Dissociation
Imagine the mind has many layers of awareness.
In clear consciousness we are aware of
our surroundings and our inner thoughts
usually at all levels. The sensation of
hunger at one level is accompanied by
fantasies of food and plans of how to
get that food at other levels. At other
levels of the mind memories of past meals
and events might be triggered too. Somehow
the thoughts, memories and sensations
on all these levels are integrated.
In dissociation disorders we might imagine
that somehow the layers are not being
integrated properly, so that there are
discrepancies or dissociations between
the thought activity at different levels.
Some people speak of a 'splitting of the
stream of consciousness'.
Braindevelopment
Dissociation in a neurological sense is: a neuro-psychological change of function which disturbes and maintains the separation of normal mutual dependent neuro-psychological processes.
A Dissociative Identity Disorder develops
in the early years of childhood. Because
the brains of babies and toddlers are
still not fully grown and developed, serious
traumas can have a devastating effect
on the development of the brains of those
children.
Brains develop in a 'user dependent' way
of growth, functioning and organizing
according to experiences. With appropriate
stimili like love, attention and care
from parents, the brains form connections
(synapses) which are necessary for good
functioning.
These reactions of little children to
traumatic experiences have a normal and
biological basis. First they are overwhelmed
by fear (hyperarousal), attended by an
increased heartbeat, muscle tension and
an inclination of 'flight or fight'.
Further they 'freeze' and withdraw into
the self (dissociation), attended by a
low heartbeat and sharpening of the perception
senses. In a matter of speaking they keep
themselves 'dead', as can also seen in
animals who are attacked. It is a survival
strategy for mammals, so also for human
beings.
Severe stress and anxiety
Mature children who are exposed to traumatic
stress several times develop a neural
system to cope and adapt to those traumatic
experiences. From an evolutionary point
of view this makes sense. "While
those areas in the brain which deal with
emotional regulation are underdeveloped
by a neglected child, those areas which
cope with stress are often overdeveloped
by such children."(Teicher;
Perry; (2002).
"A part in the brain which is
primairly affected by stress and anxiety
is the amygdala, which is involved in
the perception and response to fear-evoking
stimuli. To carry out its role in sensing
threat, the amygdala receives input from
neurons in the outermost layer of the
brain, the cortex, where much high-level;
processing takes place. Some of this input
comes from parts of the cortex that processes
sensory information f.i. recognizing faces,
as well as from the fromntal cortex, which
is involved in abstract associations.
The amygdala also takes in sensory information
that bypasses the cortex. As a result,
a subliminal preconscious emnace can activate
tha amygdala, even before there is conscious
awareness of the trigger. Imagine a victim
of traumatic experience who, in a crowd,
suddenly finds herself anxious, her heart
racing. It takes her moments to realize
that a man conversing behind her has a
voice similar to that of a man who once
assaulted her. The amygdala, in turn,
contacts an array of brain regions"(Sapolsky;
(2003)
There are two general forms of memory.
The explicit memory governs the recollection
of facts, events or associations. Explicit
memory is not well developed in children,
raising the possibility that more memories
become implicit at this age. Implicit
memory is about recalling how to ride
a bike, or play a passage on the piano.
And also the example of the woman in the
crowd who heard the voice is implicit
memory. "Researchers have begun
to understand how these fearfull memories
are formed and how they can be overgeneralized
after repeated stress. Recent research
indicates that tha amygdalic neurons of
rats in stressfull situations sprout new
branches, allowing them to make more connections
with other neurons. For instance, a victim,
if he had been robbed several times at
night, might experience anxiety and phobia
just by stepping outside his home, even
under a blazing sun."(Sapolsky;
(2003)
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(Disorganized) Attachment.
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"Attachment can also be seen
as the neurobiological dyadic regulation
of emotions". (Nicolai)
Also every human being has a need for trust,
which comes from human prehistory. Without
claws, wings or other natural weapons, human
ancestors survived by watching one another's
backs. As a result, the need for trust is
part of human biology. Trust makes us feel
safe; feeling safe is good for our mental
and physical health.
By 'attachment' and 'identification' with
the parent eventually the identity of the
child is formed. Attachment is a biological
and evolutionary fact of life. "But,
in the case of a systematic, inadequate
reaction from the parent to the child, it
cannot identify her/himself in a healthy
way". (Nicolai
2002, 2003)
"Any primate, and therefore any
human being, when vulnerable because of
physical or mental pain, loneliness, etc.,
is strongly motivated to seek help and comfort
from a well known conspecific that is perceived,
at that moment, as wiser and or stronger
than the self. This inborn motivation operates
from the cradle to the grave. The early
attachment pattern (or also called the internal
working model), previously constructed according
to real early attachment experiences, guides
the particular way of expressing this motivation
in behavior, emotion and thought".
(Bowlby,
Liotti)
"The most distinguishing mark of
extreme dissociation is because it happens
in relations in which you cannot escape,
so, with a parent or perpetrator who him/herself
is disorganized. Dissociation of 'affect'
is also seen in other traumas but in D.I.D.
it especially has to do with early development
and attachment in the parent-child relationship.
(Nicolai
1997)
In case of a DID, in a manner
of speaking, it is as multiple identifications
arise and exist beside one another. Because
the parent, for instance, is at the same
time a source of fear and safety. Later
traumatic experiences can strengthen those
fragmented parts.
Freezing reactions are also seen in DID
patients, automatic, stiffening/freezing,
withdrawl and isolation, appear not to be
in reality and looking away. Besides that,
"..there also can emerge somatoform
dissociations, like: intermittent analgesia,
anesthesia, motoric inhibitions and pain
symptoms. Somatoform dissociation is not
a somatic disturbance. Like psychological
dissociation, it involves a disturbance
of a mental function, hence, the
adjective somatoform is used".
(Nijenhuis
1999)
Fortunately, however, brains are flexible.
In answer to repeated and appropriate stimuli
from a empathic environment, the damage
can be limited and, depending on the seriousness
of early traumas, can even be adjusted in
such a way and with a good (psycho-) therapy
that in the end the patient can deal with
it.
© emma van weringh
(except where noted otherwise)
References:
Nicolai, N.J.: Hechting
en psychopathologie; Tijdschrift voor Psychiatrie
43 (2001) 5 ;
Nicolai, N.J.: Handboek Psychotherapie na
seksueel misbruik; 233-250 (2003).
Nijenhuis, E.R.S..; Somatoform Dissociation;
90-91 (1999)
Sapolsky, R.: Taming Stress; Scientific
American, october 2003, 66-75
Perry. B.D.; How Childhood Trauma Influences
Brain Development (2000)
Teicher, Martin H.: The neurobiology of
child abuse; Scientific American, march
2002, 54-61.
see for more on this subject on another
website:
*Understanding the Effects of Maltreatment
on Early Brain Development"
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