Dissociative Disorder and Boundaries: A Case of Integrative Intervention

Description

Page: 466-469

Anuja Jain, Abhijeet Singh, Shreshta Chattopadhyay, and Geetesh Kumar Singh (School of Behavioural Sciences and Forensic Investigations, Rashtriya Raksha University, Gandhinagar, Gujarat)

Dissociative disorders are multifaceted psychiatric syndromes frequently stemming from unresolved trauma and internal conflicts, tending to appear with somatic symptoms and identity problems. Such syndromes are also impacted by cultural belief systems and family dynamics. The objective of the study was to analyze the therapeutic process and clinical outcomes of an integrative psychotherapeutic treatment in a female patient suffering from dissociative disorder with mild depressive symptoms. A qualitative case design with follow-up after one month was utilized. Weekly therapy sessions were administered with the use of psychodynamic inquiry, cognitive-behavioral strategies, and skills-oriented interventions like assertiveness training and emotion regulation. Measures utilized included: Mini-Mental State Examination (MMSE), Beck Depression Inventory (BDI), Depression, Anxiety and Stress Scale-21 (DASS-21), Thematic Apperception Test (TAT). The MMSE eliminated the possibility of cognitive impairment (score: 24). BDI and DASS-21 reported mild depression. TAT disclosed unconscious conflicts focusing on helplessness, guilt, and autonomy. During more than one month, the patient displayed less dissociative episodes, greater insight, and better emotional regulation. Assertiveness and boundary-establishment in the family represented significant therapeutic improvement. It was concluded that an evidence-based integrative therapy style informed by psychodynamic formulation can be efficient in the treatment of dissociative symptoms based on complex trauma, particularly when practiced in culturally responsive situations.