Controversy Associated With Dissociative Disorders

is hard to believe but we are not in Week 9.  I have just providing a piece of the assignment that we have this week.  I find it a very interesting dx and I look forward to your insight. (Dissociative Disorders Controversy Essay for Nursing Students)

Dr. Johnson

• 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.(Dissociative Disorders Controversy Essay for Nursing Students)
• 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.(Dissociative Disorders Controversy Essay for Nursing Students)

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Dissociative Disorders Controversy Essay for Nursing Students

Dissociative disorders are mental health conditions in which individuals experience a discontinuity/disruption of motor control, memory, consciousness, perception, behavior, emotions, and identity (American Psychiatric Association [APA], 2019). These symptoms can impair psychological functioning and are experienced as unwanted intrusions into behaviors and awareness, leading to discontinuity of subjective experiences and inability to gain control of mental functions. Dissociative disorders are common with traumatic experiences and proximity to trauma. This assignment evaluates the controversy surrounding dissociative disorders.(Dissociative Disorders Controversy Essay for Nursing Students)

The Controversy

The controversy surrounding dissociative disorders centers on whether these disorders are independent conditions or related to psychological stressors/trauma. In the DSM-5, dissociative disorders are closely related to a stressor or trauma-related disorders but are not part of these disorders (Boland & Verduin, 2021). The association explains the close relationship between the dissociative and the stressor or trauma-related diagnostic classes, especially early-life trauma and/or cumulative trauma. For instance, posttraumatic and acute stress disorders have dissociative symptoms, including derealization or depersonalization, flashbacks, amnesia, and numbing (APA, 2019). Therefore, the discussion on whether dissociative disorders are artefactual conditions and are merely founded on confabulated trauma memories. Skeptics would argue that dissociative disorders are based on fantasies associated with iatrogenesis and other cultural factors, which is not supported by the literature. Despite these counterarguments, dissociative disorders are common and closely associated with trauma and stressor-related condition, but with slightly different presentations.(Dissociative Disorders Controversy Essay for Nursing Students)

Professional Beliefs

Although there is a strong relationship between dissociative disorders and stressor and trauma-relative disorders, the latter is distinctive in terms of its presentations and experience continuum. Usually, dissociative disorders are developed to cope with trauma, unlike other stressors and trauma-related disorders (Boland & Verduin, 2021). This means that with dissociative disorders, the stressor or traumatic source could still be present in the client’s life. For instance, children who have experienced emotional, sexual, or physical abuse for a long time develop dissociative disorders to help them cope with the present stimuli.(Dissociative Disorders Controversy Essay for Nursing Students)

The counter beliefs on the dissociative disorder in the mental health professional milieu are not founded on the scientific literature. Minimal evidence supports a close relationship between dissociative disorders and trauma-related disorders (Loewenstein (2022). For instance, no psychological process can explain dissociative disorders such as amnesia from trauma. In trauma-related disorders, the contents of trauma are not well-remembered. It is the same for dissociative disorders in which unwanted intrusions into behaviors and awareness cannot be comprehended.  (Dissociative Disorders Controversy Essay for Nursing Students)

Dissociative disorders are a continuum beginning from intense absorption to severe dissociation states as symptoms overlap with other disorders. This shows how complex dissociative disorders as core features usually accompany a mixture of other subjective mental health symptoms (Steele et al., 2022). Patients experience symptoms that affect personality, mood, anxiety, and functional somatic. Therefore, dissociative disorders can be overlooked, considering the polysymptomatic profile and patients’ tendency to avoid revealing trauma or dissociative symptoms. The latter refers to the psychobiological sequestration of traumatic information by altering states of consciousness. As such, the dissociation associated with dissociative disorders separates from the typical understanding and impact of traumatic events(Dissociative Disorders Controversy Essay for Nursing Students)

Therapeutic Relationship

Individuals having traumatic experiences are likely to have difficulties developing trusting relationships. However, the therapeutic alliance is associated with successful treatment outcomes. Firestone (2018) identified empathy, respect, and collaboration are crucial strategies for developing therapeutic alliance, particularly with those individuals presenting suicide ideation. Moreover, flexibility, candidness, and effective listening are some of the best strategies for creating a therapeutic alliance with individuals diagnosed with dissociative disorders. Therefore, the therapist must have a more robust understanding of the alliance to facilitate better outcomes for affected individuals. This means that therapists should strive to help the clients to understand the importance of the therapeutic alliance on the treatment outcome. Ideally, a patient’s understanding of the therapeutic relationship with clients may contribute to better health outcomes.(Dissociative Disorders Controversy Essay for Nursing Students)

Ethical and Legal Considerations

The ethical and legal considerations for clients diagnosed with dissociative disorders include confidentiality, autonomy, and non-maleficence. Confidentiality involves keeping patient information to avoid unauthorized access, while autonomy concerns the capacity of the patients to make independent choices regarding their health (Avasthi et al., 2022). A mental health professional should ensure that the client understands confidentiality and the strategies to maintain the confidentiality of their condition. Maintaining confidentiality applies to every piece of information obtained from a client in any form, i.e., recorded, written, or verbal. Circumstances under which confidentiality can be broken and procedures involved should also be communicated to the patient. Such communication is also crucial for striking a therapeutic alliance.  (Dissociative Disorders Controversy Essay for Nursing Students)

Non-maleficence involves the need to avoid harm to the client. Basic psychotherapy models involve client collaboration and shared decision-making (Avasthi et al., 2022). However, clients can only contribute to their health by making an independent decision when the mental health professional involves them, providing vital information about their health in ways that do not cause more harm. When pursuing therapy for individuals with a traumatic past, such as sexual abuse, it could be challenging for the patient to participate. In such as case, the professional should devise crucial ways to engage the client in the therapy, mainly discussing the importance.(Dissociative Disorders Controversy Essay for Nursing Students)

References

American Psychiatric Association. (2019). Diagnostic and statistical manual of mental disorders (7^th ed.). American Psychiatric Publishing, Inc.   

Avasthi, A., Grover, S., & Nischal, A. (2022). Ethical and legal issues in psychotherapy. Indian Journal of Psychiatry, 64(Suppl 1), S47. https://doi.org/10.4103%2Findianjpsychiatry.indianjpsychiatry_50_21

Boland, R., & Verduin, M. (2021). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Lippincott Williams & Wilkins.

Firestone, L. (2018). Dissociation and therapeutic alliance. In Phenomenology of Suicide (pp. 167-186). Springer, Cham.

Loewenstein, R. J. (2022). Dissociation debates: Everything you know is wrong. Dialogues in Clinical Neuroscience. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein

Steele, K., Dorahy, M. J., & van der Hart, O. (2022). Dissociation versus alterations in consciousness. Dissociation and the Dissociative Disorders: Past, Present, Future.