Home » Dissociation

Dissociation is such an essential part of being traumatized that it can not be regarded as a related disorder. You could see it as a part of how emotions should be regulated, not only memory content / identity / consciousness and often coping strategies.

Neuroimaging techniques and dissociative identity disorder treatment

© iStock/KatarzynaBialasiewicz

Neuroimaging techniques can distinguish between healthy brains and those with multiple personality disorder – could this lead to dissociative identity disorder treatment?

Machine-learning and neuroimaging techniques have been used to accurately distinguish between individuals with dissociative identity disorder and healthy individuals, on the basis of their brain structure. Published in the British Journal of Psychiatry, this research could lead to better therapy and dissociative identity disorder treatment.

Neuroimaging techniques

Performing MRI (magnetic resonance imaging) brain scans on 75 female study participants, 32 with independently confirmed diagnoses of dissociative identity disorder and 43 who were healthy controls. The two groups were carefully matched for demographics including age, years of education and ancestry.

Using machine-learning techniques and neuroimaging techniques to recognise patterns in the brain scans, the researchers were able to distinguish between the two groups with an overall accuracy of 73%, significantly higher than the level of accuracy typically expected.

This research, using the largest ever sample of individuals with dissociative identity disorder (DID) in a brain imaging study, is the first to demonstrate that individuals with this condition can be distinguished from healthy individuals on the basis of their brain structure.
The path towards dissociative identity disorder treatment Dissociative identity disorder, formerly known as multiple


personality disorder, is one of the most disputed and controversial mental health disorders, with serious problems surrounding diagnosis and misdiagnosis. Many patients with the condition share a history of years of misdiagnoses, inefficient pharmacological treatment and several hospitalisations.

It is the most severe of all dissociative disorders, involving multiple identity states and recurrent amnesia. Dissociative disorders may ensue when dissociation is used as a way of surviving complex and sustained trauma during childhood, when the brain and personality are still developing.

Dr Simone Reinders, senior research associate at the department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, England, led the multi-centre study. Reinders, commenting on the research, said: “DID diagnosis is controversial and individuals with DID are often misdiagnosed. From the moment of seeking treatment for symptoms, to the time of an accurate diagnosis of DID, individuals receive an average of four misdiagnoses and spend seven years in mental health services.

“The findings of our present study are important because they provide the first evidence of a biological basis for distinguishing between individuals with DID and healthy individuals.

Ultimately, the application of pattern recognition techniques could prevent unnecessary suffering through earlier and more accurate diagnosis, facilitating faster and more targeted therapeutic interventions.”

Source: Health Europe

A biological explanation for dissociative experiences

Dissociative cognitive and perceptual changes often occur at the time of traumatisation and as a permanent feature of post-traumatic stress disorder (PTSD). After exposure to stress, dissociative symptoms are a predictor of the development of PTSD. Recent preclinical data suggest that stress stimulates the cortico-limbic release of glutamate. The glutamate that is released during stress in animal models influences the behavior, induces various changes in neural plasticity that can have long-term effects on brain function and behavior and contributes to neural toxicity. Antagonist of the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor also stimulates transient cortico-limbic glutamate release in animals. Furthermore, some of the effects of NMDA antagonists in animals are 

that weaken glutamate release. Clinical studies suggest that NMDA antagonists can temporarily stimulate glutamate release and produce symptoms that resemble dissociative conditions in humans. A recent study suggests that a drug that reduces glutamate release also weakens the perceptual effects of the NMDA antagonist, ketamine, in people. Because of the potential contribution of hyperglutamatergic states to the acute and long-term effects of traumatic stress exposure, the therapeutic and neuroprotective potential of drugs that reduce glutamate release should be investigated in traumatized subjects with dissociative symptoms.


Source: PubMed

To assess the relationship between dissociative and psychotic experiences, New Zealand university students (N = 119) and prison inmates (N = 42) were administered the Dissociative Experiences Scale (DES) and Symptom Checklist-90-Revised (SCL-90-R). Strong correlations were found between DES scores and the psychoticism and paranoid ideation subscales of the SCL-90-R (students: r = .520, .517, respectively; inmates: r = .637, .649, respectively). While other correlations were also significant (but smaller), these results are consistent with previous studies that have used a range of measures of psychosis or schizotypy with a variety of clinical and nonclinical populations. Such consistent findings in the face of methodological diversity offer strong support for the validity of a link between the concepts of dissociation and psychosis. While this relationship has previously been interpreted indirectly, as dissociative experiences predisposing to psychotic symptoms, we suggest a direct route: that dissociative experiences of various forms may underlie some (or even all) psychotic symptoms.

