Radoslav Ivanov: A highly traumatic event can trigger a dissociative disorder

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Radoslav Ivanov: A highly traumatic event can trigger a dissociative disorder
Radoslav Ivanov: A highly traumatic event can trigger a dissociative disorder

Radoslav Ivanov is a certified Jungian psychotherapist under supervision and a clinical psychologist. Since 2009, he has been a regular member of the Bulgarian Society for Analytical Psychology "Carl Gustav Jung" in Sofia. He studied at PU "P. Hilendarski", VTU "St. St. Cyril and Methodius" and BOAP "K. G. Jung”. He participated in numerous seminars in the field of psychology, some of which were certified by a certificate (counseling for sexual dysfunctions, counseling for risky behavior, various work methods). He has 13 years of experience in conducting psychotherapy and psychological counseling, mostly in the clinical field and leading groups. He taught psychology at PU "P. Hilendarski" for five years. He leads the "Mental He alth" office at the Technological Center for Emergency Medicine at the Medical University - Plovdiv.

Member and sole representative for Bulgaria is the European Society for Trauma and Dissociation (ESTD).

Mr. Ivanov, what is the relationship between mental trauma and dissociative disorder?

- The relationship is very specific because any trauma seriously affects the psyche as an event. First, it is important to know that it is not the objective facts that determine whether an event will be a trauma or not, but the very subjective experience of the person exposed to the trauma. For example, in an accident, one person may be deeply traumatized while another is not. Therefore, the objective event may be the same, but the subjective experience may be different.

And when we have such a highly traumatic event, then a person can get some kind of dissociative disorder. So trauma is inside dissociative disorder. Because dissociation itself as a term leads to splitting, to disintegration - partial or complete of the consciousness, of the sense of identity of the person. And then, when a person falls into dissociation, somehow the connections inside the personality are severed in terms of thoughts, feelings, experiences, memories. In a dissociative disorder, as a result of some trauma, this dissociation is so strong and this traumatic experience is so great in intensity, power and persistence that it becomes unacceptable to the person himself, to his consciousness, because it is threatening.

This happens unconsciously - the psyche protects itself in this way, entering dissociation, because this event is very traumatic. Dissociation is a normal response to trauma - a way for a person to distance themselves from these difficult experiences. And when we talk about dissociative disorders, it's good to keep in mind that this is a conversion disorder. It used to be called hysteria or "the great simulant".

Why is it called the “big simulant”?

- Because this is precisely what is characteristic of hysteria: it imitates certain diseases. For example, a person may get pain in his back, leg, he may get a complete or partial loss of vision, but

without having organic disabilities

And all this is due to certain psychological reasons. And a person really hurts, does not pretend, but is convinced that there is some physical problem. And here we are talking about a problem of a psychogenic nature.


Radoslav Ivanov

How to recognize dissociative disorder?

- The first mandatory thing to do is to go to the appropriate specialist to see if the cause is indeed physical. Having rejected this possibility, the psychogenic nature of the disease remains.

In a great movie on this topic - "In Pieces", the character suffers from dissociative disorder and has 23 separate personalities. Is this fiction, or is it really inherent in dissociative disorder?

- Indeed, in dissociative disorders, we have the so-called multiple or multiple personality. This is a relatively very rare disorder. Its characteristic is that there are two or more personalities that are completely differentiated. At one point one person is involved, at another - the second, the third, etc., and one person does not know about the existence of the other. They are like autonomous to each other.

And in general, are dissociative disorders common?

- They are not that common and common. And that's good because they are serious disorders. More common are dissociative stupor, amnesia - as a result of the trauma, a person cannot remember the event.

Does one actually have to remember it? Does the treatment aim to restore memories?

- Amnesia protects a person from traumatic memories. Whether a person should regain their memories depends on the personality device - there is no general rule. The primary treatment for dissociative disorders is psychotherapy, and depth therapy works best here.

What is the essence of depth therapy?

- By depth therapy I mean Jungian and Freudian therapy. And deep means that it works with the unconscious part of the psyche

There are various therapeutic schools that are recognized by the Bulgarian Psychotherapy Association. Some of the therapies are lighter, act more on the surface - they cannot penetrate so deeply into the personality itself. In contrast, the deep ones can and have these ways to make it happen, i.e., to penetrate the deeper layers of the personality.

Both Jungian psychotherapy and Jungian analysis are based on Jung's discovery that within each of us there is a center that guides our personal development. This center, which he calls the whole personality, sends us symbolic messages which, if understood and acted upon, enable us to become whole, unique and mentally well-being individuals.

Such symbolic messages are contained in our dreams, visions, images and associations. They are all sent to us to serve as insights that, if taken into account, can make us more whole, more aware and lead us to a better and more prosperous life. These images are of utmost importance because they have the power to transform consciousness.

For Jung, dreams are valuable not because they contain unconscious desires. For him, dreams are valuable because they present an unedited, pure expression of the client's situation from the perspective of the unconscious. Dreams are more than causal messages from the past. They offer us to see our situation from a different point of view, that of the unconscious and thus complement the view of our consciousness. If dreams are understood, we can reveal unexpected aspects of our situation that our consciousness does not see.

Dream images are a symbolic expression of the living psyche, which includes various aspects of our total personality. This is why dream work supports the process of individuation.

Jungian psychotherapy and analysis is a relatively long-term relationship between two people, therapist and patient, and is aimed at exploring the patient's unconscious, its content and processes. The goal of therapy is to alleviate some mental condition that can no longer be tolerated because of its interference with conscious life. The disturbance may be neurotic in character or a manifestation of a deeper psychotic tendency. An important feature of Jungian analysis and psychotherapy is the understanding of psychopathology, disorder or syndrome. According to Jung, pathology has a purpose or it is part of the healing process. Symptoms should not be avoided or deflected because healing involves awareness of their meaning.

In your practice, which traumas most often trigger dissociative disorders?

- These are the frequent and stormy family scandals, beatings, i.e., domestic violence as well as sexual assault. It is something that affects the personality very much, and very cruelly. And, of course, serious traffic accidents, if life was very much at risk. And the younger a person is, the stronger this trauma affects his psyche.