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.
Keywords: Dissociation, Coping Mechanism, Loneliness, Trigger