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On No-Man Land: Perspectives from healthcare professionals on the impact of loneliness on dissociation as a coping mechanism
  • Mirit Agaiby
Mirit Agaiby
University of Liverpool

Corresponding Author:[email protected]

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Abstract

Background: Loneliness is a “hallmark” of dissociative disorders (DD), but its impact on DD patients is understudied in the field. Similarly, therapeutic modalities best suited for DD patients is an area of controversy; with research advocating cognitive therapies (CTs) despite the risk of retriggering trauma in patients. Research objectives: 1. To explore if dissociative episodes or phases are triggered in individuals as a result of loneliness, using mental healthcare professionals’ experiences in treating such patients. 2. To discuss participants’ recommended therapeutic techniques for DD patients experiencing loneliness. Method: Using a qualitative design, fourteen trauma and dissociation practitioners were interviewed with semi-structured questions, and a coded thematic analysis was conducted to extract codes, sub-themes, and themes from the data. Results: The findings show a two-way, yet non-linear relationship between loneliness as a trigger and the use of dissociation to cope with it. Participants strongly advocated the use of trauma-based modalities such as EMDR. Discussion and Conclusion: The severer the trauma and the less effective the patients’ coping mechanisms are, the severer their dissociation is, and their inability to connect to their own selves, and in turn, to others, which causes them to seek isolation. However, supportive, healthy networks, when patients seek/have them, contribute significantly to developing a sense of safety, which allows DD patients to feel more grounded in their outer realities and allows them to lead more satisfying lives. Practitioners agreed that safe therapeutic alliances are pivotal for patients; it allows them to connect more to their therapists, and subsequently to their social networks. Furthermore, all practitioners advocated moving away from using extensive CTs with DD patients in the initial phase of grounding and moving towards trauma-based and psychodynamic-based modalities. Recommendations: For future research, it is recommended that this link be studied by interviewing DD patients themselves, and/or conducted using quantitative designs to raise test-retest reliability.