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« Ozodi Osuji Weekly Series on Psychology 2006, #16 of 52: Sexual Disorders | Main | Ozodi Osuji Weekly Series on Psychology 2006, #18 of 52: Impulse and Control Disorders »

March 28, 2006

Ozodi Osuji Weekly Series on Psychology 2006, #17 of 52: Dissociative Disorders

by Ozodi Thomas Osuji, Ph.D. (Seatle, Washington) --- It is really amazing how our Nigerian people do not have a clue as to the range of psychological disorders that affect them. Not long ago, a man from my area, Owerri, wandered off from his town and for over a year was not seen by any one. Folks searched for him in their immediate vicinity but could not find him.

A year later, some one in another part of Nigeria reported seeing him and tried to engage him in conversation. He did not remember his past or his given name; he did not remember where he came from and did not remember knowing the man talking to him (a fellow town’s man). This man has Psychogenic Fugue, an amnesic disorder.

In psychogenic fugue, folks forget their past, take on new identities and wander away from their home and may, in fact, live the rest of their life time, without remembering their past. Every once in a while you read about a man who wandered off from England and now lives in France, or from Germany and now lives in England and does not know anything about his past.

These types of mental disorders are called Dissociative Disorders. To dissociate is to remove ones self from ones old self, to assume a new and different identity.

There are many types of dissociative disorders; some of the common ones are Multiple Personality Disorder, Psychogenic Fugue, Psychogenic Amnesia, Depersonalization Disorder, etc.

You probably have heard of Multiple Personality Disorder. Much is written about it in the press even though its actual occurrence is rare (I have seen only two of them). Essentially, what occurs here is that the individual, usually a woman, takes on many personalities, called alters, and can switch into any of them and behave as if she is that person. Thereafter, she may return to her predominant personality and may not remember anything she did when she was in the alter state; she has gaps in her memory.

The phenomenon of multiple personality is actually not as mysterious as it sounds. Consider the shy introverted child. He is unable to do many of the things out going, extraverted children do. He sits around and imagines himself doing those things he could not do. He uses his imagination to visualize himself doing everything that in real life he is inhibited from doing. He is generally prevented from doing what he wants to do by his fear of social rejection. In the process he develops a very active imagination and uses it to construct an alternative self for himself. Whereas, if he is normal he knows that he is not his alternative outgoing self but it is conceivable for him to forget his normal shy self and flip into his alternative ideal self and act as such?

A shy socially proper girl may take on the identity of an outgoing girl and go to a party and have a good old time, as she imagines that extroverted girls do. The sexual prude becomes a sex libertine, if only for a night. She goes home and forgets the fling she had the previous night and returns to being her proper Christian girl who could not even get herself to mention the word vagina.

Whereas the scenario I presented above is simplistic, the salient point is that it is possible to understand how multiple personality works. In real cases, the current hypothesis is that some of these persons, usually girls, were exposed to traumatic experiences during their childhood (age one to twelve is childhood). The experience is so painful that the only way she could cope with it is to deny that it is happening to her and her body but to some one else. Thus, she denies her real self and takes on a different self, one not hurt by the abuser.

It has been hypothesized that rape and incest is so traumatizing for young girls that some of them dissociate from their true identity and invent different identities for themselves. Some victims were subjected to multiple abuses and apparently invented many personalities for themselves.

Thus every once in a while, particularly when under stress, persons with dissociative personalities deny their normal selves and take on the personality of the alter ego. A woman could have personalities that include women and men. (I have seen a girl take on a male character and, in fact, talk like a man talks, and eventually return to her girlish voice and behavior.)

Is it true that traumatic events caused multiple personality disorder? I do not know. This is a heuristic subject and researchers are still to find present conclusive evidence on the real etiology of dissociative disorders. Perhaps, biology plays a role in it? I ask this question because the disorder is predominantly found in women and the obvious association of female body to it comes to mind. In fact, in the past Freudian psychoanalyst used to call aspects of this phenomenon hysterical conversion.

This essay is not a professional paper so we shall not permit ourselves to be bugged down with technical debates as to causal factors in mental health disorders. Let us just acknowledge that we do not know what causes mental disorders.

We are not focusing on therapy, either. Therapy means change; it consists in any effort to change something. In the case of multiple personality disorder, therapy attempts to integrate the entire individual’s various personalities into one unified personality, so that she can function in our world. It is almost impossible to function as different persons in this world, particularly on the job; one must have a unified personality that other people can identify as who one is and relate to as such. It is confusing having many selves in one person to relate to.

Amnesiac disorders are memory loss issues. These persons have problems with their long term memory but not necessarily with their short term memory. In psychogenic fugue the individual forgets about his past but is still aware of the present. He forgets that he is from Lagos and now lives at Abuja with a different personality and functions appropriately on the day to day level.

In depersonalization and derealization disorder folks temporarily feel like they are not their old selves. As it were, they no longer know who they are. Each of us has a habitual pattern of behaving and has a self concept and self image. The self concept is exactly that, concept. Who the individual thinks that he is, is an idea and is not tangible. The set of concepts that constitute the individual’s idea of who he is can be shaken by events. Another way of putting it is that each of us has an ego, a sense of me, a self that sees itself as separated from other people, a self housed in body and lives in the world of space and time. Each of us uses the various ego defense mechanisms to defend his idea of who he thinks he is. (Some of the key ego defense mechanisms are repression, suppression, denial, dissociation, projection, rationalization, displacement, sublimation, reaction formation, fantasy, minimization, intellectualization, adjustment, avoidance, fear, anger, shame, and many others.) The self is defended with these ego defenses mechanisms. If the individual is undergoing tremendous stress his usual coping pattern may not work; his ego defenses are, as it were, decompensated. He feels like he no longer knows who he is hence depersonalization and derealization. He may try to recompensate with more absurd ego defenses and if he does so he may experience transient psychosis. A person who ordinarily copes by desiring to be important, under stress, when he experiences massive failure in life, may claim to be a very successful, important person; that is, he is now deluded, for he temporarily believes what is not true as true; he has transited from merely wishing for importance to believing in importance that he does not have. Folks tend to quickly return to their normal level of functioning when the crisis is over. Some, unfortunately, remain in the psychotic state for long.

There are many other dissociative disorders. In this short essay, I just wanted to call attention to the issue and leave it to folks to go find out more about them. There is no use pretending that these issues do not exist in Nigerians and Africans. If you are a trained mental health professional you see these issues operating in Nigerians and the saddest part of it is that they may not even know that they have a problem. Consider: a woman was always having interpersonal problems, saying how nobody loved her and occasionally cutting on her arm. No one knew what was wrong with her. It took me years of training to come to know that she has borderline personality disorder (we have covered this in our essay that includes personality disorders). Many of our people have all sorts of personality disorders and do not know it. This is a shame.

If after reading this essay and you feel that you have something resembling what I described here, please do not hesitate consulting a mental health professional for help. Our country is in a bad shape inter alia, because half insane persons are everywhere running the affairs of the state. We need to have sane persons running the affairs of the state.

Ozodi@africainstituteseattle.org

Posted by Administrator at March 28, 2006 12:47 AM

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