happening around you become unreal?
What should be familiar appears very foreign. Even people who are close to you appear as strangers. Objects appear distorted and may change shape or color.

4. Do you feel as though you are split into several different people?
Rather than having beliefs, goals and ideals that are fairly consistent throughout your adult life, you have ongoing intense daily struggles as to who you are and what you think. At times, you may even wonder if you are male or female.

5. Have others commented about how your personality changes significantly?
Those close to you notice how you will act, think and feel a certain way then shift to another and very different way of looking and acting. You may use different names, change your penmanship dramatically, speak other languages or perform certain tasks even though you don’t remember learning how to do them. John, in the story above, had very different tastes in dress and habits than the family man named Tom.

How Are Dissociative Disorders Diagnosed?
There are several forms of dissociative disorders with the most serious being Dissociative Identity Disorder, formerly known as Multiple Personality Disorder. Completing a special psychological test that is administered by a person trained in psychological testing usually provides a formal diagnosis. One such test is called the “Steinberg Clinical Interview for DSM-IV Dissociative Disorders” or SCID-D. A sample of this test is in an easy-to-read book entitled The Stranger in the Mirror: Dissociation: The Hidden Epidemic by Marlene Steinberg, MD and Maxine Schnall, © 2001 by Harper Collins Publishers. By completing this sample test, you will know if you should pursue formal testing and work with a therapist trained specifically in dissociative disorders.

BUT WAIT…..

I’m afraid, if I talk to someone about these weird symptoms, I will start to think I am crazy, never mind what others will think!

Having things like severe memory loss and confusion about whether you are male or female combined with feeling like you are living in someone else’s body can be alarming, to say the least. Working with a therapist, who is trained in identifying dissociative disorders, can actually be huge relief.

For example, by providing you with a correct diagnosis, you can avoid the ineffectual medical and therapy treatments that come with being mistakenly diagnosed with other conditions such as schizophrenia or bipolar. In addition, a trained therapist will help you see how being able to dissociate saved your life and kept you from actually going crazy!

I saw a therapist who said that there is no such thing as multiple personality disorder and that I was making it all up. Should I believe him?
Fortunately, more therapists are accepting the reality that severe abuse can lead to severe dissociative disorders and they are getting training in how to work with them. While some clients may try to fake the symptoms of dissociative disorders, psychological tests combined with clinical interviews are very good tools for identifying who actually has dissociative identity disorder, formerly known as multiple personality disorder. You can find a list of professionals who know about dissociation through the International Society for the Study of Trauma and Dissociation (www.isst-d.org).

I heard that someone with severe dissociative disorders really couldn’t be healed. It’s something you just have to live with. If that’s the case, why should I even try to find a therapist?
For many years, this was the case; clinicians misdiagnosed individuals and they did not have specialized skills to address the needs of these clients. As we better understand the physiology of what happens in trauma through the work of such people as Dr. Peter Levine, PhD along with how trauma distorts our thinking and emotional development, therapy is much more effective in diminishing the body’s need to dissociate. Length of treatment will depend on how often and to what degree you dissociate.

A CASE STUDY TO ILLUSTRATE SEVERE DISSOCIATION
Several years ago, a colleague consulted with me about a client she suspected had a dissociative disorder. At her request, I met with Michael (not his real name) for several years.
Michael worked for the military in a high security position. He was very bright and earned praise and recognition from his superiors. In my office, however, Michael showed different parts of himself quite different than the hard working computer wiz. Sometimes, he spoke with a little boy’s voice; other times, he talked and took on the body gestures of Mr. Tough Guy who knew how to have a good time at the bars.
Michael was very conscientious about keeping his appointments, until one day when another part of him took him miles away from his home and my office. When he called to let me know where he was, he sounded scared and said he had no idea what route he had taken to get there. While there, he realized that he had made some purchases of furniture for which he had no need. He was quite confused as to what to do next.
I spoke to Michael, asking all of his parts to listen in. I explained that it was important for Michael to arrive safely home and asked that the other parts rest while he drove home. In addition, I asked one of his nurturing parts, who went by the name of Steve, to comfort the younger parts who could be frightened by this unexpected trip. Steve, in his baritone voice, reassured me he would do this.

SUMMING IT ALL UP
Dissociative symptoms can range from mild to severe. Formal diagnosis of the exact nature of the dissociation is made through the use of special tests. It is possible to significantly reduce the amount and number of times you dissociate by working with a therapist specially trained in dissociation. Severe dissociative symptoms are most often the result of prolonged and intense childhood abuse. As a result you may experience:

1. Severe memory loss
2. Feeling as though you are a stranger to yourself
3. Having your environment seem unfamiliar
4. Feeling as though you are split into different people
5. Having others close to you comment that you seem to have very different personalities.