NURS 6665 Assignment: Controversy Associated with Dissociative Disorders

NURS 6665 Assignment: Controversy Associated with Dissociative Disorders

Dissociative Disorders (DD) are characterized by disruption in the normal integration of memory, consciousness, perceptions, emotion, identity, motor control, body representation, and behavior. They are thought to develop after an individual undergoes an overwhelming, stressful event (Rafiq et al., 2018). The stress may be a result of traumatic events or unbearable inner conflict. DD is associated with trauma and stressor-related disorders, resulting in dissociative symptoms. The purpose of this paper is to discuss the controversy surrounding DD, professional views about DD, and ethical and legal considerations for the disorders.

The Controversy That Surrounds Dissociative Disorders

According to Loewenstein (2018), there has been controversy surrounding dissociation and DD since the start of modern psychiatry and psychology. Although DD is associated with a history of trauma, particularly childhood trauma, some professionals argue that there is no evidence supporting this. For instance, there are rare incidences of DD diagnosed in children with a history of abuse. Furthermore, some healthcare professionals argue that DD is not a real disorder and does not exist even though it is included in the DSM-V. They propose that the disorder should be removed from the DSM-V manual. In addition, there has been an argument that diagnosing and treating DD trigger memories of childhood abuse in individuals, which causes more harm than good (Loewenstein, 2018). Lastly, there have been arguments that criminals use DD as an excuse to escape responsibility for their criminal actions.

Professional Beliefs about Dissociative Disorders

My professional view of DD is that it is more of a coping mechanism for past trauma than a mental disorder. People dissociate from their memory and consciousness to block the intrusive painful memories of their childhood abuse. Rafiq et al. (2018) found that individuals who experienced childhood trauma had the highest levels of dissociation among persons with severe mental conditions. The study also identified significant positive relations between certain childhood difficulties and dissociation.

I believe that this form of coping is quite intense and negatively affects not only the individual but also those around them. Rinker (2019) explains that an individual’s vivid and broad imagination occurs mostly in childhood. The imagination is often used to cope with stress through a calm internalization. Besides, instead of a person having a single personality with diverse thoughts and emotions, the mind splits into sections, each with new ideas and attitudes that the person may agree or disagree with. Subramanyam et al. (2020) explain that dissociation is a means that allows the mind to sort out memories and thoughts from the normal consciousness. This explains my belief that DD occurs in the same way individuals usually detach themselves from an unpalatable or distressing event.

Strategies for Maintaining a Therapeutic Relationship

Creating and sustaining a therapeutic relationship with patients with DD and a history of trauma is often difficult due to distrust from the patient. Therefore, the provider should identify approaches that will help build trust with the patient to maintain the therapeutic relationship. The PMHNP or mental health provider should explain to the patient that a strong working relationship is crucial to help them return to normal functioning (Firestone, 2018). Another strategy is for the provider to collaborate with the client to identify their health needs, set therapy goals, and identify the interventions necessary to achieve these goals. The therapeutic relationship becomes stronger and lasts longer when the provider and the client have the same beliefs on treatment goals and consider the therapeutic interventions that will be used to meet these goals as appropriate and effective (Firestone, 2018). Active listening by the provider is essential in maintaining a therapeutic relationship. The provider should also be empathetic when interacting with the client to make the patient feel that their concerns have been understood.

Ethical and Legal Considerations Related to Dissociative Disorders

Ethical and legal factors that should be considered by mental health providers when dealing with patients with dissociative disorders include informed consent, privacy and confidentiality, beneficence, and nonmaleficence. In my fut