NRNP 6665: WK9 assignment Controversy Associated with Dissociative DISORDERS-nursing Paper Examples

Dissociative Disorder-Nursing Paper Examples

Dissociative disorders involve disconnection and gaps in thoughts and memories (Osmosis, 2017). Individuals with the disorder involuntarily escape reality through harmful means that adversely affect their daily functioning (Boland et al., 2022). The dissociative disorders include dissociative identity disorder and dissociative amnesia (Dissociative Disorder-Nursing Paper Examples).

Irrespective of dissociative disorders’ controversies, effective strategies should be implemented to enhance their management and coping strategies. This paper will explore controversies on dissociative disorders and provide a professional belief about the disorder. It will also examine strategies psychologists can employ to establish positive therapeutic relationships with clients diagnosed with dissociative disorder. The last part will explore the ethical and legal considerations related to dissociative disorders (Dissociative Disorder-Nursing Paper Examples).

Controversy

Dissociative disorder is controversial due to its crafty diagnosis criteria, which are considered invalid. Its diagnostic scales are craftily designed, increasing the risk of false positives and invalidating any symptoms reported by patients (Reinders & Veltman, 2021). Its symptoms are also prevalent in other conditions, including coexisting with mental health problems like depression (Dissociative Disorder-Nursing Paper Examples).

For example, it is caused by head trauma, which is also a causative element for amnesia. Besides, the disorder is likely supported by individuals with conflicts of interest associated with monetary gains from treating the disorder. For example, it requires lengthy and intensive psychotherapeutic care, which generates huge intensive annually.

Additionally, the precept that repressed adverse childhood memories cause the disease does not substantiate the presence of the disease since some patients could make up memories they never experienced. Loewenstein (2022) explains that the opponents of the disorder argue that some people are highly pretentious about memories to shadow the exact cause of mental health problems (Dissociative Disorder-Nursing Paper Examples).

Professional Beliefs about Dissociative Disorders

Patients with dissociative disorder have smaller hippocampal volumes and thinner brain cortex. Reinders and Veltman (2021) illustrate that childhood traumatic experiences affect individuals’ memory, brain shape, and behavior, making it a crucial factor in dissociative disorder diagnosis. Besides, the controversies surrounding dissociative disorders should not hinder providing care to patients exhibiting symptoms outlined in the DSM-5-TR criteria for dissociative disorders (Loewenstein, 2022) (Dissociative Disorder-Nursing Paper Examples).

The disorders are caused by adverse childhood experiences like sexual or physical abuse. Children raised in unpredictable family environments also contribute to dissociation, whereby they get disconnected from reality during stressful moments. In this case, the extent of severity of the disorder in adulthood is attributed to the severity of the childhood experiences (Reinders & Veltman, 2021).

The disconnect is integral in reducing and managing traumatic experiences. Loewenstein (2022) observes that the responses align with the trauma model of psychopathology, which assumes that patients react understandably as a protective response to traumatic mental illnesses instead of suffering silently. In this case, the disconnect helps patients with dissociative disorders to respond positively to traumatizing experiences, enabling them to remain safe and stable from suicidal or self-destructive behaviors (Dissociative Disorder-Nursing Paper Examples).

For instance, Hoktem et al. (2021) observe that child victims of alcohol abuse disconnect from the reality of previous traumatic experiences to prevent self-destructive behaviors. Thus, dissociative disorder, a brief escape from reality, such as forgetfulness, is essential in managing traumatic experiences (Dissociative Disorder-Nursing Paper Examples).

Strategies for Maintaining Therapeutic Relationships with Clients

The therapist can maintain a therapeutic relationship with clients exhibiting dissociative disorder by being direct and listening attentively to the patient’s narration of the disorder symptoms (Subramanyam et al., 2020). Listening to the patient’s concerns can make it easy to differentiate the conflicting identities of the dissociation disorders and the unmet patient needs. Besides, they should be empathetic to the patient’s experiences by understanding and validating the impact of such experiences on the patient’s mental health (Dissociative Disorder-Nursing Paper Examples).

