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Dissociation (psychology)

1 History

This article is about the psychological experience. For


other uses, see Dissociation (disambiguation).

The French philosopher and psychiatrist Pierre Janet


(18591947) is considered to be the author of the concept of dissociation.[16] Contrary to some conceptions
of dissociation, Janet did not believe that dissociation
was a psychological defense.[17][18] Psychological defense
mechanisms belong to Freuds theory of psychoanalysis,
not to Janetian psychology. Janet claimed that dissociation occurred only in persons who had a constitutional
weakness of mental functioning that led to hysteria when
they were stressed. Although it is true that many of Janets
case histories described traumatic experiences, he never
considered dissociation to be a defense against those experiences. Quite the opposite: Janet insisted that dissociation was a mental or cognitive decit. Accordingly,
he considered trauma to be one of many stressors that
could worsen the already-impaired mental eciency of
a hysteric, thereby generating a cascade of hysterical (in
todays language, dissociative) symptoms.[16][19][20][21]

In psychology, the term dissociation describes a wide


array of experiences from mild detachment from immediate surroundings to more severe detachment from
physical and emotional experience. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a loss of reality as in
psychosis.[1][2][3][4] Dissociative experiences are further
characterized by the varied maladaptive mental constructions of an individuals natural imaginative capacity.

Dissociation is commonly displayed on a continuum.[5]


In mild cases, dissociation can be regarded as a coping
mechanism or defense mechanisms in seeking to master, minimize or tolerate stress including boredom or
conict.[6][7][8] At the nonpathological end of the continuum, dissociation describes common events such as
daydreaming while driving a vehicle. Further along the
continuum are non-pathological altered states of conAlthough there was great interest in dissociation during
sciousness.[5][9][10]
the last two decades of the nineteenth century (especially
More pathological dissociation involves dissociative
in France and England), this interest rapidly waned with
disorders,
including
dissociative
fugue
and
the coming of the new century.[16] Even Janet largely
depersonalization disorder with or without alterturned his attention to other matters. On the other hand,
ations in personal identity or sense of self. These
there was a sharp peak in interest in dissociation in Ameralterations can include: a sense that self or the world is
ica from 1890 to 1910, especially in Boston as reected in
unreal (depersonalization and derealization); a loss of
the work of William James, Boris Sidis, Morton Prince,
memory (amnesia); forgetting identity or assuming a new
and William McDougall. Nevertheless, even in Amerself (fugue); and fragmentation of identity or self into
ica, interest in dissociation rapidly succumbed to the surgseparate streams of consciousness (dissociative identity
ing academic interest in psychoanalysis and behaviorism.
disorder, formerly termed multiple personality disorder)
For most of the twentieth century, there was little interest
[11][12]
and complex post-traumatic stress disorder.
in dissociation. Discussion of dissociation only resumed
Dissociative disorders are sometimes triggered by when Ernest Hilgard (1977) published his neodissociatrauma, but may be preceded only by stress, psychoactive tion theory in the 1970s and when several authors wrote
substances, or no identiable trigger at all.[13] The ICD- about multiple personality in the 1980s.
10 classies conversion disorder as a dissociative disorCarl Jung described pathological manifestations of disder.[5] The Diagnostic and Statistical Manual of Mental
sociation as special or extreme cases of the normal operDisorders groups all dissociative disorders into a single
ation of the psyche. This structural dissociation, opposcategory.[14]
ing tension, and hierarchy of basic attitudes and functions
Although some dissociative disruptions involve amnesia, in normal individual consciousness is the basis of Jungs
other dissociative events do not.[15] Dissociative disorders Psychological Types.[22] He theorized that dissociation is
are typically experienced as startling, autonomous intru- a natural necessity for consciousness to operate in one facsions into the persons usual ways of responding or func- ulty unhampered by the demands of its opposite.
tioning. Due to their unexpected and largely inexplicable
Attention to dissociation as a clinical feature has been
nature, they tend to be quite unsettling.
growing in recent years as knowledge of post-traumatic
stress disorder increased, due to interest in dissociative
identity disorder and the multiple personality controversy, and as neuroimaging research and population stud1

