A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum by Judy Eaton

Author:Judy Eaton
Language: eng
Format: epub
ISBN: 9781784503550
Publisher: Jessica Kingsley Publishers
Published: 2017-08-25T00:00:00+00:00

Dissociation

Dissociative disorders fall into three major categories: dissociative amnesia, dissociative identity disorders and depersonalisation/derealisation disorders. These tend to be associated with traumatic events and involve ‘splitting’ of the conscious mind in order to protect the individual from the painful emotions and psychological distress that result from this trauma. For some individuals, when they reach the point of no longer feeling able to regulate themselves or when they become emotionally overwhelmed, they may begin to ‘dissociate’. Someone in this state may experience loss of memory or appear paralysed or stuck in one place. They may report intrusive flashbacks or voices. Some individuals even develop conflicting images of themselves or form actual co-existing personalities (‘alters’). The most common feature of a dissociative disorder is amnesia, where the person is unable to recall specific information or an event.

Dissociative identity disorder (DID) is often referred to as multiple personality disorder and individuals can develop a number of different ‘personalities’ (usually between 5 and 10) that can emerge at any time. The switch from one personality to another can often be sudden and dramatic. The individual may or may not be aware of the other personalities. Dissociative identity disorder remains a controversial diagnosis amongst professionals and there is conflicting evidence about the efficacy and potential harm of psychotherapeutic approaches.

Both dissociative amnesia and dissociative identity disorder tend to be more prevalent in females, with most being diagnosed in adolescence or early adulthood.

There is limited research evidence with regard to the prevalence of these types of difficulty in girls with autism. However, in the course of clinical work and research for this book, a number of young people have reported features of this type of difficulty. These have tended to be girls with the pathological demand avoidance profile who report this type of experience starting in their early teens. This is a potentially interesting area for future research, given the ‘Jekyll and Hyde’ switches in mood reported by many parents of children with this profile. In addition, pathological demand avoidance is driven by highly elevated levels of anxiety, permeating across all aspects of daily life. The development of dissociative identity disorder tends to be associated with childhood trauma and, again, this could be an interesting area for future research with girls on the autism spectrum, particularly those with pathological demand avoidance, where their behaviour is often extreme and may have led to them experiencing certain situations (such as overly punitive management of their behaviour, for example, being restrained or physically removed from an area) or the reaction of others when they have experienced a behavioural meltdown as sufficiently traumatic to trigger a dissociative disorder.

Neuroscientific research has begun to identify the types of dissociative process which may be a factor in this area in a number of individuals with autism. Links have been made to a separation of the psyche (thought processes) from the soma (the body). Dissociation is described as a psychic survival tool which arises when an individual separates out and, in some way, compartmentalises aspects of traumatic experiences in order to allow them to continue to function (Howell 2005).

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