Is dissociation based in trauma or fantasy?
The question of whether dissociation is rooted in trauma or fantasy has led to the development of two primary theoretical frameworks: the Trauma Model and the Fantasy Model.
The Trauma Model (TM)
In the Trauma Model (TM) of dissociation, dissociation is conceptualized as a reaction to antecedent traumatic stress and/or severe psychological adversity (Nijenhuis, Vanderlinden, & Spinhoven, 1998; Putnam, 1997; Spiegel, 1984).
The Fantasy Model (FM)
The Fantasy Model (FM) of dissociation* proposes an alternative hypothesis. It posits that dissociation is not caused by trauma. Instead, proponents argue that individuals prone to dissociation are suggestible and fantasy prone, leading them to confabulate false memories of trauma (e.g., Giesbrecht, Lynn, Lilienfeld, & Merckelbach, 2008; Merckelbach, Horselenberg, & Schmidt, 2002).
*This model is also sometimes referred to as the sociocognitive and/or iatrogenic models of dissociation.
Empirical Evidence: Which Model is Supported?
A recent review examined the available research to determine which model had the greatest empirical support and found strong support for the TM but not for the FM (Dalenberg et al., 2012).
The key findings supporting the Trauma Model include:
The relationship between dissociation and trauma persisted even when objective measures of trauma were used.
Dissociation was found to be highest immediately after trauma and to dissipate in most individuals over time and in response to trauma treatment.
Research supported the TM theories about memory fragmentation and amnesia.
Furthermore, evidence directly countered the FM hypothesis:
Contrary to the FM claim that dissociative individuals are suggestible, the relationship between dissociation and suggestibility was found to be weak and inconsistent, with dissociation explaining only 1 – 3% of suggestibility.
Dissociation remained significantly related to trauma even when fantasy proneness was controlled.
Given the strong evidence across many researchers utilizing a variety of methodologies, Dalenberg et al. concluded that there was compelling empirical evidence that trauma causes dissociation and almost no support for the FM of dissociation (Dalenberg et al., 2012).
An empirical examination of six myths about dissociative identity disorder
Despite the ever-growing literature on Dissociative Identity Disorder (DID) (formerly known as multiple personality disorder), a number of misconceptualizations and persistent myths about the disorder remain.
The absence of research to substantiate these beliefs, coupled with a growing body of research that actively refutes them, confirms their mythical status. The cost of ignorance about DID is high for both individual patients and their support systems. Fortunately, empirically derived knowledge about DID has replaced these outdated myths.
A key empirical examination highlighted six popular myths about DID and provided the respective evidence counteracting those claims:
Brand, B. L., Sar, V., Stavropoulos, P., Kruger, C., Korzekwa, M., Martínez-Taboas, A., & Middleton, W. (2016). Separating fact from fiction: An empirical examination of common myths about dissociative identity disorder. Harvard Review of Psychiatry, 24(4), 257-270. doi: 10.1097/HRP.0000000000000100
We have highlighted six popular myths about DID and respective empirical evidence counteracting the claims on our page “Myths and Media Portrayals of Dissociative Identity Disorder”.
*For a comprehensive list of references used in Brand et al., please see here.