5 SEE ALSO

ies show its relevance.[23]

substance abuse, self-harm and suicidal ideation or


[27][28][32]
These symptoms may lead the victim
Historically the psychopathological concept of dissocia- actions.
to
present
the
symptoms
as the source of the problem.[27]
tion has also another dierent root: the conceptualization
of Eugen Bleuler that looks into dissociation related to Child abuse, especially chronic abuse starting at early
schizophrenia.[24]
ages, has been related to high levels of dissociative symptoms in a clinical sample,[33] including amnesia for abuse
memories.[34] A non-clinical sample of adult women
linked increased levels of dissociation to sexual abuse by a
2 Diagnosis
signicantly older person prior to age 15,[35] and dissociation has also been correlated with a history of childhood
Main article: dissociative disorder
physical and sexual abuse.[36] When sexual abuse is examined, the levels of dissociation were found to increase
Dissociation in community samples is most commonly along with the severity of the abuse.[37]
measured by the Dissociative Experiences Scale. The
A 2012 review article supports the hypothesis that current
DSM-IV considers symptoms such as depersonalization,
or recent trauma may aect an individuals assessment of
derealization and psychogenic amnesia to be core feathe more distant past, changing the experience of the past
tures of dissociative disorders.[25] However, in the norand resulting in dissociative states.[38]
mal population dissociative experiences that are not clinically signicant are highly prevalent, with 60% to 65%
of the respondents indicating that they have had some dissociative experiences.[26] The SCID-D is a structured in- 4 Psychoactive substances
terview used to assess and diagnose dissociation.
Main article: Dissociative drug

Relation to trauma and abuse

Dissociation has been described as one of a constellation of symptoms experienced by some victims of
multiple forms of childhood trauma, including physical,
psychological, and sexual abuse.[27][28] This is supported
by studies which suggest that dissociation is correlated
with a history of trauma.[29] Dissociation appears to have
a high specicity and a low sensitivity to having a selfreported history of trauma, which means that dissociation
is much more common among those who are traumatized,
yet at the same time there are many persons who have
suered from trauma but who do not show dissociative
symptoms.[30]
Adult dissociation when combined with a history of
child abuse and otherwise interpersonal violence-related
posttraumatic stress disorder (PTSD) has been shown to
contribute to disturbances in parenting behavior, such as
exposure of young children to violent media. Such behavior may contribute to cycles of familial violence and
trauma.[31]
Symptoms of dissociation resulting from trauma may
include depersonalization, psychological numbing,
disengagement, or amnesia regarding the events of the
abuse. It has been hypothesized that dissociation may
provide a temporarily eective defense mechanism
in cases of severe trauma; however, in the long term,
dissociation is associated with decreased psychological functioning and adjustment.[28] Other symptoms
sometimes found along with dissociation in victims of
traumatic abuse (often referred to as sequelae to abuse)
include anxiety, PTSD, low self-esteem, somatization,
depression, chronic pain, interpersonal dysfunction,

Psychoactive drugs can often induce a state of temporary dissociation.


Substances with dissociative
properties include ketamine, nitrous oxide, alcohol,
tiletamine, marijuana, dextromethorphan, MK-801,
PCP, methoxetamine, salvia, muscimol, atropine, and
ibogaine.[39]

5 See also
Altered state of consciousness
Coping (psychology)
Dissociative disorder
Dissociative Experiences Scale
Dissociative Identity Disorder
Dissociative substance
Emotional detachment
Fantasy prone personality
International Society for the Study of Trauma and
Dissociation
Psychological numbing
Repressed memory
Splitting (psychology)

References

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[3] Gleaves, DH; May, MC; Cardea, E (June 2001). An
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[10] Van der Kolk, B. A., Van der Hart, O., & Marmar, C. R.
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[18] Janet, Pierre (1965) [1920/1929]. The major symptoms of
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[25] Dissociative Disorders ( Diagnostic and Statistical Manual
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[29] van der Kolk, BA; et al. (1996). Dissociation, somatization, and aect dysregulation: The complexity of adaptation of trauma. American Journal of Psychiatry 153 (7
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[35] Briere, J; Runtz, M (1988). Symptomatology associated with childhood sexual victimization in a nonclinical adult sample. Child Abuse and Neglect 12: 5159.
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[38] Stern, DB (January 2012). Witnessing across time:
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External links
International Society for the Study of Trauma and
Dissociation

EXTERNAL LINKS

The ocial journal of the International Society for


the Study of Dissociation (ISSD), published between 1988 and 1997

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