NURS 6665 Week 9 Assignment: Controversy Associated With Dissociative Disorders

NURS 6665 Week 9 Assignment: Controversy Associated With Dissociative Disorders

NURS 6665 Week 9 Assignment: Controversy Associated With Dissociative Disorders

The DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5-TR, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder.

In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.

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To Prepare

• Review this week’s Learning Resources on dissociative disorders.
• Use the Walden Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment.

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

A Sample Of This Assignment Written By One Of Our Top-rated Writers

Dissociative Disorders

Dissociative disorders are characterized by disruption in the normal automatic integration of memory, identity, perceptions, emotion, behavior, motor control, and consciousness (Loewenstein, 2018). An individual’s self-continuity is often lost, and one can entirely forget their normal behaviors for minutes, hours, days, or weeks. Individuals may experience memory loss for vital personal information and even perceive a missing period in their experience. The purpose of this paper is to discuss controversies, approaches to having a therapeutic relationship, and ethical and legal considerations related to dissociative disorders.

Controversy Related to Dissociative Disorders

Dissociative disorders have triggered debates with some researchers that the disorder does not exist and is rather a phenomenon in Western society. Some health professionals believe that the diagnosis is not founded on scientific literature. Scientists associate Dissociative disorders with childhood trauma, whereby a person with a history of child abuse represses disturbing memories (Loewenstein, 2018). However, this has led to a controversy with arguments that most victims of childhood abuse do not entirely forget the act, especially if the abuse was chronic or severe. Some people argue that it is unusual for a person to suppress all memories of childhood abuse and then recover all the memories out of the blue (Loewenstein, 2018). Furthermore, debates have surfaced that individuals said to have Dissociative disorders are highly hypnotizable and thus very gullible. Consequently, they are prone to follow embedded hypnotic suggestions.

Professional Beliefs about Dissociative Disorders,

            In my professional view, features of Dissociative disorders often occur after a person goes through an episode of overwhelming stress. The stress can be due to traumatic events or unbearable inner conflict. Loewenstein et al. (2018) assert that Dissociative disorders are connected with trauma and stressor-related disorders, which manifest with dissociative symptoms like numbing, amnesia, flashbacks, and depersonalization. Besides, I view Dissociative disorders as a coping mechanism, especially for individuals who faced psychological trauma from rape, mistreatment, or child abuse. According to Krause-Utz (2022), it is hypothesized that dissociation may act as a defense mechanism to deal with intolerable, overwhelming events during a possibly traumatizing event. van Heugten-van der Kloet & Lynn (2020) also explain that dissociation is perceived as a coping mechanism prompted by childhood trauma in which individual personality states surface to disconnect from emotionally devastating memories.

Strategies for Maintaining a Therapeutic Relationship with a Client

Patients with dissociative disorders are a challenging population for a practitioner to create and maintain a therapeutic relationship (TR). However, providers can maintain an effective TR by establishing a strong rapport with the client and informing them that their health needs will be prioritized during treatment. Subramanyam et al. (2020) explain that the practitioner can approach a patient with dissociation by being directive and questioning the different identities to identify conflict and unmet needs. In every encounter, the therapist should point out to the patient that cooperation is vital to promote functioning. Furthermore, the therapist should apply reflective listening by listening to the client, reflecting on what they have said, and giving the client insightful information to trigger them to think differently.

Ethical and Legal Considerations

Patients with Dissociative disorders present ethical challenges for practitioners concerning their capacity to make medical decisions. Ethical and legal factors that should be considered in PMHNP practice include autonomy and the duty to cause no harm. The PMHNP should understand that a client with Dissociative disorders has one body. Thus, a treatment decision that is accepted and implemented directly affects all of the patient’s personality states (Brennan, 2020). Thus, the PMHNP should consider the extent of value-sharing and awareness among a client’s personality states and the decision at stake when allowing the client to consent to treatment decisions. Besides, the PMHNP should assess the degree of risk connected with the decision when determining the patient’s decision-making capacity to ensure decisions will not cause potential harm.

Conclusion

Patients with Dissociative disorders have disruptions in the normal integration of memory, identity, perceptions, emotion, behavior, motor control, and consciousness. Controversies have surfaced on whether Dissociative disorders are based on scientific literature and whether the symptoms are genuine or are due to hypnotization. The therapist can maintain a TR with a patient by being directive and questioning the different personalities. Besides, the PMHNP should consider how autonomy can be incorporated into the patient’s management and consider how interventions can cause harm to different personalities.

References

Brennan, T. (2020). Determining medical decision-making capacity for patients with dissociative identity disorder: a patient-centered approach (Doctoral dissertation, Memorial University of Newfoundland).

Krause-Utz, A. (2022). Dissociation, trauma, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 9(1), 14. https://doi.org/10.1186/s40479-022-00184-y

Loewenstein, R. J. (2018). Dissociation debates: everything you know is wrong. Dialogues in Clinical Neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein

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–S289. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_777_19

van Heugten-van der Kloet, D., & Lynn, S. J. (2020). Dreams and Dissociation-Commonalities as a Basis for Future Research and Clinical Innovations. Frontiers in Psychology, 11, 745. https://doi.org/10.3389/fpsyg.2020.00745