Note webmaster: A dissociative reliving of a trauma with altered consciousness can make someone suggestive of suspicion or mistrust and hence susceptible to thoughts that are contextual and therefore emotionally logical in view of the memories and feelings of trauma, but make them prone to confusion or errors of thought, thus altered cognition. This reliving is accompanied by certain thoughts, in which there is a fusion between what is real and how the client experiences it. In my view, there is a clear connection between dissociation and psychosis and that is how consciousness is altered in such a way, that it goes together

Webmaster is crazy, period.....

goes together with psychosis. But as soon as psychiatrists use the word psychosis, the conclusion is already established in advance. Namely a brain or genetic disorder. You may ask yourself whose emotional calm must be secured and also social. It has taken decades among scientists to recognize that chronic traumatization in particular leads to psychosis. But the stubbornness and therefore one-sidedness in the cause of researchers and scientists to discover the error in the brain or genes - research is allowed by me - does not lead to recognition of the emotional confusion underlying a traumatic dissociative consciousness and how these people are so confused, which lead them in a twilight zone and so ultimately psychosis. The unilateral hammering on biological or brain errors deprives us of much-needed research into the coherence of trauma, dissociation and psychosis. Finally both flashbacks and psychosis are intrusive, but when we speak of trauma it is often accompanied by dissociation

The background that the notion of dissociation has little or no interest in psychiatry and research

"We are prone to remember negative and frightful things more than pleasant ones perhaps that's why we tend to forget and ignore those who suffer"

Around the beginning of 1900 Freud occupied himself with the phenomenon of hysteria - a term we no longer use, only as a short commentary for "instigators" - and hypnosis. As an explanation, partly because of his thoughts about development of neuroses, Freud also gave rise to repression or, to put it simply, forgotten or better, not consciously as an explanation, because of a poor adaptation. Because of lack of knowledge of the brain, psychoanalysis became a dogmatic philosophy without empirical evidence or research and neurological insight. In those days a "psychologist" Janet was also living in France. As an explanation for the reason of hysteria, he saw a dissociative process as a reason as witnessed by altered consciousness and later memory loss after awakening from a hypnotic state. But Janet and his works have more or less fallen into oblivion. We collectively also the mental health and psychiatry - perhaps because it was more plausible - are more used to the ideas of repression and unconsciousness. The brain can somehow be compared with a engine, in the car we are aware of the noise, the oil pressure and revs, but not what actually happens in the engine. Does an engine also have unconsciousness? Is it necessary for man and his brain that we are conscious of why and how we walk, eat, have sex or feel. Many processes in the brain proceed naturally and we do not have to worry about that. That many processes parallel and automatically happens in networks, well we are made, formed and born that way. That our consciousness shows a few milliseconds later consciousness from imaging research and TMS does not mean that there is an undiscovered area in our brains that we need to become aware of to heal. The disadvantage of among other things, the Freudian explanation of development,

cognition and perception of the child was that it became a kind of philosophy without being prepared to be critical and to ask especially children to examine how they see and experience the world and themselves. Empirical and scientific research was strange to them in this sense. For example, for a long time the theory of development and neuroses as an explanation of mental illness became a theology an unexamined dogma that we collectively and intuitively began to see as science. That we often do not want to think about unpleasant experiences and therefore want to forget this is obvious. Coming back to Janet and his explanation of dissociation as separate processes of the psyche thus became obsolete. If you are looking for scientific information about a neurological thesis or explanation of separate processes in the brain with often memory problems afterwards, you will find almost nothing. The importance of getting a theses and doing a good research does not happen. Dissociation is a heavily underexposed phenomenon with little interest in diagnostics and in psychiatry. The problem with many psychological concepts is that they are more semantic concepts and are not derived from how the brain actually works and thus actual phenomena. Because where is the personality in the brain, how does it work are we as a person the same as ten years ago? We may think in terms that we think we suppose to see, but is that really the case? My conclusion is therefore that the concept of dissociation requires research and a theses that is neurologically substantiated that we can investigate and thus test. But we must avoid two camps - dissociation / repression - and perhaps there is a common explanation or background to both repression and dissociative processes, perhaps as a reason circumstances and how memory in relation to consciousness, cognition and the adaptive capacity of the brain works.

