Controversy Regarding Dissociative Disorders Walden University NRNP 6665: PMHNP Care Across the Lifespan I

Controversy Regarding Dissociative Disorders Dissociative disorders (DD) are mental health disorders, such as dissociative identity disorder (DID), dissociative amnesia, or depolarization/derealization disorder that involve the disruption of one or more mental functions, such as memory, identity, perception, consciousness, or motor behavior (Sadock, Sadock, & Ruiz, 2015). DD comes with many controversies, myths, and ethical issues that the advanced practitioner must take into account when treating individuals with such disorders. The following paper will discuss specific controversies and professional beliefs associated with DD, as well as strategies for maintaining therapeutic alliance and legal and ethical considerations when treating clients with DD. Controversy Surrounding Dissociative Disorders There is much evidence to support the relationship between dissociation disorders (DD) and psychological trauma, especially cumulative and/or early life trauma. Some might endorse that dissociation produces fantasies of trauma and that DD is artefactual conditions produced by iatrogenesis and/or socio-cultural factors (Loewenstein, 2018). Other controversies are stemmed from the anxiety evoked by unsettling clinical presentation seen with DD, which may be similar to some clinicians’ emotional reactions to psychiatric emergency patients. There is also a dispute over the meaning of observed symptoms of DD, and whether they are a unique and subtle set of core symptoms and behaviors that some clinicians do not see when it is before their eyes, or as a willful malingering cause of symptoms created by the other clinicians who think something is there that is not (Loewenstein, 2018). A final controversy is a fear that criminals will “get off” without being punished by a gullible justice system, which attributes behavior to another personality and does not hold the perpetrator responsible (Loewenstein, 2018)