Ebeveynler Çocuklarla Nasıl Oyun Oynamalı?
10 Haziran 2022
Ergen Bireylerde Sosyal Beceri
15 Haziran 2022
Dissosiyatif Bozukluklar
Dissosiyasyon kelimesi “ayrılma, kopma, dağılma” gibi anlamlar taşır
Dissosiyatif bozukluk ise kişinin bilinç, bellek, kimlik ya da algısında belirli bozukluklar görülmesidir ve çoğunlukla erken çocuklukta başlayan, çocukluk çağı travmalarının sebebiyetinden kaynaklanan bir psikiyatrik tanıdır. Çoklu kişilik bozukluğu olarak da adlandırılır.
Travma merkezli sayılabilecek dissosiyatif bozukluklar, depresyon, anksiyete gibi tanılar almış kişilerde ek olarak da görülebilir. Kendine zarar verme davranışları, konsantrasyon güçlükleri, öfke patlamaları, duygu durumunda ani değişiklikler, dalgınlık, unutma, hayal kurma gibi kişinin günlük yaşamda deneyimlediği düşünce, davranış ve duygularındaki değişikliklerden fark edilebilir.
Dissosiyatif kimlik bozukluğu ölçütleri;
- Kişide çevresi ve benliğine dair kalıcı algılama, düşünme ve ilişki kurma örüntüsüne sahip iki ya da daha çok sayıda kimliğin varlığı
- En azından iki kimliğin kişinin davranışlarına tekrarlayıcı bir biçimde etki etmesi
- Kişinin önemli kişisel bilgilerini geniş çaplı bir biçimde anımsayamaması
- Bu belirtilerin belirgin olarak sosyal yaşam, iş yaşamı ya da başka önemli işlev alanlarında fark edilebilir bozulmalar yaratması
olarak belirlenmiştir.
Dissosiyatif kimlik bozukluğu görülen kişilerde ikiden fazla bulunan kimlikler, ev sahibi kimlik ve öteki kimlik olarak adlandırılır. Vakaların çoğunda, kişinin kendi ismini taşıyan ve en çok görülen kimlik ev sahibi kimlik olarak adlandırılır. Öteki kimlikler cinsiyet, yaş, sağ-sol el kullanımı, cinsel yönelim, konuşulan dil gibi farklılıklar gösterebilir. Örneğin, aynı kişinin sahip olduğu bir öteki kimlik kaygılı, sakin ve sağ elini kullanıyorken, diğer öteki kimlik kaygısız, hareketli ve sol elini kullanıyor olabilir.
Genellikle çocukluk döneminde başladığı düşünülse de kişiler ergenlik dönemine geldiklerinde bu tanıyı alırlar. Kadınlarda görülme sıklığı erkeklerde görülme sıklığından fazladır.
Dissosiyatif bozukluklar, dissosiyatif amnezi ve depersonalizasyon-derealizasyon bozukluğu başlıkları altında incelenebilir:
Amnezi, bir çeşit hafıza kaybıdır. Dissosiyatif amnezi ise kişinin önemli kişisel bilgileri sıradan bir unutkanlıkla açıklanamayacak biçimde anımsayamaması olarak tanımlanır. Genellikle ani bir biçimde başlar ve biter; iyileşme sıklıkla kendiliğinden olur.
Dissosiyatif amnezi sırasında dissosiyatif füg (kişinin içinde bulunduğu ortamı ve hayatı reddedip kişilik ve kimlikle ilgili hafıza sorunları yaşaması) de görülebilir. Dissosiyatif füg sırasında kişilerin zihinlerinden “Bu hayat gerçekten bana mı ait?” tarzında sorular geçebilir.
Depersonalizasyon (kişiliksizleşme/ gerçekdışılaşma) kişinin kendisine ya da çevresine karşı yabancılık duygusu içinde olmasıdır. Yaşıyor gibi olmama, bedeninin bazı parçalarının değişmiş gibi hissedilmesi, kendi vücuduna dışarıdan bakma biçiminde tanımlanır. Kişiler kendilerini tanıyamadıklarını söyleyebilirler. Kişilerin zaman algılarında bozulmalar gözlenebilir.
Derealizasyonda ise kişiye çevresi yabancı, kendisinden uzaklaşmış ve gerçekdışı gelir. Bu yaşantılar genellikle birkaç saat sürse de devamlı biçimde gözlendiği de olur.
Dissosiyatif kimlik bozukluğunun belirli bir ilaç tedavisi bulunmamaktadır. Ruh sağlığı uzmanlarının uyguladığı uygun psikoterapi yöntemleri (örneğin EMDR terapisi) dissosiyatif bozuklukların tedavisinde kullanılır.
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