Dissociative disorders are a common group of disorders. The prevalence of these disorders is about 0.3-0.5% of the population. They often arise in youth, with a higher incidence in females compared to males, particularly under unfavorable mental and physical conditions.
What are Dissociative Disorders?
Dissociative disorders in a group setting refer to a condition of dissociative disorder (Hysteria) manifested within a collective. These are cases of conversion disorders where individuals experience real sensations triggered by psychological symptoms. It begins with individual disorders and can develop into an epidemic within a larger group.
Symptoms of Dissociative Disorders
Cases of simultaneous dissociative disorders are referred to as “mass psychogenic illness.”
The symptoms of dissociative disorders are quite diverse: generalized shaking, continuous nodding or head shaking, speech difficulties, loss of taste, vision, hearing, paralysis of a limb or all limbs, thought disturbances, etc.
Simultaneous occurrences of dissociative disorders are referred to as “mass psychogenic illness.” When one person in a group exhibits symptoms of dissociation, others tend to “catch” it, often as a mechanism to relieve pressure from studies or work.
- Motor disorders: These can vary widely, including head shaking, nodding, blinking, convulsive movements, etc. The most common symptoms are generalized tremors or localized tremors in specific limbs, which increase with attention. Dissociative paralysis can also occur at various levels, including both rigid and flaccid paralysis affecting one or more limbs, but muscle tone remains unchanged. Speech disorders like difficulty speaking or stuttering can occur, even when the speech apparatus is not damaged.
- Sensory disorders: Common sensory disturbances in dissociation include pain sensations. Areas of lost sensation do not correspond correctly to the mapped regions of sensory nerves. Increased pain sensitivity in complex dissociation can easily be mistaken for “organic” pain symptoms such as appendicitis, biliary colic, precordial pain, or sciatic nerve pain.
- Disorders of the senses (dissociative blindness, dissociative deafness, loss of taste and smell, dissociative visceral disorders); psychiatric disorders (amnesia, emotional disturbances, thought disorders…).
- Dissociative stupor: Voluntary movement is reduced or lost, with the patient lying or sitting immobile for long periods. There is no speech or activity, and no response to certain stimuli like noise, without loss of consciousness, with eyes either open or tightly shut, and without other bodily or mental disorders related to the stupor state, making it difficult to distinguish from catatonic stupor or depressive stupor.
- Possession and intrusion disorders: Temporary loss of consciousness. The individual acts as if under the control of another personality, spirit, deity, or force. Some limited and repetitive movements, postures, and speech may occur. These disorders appear involuntarily, undesirably, and can occur amidst ordinary activities.
Factors Favoring the Development of Dissociative Disorders
The primary cause of dissociative disorders is psychological trauma or conflict situations. These are traumas that induce strong emotions such as extreme fear, excessive anger, or severe disappointment.
These disorders typically arise shortly after the trauma. Sometimes, it is challenging to find traces of psychological trauma, especially in cases of multiple recurrences.
Favorable factors that promote the development of dissociative disorders include weak personality traits, lack of self-control, lack of restraint, a tendency to seek indulgence, a desire for attention, poor resilience to hardship, and a lack of healthy life ideals. Additionally, other harmful factors such as infections, poisoning, malnutrition, and head injuries can also be present.
When one person in the group is affected, many others may also be affected, creating a sense that the illness is contagious.
Characteristics of Dissociative Disorders
These disorders are characterized by heightened emotions and increased suggestibility. Heightened emotions result from weakened cortical activity, which fails to suppress subcortical control, leading to a lack of self-regulation in response to strong traumatic stimuli, resulting in a state of inhibition in the cortex. Due to the lack of cortical regulation, subcortical activity increases, leading to the diverse symptoms of dissociative disorders.
The mechanism of suggestibility is triggered by stressful and fear-inducing emotions, with traumatic stimuli easily causing a chain reaction within the group. Thus, when one person in the group is affected, many others may also be affected, fostering a perception that the illness can spread. Sometimes, these occurrences are attributed to supernatural causes.
Clinically, patients present with a range of bodily symptoms along with secondary functional losses without any identifiable physical injury. The manifestations of the illness are highly diverse, leading to various classification methods.
Treatment for Dissociative Disorders
Treatment primarily involves psychological therapy. Suggestive therapy is often effectively applied. Psychotropic medications, acupuncture, and acupressure can create a strong psychological impression that helps patients have absolute confidence in their healthcare providers, alleviating the symptoms of functional disorders.
Hypnotic sleep therapy also yields good results. When applying psychological therapy, it is crucial to show respect for the patient and not view them as malingerers. Avoid overly indulgent or anxious attitudes and avoid close monitoring that might inadvertently suggest to the patient that their condition is severe. Alongside psychological therapy, it is essential to enhance psychiatric treatment, support the patient’s physical state, and adjust the imbalance between excitation and inhibition processes in the cortex using mild tranquilizers and cortical stimulants like bromides and caffeine. This should be combined with comprehensive treatment approaches such as music therapy, physical exercise, labor, relaxation, and training.
To prevent this disorder, it is necessary to promote public education regarding the essential knowledge about dissociative disorders. Cultivating personality traits from a young age, fostering solidarity, affection, and a sense of community, and avoiding mental stress in daily life, studies, and work are crucial.
