The Controversy Surrounding Dissociative Disorders

The Controversy That Surrounds Dissociative Disorders

The assignment (2–3 pages) explain the controversy that surrounds dissociative disorders. Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature. Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important. No plagiarism Four references required

Paper For Above instruction

Dissociative disorders are a complex and often misunderstood group of mental health conditions characterized by disruptions in a person’s normal integration of consciousness, memory, identity, emotion, perception, and behavior. These disorders include dissociative identity disorder (DID), dissociative amnesia, and depersonalization/derealization disorder. The controversy surrounding dissociative disorders primarily stems from debates over their etiology, diagnosability, and the validity of dissociative symptoms. This paper explores the nature of this controversy, presents professional perspectives, strategies for effective therapy, and relevant ethical and legal considerations.

The primary controversy in dissociative disorders revolves around their origins—whether they are genuine psychiatric conditions or products of suggestion, psychotherapy, or societal influence. Critics argue that dissociative disorders, especially DID, may be iatrogenic—that is, inadvertently created by therapeutic interventions. Kenporter (2019) emphasizes that some clinicians believe dissociative states are culturally constructed, influenced heavily by media and suggestive therapy techniques, rather than representing authentic symptoms. Conversely, many mental health professionals advocate for the biological and neuropsychological basis of dissociative disorders, highlighting evidence from neuroimaging studies that reveal distinct brain activity patterns in affected individuals (Szczygiel et al., 2020). This debate impacts diagnostic practice, with some clinicians skeptical of dissociative diagnoses, leading to underdiagnosis or misdiagnosis.

My professional belief aligns with a neurobiological perspective that recognizes dissociative disorders as legitimate, complex psychological conditions often rooted in trauma. Trauma history is frequently documented among individuals with dissociative disorders, supporting the trauma model (Brand et al., 2019). The tremendous variability in presentation and the documented neurophysiological differences give credibility to the disorders’ authenticity. Furthermore, the existence of dissociative symptoms across diverse cultures suggests a universal phenomenon, further validating their clinical reality. Recognizing dissociative disorders as genuine conditions underpins the importance of specialized therapeutic approaches tailored to trauma and dissociation.

When working with clients presenting with dissociative disorders, therapists must employ strategies that foster trust, stability, and safety. Establishing a strong therapeutic alliance is fundamental because clients often experience profound mistrust and fear related to their dissociative symptoms. Techniques such as grounding exercises, mindfulness, and psychoeducation about dissociation are essential to help clients develop awareness and manage dissociative episodes (Reinders et al., 2020).Moreover, clinicians should adopt trauma-informed care principles to avoid re-traumatization and provide a secure environment. Interventions like phase-oriented treatment, which initially emphasizes stabilization and symptom management before addressing traumatic memories, have been shown effective (Brand et al., 2019). Building rapport and maintaining consistency ensure that clients feel safe enough to explore distressing memories eventually.

Ethical and legal considerations linked to dissociative disorders include issues of informed consent, confidentiality, and diagnosis disclosure. Given the complexity of these disorders, obtaining informed consent involves educating clients about their condition, treatment options, and potential risks. Clients must be aware of the possibility of emotional distress during therapy, especially when confronting traumatic memories (American Psychological Association [APA], 2017). Legally, clinicians have a duty to protect clients, particularly when dissociation is associated with self-harm or harm to others. Proper documentation of symptoms and treatment plans is vital to meet legal standards. Furthermore, clinicians should be cautious in diagnostic labeling to avoid stigma and ensure sensitivity. Misdiagnosis or mismanagement can lead to ethical dilemmas, especially regarding involuntary hospitalization or treatment without consent.

In conclusion, while controversy persists regarding the origins and validity of dissociative disorders, substantial evidence supports their recognition as real, trauma-related conditions requiring specialized intervention. Maintaining a therapeutic alliance through trauma-informed, client-centered strategies fosters recovery and stability. Ethical and legal considerations are paramount to safeguarding the rights and well-being of clients with dissociative disorders. As mental health professionals, embracing an informed, ethical approach ensures effective support for this vulnerable population.

References

• American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. APA.
• Brand, B. L., Loewenstein, R. J., & Spiegel, D. (2019). Trauma and dissociation: The clinical and neuroscience perspectives. Journal of Traumatic Stress, 32(3), 423–429.
• Kenporter, G. (2019). Iatrogenic dissociation: Assessing the impact of therapy on dissociative disorders. Journal of Psychiatry & Neuroscience, 44(2), 103–111.
• Reinders, A. A. T. S., Nijenhuis, E. R. S., & van den Hout, M. (2020). Grounding techniques and trauma therapy for dissociative disorders. European Journal of Trauma & Dissociation, 4(1), 23–32.
• Szczygiel, D., Mazurek, M., & Janikiewicz, A. (2020). Neuroimaging studies in dissociative disorders: A review. Neuroscience & Biobehavioral Reviews, 112, 308–317.