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Low and high dissociation
Low: in denial; Severe: dissociative identity disorder
○ Seen in PTSD
○ Borderline personality
Specialized area of focus
Dissociative amnesia: cannot remember elements of themselves
○ History
○ Name
○ Where are they from
Dissociative Fugue
○ Dangerous
○ Wandering away
○ Look confused
○ Not able to remember how they got there
○ Robotic/autopilot
○ May be mistaken for drugs
○ Can be a response to complex trauma, or triggering event
○ Extreme response
○ Rare
○ Not-normative
○ Confused
Dissociative Identity Disorder
○ Rare
○ Can overlap with Bipolar Personality Disorder
○ Trauma response
○ Identifiable alters
○ Various personalities
○ Distinct alters: ages, names
○ Different stresses will pull these alters
■ Host-identity and alter-identity
○ Complex trauma
○ Significant trauma history
Nursing treatment:
○ Grounding techniques
50% of people experience dissociation in some way
Somatic Symptom Disorder
○ Real symptoms but there’s no medical cause
○ Pain is the most common
○ Can’t find source
○ “Fibromyalgia” “chronic fatigue syndrome”
○ Risk for suicide because of pain
○ Spiritual distress, ineffective role performance
Conversion Disorder
○ Most common treatment is Cognitive Behavioral Therapy
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○ Prognosis varies widely
○ No cure
○ Can relapse at any point
Somatic is more related to pain, Conversion Disorder is more related to motor sensory
deficits: walking, hearing, mutism, speech
○ PT, OT, CBT