The need to think more in fragmentation

It is important to ask more and be aware of how victims use or can use fragmentation of the person through dissociative processes. That our brains have multiple areas for different memories - including motor and other is more clear recently - and the integration of these may be assumed to be more familiar. Fragmentation of the functioning of, among other things, memory processes is an unexplored scientific neurological area. Memory, awareness and other processes are integrative neurological processes of networks. With the current techniques one can do better research on this. It should be clear that a growing child with strong dissociative tendencies will not be able to integrate these networks and will thus develop more. What we often do will have an impact on network formation and thus structures in our brain. That could mean that clusters of networks arise that are not well integrated. But they are and remain partly synaptic connections that can also be restored.

Finally, I regret that many people with DID and MPD are not taken seriously in terms of experiences and that it is still an iantrogenic diagnosis or a result of imaginative people. Let's face it, we also take people with anxiety and depressive complaints serious when it comes to their experiences. It is actually no more than fragmentation of the personalty. It is partly a survival mechanism and partly a major suffering as a result of fragmentation due to severe traumatization. Children want to keep hope, doing so they use imagination to be able to continue or simply can - stress indued - alter their consciousness. Children often use their imagination to survive mentally.  Often imaginative children are cognitively gifted children, when they talk and plays with imaginary friends. It is time to take DID or MPD seriously. The result is actually what they can not do, integrate and process. The despair caused by fragmentation and in the past living with all contradictions, sometimes unconsciously just to meet the requirements of everyday life, makes this problem rather complex.


Concerning those with DID and DESNOS, the emotional upheaval is greater and more complex. They often have a range of psychiatric complaints, most of which are also part of the complex PTSD. It is unfortunate that they are often seen as people with an imaginative mind or fantasy and worse as people suffering from a psychosis, whose identities - voices that are fragments of the personality - and thus interpret their voices as part of a schizo-disorder. Many have considerable black holes in their early memories or sometimes loss of complete memories of their usually early childhood.

What is happening here is actually fragmentation of the personality. It is often the case that circumstances often act as a trigger that activate a certain identity. Work or requirements can also make a certain identity be more active. It is a pity because the protocol treatment in psychoses often does not benefit them. In psychoses we must consider that this occurs criss-cross in the whole population of those with psychiatric disorders. Yet this diagnosis or dissociative disorder is well treatable (Onno van der Hart). It takes time, but the It takes time unfortunately and with the protocol EMDR treatment is not adequate.

"Something in me feels, thinks and does not know that it has been."

Dissociation is really not to associate. This may involve consciousness, the identity and the memory. Dissociation means that the person does not integrated parts of the personality resulting in a change of cognition, behavior and thus feelings that are triggered by circumstances that are similar to the traumatic experiences and thus can't be worked through. The decision not be aware or being conscious is not a sign of dissociation. Many know that one sometimes can be so preoccupied in what they are doing or thinking, that as a result one is not aware of its surrounding or actions. That is also no dissociation. It basically means that the person suffering from dissociation is imprisoned as it were, in his / her memories that can't be experienced or felt as a memory in the sense that it has a place in time and space. So it can happen that traumatized parts of the personality often have the same responses when triggered in situations reminiscent of the trauma. The trauma is, as it were encapsulated in the personalities and these fragmented parts have their own reality, in terms of thinking, feeling and knowing. 

The trauma is, as it were is encapsulated in the personalities and these fragmented parts have their own reality, in terms of thinking, feeling and knowing. The dissociative identity disorder develops so that there is also amnesia between periods in which these fragmented parts as it were, temporarily took over the rudder. This form of dissociation is a result of often severe child abuse often in early childhood. Some often hear voices of these fragmented parts in their head. That makes it so difficult to distinguish it from schizophrenia with auditory hallucinations. Often partly because DIS is questionable diagnosis within the mental health care, often labeled as a schizo-disorder.


"Then the world seemed distorted, not real ..."

Derealization is a part of a dissociative disorder. One has the idea or is aware that the environment, objects and people are deformed, distorted and unreal. The world seems like looking through a distorted spectacle, which distorts the experience of reality. It is often accompanied by anxiety, which seems logical. It is for those who suffer from it very unreal. Also, many people with psychosis may have the perception, the hallucinations and anxieties result in a  distorted feeling of reality. However, in the latter case, the experiences or more bizar. Derealization is not accompanied by hallucinations, such as hearing voices or delusions.

Often people with derealization have a sense of reality, which is often highly absent in people with psychoses.


"Then I seemed to look at myself as if I was not there"

If you are suffering from depersonalization your body feels strange. You do not seem to be yourself and real anymore. You can really be frightened. You don't feel "normal."
I sometimes felt that my body was not present in the room, as if I was dreaming, I was not there.

People say:
"I feel flattened"
"I feel no emotion, either positive or negative"
"I feel like a robot"

"I feel blurry"
"I look like a spectator"