NR 607 Week 6 Discussion; Dissociative and Somatic Symptom

strengthening the belief that complex trauma literally changes the way trauma survivors respond to stress throughout their lives, survivors often continuing to experience dissociation and somatic symptoms long after the trauma has ended (Bistas & Grewal, 2024). Dissociation, which can be defined as disconnections between thoughts, feelings, behaviors, sensations, and other mental processes that would normally be connected, is a natural human phenomenon, and can be as benign as daydreaming during a boring class lecture or as damaging and problematic as the experience of rape survivors who ‘check out’ during the assaults and then dissociate automatically in response to any unwanted stressors in their life (Boyer et al., 2022). Dissociation is perceived to be a protective mechanism triggered by profound trauma; the dissociative tendencies develop as a coping mechanism to navigate the ongoing trauma that a child is unable to escape from on their own. Studies have shown a robust correlation between repeated childhood trauma and dissociation, which can serve as a psychic escape in the face of overwhelming trauma when there is no chance of physical escape (Bistas & Grewal, 2024). It is thought that when children are subjected to repeated traumas and are unable to “help themselves,” due to being a child without resources, dissociation serves as a survival strategy, shielding the young mind from the overwhelming emotional and psychological repercussions of trauma (Bistas & Grewal, 2024). As a defense mechanism, dissociation involves compartmentalization, emotional numbing, detachment from traumatic experiences and amnesia or memory gaps (Bistas & Grewal, 2024). While dissociation offers short-term benefits to survive trauma, when it persists and becomes a rigid and automatic response to stress, dissociation can disrupt the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and social behavior (Boyer et al., 2022). While the dissociation may have been a protective adaptation for trauma survivors during the traumatic experiences, severe persisting dissociative and somatic symptoms can interfere with all aspects of functioning and bring increased health and social risks including chronic pain, somatic symptoms, psychogenic seizures, and a decreased ability to process cues of danger and discern threatening situations (Boyer et al., 2022). Experts in the field propose that DD arises from the traumatized children’s inability to form a cohesive sense of self, leading to development of dissociative and somatic symptoms and in the case of prolonged and intense trauma, dissociative identity disorder (DID), considered the most severe form of childhood- onset PTSD (Bistas & Grewal, 2024). Even the physical location of DD in the DSM-5-TR shows how the complex developmental condition of DD arises from post-traumatic experiences: It is strategically positioned after the chapter on trauma and stressor-related disorders, such as PTSD, acknowledging the strong causation link between the DD spectrum and psychological trauma (Bistas & Grewal, 2024). Interestingly, the vast majority of people diagnosed with DDs also experience comorbid PTSD (Bistas & Grewal, 2024). Because of the pervasive professional skepticism and negative media representation of DD, clinicians working with clients experiencing dissociative and somatic symptom-related disorders will