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.