They should emphasize the patient’s internal awareness to promote self-respect, which is integral in reducing adverse memories (Subramanyam et al., 2020). Additionally, they should encourage the patients to remain positive and realistic in the treatment process. This can involve teaching the patients effective emotion regulation skills, such as accepting the need to embrace adverse emotions and engaging in mindfulness techniques.

Moreover, the therapist should establish trustful relationships with the client through trauma-informed considerations, such as avoiding touching the patient without permission. Thayyil and Rani (2020) illustrate that patients presenting with the disorder often feel ashamed and may not comprehensively disclose their experiences, like distorted thinking or emotion regulation struggles. As a result, establishing trust can help build their self-esteem and improve the dissociative disorder coping mechanisms among patients (Dissociative Disorder-Nursing Paper Examples).

Ethical and Legal Considerations

The therapist should respect the autonomy of patients diagnosed with dissociative disorders. Respecting the patient’s decision is integral to maintaining positive therapeutic relationships with the patients (Bloch & Green, 2021). Besides, they should also uphold the ethical principle of nonmaleficence, obligating them not to harm the patient. They should help patients choose the most effective type of treatment intervention for the varying personality traits exhibited by the patients.

Also, they should maintain the patient’s confidentiality to prevent them from experiencing intense shame, which deteriorates their mental health and self-esteem (Bloch & Green, 2021). These patients often feel ashamed to share their experiences, such as distorted thinking, indicating the need for therapists to maintain the confidentiality of the information shared (Osmosis, 2017) (Dissociative Disorder-Nursing Paper Examples).

Dissociation disorder causes amnesia, which may inhibit patients from recognizing their unwanted behaviors. As a result, a comprehensive examination of the patient’s mental health should be done before holding them accountable for some behaviors they committed unintentionally (Dissociative Disorder-Nursing Paper Examples).

Conclusion

Implementing effective strategies to manage dissociation disorder without considering the controversies surrounding the condition is important. The controversies surrounding the disorder include invalid diagnostic criteria, conflicts of interest among its proponents, and difficulty substantiating the causes of the cause of the disease, such as childhood trauma. However, it is important to note that the disorder occurs to shadow the adverse childhood experiences and help manage the trauma (Dissociative Disorder-Nursing Paper Examples).

As a result, therapists can establish fruitful relationships with the patients through active listening, showing empathy, and trust, and encouraging positivity among the patients. Finally, therapists should maintain autonomy, confidentiality, and nonmaleficence in helping patients manage dissociation disorder symptoms (Dissociative Disorder-Nursing Paper Examples).

References

Bloch, S., & Green, S. A. (2021). Psychiatric ethics. United Kingdom: Oxford University Press.

Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry. (12th ed.). Wolters Kluwer.

Hoktem, B., Karas, H., & Yalcin, M. (2021). The effect of childhood trauma on alcohol and nonalcohol substance use in a Turkish sample of university students: The mediating role of dissociative experiences. Dusunen Adam, 34(4), 375-382. Doi: 10.14744/DAJPNS.2021.00160

Loewenstein, R. J. (2022). Dissociation debates: Everything you know is wrong. Dialogues in Clinical Neuroscience.https://doi.org/10.31887%2FDCNS.2018.20.3%2Frloewenstein

Osmosis. (2017, November 20). Dissociative disorders – causes, symptoms, diagnosis, treatment, pathology. [Video]. YouTube. https://youtu.be/XF2zeOdE5GY

Reinders, A. A., & Veltman, D. J. (2021). Dissociative identity disorder: out of the shadows at last? The British Journal of Psychiatry, 219(2), 413-414. https://doi.org/10.1192/bjp.2020.168

Subramanyam, A. A., Somaiya, M., Shankar, S., Nasirabadi, M., Shah, H. R., Paul, I., & Ghildiyal, R. (2020). Psychological interventions for dissociative disorders. Indian Journal of Psychiatry, 62(Suppl 2), S280. https://doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_777_19

Thayyil, M. M., & Rani, A. (2020). Structural Family Therapy with a Client Diagnosed with Dissociative Disorder. Indian Journal of Psychological Medicine, 43(6), 549-554. https://doi.org/10.1177/0253717620969067