560 CHAPTER 14
Dissociative Disorders: Altered Identities
Just as there is sometimes overlap of symptoms between different diagnoses, various
disorders can be related to similar circumstances or phenomena. As already discussed,
exposure to trauma is a key component to ASD and PTSD, and both may include symp-
toms of dissociation. Dissociation plays a more prominent role in the dissociative disor-
ders, where the dissociative symptoms encompass many aspects of everyday life and not
just memories of the traumatic events themselves or the time around them (American
Psychiatric Association, 2013).Types of Dissociative Disorders
14.7 Differentiate among dissociative amnesia, dissociative fugue, and
dissociative identity disorder.
Dissociative disorders involve a break, or dissociation, in consciousness, memory, or
a person’s sense of identity. This “split” is easier to understand when thinking about
how people sometimes drive somewhere and then wonder how they got there—they
don’t remember the trip at all. This sort of “automatic pilot” driving happens when the
route is familiar and frequently traveled. One part of the conscious mind was think-
ing about work, school, or whatever was uppermost in the mind, while lower centers
of consciousness were driving the car, stopping at signs and lights, and turning when
needed. This split in conscious attention is very similar to what happens in dissociative
disorders. The difference is that in these disorders, the dissociation is much more pro-
nounced and involuntary.DISSOCIATIVE AMNESIA AND FUGUE: WHO AM I AND HOW DID I GET HERE? In
dissociative amnesia, the individual cannot remember personal information such as
one’s own name or specific personal events—the kind of information contained in
episodic long-term memory. to Learning Objective 6.5. Dissociative amnesia
may sound like retrograde amnesia, but it differs in its cause. In retrograde amnesia,
the memory loss is typically caused by a physical injury, such as a blow to the head.
In dissociative amnesia, the cause is psychological rather than physical. The “blow”
is a mental one, not a physical one. The reported memory loss is usually
associated with a stressful or emotionally traumatic experience, such as
rape or childhood abuse (Chu et al., 1999; Kirby et al., 1993), and cannot
be easily explained by simple forgetfulness. It can be a loss of memory for
only one small segment of time, or it can involve a total loss of one’s past
personal memories. For example, a soldier might be able to remember
being in combat but cannot remember witnessing a friend get killed, or a
person might forget his or her entire life. These memories usually resur-
face, sometimes quickly and sometimes after a long delay. Dissociative
amnesia can occur with or without fugue. The Latin word fugere means
“flight” and is the word from which the term fugue is taken. A dissociative
fugue occurs when a person suddenly travels away from home (the flight)
and afterwards cannot remember the trip or even personal information
such as identity. The individual may become confused about identity,
sometimes even taking on a whole new identity in the new place (Nijen-
huis, 2000). Such flights usually take place after an emotional trauma and
are more common in times of disasters or war.DISSOCIATIVE IDENTITY DISORDER: HOW MANY AM I? Perhaps the
most controversial dissociative disorder is dissociative identity disorderAn apparent case of dissociative amnesia and fugue. Edward
Lighthart, or as he preferred, John Doe, was found in Seattle,
Washington in 2009. During the interview when this photo
was taken, Doe reported memories were slowly trickling back
during the nearly seven weeks since he walked out of a Seattle
park with no idea of who he was and how he got there. News
reports indicated he was found later that same year in Las
Vegas, New Mexico, again without knowing who he was or
how he got there.
dissociative disorders
disorders in which there is a break
in conscious awareness, memory,
the sense of identity, or some
combination.
dissociative identity disorder
(DID)
disorder occurring when a person
seems to have two or more distinct
personalities within one body.