Introduction and Background

Research on dissociation has primarily focused on its development into Dissociative Identity Disorder (DID), and Depersonalization/Derealization Disorder (DDD), which is commonly comorbid with Borderline Personality Disorder (BPD) populations (Mosquera & Steele, 2017; van der Hart, Steele, & Nijenhuis, 2017). However, research has not delved enough into the triggers that may cause dissociative disorders (DD) populations to keep resorting to dissociation to cope. This study looks into how loneliness as a trigger can cause DD populations to keep using dissociation to cope with the discomfort of this trigger.
Looking at this link from an existential psychological standpoint, May (1959) posited a theory in his book that noted that those least comfortable with being alone were likely to resort to mechanisms known today to be dissociative once they became lonely in order to help them cope. To date, only Kearney et al. (2016) investigated the link between trauma and dissociation and loneliness primarily as an outcome of dissociation, though not as a factor contributing to dissociation, which is what this research has done. Other research studies explored the subject of dissociation and loneliness as a byproduct, but in no means assessed a direct link between the two variables (Dorahy et al., 2015; Mauss et al., 2011; Ross, Banik, Dedova, Mikulaskova, & Armour, 2018).
In regards to treatment, practitioners outline in their guides that therapy must ensue in three main stages: stabilization, treating traumatic memories (reconsolidation), and the reintegration of personality and its rehabilitation (Ducharme, 2017; ISSTD, 2015; van der Hart et al., 2017). Some of the literature has advocated the use of cognitive therapies (CT) and exposure exercises as well (Blankenship, 2017; Linehan, 2015; Mosquera & Steele, 2017), whereas others advocate treatments using psychodynamic approaches and other modalities more focused on trauma reconsolidation such as Eye Movement Desensitization and Reprocessing (EMDR) (Alaryian, 2019; Cusack et al., 2016; Kalsched, 2017). Treatment is an important factor in the perceived link between loneliness and dissociation because it breaks the cycle, since it aids patients in developing more adaptive coping mechanisms, one of which, is building social support networks to keep them grounded.
Thus, the literature has very largely focused on dissociation as a coping mechanism for trauma (Mosquera & Steele, 2017), but it has not looked closely enough at a direct link between dissociation as a coping mechanism and loneliness (the lack of a social support network). To that end, this research looked at this gap using the following research question: What is the perceived impact of loneliness on dissociation as a coping mechanism? The research’s objectives were, first: to explore if dissociative episodes or mechanisms are triggered in individuals when they experience discomfort as a result of feeling abandoned and involuntarily alone, using mental healthcare professionals’ perspectives from their experiences treating such patients; and second, to identify strategies from the perspectives of mental healthcare professionals that should be in place to treat such patients, when loneliness may trigger dissociative mechanisms.